The Difficulty of Case Management or Counseling for Non-suicidal Self-injury in Adolescents: Focused on the Factors in the Community

Purpose@#This qualitative study is aimed to explore the factors in the aspect of the community that made it difficult for field experts to conduct counseling and case management. @*Methods@#A total of four focus group interviews composed of 15 field experts including nurses were conducted. @*Results@#A theme, six categories and 22 subcategories were derived. As for the theme, it was found that legal, educational, and environmental systems reflecting non-suicidal self-injury of the characteristics in adolescents were insufficient. In the legal aspect, the defect of the parental education legal system, the reality of having to rely on parental consent when supporting adolescents with non-suicidal self-injury; in the educational aspect, the lack of manuals and education for counseling and case management for adolescents with non-suicidal self-injury; in the environmental aspects, the defect of economic burden and support, a lack of information systems for various organizations in the local community, absence of a dedicated support system for adolescent with non-suicidal self-injury and a lack of human and physical resources. @*Conclusion@#Based on the results of this study, there needs to be a responsible institution that can comprehensively manage the non-suicidal self-injury of adolescents, and efforts to develop the competence of community nurses.

Mental Health of Adolescents in a Community / 農村醫學 地域保健

OBJECTIVES: The aim of this study was to establish the basic data for adolescents' mental health states in a community. METHODS: 466 middle school and high school students were analyzed by visit-survey with an organized questionnaire from March to June 2008. K-YSR for measurement of mental health was used. RESULTS: The score of total behavior (p<0.01), anxious/depressed (p<0.05), though problems (p<0.001), attention problems (p<0.001), aggressive behavior (p<0.01) and internalizing problems (p<0.05) in girls appeared significantly higher as compare to those the boys. Also, total competence (p<0.05) in high school students appeared significantly lower as compare to those middle school students. Withdrawn (p<0.01) in high school students appeared significantly higher as compare to those middle school students. The though problems (p<0.001) and aggressive behavior (p<0.05) in middle school students appeared significantly higher as compare to those high school students. The distribution of clinical group was school 93.8%, total competence 32.6%, attention problems 8.8%, total behavior problems 8.6%, anxious/depressed 7.7%, aggressive behavior 6.4% et. al. The social (p<0.05), anxious/depressed (p<0.05), attention problems (p<0.01), internalizing problems (p<0.05) and externalizing problems (p<0.05) in girls of clinical group were more frequent significantly as compared to those the boys of clinical group. Also, the social (p<0.01) in middle school students of clinical group was more frequent significantly as compared to those the high school students of clinical group. CONCLUSIONS: This study result will be significant in that it can provide basic data for the school mental health services.

The Effects of Hospice Care in Public Health Centers on Quality of Life of Terminal Cancer Patients and Care-giver Burden of Families / 農村醫學 地域保健

OBJECTIVES: This study aimed to find out the effects of hospice care in public health centers by evaluating the quality of life of terminal cancer patients and care-giver burden of their families. METHODS: From January to December 2007, 32 terminal cancer patients and their familes were selected as subjects for this study based on the research criteria. The data were collected using the questionnaire along with interviews. Instruments used for this study were C-QOL(Cancer-Quality of Life) that was developed by Lee(2007) and care-giver burden of families that was developed by Seo et al(1993). The data were analyzed using frequency, percentage and paired t-test. RESULTS: There was a statistically significant differences in the global overall quality of life between before and after receiving the comprehensive hospice care(t=18.997, p=.000). There was a statistically significant differences in the level of the quality of life of the hospice patients in physical aspects(t=21.196, p=.000), in emotional aspects(t=11.803, p=.000), in social aspects(t=24.310, p=.000) between before and after receiving the comprehensive hospice care. There was a statistically significant differences in care-giver burden of families between before and after receiving the comprehensive hospice care(t=36.468, p=.000). CONCLUSIONS: Hospice care in the public health center could be considered as an effective intervention to improve general quality of life of the terminally ill out patients and to decrease of care-giver burden of families with terminal cancer patients. It is recommended that hospice care in public health centers for the terminally ill out clients and their families should be increased.

