Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.
BACKGROUND/OBJECTIVES: The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics. SUBJECTS/METHODS: The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis. RESULTS: Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28-2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69-3.42), having a lower education level (OR = 2.29, 95% CI = 1.33-3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32-3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43-46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75-4.23), lowered appetite (OR = 3.27, 95% CI = 2.16-4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83-4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors. CONCLUSIONS: It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.
This study was undertaken to investigate the effectiveness of a hospital organization targeting both hospital administrative staff members and internal/external customers under a rapidly changing organizational environment, where the effect of creative behavior on passion about one's job was controlled with the participation of 55 people from two larger general hospitals, with 103 people from four general hospitals, with 51 people from eight regular hospitals. Thus, data from a total 209 people were collected. The creative behavior of hospital administrative staff members working for general hospitals and larger general hospitals significantly affected job engagement, showing that 'Relevant knowledge, maintaining status, and application appetite' were higher than the scores of 'new knowledge pursuit activities.' However, a weaker relationship between creative behavior and job engagement was found in medical institutions than for hospitals.
Recently, a lot of consumers in the United States are trying to find out the diverse Asian foods due to the raw material used,sauce,flavor,taste, and cooking philosophy. Asian fare has boomed up in the past decades at restaurants and retail food markets. These phenomena are considered to continue since many Americans become more cautious for health since they believe the traditional Asian foods are better for health than European, Latin, and traditional American diets. The increase of Asian population in America also induce the increased consumption of Asian foods, and those who traveled and tasted Asian foods during their journey want to take Asian foods after back home. Several sauces including gochujang, ramen, and seaweed snack are examples of Asian foods consumed in a large quantity. Many Asian food and material suppliers are trying to pioneer and penetrate American food market with exotic multifaceted Asian cuisine.
The purpose of this study is to know whether single layer continuous connell suture is an acceptable alternative to simple interrupted approximating suture for end-to-end intestinal anastomosis in dogs. Fourteen mixed-breed dogs weighing 2 to 5 kg were allotted to group treated with simple interrupted approximating suture (Group I) and group treated with single layer continuous Connell suture (Group II), each of 7 dogs. All dogs in each suture pattern were compared with time for total operation ad suture elapsed for intestines to anastomose, clinical signs, changing of pre-and postoperative luminal size, status of feces, adhesion at anastomotic site for 14 days after operation. Time for total operation and suture time for intestinal anastomosis were none significant between Group I and Group II, although those in Group II was about 3 minutes shorter than those in Group I, respectively. Group I spent average 47.08${\pm}$11.10 minutes on total operation, 20.97${\pm}$5.54 minutes on suture time for intestinal anastomosis and Group II spent average 44.74${\pm}$7.77 minutes, 17.73${\pm}$3.05 minutes, respectively. All dogs were no special differences in vitality, vomiting, appetite between Group I and Group II for 14 days after operation. All dogs, except one dog in Group I, had showed normal vitality and appetite since 6~8 days after operation. Initial return of fecal passage showed in all dogs before 6 days after operation and thereafter most dogs showed normal feces. According to results, it was thought that all dogs with normal vitality and appetite before 8 days had showed good prognosis. There were no changes of intestinal luminal size in 2 dogs performed Group In and one dog performed Group II between at operation and 14 days after operation. Narrowing rate of intestinal lumen in Group I was average 9.3% of the normal diameter, whereas in Group II, 9.5% of normal diameter. In complications after operation, only one dog in Group I showed intestinal intussusception but the others didn't. Length of adhesion was measured between intestinal anastomotic site and omental graft. Length of adhesion in dogs performed Group II was mostly shorter than that of Group I. Adhesion with proximate intestines occurred in five dogs, which consisted of 3 dogs performed Group I and 2 dogs performed Group II. Concurrently, they had a great length of adhesion between anastomotic site and omental graft. There were no great differences between Group I and Group II about speed of operation, clinical signs, complications such as leakage and stricture. And all dogs performed intestinal anastomosis showed good clinical condition and prognosis. In conclusion, Single layer continuous Connell suture can safely perform an intestinal anastomosis and be an alternative of simple interrupted approximating suture in aspect of speed clinically.
This study was designed to assess the iron nutritional status and anemia of middle school girls in Ulsan City, who were evaluated with a questionnaire, measurement of hematological indices. The average height and weight of respondents were 154.81$\pm$6.28cm and 48.51$\pm$8.80kg, respectively. Mean daily energy intake was 1815.72$\pm$328.04kcal and iron intake was 15.13$\pm$4.50mg. The average hemoglobin concentration of subjects was 11.98$\pm$0.78g/dl, and the average hematocrit level was 36.62$\pm$2.21%. Transferrin saturationTS (%) was 25.58$\pm$9.82%, and the ferritin level was 40.45$\pm$23.03ng/ml. Iron deficiency anemia among the subjects was estimated as 54.2% by using hemoglobin(<12g/이), 33.9% by hematocrit (<36%). The clinical symptoms relating anemia were measured with 4 Likert scale (1 : never, 4 : often), 'tired out easily (2.34$\pm$0.92)' was the highest, followed by 'feel dizzy always (2.26$\pm$0.85)', 'decreasing ability to concentrate (2.23$\pm$0.77)', 'get a cold easily (2.19$\pm$0.82)', 'have a headache (2.10$\pm$0.79)', 'poor memory (2.09$\pm$0.83)', 'no appetite (1.99$\pm$0.85)', As for the correlation between iron parameter and clinical symptoms related to anemia, the hematocrit rate was negatively correlated with 'get a cold easily', 'pale face', 'feeling blue', 'difficult digestion' (p<0.05). The level of iron was negatively correlated with 'tired out easily', 'get a cold easily' (p<0.05) and TS (%) were negatively correlated with 'tired out easily (p<0.05)', 'get a cold easily (p<0.01). Our study resulted that the prevalence of a iron deficiency of a middle school girl is very high, therefore the guidelines for iron supplementation and nutritional education to improve their iron status should be provided.
