2.Taiwanese Parents' Experience of Making a "Do Not Resuscitate" Decision for Their Child in Pediatric Intensive Care Unit.
Shu Mei LIU ; Hung Ru LIN ; Frank L LU ; Tzu Ying LEE
Asian Nursing Research 2014;8(1):29-35
PURPOSE: The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. METHODS: A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. RESULTS: Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "postsigning relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". CONCLUSION: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.
Adolescent
;
Adult
;
Child
;
Child, Preschool
;
*Decision Making
;
Female
;
Humans
;
Infant
;
Intensive Care Units, Pediatric
;
Male
;
Middle Aged
;
Palliative Care/*psychology
;
Parents/*psychology
;
*Professional-Family Relations
;
Qualitative Research
;
Resuscitation Orders/*psychology
;
Taiwan
;
Young Adult
3.Applying Mindfulness Techniques to the Management of Depressive Tendencies in Women in Taiwan in the Perinatal Period: A Qualitative Study
Wan-Lin PAN ; Meei-Ling GAU ; Tzu-Chuan HSU ; Shu-Chiao SHEN ; Tzu-Ying LEE
Asian Nursing Research 2022;16(3):149-154
Purpose:
Perinatal distress, especially depression, commonly occurs during pregnancy and the first year postpartum, but this medical condition are often undiagnosed and untreated. The present study explored how women with depressive symptoms during the perinatal period who had participated in a mindfulness course applied the training and perceived its effects.
Methods:
This descriptive qualitative study included 16 women with probable perinatal depression who had participated in an 8-week mindfulness-based childbirth and parenting program during their pregnancy and agreed to be interviewed. One-to-one in-depth interviews were conducted and recorded following the completion of the mindfulness course, approximately 1 month after childbirth. Verbatim transcripts were analyzed using content analysis.
Results:
We proposed three themes and six subthemes relating to first-time mothers’ experiences during and after the group mindfulness-based intervention: learning to be aware of the body and mind (confronting awareness of physical change, managing negative feelings differently), building positive family relationships (strengthening the motherebaby bond, developing a satisfactory marital partnership), and overcoming ongoing challenges (conquering childbirth pain with confidence, accepting unexpected situations). Three main themes were generated to demonstrate how women experience the effects of mindfulness training.
Conclusions
Mindfulness-based interventions helped the participants develop insight into their mood and physical changes and accept their childbirth process. Therefore, mindfulness education programs can be incorporated into prenatal care to enhance the management of the depressive symptoms of perinatal women.
4.Hyperpolarized Carbon-13 Magnetic Resonance Imaging:Technical Considerations and Clinical Applications
Ying-Chieh LAI ; Ching-Yi HSIEH ; Yu-Hsiang JUAN ; Kuan-Ying LU ; Hsien-Ju LEE ; Shu-Hang NG ; Yung-Liang WAN ; Gigin LIN
Korean Journal of Radiology 2024;25(5):459-472
Hyperpolarized (HP) carbon-13 ( 13C) MRI represents an innovative approach for noninvasive, real-time assessment of dynamic metabolic flux, with potential integration into routine clinical MRI. The use of [1- 13C]pyruvate as a probe and its conversion to [1- 13C]lactate constitute an extensively explored metabolic pathway. This review comprehensively outlines the establishment of HP 13C-MRI, covering multidisciplinary team collaboration, hardware prerequisites, probe preparation, hyperpolarization techniques, imaging acquisition, and data analysis. This article discusses the clinical applications of HP 13C-MRI across various anatomical domains, including the brain, heart, skeletal muscle, breast, liver, kidney, pancreas, andprostate. Each section highlights the specific applications and findings pertinent to these regions, emphasizing the potential versatility of HP 13C-MRI in diverse clinical contexts. This review serves as a comprehensive update, bridging technical aspects with clinical applications and offering insights into the ongoing advancements in HP 13C-MRI.
5.Relationship of Polymorphisms in the Oxidative Stress Related Genes - Paraoxonase and p22phox - to Variant Angina and Coronary Artery Stenosis in Korean.