The Relationship between Family Burden and Mental Health Service Needs of Family for Home-based Chronic Mental Patients in Community / 農村醫學 地域保健

OBJECTIVES: This study was carried out to identify the relationships of family burden and mental health service needs of chronic mental patients in community. METHODS: Objects of the study were 153 chronic mental patients in community of P. city in korea. Data were collected from December, 2007 to February, 2008 using structured questionnaire. Research tools of this study were family burden tool developed by Pai & Kapur (1981) and mental health service needs tool developed by Kim (2003). RESULTS: The average grades for family burden was 1.62 points. And the biggest part of family burden was economic burden(1.74), followed by interrupt of daily life(1.67), interrupt of family relationship(1.64), interrupt of family leisure (1.57), effects of mental health(1.50), and effects of physical health(1.43). The average grades for mental health service needs was 2.72 points. And the biggest part of mental health service needs was rehabilitation service(3.09), followed by social service(2.87), and Psychiatric medical service(2.21). Positive correlation showed between all parts of family burden. And, positive correlation showed between psychiatric medical service and interrupt of daily life(r=.281, p<.01), psychiatric medical service and effects of physical health(r=.355, p<.01), social service and effects of mental health(r=.213, p<.01). CONCLUSION: The family burden for care giver of mental patients was related with all parts of family burden and mental health service needs of family. Thus, these results should be considered to reduce family burden for care giver of mental patients in community.

The Effect of Group Art Therapy in Children with Withdrawn Behaviors / 아동간호학회지

PURPOSE: The purpose of this study was to examine the effects of group art therapy on the withdrawn behavior, social behavior, social problems, anxiousness/depression, internalizing problems, total behavior problems and self-esteem in children who are withdrawn. METHOD: A randomized controlled pre-post test design was used. The participants were 31 children who were withdrawn attending J. P. Elementary School in Pohang City. Sixteen were assigned to the experimental group and 15 to the control group. The program consisted of20 sessions of 80 minutes per session, 2 days a week, for 10 weeks. Instruments used for this study were the Children's Behavior Check List -Korean version (K-CBCL) and a self-esteem inventory. The data were analyzed using Fisher exact test and Mann-Whitney U test. RESULTS: Thescores for withdrawn behavior, social problems, anxiousness/depression, internalizing problems and total behavior problems decreased significantly in the experimental group as compare to the control group. Social behavior and self-esteem increased significantly in the experimental group as compared to the control group. CONCLUSIONS: This study provides evidence for the pontential and beneficial effects of group art therapy in children who are withdrawn. The program could be adequately used to improve problem behavior in withdrawn children.

Effects of Aerobic Exercise Program for Obese Elderly Women / 성인간호학회지

PURPOSE: To examine the effects of the aerobic exercise program on changing the body composition, blood lipids and self-esteem of the obese elderly women. METHOD: A total of 26 obese elderly women(%body fat: over 30%) have been selected for this research[Experimental Group(EG):13, Control Group(CG):13). Walking at a 50% intensity was administered 4 days a week for 14 weeks. The data was analyzed using the SPSS program. RESULT: The level of % body fat, TC, LDL-C, and %TC/HDL-C in EG was significantly lower than those of the CG after 14 weeks. In addition, the level of HDL-C and self-esteem in EG was significantly higher than those of the CG after 14 weeks. However, TG, body weight between groups didn't appear significant at the end of 14 weeks. CONCLUSION: The results showed that the aerobic exercise program was effective in changing body composition, blood lipids and self-esteem of the obese elderly women.

The Effects of Aerobic Exercise on Hormones, Blood Lipids and Body Composition in Middle-Aged Obese Women according to 3-Adrenergic Receptor Gene Polymorphisms / 간호학회지

PURPOSE: This research was conducted to provide basic information about the effects of aerobic exercise on physiological change in middle-aged obese women according to differences of beta3-adrenergic receptor polymorphisms. METHOD: Twenty-nine middle aged obese women with over 30%BMI were divided into three groups according to beta3-adrenergic receptor gene polymorphism[Variable Group(VG):9, Normal Group(NG):10, Control Group(CG):10]. The VG and NG groups performed walking at 50% exercise intensity for 30 minutes a day, 4 days a week, for 12 weeks. The data was analyzed using the SPSS program. RESULT: The level of leptin, insulin and % body fat in the VG and NG groups was significantly lower than those of the CG after 12 weeks. In addition, the level of HDL-C in the VG and NG was significantly higher than that of the CG after 12 weeks. However, TC, TG and body weight between groups didn't appear significant at the end of 12 weeks. CONCLUSIONS: Aerobic exercise didn't cause differences in persons with differing beta3-adrenergic receptor gene polymorphisms, but aerobic exercise affected the physiological change in middle-aged obese women. The findings suggest that aerobic exercise is a desirable nursing intervention for obesity control in middle-aged obese women.

