Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Clonidine ; Education ; Genetics ; Humans ; Hygiene ; Melatonin ; Parents ; Risperidone ; Sleep Initiation and Maintenance Disorders

Alcohol has been used as sedatives historically. The effect of alcohol on sleep is different according to its dose, timing of ingestion, and drinking frequency. Sleep problems may play a role in the development and course of alcohol-related disorders. Insomnia in alcohol-dependent patients is common and early treatment of insomnia may reduce the rate of relapse. Sleep apnea, restless legs syndrome, periodic limbs movement disorder, and altered circadian rhythm may be more frequent in this patients. Management of sleep and alcohol problems is important in treating alcohol-related disorder and sleep disorders, respectively.
Alcohol-Related Disorders ; Circadian Rhythm ; Drinking ; Eating ; Extremities ; Humans ; Hypnotics and Sedatives ; Movement Disorders ; Recurrence ; Restless Legs Syndrome ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders

Early identification and intervention for autism spectrum disorder (ASD) were reported to be important for outcomes or clinical courses. However, there have been a few robust evidences for effectiveness of early intervention until now. This review aims to identify the effectiveness of early intervention by investigating the randomized controlled trial (RCT) of early intervention for autism. There are some RCT studies using behavioral program. Although there are some significant findings, the outcome measurements and small sample size are the limitations. Further studies are needed.
Autism Spectrum Disorder ; Autistic Disorder ; Child ; Early Intervention (Education) ; Humans ; Sample Size

INTRODUCTION: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only a few studies on the sleep patterns of medical students and the related factors. Therefore, the present study aimed to investigate the medical students' sleep patterns and the related factors. METHODS: A questionnaire package was administered to the 1st to 4th year medical students at one medical school. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), global assessment of recent stress scale (GASS), the center for epidemiologic studies-depression scale (CES-D), and Moudsley obsessive-compulsive inventory (MOCI). A total of 352 students (206 males and 146 females) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's correlation and ANOVA. p-values of less than 0.05 were considered statistically significant in analyses. RESULTS: The weekend bedtime was significantly delayed (0 : 49 on weekday ; 1 : 34 on weekend ; t=-5.23, p<0.001), the weekend rise time was delayed (6 : 58 on weekday ; 9 : 30 on weekend ; t=-24.48, p<0.001) and the total sleep time was increased on weekends (5 : 36 on weekday ; 7 : 39 on weekend ; t=15.94, p<0.001). The PSQI score of all subjects was 6.43+/-2.64. PSQI was positively correlated with ESS (r=0.383, p<0.001), GASS (r=0.326, p<0.001), CES-D (r=0.393, p<0.001), and MOCI (r=0.247, p<0.001), but not with GPA (r=0.072, p=0.228. The more senior students had lower PSQI, GASS, CES-D, and MOCI score (p<0.05). CONCLUSION: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the medical students were experiencing poor sleep quality and sleep deprivation. Poor sleep quality is associated with psychological problems (daytime sleepiness, stress, depression, and obsessive tendency).
Depression ; Humans ; Life Style ; Male ; Surveys and Questionnaires ; Schools, Medical ; Sleep Deprivation ; Students, Medical*

Attention-deficit hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, impulsiveness and problems in other higher cognitive processes such as executive function deficits. Currently, there are many treatment modalities, of which pharmacotherapy is the most strongly supported by scientific and clinical evidence. Stimulants, which are first choice in the pharmacological treatment of ADHD, block dopamine reuptake by binding the dopamine transporter and so increasing the concentration of dopamine in synaptic clefts. Stimulants are effective in improving core ADHD symptoms, as well as the nonspecific symptoms, such as aggressiveness and oppositional behavior. Frequently reported short-term adverse effects are decreased appetite, sleep disturbance, headache, dizziness and irritability. Although questions have been raised about the long-term side effects of stimulants, including growth suppression, cardiovascular events, and abuse potential, there is no clear evidence to support these concerns.
Appetite ; Dizziness ; Dopamine ; Dopamine Plasma Membrane Transport Proteins ; Executive Function ; Headache