Young Seok CHO ; Jin Ho CHOI ; Shu Ying ZHANG ; Jun Hee LEE ; Kyung Kuk HWANG ; Hyo Soo KIM ; Byung Hee OH ; Myoung Mook LEE ; Young Bae PARK ; Yun Shik CHOI
Korean Circulation Journal 2003;33(2):104-112
BACKGROUND AND OBJECTIVES: Oxidative stress plays an important role in the pathogenesis of coronary atherosclerosis and spasm. We investigated whether the polymorphisms in two oxidative stress-related genes, paraoxonase and p22phox, are associated with risks of coronary artery spasm and stenosis. SUBJECTS AND METHODS: The study comprised of 116 patients with variant angina, 118 patients with coronary artery stenosis and 117 control subjects, who were all classified by coronary angiography. In all three groups, the genotype frequencies of the Q192R polymorphism of the paraoxonase gene and C242T polymorphism of the p22phox gene were analyzed, and the serum thiobarbituric acid-reactive substance concentrations measured. RESULTS: The frequency of the RR genotype of the paraoxonase Q192R polymorphism was significantly higher in patients with variant angina and coronary artery stenosis than in the control subjects (40.4% in variant angina and 37.8% in coronary artery stenosis vs. 24.7% in control, p=0.020 and 0.048, respectively). From the multivariate analysis, the odds ratio of the RR genotype was 2.240 for variant angina (95% confidence interval ; 1.012-4.956), and 2.333 for coronary artery stenosis (95% confidence interval ; 1.140-4.777), in relation to the control subjects. The thiobarbituric acid-reactive substance level was significantly higher in the RR type than in the QQ+QR types (RR vs. QQ+QR : 1.106+/-0.420 nmol/mL vs. 0.949+/-0.311 nmol/mL, p=0.028). There was no significant difference in the prevalence of the C242T polymorphism of the p22phox gene between the three groups. CONCLUSION: The RR genotype of the paraoxonase gene Q192R polymorphism was found to be an independent risk factor for both coronary spasm and stenosis.
Angina Pectoris
;
Aryldialkylphosphatase*
;
Constriction, Pathologic
;
Coronary Angiography
;
Coronary Artery Disease
;
Coronary Stenosis*
;
Coronary Vessels*
;
Genotype
;
Humans
;
Multivariate Analysis
;
Odds Ratio
;
Oxidative Stress*
;
Polymorphism, Single Nucleotide
;
Prevalence
;
Risk Factors
;
Spasm
6.Healthcare cost of patients with multiple chronic diseases in Singapore public primary care setting.
Shu Yun TAN ; Kaiwei Jeremy LEW ; Ying XIE ; Poay Sian Sabrina LEE ; Hui Li KOH ; Yew Yoong DING ; Eng Sing LEE
Annals of the Academy of Medicine, Singapore 2021;50(11):809-817
INTRODUCTION:
The rising prevalence of multiple chronic diseases is an important public health issue as it is associated with increased healthcare utilisation. This paper aimed to explore the annual per capita healthcare cost in primary care for patients with multiple chronic diseases (multimorbidity).
METHODS:
This was a retrospective cohort study conducted in a cluster of public primary care clinics in Singapore. De-identified data from electronic medical records were extracted from July 2015 to June 2017. Only patients with at least 1 chronic disease were included in the study. Basic demographic data and healthcare cost were extracted. A list of 20 chronic diseases was considered for multimorbidity.
RESULTS:
There were 254,377 patients in our study population, of whom 52.8% were female. The prevalence of multimorbidity was 62.4%. The median annual healthcare cost per capita for patients with multimorbidity was about twice the amount compared to those without multimorbidity (SGD683 versus SGD344). The greatest percentage increment in cost was when the number of chronic diseases increased from 2 to 3 (43.0%).
CONCLUSION
Multimorbidity is associated with higher healthcare cost in primary care. Since evidence for the optimal management of multimorbidity is still elusive, prevention or delay in the onset of multimorbidity in the general population is paramount.
Chronic Disease
;
Comorbidity
;
Cross-Sectional Studies
;
Female
;
Health Care Costs
;
Humans
;
Prevalence
;
Primary Health Care
;
Retrospective Studies
;
Singapore/epidemiology*
7.Role of 5-HT2A Receptor Gene T102C Polymorphism in Coronary Artery Disease and Serum Lipid Level.