The Effects of Exercise Therapy and Exercise-Behavior Modification Therapy on Obesity, Blood Lipids, and Self-esteem of the Obese Middle-aged Women / 간호학회지

PURPOSE: To examine the effect of the exercise therapy, and exercise-behavior modifi- cation therapy on obesity, blood lipids and self-esteem of the obese middle-aged women. METHOD: A total of 35 middle-aged women (BMI: over 30) were selected for this research. Walking at a 50% intensity was administered 4 days a week for 12 weeks, while the behavior modification therapy performed for 60~90 minutes per week for 12 weeks. RESULT: Body weight and BMI has significantly reduced in the case of EG and E.BG. The result of comparing body weight between groups showed significant difference between EG and CG, and E.BG and CG whereas BMI showed significant difference between EG and CG only. TC, TG, LDL-C, %TC/HDL-C have shown significant decrease in EG and E-BG, while HDL-C displayed significant increase in EG and E.BG. And HDL-C showed significant decrease in CG. As for comparison between groups, significant difference was noted in EG and CG, and E.BG and CG at TC, HDL-C, LDL-C, and in EG and CG at %TC/HDL-C. Self-esteem displayed significant increase in EG and E.BG; however, there was no significant different in CG. As for comparison between groups, there was significant difference noted in E.BG and CG only. CONCLUSION: The results showed that the exercise therapy and the exercise-behavior modification therapy were effective in changing obesity, blood lipids and self-esteem of the obese middle-aged women.

The Effect of Exercise Combined with Behavior Modification Therapy on the Degree of Obesity, Blood Lipid Level and Self-Esteem in Obese Middle-Aged Women / 기본간호학회지

PURPOSE: To investigate the effects of exercise combined with behavior modification therapy on the degree of obesity, blood lipid level and self-esteem in obese middle-aged women. METHOD: 18 obese middle-aged women volunteers with a BMI over 30% were assigned to exercise combined with behavior modification therapy (n=9) or to a control group(n=9). For the intervention the experiment group used walking outdoors as excercise and behavior modification therapy for 12 weeks. RESULT: Body weight, BMI, TC, TG, LDL-C, and % TC/HDL-C were significantly decreased in experimental group. Changes in HDL-C and self-esteem were significantly increased in the experimental group. CONCLUSION: This study provides evidence that regular exercise combined with behavior modification is effective in changing the degree of obesity, blood lipid level and self esteem in obese middle-aged women over 12 weeks.

Effects of Relaxation Therapy and Exercise Therapy on the ACTH and Cortisol Hormone Level in Workers / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the effect of exercise therapy and relaxation therapy on the level of ACTH and cortisol in workers and to determine, from this information, the effectiveness of applied exercise therapy and relaxation therapy as a nursing intervention method for workers experiencing stress. METHOD: The subjects were divided into an exercise therapy group, a relaxation therapy group, and a control group. The research design was a nonequivalent control group pretest-posttest design (exercise therapy: n=12, relaxation therapy: n=12, control group, the group without exercise or relaxation therapy: n=12). The subjects in the exercise therapy group were given a particular intensity for each kp over 30 min, bicycle ergometer which uses the LX PE training system before and after four weeks of training. The subjects did 60-70% exercise intensity exercise therapy for eight weeks. The relaxation therapy subjects were trained using a modified Jacobson's relaxation technique for eight weeks. The exercise and relaxation therapy groups were trained at the following intensity for eight weeks (3 times/week, 30 min/day). Changes in the levels of ACTH and cortisol were identified. Two-way ANOVA and multiple range test (SNK: Student Newman Keul) were used to examine the effects of exercise therapy and relaxation therapy at four and eight weeks.. RESULT: 1. Changes in the level of ACTH in the relaxation therapy group were statistically significant at .05 level, and were better than that of the exercise therapy group after eight weeks. But there was no significant difference between the exercise therapy group and the control group. 2. Change in the level of cortisol in the relaxation therapy group were statistically significant at .05 level as compared to the exercise therapy group and the control group after four weeks, but not after eight weeks. Also, the relaxation therapy was statistically significant at .05 level after four weeks compared to before treatment, but there was a tendency toward increased cortisol after eight weeks. CONCLUSION: Relaxation therapy was found to be more effective in stress treatment than exercise therapy and as such is a desirable nursing intervention method for stress hormone reduction in workers.