The purpose of this study was to compare dietary behavior and food intake in relation to physical complaints, such as farmer' syndrome(FS) and gastro-intestinal(GI) problem among Korean farmers. The questionnaire was composed of 24 Cornell Medical Index (CMI), 8 farmers' syndrome, and 5 GI problem questions. Food intake data was gathered by the semi-quantitative food frequency method. The subjects(male 226, female 415) who had FS and Gi problem were 12./8% and 8.3%, respectively. The physical complaints were higher in female and the elderly group. In the FS group, lower activity was seen that in normal groups. The lower health status and fatigues were found in the physical complaint groups. Dietary behavior showed low appetite in the physical complaint group, irregular lunch in FS, and irregular breakfast in GI problem group. Changes in dietary behavior were shown in the aspects of lower amount of intake quantity(40.8%), lower consumption in fat(32.8%) and salty(38.8%) foods, and diverse food items(47.8%). Quantity of food consumed was significantly different withing groups with FS. Kinds of food consumed, intake of protein source foods, milk and calcium and total animal foods were lower in the FS group. But milk and calcium source food and all animal food intakes were higher in the GID problem group. The results suggest that dietary behavior and food intake differ within the group of physical complaints.
Kim, Sung Woo;Mateo, Ronald D.;Yin, Yu-Long;Wu, Guoyao
Asian-Australasian Journal of Animal Sciences
/
v.20
no.2
/
pp.295-306
/
2007
The growth and health of the fetus and neonate are directly influenced by the nutritional and physiological status of sows. Sows are often under catabolic conditions due to restrict feeding program during pregnancy and low voluntary feed intake during lactation. The current restrict feeding program, which aims at controlling energy intake during gestation, results in an inadequate supply of dietary protein for fetal and mammary gland growth. Low voluntary feed intake during lactation also causes massive maternal tissue mobilization. Provision of amino acids and fatty acids with specific functions may enhance the performance of pregnant and lactating sows by modulating key metabolic pathways. These nutrients include arginine, branched-chain amino acids, glutamine, tryptophan, proline, conjugated linoleic acids, docosahexaenoic acid, and eicosapentaenoic acid, which can enhance conception rates, embryogenesis, blood flow, antioxidant activity, appetite, translation initiation for protein synthesis, immune cell proliferation, and intestinal development. The outcome is to improve sow reproductive performance as well as fetal and neonatal growth and health. Dietary supplementation with functional amino acids and fatty acids holds great promise in optimizing nutrition, health, and production performance of sows and piglets. (Supported by funds from Texas Tech, USDA, NLRI-RDA-Korea, and China NSF).
In this study an attempt was made to determine the factors affecting anemia in female industrial workers. The population was identified through the records of screening examinations given by Kosin Medical Center to the industrial workers in Sasang Industrial Complex during the period from March 1987 to October 1988. One hundred twenty eight cases were selected from the records screening examination of 155 anemic patients. A case-control study was carried out using matched 128 anemic cases and 128 non-anemic workers who were selected by simple random sampling. Age was matched, and their occupational history, general characteristics, physical characteristics and health status were analyzed. The results were; 1. In the anemic group, educational level was lower, and the frequencies of irregular menstruation and poor appetite were higher than in the control group but these differences were statistically not significant. 2. The percentage of workers working with organic solvents, working hours and years of service (total years exposed to organic solvents) were significantly higher in the anemic group than those in the control group. 3. A career exposed to organic solvents was more influential factor affecting anemia in the female industrial workers rather than menstruation amount of other factors, and it was statistically significant.
The purpose of this study was to investigate the relationship between birth weight and appetite related hormones, insulin resistance, and antioxidant status in overweight children aged 9-10 years. Thirty-four healthy overweight children (18 boys, 16 girls) were evaluated with respect to anthropometric measurement, lipid profiles, leptin, ghrelin, glucose, insulin, C-peptide, lipid soluble vitamins, and antioxidant enzyme activities. I found that birth weight was negatively correlated with insulin resistance parameters, ghrelin, and coenzyme Q10 levels. There was a significant positive correlation between present BMI and leptin level, while a negative correlation was noted between the BMI and $\alpha$-tocopherol and lycopene levels. When total subjects were classified into three groups by tertiles of birth weight, the lowest tertile of birth weight (LTB) group showed higher levels of fasting glucose, HOMA-IR, and ghrelin level than the highest tertile of birth weight (HTB) groups. On the other hand, HTB group showed an increased oxidative stress (decreased coenzyme Q10 level and catalase activity) compared to the LTB group. In conclusion, plasma ghrelin level might play an important role in accelerated growth in overweight children with LTB. Increased insulin resistance is present in overweight children with LTB, while decreased coenzyme Q10 and catalase activity in overweight children with HTB. These results suggest that birth weight might be an important factor for determination of treatment for obesity related complications in childhood obesity.
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