Jin Ho CHOI ; Shu Ying ZHANG ; Young Seok CHO ; Kyoung Kook WHANG ; Jun Hee LEE ; Seil OH ; In Ho CHAE ; Joo Hee ZO ; Hyo Soo KIM ; Byung Hee OH ; Myoung Mook LEE ; Yun Shik CHOI ; Young Bae PARK
Korean Circulation Journal 2003;33(4):269-276
BACKGROUND AND OBJECTIVES: The 5-HT2A receptor is one of the main mediators of a serotonin-evoked coronary artery contraction. This is because vasoconstriction is selectively blocked by the 5-HT2 receptor antagonist, with the 5-HT2A receptor gene mRNA being detected in spastic coronary arteries. The relationship between the T102C polymorphism of the 5-HT2A receptor gene and the response to the 5-HT2A antagonist (clozapine) has recently been established, suggestive of a functional implication. Previous studies have observed an association between low cholesterol levels and mental disorders, but the underlying cause has not been determined. It has been established that the T102C polymorphism of the 5-HT2A serotonin receptor gene and a variety of psychological problems are related, but the relationship between the serum lipid level and this genetic polymorphism has not been reported. We investigated the influence of this polymorphism on coronary artery disease, including vasospastic angina and the clinical parameters, such as the lipid profile. SUBJECTS AND METHODS: After a diagnostic angiography was performed, the genotype was identified from the genomic DNA extracted from the peripheral blood of 646 patients without specific psychiatric diseases. RESULTS: There were no differences in the genotype frequencies between coronary artery disease, coronary artery disease with vasospasm, and the normal control groups, even from a subgroup analysis of the clinical parameters. Contrary to previous reports, the genotype distribution was not related to a myocardial infarction or hypertension. The lipid profile analysis showed significantly lower total cholesterol (193.5 vs. 202.1mg/dL, p=0.016) and HDL-cholesterol (42.7 vs. 46.2mg/dL, p=0.003) levels in the CC genotype than the other genotypes, and the frequencies of CC genotype showed a significantly decreasing trend between the HDL-cholesterol (p=0.003) and total cholesterol (p=0.003) quartiles. From a multivariate analysis, only the HDL-cholesterol level was significantly associated with a lower frequency of the CC genotype (p=0.006). CONCLUSION: The T102C polymorphism is not related to coronary artery disease, including vasospasm of the coronary artery, but the CC genotype of this polymorphism is related to low HDL-cholesterol. We identified a novel genetic polymorphism of the serotonin receptor, which affects the HDL-cholesterol level. Because previous observational studies have shown an association between low cholesterol levels and mental disorders, our data should be considered when analyzing the serum lipid levels and serotonin receptor function in humans.
Angiography
;
Cholesterol
;
Coronary Artery Disease*
;
Coronary Vessels*
;
DNA
;
Genotype
;
Humans
;
Hypertension
;
Mental Disorders
;
Multivariate Analysis
;
Muscle Spasticity
;
Myocardial Infarction
;
Polymorphism, Genetic
;
Receptor, Serotonin, 5-HT2A*
;
RNA, Messenger
;
Serotonin
;
Serotonin 5-HT2 Receptor Antagonists
;
Vasoconstriction
8.Technological Challenges and Solutions in Emergency Remote Teaching for Nursing: An International Cross-Sectional Survey
Eunjoo JEON ; Laura-Maria PELTONEN ; Lorraine J. BLOCK ; Charlene RONQUILLO ; Jude L. TAYABEN ; Raji NIBBER ; Lisiane PRUINELLI ; Erika Lozada PEREZMITRE ; Janine SOMMER ; Maxim TOPAZ ; Gabrielle Jacklin ELER ; Henrique Yoshikazu SHISHIDO ; Shanti WARDANINGSIH ; Sutantri SUTANTRI ; Samira ALI ; Dari ALHUWAIL ; Alaa ABD-ALRAZAQ ; Laila AKHU-ZAHEYA ; Ying-Li LEE ; Shao-Hui SHU ; Jisan LEE
Healthcare Informatics Research 2024;30(1):49-59
Objectives:
With the sudden global shift to online learning modalities, this study aimed to understand the unique challenges and experiences of emergency remote teaching (ERT) in nursing education.
Methods:
We conducted a comprehensive online international cross-sectional survey to capture the current state and firsthand experiences of ERT in the nursing discipline. Our analytical methods included a combination of traditional statistical analysis, advanced natural language processing techniques, latent Dirichlet allocation using Python, and a thorough qualitative assessment of feedback from open-ended questions.
Results:
We received responses from 328 nursing educators from 18 different countries. The data revealed generally positive satisfaction levels, strong technological self-efficacy, and significant support from their institutions. Notably, the characteristics of professors, such as age (p = 0.02) and position (p = 0.03), influenced satisfaction levels. The ERT experience varied significantly by country, as evidenced by satisfaction (p = 0.05), delivery (p = 0.001), teacher-student interaction (p = 0.04), and willingness to use ERT in the future (p = 0.04). However, concerns were raised about the depth of content, the transition to online delivery, teacher-student interaction, and the technology gap.
Conclusions
Our findings can help advance nursing education. Nevertheless, collaborative efforts from all stakeholders are essential to address current challenges, achieve digital equity, and develop a standardized curriculum for nursing education.
