OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is a disease of high heritability. Parents of children with ADHD have high parenting stress and low parenting efficacy. In this study, we assessed parents' characteristics including inattention, hyperactivity, impulsivity, executive function, anxiety/depression severity level, child's ADHD symptom severity, and parents' emotional distress level. The relationships between severity of ADHD symptoms in children, cognitive and emotional characteristics in parents, as well as parenting stress and parenting efficacy were evaluated. METHODS: 96 parents participated in the study. Each parent assessed their child's ADHD symptom severity, their own ADHD symptom severity, as well as executive function, depression, anxiety, parenting stress and parenting efficacy. Collected data was analyzed using multiple regression analysis. RESULTS: The mean ADHD Rating Scale score of 53 children was 22.91 (±9.63). Of these, 26 (49.0%) were taking medication. Eight (8.3%) of the 96 parents had psychiatric illnesses and 12 (12.5%) had the possibility of ADHD. Mothers showed significantly higher levels of parenting stress (p < 0.001), depression (p=0.006), and parenting efficacy (p < 0.001) compared with fathers. The children's ADHD symptoms, severity, and parental depression were related to high parenting stress. The ADHD symptoms of parents were associated with high parenting stress (p=0.032). Parental executive function was significantly associated with low parenting efficacy (p=0.015). CONCLUSION: Children's ADHD symptoms severity, parental depression and ADHD symptom severity were significantly associated with high parenting stress. Parental executive function was significantly associated with low parenting efficacy. In addition to treating the children with ADHD, evaluation and treatment of parents' symptoms is needed in order to reduce parenting stress and provide a stable parenting environment.
Anxiety ; Attention Deficit Disorder with Hyperactivity* ; Child ; Depression ; Executive Function* ; Fathers ; Humans ; Impulsive Behavior ; Mothers ; Parenting ; Parents*

OBJECTIVE: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. METHODS: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners’ Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson’s correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. RESULTS: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. CONCLUSION: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.
Adult ; Anxiety* ; Attention Deficit Disorder with Hyperactivity* ; Comorbidity ; Depression ; Diagnosis ; Humans ; Linear Models ; Quality of Life ; Weights and Measures

OBJECTIVES: This study examined the association between executive functions and time perspectives in patients with adult attention-deficit/hyperactivity disorder (ADHD). The executive function including self-management to time, self-organization/problem solving, self-restraint or inhibition, self-motivation, and self-regulation of emotion was analyzed. In addition, the time perspective, including past-negative, past-positive, present-hedonistic, present-fatalistic, future-negative, and future-positive, were investigated. The correlations between the executive functions and time perspectives were analyzed in an adult ADHD patient group. METHODS: Thirty-six participants were divided into 17 in the ADHD group and 19 in the Control group. The participants conduct psychological tests including Barkley Deficits in Executive Functioning Scale (BDEFS), ADHD Self-Report Scale, and the Swedish Zimbardo Time Perspective Inventory to confirm their executive functions, attention, and time perspectives. The participants were recruited at Samsung Medical Center from April 2017 to November 2018. The collected data was analyzed using a t-test and Pearson correlation analysis. RESULTS: The adult ADHD patients group showed significantly higher scores in the BDEFS and ADHD Self-Report Scale than the control group. In time perspective scores, the adult ADHD patients group was higher in the past-negative, present-hedonistic, present-fatalistic time perspectives than the control group. In addition, the adult ADHD patients group was lower in future-positive than the control group. In the adult ADHD patients group, the future-positive time perspectives were negatively correlated with the executive functions. CONCLUSION: These results suggest that the negative time perspective is related to the executive function deficits in an adult ADHD group, particularly in the self-management of time, self-organization/problem solving, and self-motivation.
Adult ; Executive Function ; Humans ; Psychological Tests ; Self Care ; Self-Control

The purpose of this study is to develop an internet based hospice information service system as a solution to the problems identified in our previous studies. Databases and homepage were designed and developed for the information needed for the hospice care and these services were available through the Internet. The hospice information service system has three subsystems. Frrst subsystem, which is training and education for the hospice care personnel includes general hospice information, pain and symptom management, the role of hospice care program information, and hospice care standard. Second subsystem which is patient management includes patient's general information, medical record, nursing record, major symptoms and nursing care plan, statistical data management, and hospice care facilities. Third subsystem includes Q and A for patient, family members, and hospice care team members. The system was tested through providing hospice care to the terminally ill patients and their family members by home visiting nurses. Through this study, it was found that hospice information system is very effective for those who need hospice care at home. But in order for the system to be more effective, system needs to be upgraded with more information on spiritual and social welfare and specialists who provided spiritual care and social welfare need to be included in the hospice care team.
Education ; Home Care Services ; Hospice Care ; Hospices* ; House Calls ; Humans ; Information Services* ; Information Systems ; Internet* ; Medical Records ; Nursing Records ; Patient Care Planning ; Social Welfare ; Specialization ; Terminally Ill

