This longitudinal study examines the burdens and related factors for stroke patient's primary family caregivers. Sixty-one patients treated for stroke at a general hospital in Chung-nam province and family member caregivers participated in this study from July 28, 1998 to August 1, 1999. Family caregivers' burdens were assessed by the burden scale originally developed by Zarit(1980) and Novak &Geust(1989) and modified by Oh's(1993) for use in Korea. The burden scale instrument consists of five subscales.: financial burden, social burden, physical burden, dependency burden, and emotional burden. Repeated ANOVA and Stepwise multiple regression were used in the data analyses. The results were as follows: The burden mean score was 3.23 in the hospital, 3.26 after hospital release, and 3.27 in the home environment. In the hospital, a patient's degree of cognition, and social support for family caregivers were significant factors affecting the sense of burden felt by family caregivers. After hospital release, the significant factors affecting the sense of burden were the degree to which stroke patients could participate in daily living activities, social support for family caregivers, and changing to a second caregiver. In the home environment, the most significant factor affecting the sense of burden was social support for family caregivers.
Activities of Daily Living ; Caregivers* ; Cognition ; Dependency (Psychology) ; Hospitals, General ; Humans ; Korea ; Longitudinal Studies* ; Statistics as Topic ; Stroke*

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress. social isolation. and financial constraints. However. the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Fersonal Resource Questionnaire). Our results showed that the mean burden score was 3,11. indicating high level of burden, Among the sub-domain scores, financial burder was the highest, In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver (p<.001): low cognitive function of the patients(p<.001): low level of ADL(p<.001), the gender of caregiver(p<.001) the current employment status of caregivers(p<.01) the presence of social support for caregiver(p<.001), and the availability of alternative caregivers (p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%). and gender of caregiver (female, 0,4%) were significant explanatory factors of overall burden, The caregivers' burden in acute stages during hospitalization following stroke was high, Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.
Caregivers ; Cognition ; Employment ; Hospitalization ; Humans ; Neurology ; Neurosurgery ; Nursing ; Surveys and Questionnaires ; Social Isolation ; Stroke*

A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was bluish opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined cell borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Chest Pain ; Chondrosarcoma ; Chromatin ; Cytoplasm ; Diagnosis ; Dyspnea ; Eosinophils* ; Female ; Humans ; Mesothelioma ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Pleural Cavity ; S100 Proteins ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

No abstract available.
Abdominal Cavity* ; Catheters* ; Diaphragm*

No abstract available.
Humans*

In this article, we reviewed the literature on risk assessment (RA) models with and without molecular genomic markers and the current utility of the markers in the pharmacogenetic field. Epidemiological risk assessment is applied using statistical models and equations established from current scientific knowledge of risk and disease. Several papers have reported that traditional RA tools have significant limitations in decision-making in management strategies for individuals as predictions of diseases and disease progression are inaccurate. Recently, the model added information on the genetic susceptibility factors that are expected to be most responsible for differences in individual risk. On the continuum of health care, from diagnosis to treatment, pharmacogenetics has been developed based on the accumulated knowledge of human genomic variation involving drug distribution and metabolism and the target of action, which has the potential to facilitate personalized medicine that can avoid therapeutic failure and serious side effects. There are many challenges for the applicability of genomic information in a clinical setting. Current uses of genetic markers for managing drug therapy and issues in the development of a valid biomarker in pharmacogenetics are discussed.
*Genetic Markers ; Genetic Predisposition to Disease ; Genetic Testing ; Genome, Human ; Humans ; Individualized Medicine ; Models, Statistical ; *Molecular Epidemiology ; *Pharmacogenetics ; Risk Assessment

There was an error in the numbering of the references in page 375-376: Sue K. Park, Ji-Yeob Choi. Risk Assessment and Pharmacogenomics in Molecular and Genomic Epidemiology. J Prev Med Public Health 2009; 42(6): 371-6.

No abstract available.
Sarcoma 180* ; Sarcoma*

Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.