• 제목/요약/키워드: Family Therapy

검색결과 832건 처리시간 0.028초

스포츠 정신의학 (Sports Psychiatry)

  • 한덕현;나철;이영식
    • 정신신체의학
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    • 제12권2호
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    • pp.95-102
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    • 2004
  • 연구배경: 정신적인 면에 밀접한 관련이 있는 스포츠에 정신과적인 관심은 체계적으로 적용되지 못해왔으며 심리학에 비해 관심의 정도나 다양성은 많이 부족하였다. 이번 스포츠 정신의학의 소개는 기본적 개념과 영역을 간단히 논함으로써 정신과 의사로써 스포츠를 보는 다양한 시각을 제공하고 정신과 의사가 할 수 있는 기본적인 역할에 대해 소개하고자 한다. 결과 및 토론 : 운동선수들의 심리학적 발달 단계를 이해하는 것은 그들의 정신 구조를 알아가는데 많은 도움을 준다. 또한 어린 시절부터 지속되어온 일정한 성향은 시합 중에 혹은 연습 중에 간혹 보일 수 있는 문제점을 신속히 알아내는 데 많은 자료를 제공할 것이다. 운동의 정신 생물학은 운동 선수들의 정신 상태에 영향을 끼칠 수 있는 호르몬이나 신경 전달물질 같은 생물학적인 면을 논하게 된다. 운동 선수의 훈련이나 경기 중 일어날 수 있는 정신적 문제를 크게 5가지 항목으로 나눌 수 있다, choke, 슬럼프, 부상, 대인관계, 훈련딜레마. 선수들도 일반인들과 똑같이 정신과적 모든 질환에 노출되어 있다. 정신치료, 집단치료, 가족치료, 약물 치료 등 정신과 환자에게 사용될 수 있는 모든 치료법은 스포츠정신의학에서 사용될 수 있다. 결론: 비록 정신과 의사들이 영향을 끼칠 수 있는 중요한 부분들은 임상적 상황이 되겠지만 선수들 운동과 인생 전반에 걸쳐 벌어지는 선수들의 역할과 갈등에 관심 가짐으로써, 자신의 운동과 인생을 즐기며 살아가는 더 많은 인본주의적인 선수 출현에 일조했으면 한다.

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Change in Trend in Various Clinico-Pathological Factors and Treatment Profile of Breast Cancer Patients: a Tertiary Cancer Centre Experience

  • Shankar, Abhishek;Roy, Shubham;Rath, GK;Kamal, Vineet Kumar;Bhandari, Menal;Kulshrestha, Rashi;Prasad, Neelam;Sachdev, Jaineet;Jeyaraj, Pamela
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.3897-3901
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    • 2016
  • Background: Breast cancer is by far the most frequent cancer of women (23% of all cancers), ranking second overall when both sexes are considered together. Since there has been change in clinico-pathological factors and treatment profiles for breast cancer patients over the years, the present study to evaluate the change trends in India. Materials and Methods: A detailed analysis was carried out with respect to age, menopausal status, family history, disease stage, surgery performed, histopathology, hormone receptor status, and use of chemotherapy or hormonal therapy. Change in various clinico-pathological factors and treatments of breast cancer cases was recorded and analysed. Results: Mean age at presentation was found to be earlier in 2005-2006 compared with 1997-98 (p value: 0.046). More premenopausal women were diagnosed with breast cancer in 2005-2006 when this was compared with initial years of assessment (p value ${\leq}0.001$). When change in the receptor status was evaluated, we observed that there was a decrease in cases of ER and PR receptor positivity which was significant (p value: 0.007). Over the period of time, more f patients were not offered surgery initially in view of advanced disease when the two time periods were compared (p value: ${\leq}0.001$). There was a significant increase in patients who were initially offered neo-adjuvant chemotherapy in view of advanced disease at presentation (p value: ${\leq}0.001$). There was increasing number of patients who received palliative treatment for symptoms in 2005-2006 when compared to patients treated in 1997-98((p value: ${\leq}0.001$). Conclusions: Changes in mean age at presentation, premenopausal status, and stage at presentation have occurred over the years. More aggressive patterns of disease have become more common with early age at presentation and aggressive biological behaviour with receptor negative tumours.

Dietary Habits Contributing to Breast Cancer Risk Among Iranian Women

  • Mobarakeh, Zahra Sheikhi;Mirzaei, Khadijeh;Hatmi, Nadia;Ebrahimi, Mandana;Dabiran, Sohaila;Sotoudeh, Gity
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9543-9547
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    • 2014
  • Background: The aim of this study was to investigate demographic features, dietary habits, and some possible risk factors for being susceptible to breast cancer in Iranian women. Materials and Methods: A study of dietary habits and breast cancer was conducted among 53 Iranian women with histological confirmed disease and 40 matched controls. A dietary habits questionnaire was used to evaluate the pattern of selected food intakes. The risk of cancer was analyzed after adjustment for confounding factors. Age, weight, body mass index (BMI), waist circumference, educational status, parity, lactation, marital status, menopause, history of estrogen therapy, and family history of breast disease or cancer were assessed among participants. Special attention was given to the relationship between consumption of high fat meat, milk, yogurt and cheese as well use of frying oils for frying foods, use of olive/liquid oils for cooking, removing fat from meat and poultry, removing chicken skin and not use of mayonnaise as salad dressing and the risk of breast cancer. Moreover, salad, vegetable and fruit consumption, and eating outdoors owere investigated. Results: Our results revealed significant lower education and higher BMI and waist circumference levels in patients with breast cancer. There was significantly increased breast cancer risk in overweight women in comparison with normal weight (OR=2.91, 95%CI 1.24 to 6.82). High intake of fat dairy products including milk and cheese was found to be a statistically significant factor for increasing breast cancer risk in models adjusting for age, BMI and education. Use of olive/liquid oils for cooking and avoidance of mayonnaise as salad dressing are related to lower risk of breast cancer. The frequency of vegetable and fruit consumption was significantly lower in patients with breast cancer compared to healthy women. Conclusions: Dietary habits might be risk factors for breast cancer among Iranian women. Adoption of a prudent diet could be an appropriate strategy for preventing breast cancer.

