Purpose: The incidence and prevalence of neurodevelopmental disorders have rapidly increased, indicating an urgent need for assistance through parenting interventions. This study aimed to evaluate the effects of a sociodrama-based communication enhancement program on mothers of children with neurodevelopmental disorders.Method: A non-randomized controlled experimental study design was employed. The experimental and control groups had 16 and 18 participants, respectively. The once-a-week six-session intervention was conducted from September to November 2017, in South Korea. The effects of group, time, and group-by-time interactions among the groups were verified using generalized estimating equations with an autoregressive correlation structure. Results: There was a significant decrease in the parenting burden, alongside a significant improvement in parent-child communication and parenting competence in the experimental group compared to the control group. Conclusion The sociodrama-based communication enhancement program was found to positively influence the parenting burden, communication, and parenting competence of mothers of children with neurodevelopmental disorders. These findings suggest that sociodrama-based programs may be an effective intervention strategy for parents of children with neurodevelopmental disorders. The sociodrama-based communication enhancement program can be applied to decrease parenting burden and improve parent-child communication and parenting competence. Through continuous parenting interventions, an improvement in expressive language and an increase in the attachment behaviors of children with neurodevelopmental disabilities could be expected.

PURPOSE: This study was done to examine the effects of Aroma inhalation therapy on test anxiety, stress and serum cortisol in nursing students. METHODS: The study design was a pre posttest randomized design with a pre-survey, a 5-day experimental treatment (2012.11.17-21) and a post survey. Participants were 65 students - 31 in the aromatic inhalation group and 34 in the control group. The pre-survey included general demographic characteristics and test anxiety, stress and serum cortisol levels for all students. The experimental group received the aromatic inhalation using aroma oil (mixed Maychang, lavender, rosewood essence - ratio of 3:5:2). RESULTS: The experimental group treated with aromatic inhalation scored significantly lower for test anxiety (t=-2.330 p=.023), physical stress (t=-2.910 p=.005) and psychological stress (t=-3.285 p=.002) compared to the control group. However, there were no differences in serum cortisol levels (t=0.228 p=.820). CONCLUSION: Results indicate that Aromatic inhalation, using maychang, lavender and rosewood essential oils, contributes significantly to reducing anxiety and stress among nursing students, and can therefore be an effective intervention for anxiety and stress.
Anxiety* ; Aromatherapy ; Humans ; Hydrocortisone* ; Inhalation* ; Lavandula ; Nursing* ; Oils, Volatile ; Respiratory Therapy ; Stress, Psychological ; Students, Nursing*

OBJECTIVES: A growing body of research has documented that job stress has a pivotal role in developing adverse health outcomes. However, little is known about the relationship between farmers' job stress and health outcomes. This study was undertaken to identify the relationship between job stress and self-perceived fatigue in Korean farmers. METHODS: A total of 526 Korean farmers were asked to participate in this study. A self-administered questionnaire was used to assess the participants' general characteristics, job stress and self-perceived fatigue. Job stress was measured using a forty-eight item Farm Stressor Inventory (FSI), and the self-perceived fatigue was estimated by Multidimensional Fatigue Scale (MFS). Binary logistic regression analysis was conducted to examine the relationship between job stress and self-perceived fatigue. RESULTS: The result showed that job stress was associated with self-perceived fatigue. For the farmers with high job stress, the risk of self-perceived fatigue was more likely to increase compared to those with low job stress. For males, labor intensity (OR, 3.88; 95% CI, 1.91~7.89), job environment (OR, 2.45; 95% CI, 1.22~4.93), social support (OR, 2.10; 95% CI, 1.07~4.13), social isolation (OR, 2.45; 95% CI, 1.15~5.60), financial problems (OR, 3.25; 95% CI, 1.53~6.91), uncertainty (OR, 2.48; 95% CI, 1.30~4.75) and health problems (OR, 5.77; 95% CI, 2.46~13.53) were associated with self-perceived fatigue. For females, job environment (OR, 2.23; 95% CI, 1.22~4.08), social isolation (OR, 2.08; 95% CI, 1.05-4.15), physical environment & weather condition (OR, 2.61; 95% CI, 1.33~5.12), financial problems (OR, 2.87; 95% CI, 1.55~5.32), uncertainty (OR, 3.65; 95% CI, 1.95~6.83) and health problems (OR, 3.38; 95% CI, 1.57~7.27) were associated with self-perceived fatigue. CONCLUSIONS: This result suggests that farmers' job stress plays a role in the development of fatigue, and job stressors related to fatigue are slightly different according to gender.
Agriculture ; Fatigue ; Female ; Humans ; Logistic Models ; Male ; Questionnaires ; Social Isolation ; Uncertainty ; Weather