A Study on Change in Death Orientation of College Student Nurses : comparison of pre and post hospice care class / 기본간호학회지

PURPOSE: The purpose of this study was to identify the death orientation of college student nurses and to evaluate the effectiveness in death orientation of a class on 'hospice care'. this was done by investigating the difference between the death orientation before and after the class. METHOD: The instrument used in this investigation was the death orientation scale developed by Thorson and Powell (1988). The subjects of the study were the 47 college student nurses in a 'hospice care' class. The research was carried out between March 2, 2001, when the class began, and June 21, 2001 when the class ended. The collected data were examined using arithmetic mean, percentage, t-test, ANOVA. RESULT: The results of the study are as follows: 1. The average death orientation score of the subjects before the class was 2.80. 2. There were a significant difference in the death orientation scores before and after the class (p0.05). CONCLUSION: This study showed that a class on hospice care was effective in changing the death orientation of student nurses.

The Effect of Antifibrinolytic Therapy in Prevention of Rebleeding before Early Aneurysm Surgery

OBJECT: This study was conducted to evaluate whether short-term intravenous infusion of tranexamic acid (AMCA) was able to improve the management outcome by preventing rebleeding without increasing vasospasm and hydrocephalus associated with the long-term administration of this agent in the patients with aneurysmal subarachnoid hemorrhage(SAH) who were planned for the early surgery. METHODS: During the period from June, 1996 to May, 1998, 137 patients admitted within 3 days of their SAH and planned for early surgical intervention were subject to study population. Of these, 60 patients who had been treated with AMCA were classified as AMCA treated group and 77 patients without AMCA treatment as AMCA untreated group. Initially, prognostic factors for rebleeding, vasospasm, hydrocephalus and outcome following SAH including age, sex, clinical grade, CT grade, site of ruptured aneurysms, admission day after SAH, surgery day after SAH, number of aneurysms and hypertension history, were analyzed and compared between AMCA treated group and untreated group. Secondly, the incidence of rebleeding, symptomatic vasospasm and hydrocephalus were compared between the two groups. Also, the management outcome of the patients was compared between the two groups. RESULTS: There were no significant differences in prognostic factors between the two groups. The rebleeding rate was 0% in the AMCA treated group whereas the rate was 7.8% in the untreated group. This difference was statistically significant. The incidences of symptomatic vasospasm and hydrocephalus were found not to be significantly different between the two groups. Of the treated group, 31.7% of patients developed hydrocephalus compared to 32.5% of those at the untreated group. Fourteen(23.3%) patients in treated group developed symptomatic vasospasm and 6 of them(10%) suffered stroke whereas incidences of these in untreated group were 25.9% and 11.7%, respectively. The AMCA treated group showed more favorable outcome than that of untreated group. There was no case of death by rebleeding in the AMCA treated group while one of the main causes of death in the untreated group was rebleeding. CONCLUSION: Short-term high-dose AMCA administration is considered beneficial in improving outcome and diminishing the risk of rebleeding in the patients who suffer from an aneurysmal SAH prior to early surgical intervention.

Characteristics of NMDA- and Glutamate-Induced Currents in Primary Cultured Rat Hippocampal Neuron

No abstract available.

Linac Based Radiosurgery for Cerebral Arteriovenous Malformations

No abstract available.

