The Effects of Chronic Diseases, Sleep and Serotonin Concentration on Depression among Elderly People Living in the Community

Purpose@#This study identified the effects of chronic disease number, quality of sleep and, serum serotonin concentration on the elderly’s depression in order to provide basic data for the development of intervention program to effectively prevent and manage depression of the elderly living in the community. @*Methods@#The study surveyed 207 people aged 65 or older living in the community. The general characteristics of the subjects, the number of chronic diseases, the quality of sleep (PSQI-K), the hematological test (Serotonin) and the depression (K-GDS) were statistically analyzed using SPSS/WIN 23.0. @*Results@#It was shown that the elderly’s depression differed significantly depending on the number of chronic diseases, the quality of sleep, and serum serotonin concentration, and that the variable that most affected depression was the quality of sleep. Next, the number of chronic diseases and serum serotonin levels were the variables affecting the depression of the elderly. Conclusion: In order to prevent and manage the depression of the elderly in the future, treatment and education for diseases and depression should be provided to the subjects. In particular, nursing interventions are needed to improve the quality of sleep for the elderly. Health care programs should also be provided, such as providing nutritional supplements to provide serotonin and increasing daytime activities.

The Effects of Chronic Diseases, Sleep and Serotonin Concentration on Depression among Elderly People Living in the Community

Purpose@#This study identified the effects of chronic disease number, quality of sleep and, serum serotonin concentration on the elderly’s depression in order to provide basic data for the development of intervention program to effectively prevent and manage depression of the elderly living in the community. @*Methods@#The study surveyed 207 people aged 65 or older living in the community. The general characteristics of the subjects, the number of chronic diseases, the quality of sleep (PSQI-K), the hematological test (Serotonin) and the depression (K-GDS) were statistically analyzed using SPSS/WIN 23.0. @*Results@#It was shown that the elderly’s depression differed significantly depending on the number of chronic diseases, the quality of sleep, and serum serotonin concentration, and that the variable that most affected depression was the quality of sleep. Next, the number of chronic diseases and serum serotonin levels were the variables affecting the depression of the elderly. Conclusion: In order to prevent and manage the depression of the elderly in the future, treatment and education for diseases and depression should be provided to the subjects. In particular, nursing interventions are needed to improve the quality of sleep for the elderly. Health care programs should also be provided, such as providing nutritional supplements to provide serotonin and increasing daytime activities.

Effects of a Program to Promote Multicultural Awareness and Multicultural Efficacy toward North Korean Defectors for Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to develop a program to improve the cultural competence of nursing students related to North Korean defectors and to investigate the effectiveness of the program. METHODS: There were 36 nursing students in the experimental group and 30 in the control group, who were recruited from a university in I-city, Korea. A Chi-square, t-test, and ANOVA with the SPSS/Win 21.0 program were used to analyze the data. RESULTS: After the intervention, the experimental group showed a statistically significant increase in the total score for multicultural awareness toward North Korean defectors over the control group (t=0.85, p=.026). Scores for cognitive area (t=0.89; p=.037), ritual area (t=-0.10, p=.915), and action area (t=1.18, p=.031) increased, but the conscious area score was not statistically significant. The experimental group showed a statistically significant increase in the total score for multi-cultural efficacy for North Korean refugees (t=0.36, p=.030). Scores for cognitive area (t=0.63; p=.029), working area (t=0.05, p=.955), and emotional area (t=0.79 and p=030) increased, but the working area score was not statistically significant. CONCLUSION: It was found that the program to promote multicultural efficacy related to North Korean defectors applied in this study was effective in enhancing multicultural awareness and efficacy of nursing students.