BACKGROUND: While there is an evidence that the anti-inflammatory properties of spironolactone can attenuate proteinuria in type 2 diabetes, its effects on vascular endothelial growth factor (VEGF) expression in diabetic nephropathy have not been clearly defined. In this study, we examined the effects of spironolactone, losartan, and a combination of these two drugs on albuminuria, renal VEGF expression, and inflammatory and oxidative stress markers in a type 2 diabetic rat model. METHODS: Thirty-three Otsuka-Long-Evans-Tokushima-Fatty (OLETF) rats were divided into four groups and treated with different medication regimens from weeks 25 to 50; OLETF diabetic controls (n=5), spironolactone-treated (n=10), losartan-treated (n=9), and combination of spironolactone- and losartan-treated (n=9). RESULTS: At week 50, the albumin-to-creatinine ratio was significantly decreased in the losartan and combination groups compared to the control OLETF group. No decrease was detected in the spironolactone group. There was a significant reduction in renal VEGF, transforming growth factor (TGF)-beta, and type IV collagen mRNA levels in the spironolactone- and combination regimen-treated groups. Twenty-four hour urine monocyte chemotactic protein-1 levels were comparable in all four groups but did show a decreasing trend in the losartan and combination regimen groups. Twenty-four hour urine malondialdehyde levels were significantly decreased in the spironolactone- and combination regimen-treated groups. CONCLUSION: These results suggest that losartan alone and a combined regimen of spironolactone and losartan could ameliorate albuninuria by reducing renal VEGF expression. Also, simultaneous treatment with spironolactone and losartan may have protective effects against diabetic nephropathy by decreasing TGF-beta and type IV collagen expression and by reducing oxidative stress in a type 2 diabetic rat model.
Albuminuria ; Animals ; Chemokine CCL2 ; Collagen Type IV ; Diabetic Nephropathies ; Losartan ; Malondialdehyde ; Oxidative Stress ; Proteinuria ; Rats ; RNA, Messenger ; Spironolactone ; Transforming Growth Factor beta ; Transforming Growth Factors ; Vascular Endothelial Growth Factor A

PURPOSE: Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. METHODS: A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology outpatient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. RESULTS: The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion(47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). CONCLUSION: Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.
Adult ; Aged ; *Caregivers/psychology ; *Cost of Illness ; Cross-Sectional Studies ; Female ; Humans ; Korea ; Male ; Middle Aged ; *Parkinson Disease ; *Quality of Life