Effects of Relaxation Therapy and Exercise Therapy on Catecholamine and Heart Rate Response for Job Stress of White Color Workers / 기본간호학회지

The purpose of this study was to investigate the effects of exercise therapy and relaxation therapy on catecholamine and heart rate in people in white color jobs and to determine this information the effectiveness of applied exercise therapy and relaxation therapy as a nursing intervention method for stress patients. The subjects were divided into an exercise therapy group, a relaxation therapy group, and control group and the research design was a nonequivalent control group pretest-post test design(exercise therapy : n=12, relaxation therapy : n=12, control group, the group without any treatment in exercise on relaxation therapy : n=12). The subjects in the exercise therapy group were given a particular intensity for each kp during 30min, bicycle ergometer which is using an LX PE training system before & after 4weeks of training. The exercise therapy that was used was Astrard load method which tested absolute exercise load of heart rate before & after four weeks, and resting heart rate was tested for exercise and relaxation therapy before, after four weeks, and at eight weeks. The results of each kp & absolute exercise load were calculated with the target rate formula(maximal heart rate-rest heart rate) x exercise intensity(%) rest heart rate so the subjects could continue 60-70% exercise intensity for exercise therapy over eight weeks. The relaxation therapy subjects were trained using a modified Jacobson's relaxation technique for eight weeks. The exercise and relaxation therapy were trained at the following intensity for eight weeks(3 times/week, 30 min/day) to see changes in catecholamine & heart rates. After eight weeks, statistical analysis of exercise & relaxation therapy were carried out Two-way ANOVA and multiple range test(SNK : Student Newman Keul) were used. The results are as follows : 1. The change of epinephrine & norepinephrine in the exercise therapy, relaxation therapy, and control group was statistically significant at the .05 level after four weeks & eight weeks. Also, exercise therapy was statistically significant at .05 level over that of the control group after 4 weeks. 2. The change of heart rate in relaxation therapy was statistically significant at the .05 level, and was statistically significant at the .05 level over that of the exercise therapy and control group. In conclusion, it is obvious that exercise therapy and relaxation therapy should be one of the most effective stress treatment and desirable nursing interventions methods for job stress in people in white color jobs.

Comparison of Surgical Results between Anterior Cervical Interbody Fusion(ACIF) and Microsurgical Anterior Cervical Foraminotomy(MACF) for Cervical Disc Herniation

OBJECTIVE: Until recently anterior cervical discectomy with or without bone fusion has been widely used for the treatment of cervical disc herniation. After introduction of the microsurgical anterior cervical foraminotomy(MACF), there has been a tendency to preserve the functioning motion segment. But some worried about technical difficulties and complications such as injury to the vertebral artery. This study is to compare the short-term results of anterior cervical interbody fusion(ACIF) with that of MACF. METHODS: We reviewed medical records of 40 patients, 20 patients of ACIF performed during 30 months and 20 patients of MACF performed during 8 months. RESULTS: The average length of stay in the hospital was longer in cases of ACIF(12.9 days) than in those of MACF(7.1 days). The rate of the symptom relief within 1 day was higher in MACF(90%) than in ACIF(70%). The overall satisfaction experienced by the patients after surgery was higher in MACF(85%) than in ACIF(70%). The rate of the recommendation for surgical treatment to other people was higher in MACF(85%) than in ACIF(65%). But the differences were not significant statistically. The major complication was bone donor site pain in ACIF cases and neck and shoulder pain in MACF cases. CONCLUSION: This data demonstrate that MACF is of value in the treatment of cervical disc herniation, which can be performed with safety and good outcome like conventional ACIF.

Caudal Epidural Injectioin in Treatment of Lumbosacral Radicular Leg Pain

An spinal epidural injection is a relatively benign procedure and widely used for symptomatic relief of back and radicular leg pain. The authors evaluated the efficacy of caudal epidural injection with corticosteroids and local anesthetics which was performed by a neurosurgeon for the treatment of ongoing lumbosacral radicula, symptoms. Between July 1997 and June 1998, 20 patients with back pain and radiating leg pain invloving lumbosac ral degenerative spine disease, who refused operation or were unsuitable for general anesthesia, were treated and followed for more than 6 months. All procedure was done under radiogaphical guidance aseptically. The authors used the mixed solution of 1% lidocaine(6 cases) or 0.25% bupivacaine(14 cases) with methylprednisolone acetate(1- 2ml). The mean total volume of the mixture was 15.6 ml. The preoperative neurosurgical diagnosis included 11 lumbar disc herniation,6 lumbar stenosis and 3 spondylolisthesis and the invloved nerve roots presenting with typical radiculopathy were L5 root(17 patients), S1 root(15 patients), L4 root (4 patients), and S2 root(1 patient). The responses from patients were classified into 4 groups, and excellent or good results with marked reduction on radicular leg pain we re noted in 19 cases. There were a few transient complications such as headahce, leg numbness, perisacral hypesthesia, injection pain, constipation and malpositioned spinal needle. The authors suggest that the cadual epidural injections is a reasonable alternative to spinal surgery if patients pain is severe enough and you a re exhausted other methods to relieve the pain.