The Relation between Stress of Clinical Practice and Burnout among Nursing Students: The Mediation Effect of Spiritual Well-being / 한국간호교육학회지

PURPOSE: The purpose of this study is to examine the factors that influence the clinical practice of nursing students and to identify the mediating effects of spiritual well-being in the relation between stress of clinical practice and burnout caused by clinical practice. METHODS: Data were collected by self-report questionnaires targeting 420 nursing students in three nursing colleges located in Gyeonggi and Chungnam province. RESULTS: Burnout of clinical practice according to general characteristics of the study subjects showed significant difference in religion (t=1.895, p=.049). Stress of clinical practice and burnout of clinical practice showed positive correlation (r=.42, p<.001), existential spiritual well-being showed negative correlation between stress of clinical practice (r=-.17, p<.001) and burnout of clinical practice (r=-.47, p<.001). In addition, religious spiritual well-being in spiritual well-being showed no mediating effects and existential spiritual well-being showed mediating effects between burnout in clinical practice stress. CONCLUSION: In order to alleviate the stress of clinical practice for burnout of clinical practice prevention of nursing students, solutions to improve the existential spiritual well-being will be required in the future.

Experience of Frailty in Korean Elderly: A Phenomenological Study Utilizing the Colaizzi Method

PURPOSE: This study attempts to explore the subjective experience of frailty among elderly individuals in Korea. METHODS: From June to August in 2014, 11 elderly persons who had experienced frailty in a community were interviewed. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. RESULTS: According to the analysis, the study participants' frailty process was structured in seven categories: (a) ‘natural phenomenon with ageing,’ (b) ‘life force comes to an end,’ (c) ‘the light in my heart turns off,’ (d) ‘unavoidable situation,’ (e) ‘continuous and connected vicious cycle,’ (f) ‘the limit of recovery energy already passes,’ and (g) ‘life is supported by someones help.’ CONCLUSION: The frailty experience in the participants is a natural process of aging, which cause vicious cycle acting with each other among physical, psychological, and social health. It is said that the cycle of frailty was started from weight loss and insufficient sleep, and boostered by pain. The participants from repetition of the vicious cycle become exhausted and pass the threshold of their recovery energy at some points. If they meet with sudden accidents such as falling, traffic accident and so on, they become to live a dependent life supported by someone's help in a moment. To prevent frailty and worsening conditions in Korean elderly individuals, it is recommended to provide a interventional programs using this study's results.

Factors Influencing the Adaptation to the College Life of Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to determine the degree of undergraduate nursing student adaptation to college life and investigate the factors that influenced that adaptation. METHODS: First-year (undergraduate) students attending three nursing colleges were surveyed from November 24 through December 5, 2014; and data from 206 respondents were analyzed. For data analysis, multiple regression analysis was performed using the SPSS WIN 18.0 program. RESULTS: The findings showed that age (p=.002), emotional intelligence (p<.001), and self-efficacy (p<.001) were significant variables that influenced first-year undergraduate nursing student adaptation to college life. Undergraduate nursing student adaptation was explained by self-efficacy (beta=.327, p<.001), emotional intelligence (beta=.222, p=.001), satisfaction with education in their academic major (beta=-.217, p<.001), and academic achievement (beta=.136, p=.018); and, the explanatory power of these variables was 41.2%. CONCLUSION: To facilitate undergraduate nursing student adaptation to college life prior to clinical practice, developing and apply programs to improve self-efficacy, emotional intelligence, satisfaction with education in their major, and academic achievement is deemed necessary.

Clinical Characteristics and Prognostic Impact of Bacterial Infection in Hospitalized Patients with Alcoholic Liver Disease

Bacterial infection is an important cause of death in patients with liver cirrhosis. The aim of this study was to investigate the clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease (ALD). We retrospectively analyzed data from 409 patients consecutively admitted to a tertiary referral center with ALD diagnosis. Of a total of 544 admissions, 133 (24.4%) cases presented with bacterial infection, of which 116 were community-acquired whereas 17 were hospital-acquired. The common types of infection were pneumonia (38%), biliary tract infection (17%), soft tissue infection (12%), and spontaneous bacterial peritonitis (9%). Diabetes, serum Na or =20 mg/L, systemic inflammatory response syndrome (SIRS) positivity were independently associated with bacterial infection in patients with ALD. Overall 30-day and 90-day mortalities in patients with bacterial infection were significantly (P or =32 (HR, 2.3; 95% CI, 1.036-5.222, P = 0.041), and hemoglobin <12 g/dL (HR, 2.4; 95% CI, 1.081-5.450, P = 0.032) were independent predictors of short-term mortality. In conclusion, bacterial infection and SIRS positivity predicted short-term prognosis in hospitalized patients with ALD. A thorough evaluation at admission or on clinical deterioration is required to detect possible infection with prompt management.