PURPOSE: Human angiotensin converting enzyme (ACE) gene shows an insertion/deletion polymorphism in 16 intron, and three genotypes are determined by whether a 287 bp fragment of the DNA is present or not; II, ID and DD genotype. DD genotype has been suggested as a risk factor of chronic nephrotic disease such as IgA nephropathy and diabetic nephropathy, various cardiovascular diseases and several other diseases. ACE activity increases in acute hepatitis, chronic persistent hepatitis, chronic active hepatitis and cirrhosis. On the other hand, patients with fatty livers have normal ACE activity. This study was designed to find out the relation between polymorphsims of the ACE genes and neonatal hyperbilirubinemia in Koreans. METHODS: The genomic DNA was isolated from 110 full-term Korean neonates who had hyperbilirubinemia with no obvious causes (serum bilirubin?12 mg/dL) and 164 neonates of a control population (serum bilirubin?12 mg/dL). We performed polymerase chain reaction (PCR) to see the allele of the ACE gene. Electrophoresis was done in the PCR products in 1.5 percent agarose gel, and then DNA patterns were directly visualized under ethidium bromide staining. RESULTS: ACE genotypes in the hyperbilirubinemia group are as follows; 26.36 percent for II, 53.64 percent for ID, 20.00 percent for DD, 0.532 for I allele and 0.468 for D allele. These distributions were not significantly different from those in the control group; 24.39 percent for II, 51.83 percent for DI, 23.78 percent for DD, 0.503 for I allele and 0.497 for D allele. CONCLUSION: In this study, ACE gene polymorphism was detected in the neonatal hyperbilirubinemia and control group. The most frequent genotype was ID. Our results indicate that the ACE gene polymorphism is not associated with the prevalence of neonatal hyperbilirubinemia in Koreans.
Alleles ; Angiotensins* ; Cardiovascular Diseases ; Diabetic Nephropathies ; DNA ; Electrophoresis ; Ethidium ; Fibrosis ; Genotype ; Glomerulonephritis, IGA ; Hand ; Hepatitis ; Hepatitis, Chronic ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal* ; Infant, Newborn ; Introns ; Korea* ; Liver ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Prevalence ; Risk Factors ; Sepharose

BACKGROUND: This study was to evaluate a nationwide nosocomial infection rate and antimicrobial resistance in intensive care units(ICUs) in Korea. METHODS: The study was carried out at 16 university-affiliated teaching hospitals from July through October 2004. We performed a prospective multicenter study to investigate nosocomial infection rates, device-associated infection rated, and causative pathogens and their antimicrobial resistance. RESULTS: The urinary tract was the most commonly involved site. Nosocomial infection rate was 12.48 in medical. ICU (MICU), 9.59 in medical surgical ICU (MSICU), 14.76 in surgical ICU (MSICU), and 11.60 in other lCU. Device-associated infection rates were as follow: 1) rates of urinary catheter-associated urinary tract infection were 4.26 in MICU, 3.17 in SICU, 4.88 in MSICU, and 5.87 in other ICU; 2) rates of central line-associated bloodstream infection were 3.24 in MICU, 1.56 in SlCU, 2.36 in MSICU, and 1.78 in other ICU; 3) rates of ventilator-associated pneumonia were 3.61 in MlCU, 13.05 in SICU, 1.68 in MSICU, and 4.84 in other lCU. Staphylococcus aureus was the most frequently identified microorganism in this study; 93% of S. aurues were resistant to methicillin; 17% of Pseudomonas aeruginosa isolated were resistant to imipenem; 11% of Enterococcus faecium and 18% of Enterococcus faecalis showed resistance to vancomycin. Over a half of Acinetobacter spp, Stenotrophomonas maltophilia, Klebsiella pneumoniae, and Escherichia coli showed resistant to fluoroquinolone. Conclusion: This study shows the seriousness of antimicrobial resistance and the importance of infection control in the lCU in Korea. This study should provide a theoretical strategy to enforce the infection control.
Acinetobacter ; Cross Infection* ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Hospitals, Teaching ; Hospitals, University* ; Imipenem ; Infection Control ; Intensive Care Units* ; Critical Care* ; Klebsiella pneumoniae ; Korea* ; Methicillin ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Stenotrophomonas maltophilia ; Urinary Tract ; Urinary Tract Infections ; Vancomycin