Twenty four patients with gap nonunions of the tibia were treated with the Ilizarov intercalary bone transport method. The purpose of this retrospective study is to evaluate the results and complications in gap nonunions of the tibia treated using the Ilizarov method. There were 22 males and two females with an average age of the 35.8 years(range, 23-63 years). The mean follow up period was 30.2 months(range, 17-70 months). Ten of the 24 patients had no external shortening with bone gap, 13 external shortening with gap and one hemicircumferential defect. On average, the size of bone loss measured 8.2 cm(range, 3-18 cm). Twenty-one of 24 patients were treated by whole segment internal transport(fifteen were proximal fragment transport, five were distal fragment transport, one was proximal and distal fragment transport), one patient by anterior hemicircumferential corticotomy and partial bone fragment internal transport and tow patients by fibula transfer. All patients healed with solid bony union, although twelve patients required bone grafts, eleven at the docking site and one at the distraction site. On average, the healing index was 49 days/cm(range, 18-82 days/cm). There was on relationship between the percentage transport(size of the distraction gap/the transporting fragment length x 100) and healing index. Numerous complications were encountered, most commonly delayed union and pin site infection, Conclusively, the application of Ilizarov techniques to gap nonunions of the tibia was very effective, but required correct technique and careful follow-up examination.
Female ; Fibula ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Male ; Methods ; Retrospective Studies ; Tibia ; Transplants

Purpose: This qualitative study was to understand the awareness of epidemiological investigation tasks for nurses who were in charge of coronavirus disease 2019 (COVID-19) epidemiological investigations. Methods: Before data collection, written consent was obtained from 13 participants, and the data were then collected from September 1 to December 31, 2021. Individual interviews were conducted and recorded by video interview using Zoom, and data were transcribed verbatim. Four themes were derived by using the qualitative thematic analysis method. Results: The participants perceived that epidemiological investigations were burdensome but that the field work was important, and that expertise and collaboration were required. The participants started work without preparation due to the explosive increase in the number of confirmed COVID-19 cases, and they recognized work conflicts, unstable employment, and exhaustion as obstacles to their work performance. On the other hand, the participants took pride in contributing to the national epidemiological investigation and control and felt a sense of responsibility as nursing professionals. Finally, participants mentioned that the training of infectious disease practitioner was important for work improvement. Conclusion Further research is needed on the development of standardized manuals for the training of nursing personnel as infectious disease specialists through the job analysis of epidemiological investigators.

A 38-year-old woman presented with a week’s history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

The objectives of this study were to assign reasonability to importance of weight selection issue in key performance indicator for performance evaluation of Centers for Child-care Foodservice Management (CCFSM) developed by using Balanced Scorecard (BSC), to draw key performance indicator (KPI) by perspective and to analyze differences in recognition on importance. From September 25 to October 9, 2012, we conducted a questionnaire-based study via e-mail, targeting chiefs and team leaders of nationwide 21 CCFSMs (43 persons), officials of local governments where CCFSM was established (21 persons), officials of Korea Food and Drug Administration (2 persons) and foodservice management experts (27 persons) in order to estimate the relative importance on 4 perspectives and 14 KPIs and analyzed its results by using 61 collected data. The results showed that relative importance of perspectives was estimated in order of importance as follows: business performance (0.3519), customer (0.3393), resource (0.1557), learning and growth (0.1531). Relative importance of KPIs was in order of importance as follows: Evaluation of sanitary management level in childcare foodservice facilities (0.1327), Level of customer recognition and behavior improvement (0.1153), performances of round visiting inspection on foodservice, sanitary, safety management, and foodservice consulting (0.0913). Our results showed that the recognition differences exist on the relative importance of perspectives and KPIs between officials of CCFSM, KFDA, local government and foodservice management experts. These observations will form the basis for developing evaluation systems, and it is considered that performance indicators developed on this basis will suggest direction of operation which CCFSM will have to perform.
Commerce ; Electronic Mail ; Korea ; Learning ; Local Government ; Safety Management ; United States Food and Drug Administration

No abstract available.
Dermatofibrosarcoma* ; Nose*