9.Virtual Screening and Testing of GSK-3 Inhibitors Using Human SH-SY5Y Cells Expressing Tau Folding Reporter and Mouse Hippocampal Primary Culture under Tau Cytotoxicity
Chih-Hsin LIN ; Yu-Shao HSIEH ; Ying-Chieh SUN ; Wun-Han HUANG ; Shu-Ling CHEN ; Zheng-Kui WENG ; Te-Hsien LIN ; Yih-Ru WU ; Kuo-Hsuan CHANG ; Hei-Jen HUANG ; Guan-Chiun LEE ; Hsiu Mei HSIEH-LI ; Guey-Jen LEE-CHEN
Biomolecules & Therapeutics 2023;31(1):127-138
Glycogen synthase kinase-3β (GSK-3β) is an important serine/threonine kinase that implicates in multiple cellular processes and links with the neurodegenerative diseases including Alzheimer’s disease (AD). In this study, structure-based virtual screening was performed to search database for compounds targeting GSK-3β from Enamine’s screening collection. Of the top-ranked compounds, 7 primary hits underwent a luminescent kinase assay and a cell assay using human neuroblastoma SH-SY5Y cells expressing Tau repeat domain (TauRD) with pro-aggregant mutation ΔK280. In the kinase assay for these 7 compounds, residual GSK-3β activities ranged from 36.1% to 90.0% were detected at the IC50 of SB-216763. In the cell assay, only compounds VB-030 and VB-037 reduced Tau aggregation in SH-SY5Y cells expressing ΔK280 TauRD-DsRed folding reporter. In SH-SY5Y cells expressing ΔK280 TauRD, neither VB-030 nor VB-037 increased expression of GSK-3α Ser21 or GSK-3β Ser9. Among extracellular signal-regulated kinase (ERK), AKT serine/threonine kinase 1 (AKT), mitogen-activated protein kinase 14 (P38) and mitogenactivated protein kinase 8 (JNK) which modulate Tau phosphorylation, VB-037 attenuated active phosphorylation of P38 Thr180/ Tyr182, whereas VB-030 had no effect on the phosphorylation status of ERK, AKT, P38 or JNK. However, both VB-030 and VB-037 reduced endogenous Tau phosphorylation at Ser202, Thr231, Ser396 and Ser404 in neuronally differentiated SH-SY5Y expressing ΔK280 TauRD. In addition, VB-030 and VB-037 further improved neuronal survival and/or neurite length and branch in mouse hippocampal primary culture under Tau cytotoxicity. Overall, through inhibiting GSK-3β kinase activity and/or p-P38 (Thr180/Tyr182), both compounds may serve as promising candidates to reduce Tau aggregation/cytotoxicity for AD treatment.
10.Six Months Follow Up Results of "Granulocytes-Colony Stimulating Factor" Based Stem Cell Therapy in Patients with Myocardial Infarction: MAGIC Cell Randomized Controlled Trial.
Hyun Jae KANG ; Hyo Soo KIM ; Sang Hoon NA ; Shu Ying ZHANG ; Won Jun KANG ; Tae Jin YOUN ; Bon Kwon KOO ; Yong Jin KIM ; Dong Soo LEE ; Dae Won SOHN ; Kyou Sup HAN ; Byung Hee OH ; Young Bae PARK
Korean Circulation Journal 2006;36(2):99-107
BACKGROUND AND OBJECTIVES: Granulocytes-colony stimulating factor (G-CSF) has a stem cell mobilizing capacity and favorable effects on ventricular remodeling following a myocardial infarction. G-CSF based stem cell therapy has shown favorable results in animal studies. However, the long term outcome of G-CSF based stem cell therapy in clinical trial remains unknown. Herein, we report the six month follow up results of two different G-CSF based stem cell therapy strategies. SUBJECTS AND METHODS: We compared the intra-coronary infusion of mobilized peripheral blood stem cells (PBSCs) with G-CSF (n=10), mobilization with G-CSF alone (n=16) and control percutaneous coronary intervention (PCI) alone (n=15) in patients following a myocardial infarction. RESULTS: At the six month follow up evaluations, the intra-coronary cell infusion was found to have improved the left ventricular (LV) systolic function and remodeling compared to the baseline, whereas G-CSF alone showed no improvement. Therefore, an intra-coronary cell infusion showed better improvements in the LV systolic function (p<0.001) and remodeling (p<0.01) than G-CSF alone. Cell infusion also showed better results than the control PCI alone group, but these did not reach statistical significance with the limited number of patients used in this study. Patients who received G-CSF administration showed a modest increase of binary restenosis (p=0.185) and a greater late loss in the minimal luminal diameter at the 6 month follow up than the control group. CONCLUSION: An intra-coronary cell infusion of mobilized PBSCs using G-CSF was found to be better than G-CSF alone at the six month follow up evaluation. G-CSF was also found to increase the potential risk of restenosis, especially when administered prior to stent implantation. The efficacy of an intra-coronary infusion of mobilized PBSCs should be evaluated in a large randomized controlled trial.
Animals
;
Coronary Restenosis
;
Follow-Up Studies*
;
Granulocyte Colony-Stimulating Factor
;
Humans
;
Magic*
;
Myocardial Infarction*
;
Percutaneous Coronary Intervention
;
Phenobarbital
;
Stem Cells*
;
Stents
;
Ventricular Remodeling