Clinical Features and Risk Factors for Severe Complications among Patients with Acute Hepatitis A Virus Infection in The Jeonbuk Province of Korea / 대한소화기학회지

BACKGROUND/AIMS: The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure. METHODS: We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection. RESULTS: In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age > or =40 years (OR 2.63, p=0.024) and peak PT (INR) > or =1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age > or =40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age > or =40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure. CONCLUSIONS: Age > or =40 years, female gender, HBsAg positivity, peak PT (INR) > or =1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections.

Parthenolide Sensitizes Human Colorectal Cancer Cells to Tumor Necrosis Factor-related Apoptosis-inducing Ligand through Mitochondrial and Caspase Dependent Pathway

BACKGROUND/AIMS: Combination therapy utilizing tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) in conjunction with other anticancer agents, is a promising strategy to overcome TRAIL resistance in malignant cells. Recently, parthenolide (PT) has proved to be a promising anticancer agent, and several studies have explored its use in combination therapy. Here, we investigated the molecular mechanisms by which PT sensitizes colorectal cancer (CRC) cells to TRAIL-induced apoptosis. METHODS: HT-29 cells (TRAIL-resistant) were treated with PT and/or TRAIL for 24 hours. The inhibitory effect on proliferation was detected using the 3-(4, 5-dimethylthiazol-2yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Annexin V staining, cell cycle analysis, and Hoechst 33258 staining were used to assess apoptotic cell death. Activation of an apoptotic pathway was confirmed by Western blot. RESULTS: Treatment with TRAIL alone inhibited the proliferation of HCT 116 cells in a dose-dependent manner, whereas proliferation was not affected in HT-29 cells. Combination PT and TRAIL treatment significantly inhibited cell growth and induced apoptosis of HT-29 cells. We observed that the synergistic effect was associated with misregulation of B-cell lymphoma 2 (Bcl-2) family members, release of cytochrome C to the cytosol, activation of caspases, and increased levels of p53. CONCLUSION: Combination therapy using PT and TRAIL might offer an effetive strategy to overcome TRAIL resistance in certain CRC cells.

The Effects of an Exercise Program on Anthropometric, Metabolic, and Cardiovascular Parameters in Obese Children

BACKGROUND AND OBJECTIVES: Obesity is a chronic disease that requires good eating habits and an active life style. Obesity may start in childhood and continue until adulthood. Severely obese children have complications such as diabetes, hypercholesterolemia, hypertension and atherosclerosis. The goal of this study was to determine the effects of exercise programs on anthropometric, metabolic, and cardiovascular parameters in obese children. SUBJECTS AND METHODS: Fifty four obese children were included. Anthropometric data such as blood pressures, body mass index (BMI) and obesity index (OI) were measured. Blood glucose, total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), high sensitive-CRP (hs-CRP), brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index (ABI) were measured. Physical fitness measurements were done. Obese children were divided into three groups: an aerobic exercise group (n=16), a combined exercise group (n=20), and a control group (n=18). Obese children exercised in each program for 10 weeks while those in the control group maintained their former lifestyle. After 10 weeks, anthropometric data and cardiovascular parameters were compared with the data obtained before the exercise program. RESULTS: LDL-C, waist circumference, and systolic blood pressure decreased significantly in the aerobic exercise group compared to the control group (p<0.05). Waist circumference and systolic blood pressure decreased significantly in the combined exercise group compared to controls (p<0.05). Physical fitness level increased significantly after the exercise programs (p<0.05 vs. control). PWV did not show a significant change after exercise. CONCLUSION: A short-term exercise program can play an important role in decreasing BMI, blood pressure, waist circumference, LDL-C and in improving physical fitness. Future investigations are now necessary to clarify the effectiveness of exercise on various parameters.