Coexistence of Neoplasia and Cortical Dysplasia Associated with Intractable Epilepsy: A Clinical Study of Seven Surgical Patients and Surgical Strategies

A tumor and cortical dysplasia may be the concomitant cause of the causes of intractable epilepsy, but a few studies have examined so far. From among 249 patients who underwent surgery for intractable epilepsy at Dongsan Epilepsy Center, those in whom neoplasia and cortical dysplasia coexisted were selected for this study, and were reviewed the clinical, electrophysiological, neuroimaging and pathological findings. In 17 of 25 lesionrelated epilepsy patients, tumors including dysembryoplastic neuroepithelial tumor(DNT)(n=6), ganglioglioma(n=5), gangliocytoma(n=1), low grade astrocytoma(n=2), oligodendroglioma(n=2), hypothalamic hamartoma(n=1) were verified. Of these 17 cases involving tumors, concomitant cortical dysplasia was observed in 7(DNT; 6, ganglioglioma; 1). All these patients underwent sophisticated presurgical evaluation and intraoperative acute recording(EcoG) for the identification of adjacent or remote epileptogenic areas as well as functional brain mapping by electrical stimulation or SSEP to verify the eloquent areas. In intractable epilepsy, the coexistence of cortical dysplasia and neoplasia is not common, though careful intraoperative evaluation of the tumor and surrounding tissue using electrocorticogram (EcoG) may lead to its pathological identification and excellent surgical results for these rare lesions.

Symptomatic Isolated IV Ventricular Hydrocephalus in Adults: Clinical Diagnosis and Management of Five Cases

Isolated fourth(IV) ventricle in shunted patients has been reported with increasing frequency. Symptomatic isolated IV ventricular hydrocephalus in adults, however, has seldom been described. We report five such cases among total of 420 shunted cases in our institution from January 1992 to December 1995. The causes of initial hydrocephalus were postsurgical meningitis(SAH, teratoma and abscess of posterior fossa), tuberculous meningitis and neurocysticercosis of the IV ventricle. All cases were symptomatic with clinical findings related to posterior fossa lesions. Two patients developd symptoms in 2 months after V-P shunts and the others between 17 and 118 months after V-P shunts. These 5 patients required IV ventricular shunting. All patients improve postoperatively except one patient who developed 6th nerve palsy related to secondary irritation of the brainstem by the IV ventricular catheter. Inflammatory changes in the ependyma of both aqueduct of Sylvius, foramina Luschka and Magendi have been regarded as the most important factors in the development of the isolation of IV ventricle, especially in adults. It is generally recommended to shunt in cases of the adult symptomatic isolated IV ventricle. Alternative surgical techniques and prevention of such complications are discussed.

Radial Tunnel Syndrome: Case Report

Radial tunnel syndrome is a rare disorder and it's symptoms sometimes so closely overlap those lateral epicondylitis, causing difficulties to differentiate. A 39-year-old man was presented who had a 2.5-year history of right elbow and forearm pain which was unseccesfully treated as 'tennis elbow'. Clinically, severe tender point over the forearm was relieved after a local anesthetic injection. Axial STIR(short tau inversion recovery) image showed high signal intensity at the origin of the extensor carpi radialis brevis, which was so minimal that it was not comparable to clinical symptoms. But radial nerve was revealed normal. So we decided that the symptoms were caused not by lateral epicondylitis but rather by radial tunnel sybdrome and an operation was performed. In the operative field, the most proximal part of the superficial head of the supinator muscle was tendinous and formed a fibrous arch, which was resected. After the operation, the right arm pain was relieved. This is a case diagnosed as lateral epicondylitis which showed no improvement under conservative treatment, but improved after a local anesthetic injection on the tender point. When a case with no correlations between lateral epicondylitis degree in MRI and clinical symptoms, one should take the possibility of radial tunnel syndrome into consideration.