BACKGROUND: Although hepatic resection (HR) is the mainstay for the treatment of hepatocellular carcinoma (HCC), high recurrence rate (>60%) is major serious problem. Thus preoperative transarterial chemoembolization (TACE) has been proposed as a neoadjuvant treatment before HR. However, the effect of preoperative TACE in preventing recurrence for initially resectable HCC remains controversial. This study aims at assessing the role of preoperative TACE on the early and long-term outcome following resection of HCC. METHODS: Retrospective randomized analysis was performed. A total of 366 patients who had HR for HCC between January 1995 and December 2000, were included, 132 patients underwent preoperative TACE (TACE plus HR) and 234 patients did not (HR). Statistically no baseline characteristic difference in two groups. RESULTS: HR group was significantly higher than TACE plus HR group in disease-free survival rate and overall survival rate (p<0.001, p<0.01). In subgroup analysis, the disease-free survival rate of HR group was higher than TACE plus HR group in UICC T1-2 and UICC T3 (p<0.01 for both), whereas the difference in overall survival rate was significant only in UICC T3 (p<0.01). Those who achieved tumor necrosis of more than 95% by preoperative TACE showed comparable overall survival rate with HR group, while it was significantly lower in patients who demonstrated tumor necrosis of less than 95% (p<0.001). CONCLUSIONS: Preoperative TACE for initially resectable HCC may promote early and late tumor recurrence and reduces overall survival rate after surgery particularly in patients with advanced- stage tumors.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Humans ; Necrosis ; Neoadjuvant Therapy ; Recurrence ; Retrospective Studies ; Survival Rate

Autoimmune hypoglycemia is characterized by hyperinsulinemia, fasting hypoglycemia, and the presence of insulin auto- antibodies without previous exposure to exogenous insulin. We experienced a case of autoimmune hypoglycemia without diabetes mellitus or any evidence of insulinoma. The insulin auto-antibody and insulin receptor auto-antibody were present. We diagnosed the patient as having autoimmune hypoglycemia and treated with glucocorticoid. After treatment, the hypoglycemic symptoms were resolved. However, four months later, the patient was readmitted with transient diabetic ketoacidosis. After recovery, he showed no signs of diabetes mellitus. We believe that insulin auto-antibodies may play a role in autoimmune hypoglycemia and diabetic ketoacidosis, but its role and mechanism are not precisely known. Further studies are needed to define the action mechanisms and the functions of insulin auto-antibodies: here we present case with a relevant literature.
Diabetic Ketoacidosis/*complications/*immunology/pathology ; Human ; Hypoglycemia/*complications/*immunology/pathology ; Insulin Antibodies/*blood ; Magnetic Resonance Imaging ; Male ; Middle Aged

OBJECTIVES: This study aimed to examine the effect of biofeedback treatment on the clinical symptoms and stress responses in chronic headache patients. METHODS : We recruited 18 chronic headache patients who were treated with 8 sessions of biofeedback treatment and 18 age and sex-matched control headache patients. All subjects consisted of patients with chronic tension headache and migraine headache. Stress responses were measured using Symptoms of stress (SOS) inventory and all subjects performed Beck depression inventory (BDI), Spielberger state anxiety inventory (STAIS), and visual analogue scale (VAS). Biofeedback physiological variables including frontal and forearm EMG, electrodermal response (EDR) and skin temperature at pre-and post-treatment were also measured in all subjects. RESULTS : Compared with control patients, patients on biofeedback treatment showed significant reduction in scores of STAIS (t=3.705, p<.001), and VAS (t=3.392, p=.001) as well as SOS subscales;peripheral manifestations (t=1.788, p=.042), habitual patterns (t=2.008, p=.027), depression (t=2.081, p=.023), anxiety (t=1.990, p=.028), and total score (t=2.045, p=.025). There was a significant increase of skin temperature (t=-1.835, p=.038) only in the biofeedback treatment group. CONCLUSION : These results suggest that biofeedback treatment may be effective in relieving chronic headache by reducing psychological and physiological stress responses.
Anxiety ; Biofeedback, Psychology ; Depression ; Forearm ; Galvanic Skin Response ; Headache ; Headache Disorders* ; Humans ; Migraine Disorders ; Relaxation* ; Skin Temperature ; Stress, Physiological ; Tension-Type Headache