Two Cases of Vulvar Malignant Melanoma / 대한산부인과학회잡지

Malignant melanoma may show a predisposition for vulvar skin. Although 37% of all melanomas in women affect the vulva, the skin in this area accounts for only 12% of the total surface area of body. Malignant melanoma of the vulva presented as polypoid tumours in 35% of patients. The most common sites of disease were the clitoral area and the labia majora, which accounted for more than 60% of all lesions. Only 15% of tumours were located primarily in hair-bearing areas. Two women who were diagnosed vulvar melanoma in Uijongbu St. Mary's Hospital were evaluated. We reviewed their medical records. One woman underwent the radical vulvectomy with bilateral inguinal and femoral lymph node dissection, and the other underwent wide local excision with both inguinal lymph nodes dissection. We experienced 2 cases of vulvar melanoma, so we report it with a brief review of literature.

Impairment of diastolic function in newly diagnosed non-insulin-dependent diabetes mellitus / 대한내과학회지

BACKGROUND: Heart failure is one of the major cause of premature mortality and morbidity in diabetes mellitus. It has been well recognized that left ventricular diastolic dysfunction caused by autonomic neuropathy, hyperinsulinemia, hyperlipidemia might be a preceding underlying mechanism of heart failure in diabetes. Also, an impairment of diastolic function in early diabetic patients has been reported in some literature. So, we evaluated the diastolic function in newly diagnosed diabetics with echocardiography. METHODS: All patients with newly diagnosed NIDDM in Pundang Cha general hospital from December 1996 to June 1998 were enrolled (n=20). The 20 healthy volunteers comparable for age, sex, body surface area were enrolled as a control group. The echocardiography was performed in all patients before any treatment. Blood pressure, pulse rate, fasting and postprandial sugar and insulin level, serum total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol were also checked in all patients. RESULTS: There were no significant difference in blood pressure, pulse rate, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol level between both groups. E and A ratio of mitral inflow and peak diastolic velocity of pulmonary vein flow were significantly decreased in NIDDM group compared with control group (p<0.01). But there were no significant difference in left ventricular mass index, isovolumic relaxation time, deceleration time and peak atrial reversal velocity. CONCLUSION: This study demonstrates that an impairment of left ventricular diastolic function occurs early in the NIDDM and investigation of diastolic function should be performed in the clinical evaluation of early diabetic patients.

Evaluation of the Completeness of Case Reporting during the 1998 Cheju-do Mumps Epidemic, Using Capture-recapture Methods / 예방의학회지

OBJECTIVES: To estimate mumps incidence during the study period and to evaluate the completeness of case reporting. METHODS: Capture-recapture methods, originally developed for counting wildlife animals, were used. The data sources were 1) the National Notifiable Communicable Disease Reporting System (NNCDRS; 848 cases), 2) the School Health Reporting System, temporarily administered by the Division of Education (SHRS; 1,026 cases), and 3) a survey of students (785 cases). We estimated the number of unobserved mumps cases by matching the three data sources and fitting loglinear models to the data. We then determined the estimated total number of mumps cases by adding this to the number of observed cases. Completeness was defined as the proportion of observed cases from each source to the total of estimated cases. RESULTS: The total number of observed cases was 1,844 and the total number of estimated cases was 1,935 (95% CI: 1,878-2,070). The overall completeness was 43.8% of the NNCDRS, 53.0% of the SHRS, and 40.6% of the survey. However, completeness varied by area and age. CONCLUSION: Although the completeness of NNCDRS data appeared higher than in the past, it is difficult to generalize this result. In Korea, it is possible to estimate the size of health hazards relatively cheaply and quickly, by applying capture-recapture methods to various data using a multiple data collection system.