PURPOSE: To correlate CT attenuation and MR signal intensity with concentration of protein solution. MATERIALS AND METHODS: CT and MR examinations of a phantom containing bovine serum albumin solutions of various concentrations ranging from 0 to 55% were performed. CT Hounsfield units(HUs), MR signal intensities, and apparent diffusion coefficients (ADCs) of each albumin solution were measured, and CT HUs and MR signal intensities of the solutions were compared with those of cerebrospinal fluid (CSF), white matter, and cortical gray matter. RESULTS: CT HU increased gradually with increasing albumin concentration. On T1-weighted images(T1WI), signal intensity increased with increasing albumin concentrations of up to 35% but then decreased. On T2-weighted images(T2WI), gradually decreasing signal intensity and increasing albumin concentration were oibserved. Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted images (DWIs) showed that signal intensity peaked at a concentration of 10% and then gradually decreased. The ADC of the solution gradually decreased as concentration increased. Compared with those of normal brain structures, the CT HUs of solutions at concentrations of over 20% were higher than those of white and gray matter. At T1WI, the signal intensities of 10-45% solutions were similar to or higher than that of the gray matter. At T2WI, the signal intensities of solutions above 25, 35, and 40% were lower than those of CSF, gray matter, and white matter, respectively. FLAIR images showed that the signal intensities of 5-35% solutions were higher than that of gray matter. CONCLUSION: The CT attenuation of albumin solution increased gradually with increasing concentration. MR signal intensities peaked at 35% concentration on T1WI and at 10% on FLAIR and DW images, respectively, and then gradually decreased. T2WI and ADC map images showed gradually decreasing signal intensity and ADC as albumin concentration increased.
Brain ; Cerebrospinal Fluid ; Diffusion ; Serum Albumin, Bovine

PURPOSE: Our aim was to evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging for detection of acute subarachnoid hemorrhage (SAH) compared with unenhanced CT. MATERIALS AND METHODS: We compared FLAIR MR images with unenhanced CT scans in 28 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0 (absence), 1 (suspicious), 2 (definite) in the cerebral sulci, sylvian fissure, basal cistern, and cisterns of the posterior fossa. We also compared FLAIR MR images of 28 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. RESULTS: FLAIR MR image was superior to CT in detecting SAH in the posterior fossa (1.41+/-.74 vs 0.78+/-.80; p<0.05) and cortical sulci(1.11+/-.80 vs 0.70+/-.83; p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cistern and sylvian fissure. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. CONCLUSION: FLAIR MR image is useful in detecting acute SAH, especially in patients with small amount of SAH or SAH in the posterior fossa.
Humans ; Magnetic Resonance Imaging* ; Sensitivity and Specificity ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

OBJECTIVES: To investigate the cognitive functions of pediatric cancer patients and to test the hypotheses that the impairment of processing speed and working memory are more prevalent in children with medulloblastoma (MBL) compared to children with neuroblastoma (NBL). METHODS: We gave the Korean version of the Wechsler Intelligent Scale for Children-III to 21 children with MBL and 24 children with NBL during outpatient follow-up after the treatment was completed. RESULTS: Children with MBL showed below average performance across most of the sub-tests. The full scale IQ, verbal IQ, and performance IQ of children with MBL were significantly lower than those of children with NBL. There were significant differences between two groups in coding and Digit Span subtest scores. Children with MBL performed especially poorly in the coding subtest. CONCLUSION: These findings support previous reports of generally low IQ and the dysfunction of processing speed and working memory among children with MBL, a kind of central nervous system tumor. Further investigation is needed to determine how the deficit of processing speed and working memory affect neurocognitive development and general intelligent functions.
Central Nervous System ; Child ; Clinical Coding ; Follow-Up Studies ; Humans ; Medulloblastoma ; Memory, Short-Term ; Neuroblastoma ; Outpatients

OBJECTIVES: To investigate the cognitive functions of pediatric cancer patients and to test the hypotheses that the impairment of processing speed and working memory are more prevalent in children with medulloblastoma (MBL) compared to children with neuroblastoma (NBL). METHODS: We gave the Korean version of the Wechsler Intelligent Scale for Children-III to 21 children with MBL and 24 children with NBL during outpatient follow-up after the treatment was completed. RESULTS: Children with MBL showed below average performance across most of the sub-tests. The full scale IQ, verbal IQ, and performance IQ of children with MBL were significantly lower than those of children with NBL. There were significant differences between two groups in coding and Digit Span subtest scores. Children with MBL performed especially poorly in the coding subtest. CONCLUSION: These findings support previous reports of generally low IQ and the dysfunction of processing speed and working memory among children with MBL, a kind of central nervous system tumor. Further investigation is needed to determine how the deficit of processing speed and working memory affect neurocognitive development and general intelligent functions.
Central Nervous System ; Child ; Clinical Coding ; Follow-Up Studies ; Humans ; Medulloblastoma ; Memory, Short-Term ; Neuroblastoma ; Outpatients

Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.