만성질환자의 퇴원후 가정간호 요구변화 추이에 관한 조사 연구 (A Study on the Home Nursing Care Need Trajectory of the patients with chronic illnesses after discharged from Hospital)

  • 이소우;서문자;김금순;이인숙;이은숙;김명애
    • 가정∙방문간호학회지
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    • 제3권
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    • pp.86-97
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    • 1996
  • The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

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PEP-1-GSTpi protein enhanced hippocampal neuronal cell survival after oxidative damage

  • Sohn, Eun Jeong;Shin, Min Jea;Kim, Dae Won;Son, Ora;Jo, Hyo Sang;Cho, Su Bin;Park, Jung Hwan;Lee, Chi Hern;Yeo, Eun Ji;Choi, Yeon Joo;Yu, Yeon Hee;Kim, Duk-Soo;Cho, Sung-Woo;Kwon, Oh Shin;Cho, Yong-Jun;Park, Jinseu;Eum, Won Sik;Choi, Soo Young
    • BMB Reports
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    • 제49권7호
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    • pp.382-387
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    • 2016
  • Reactive oxygen species generated under oxidative stress are involved in neuronal diseases, including ischemia. Glutathione S-transferase pi (GSTpi) is a member of the GST family and is known to play important roles in cell survival. We investigated the effect of GSTpi against oxidative stress-induced hippocampal HT-22 cell death, and its effects in an animal model of ischemic injury, using a cell-permeable PEP-1-GSTpi protein. PEP-1-GSTpi was transduced into HT-22 cells and significantly protected against H2O2-treated cell death by reducing the intracellular toxicity and regulating the signal pathways, including MAPK, Akt, Bax, and Bcl-2. PEP-1-GSTpi transduced into the hippocampus in animal brains, and markedly protected against neuronal cell death in an ischemic injury animal model. These results indicate that PEP-1-GSTpi acts as a regulator or an antioxidant to protect against oxidative stress-induced cell death. Our study suggests that PEP-1-GSTpi may have potential as a therapeutic agent for the treatment of ischemia and a variety of oxidative stress-related neuronal diseases.

여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 - (Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic)

  • 박영숙
    • 여성건강간호학회지
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    • 제5권1호
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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Clinical Presentation and Frequency of Risk Factors in Patients with Breast Carcinoma in Pakistan

  • Memon, Zahid Ali;Qurrat-ul-Ain, Qurrat-ul-Ain;Khan, Ruba;Raza, Natasha;Noor, Tooba
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7467-7472
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    • 2015
  • Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.

Expression of Transcription Factor FOXC2 in Cervical Cancer and Effects of Silencing on Cervical Cancer Cell Proliferation

  • Zheng, Chun-Hua;Quan, Yuan;Li, Yi-Yang;Deng, Wei-Guo;Shao, Wen-Jing;Fu, Yan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권4호
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    • pp.1589-1595
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    • 2014
  • Objective: Forkhead box C2 (FOXC2) is a member of the winged helix/forkhead box (Fox) family of transcription factors. It has been suggested to regulate tumor vasculature, growth, invasion and metastasis, although it has not been studied in cervical cancer. Here, we analyzed FOXC2 expression in cervical tissues corresponding to different stages of cervical cancer development and examined its correlation with clinicopathological characteristics. In addition, we examined the effects of targeting FOXC2 on the biological behavior of human cervical cancer cells. Methods: The expression of FOXC2 in normal human cervix, CIN I-III and cervical cancer was examined by immunohistochemistry and compared among the three groups and between cervical cancers with different pathological subtypes. Endogenous expression of FOXC2 was transiently knocked down in human Hela and SiHa cervical cells by siRNA, and cell viability and migration were examined by scratch and CCK8 assays, respectively. Results: In normal cervical tissue the frequency of positive staining was 25% (10/40 cases), with a staining intensity (PI) of $0.297{\pm}0.520$, in CIN was 65% (26/40cases), with a PI of $3.00{\pm}3.29$, and in cancer was 91.8% (68/74 cases), with a PI of $5.568 {\pm}3.449$. The frequency was 100% in adenocarcinoma (5/5 cases) and 91.3% in SCCs (63/69 cases). The FOXC2 positive expression rate was 88.5% in patients with cervical SCC stage I and 100% in stage II, showing significant differences compared with normal cervix and CIN. With age, pathologic differentiation degree and tumor size, FOXC2 expression showed no significant variation. On transient transfection of Hela and SiHa cells, FOXC2-siRNA inhibition rates were 76.2% and 75.7%; CCK8 results showed reduced proliferation and relative migration (in Hela cells from $64.5{\pm}3.16$ to $49.5{\pm}9.24$ and in SiHa cells from $60.1{\pm}3.05$ to $44.3{\pm}3.98$) (P < 0.05). Conclusion: FOXC2 gene expression increases with malignancy, especially with blood vessel hyperplasia and invasion degree. Targeted silencing was associated with reduced cell proliferation as well as invasion potential.

일부 군 사병의 성 의식과 에이즈에 대한 지식 및 태도 (Sexual Orientation, Knowledge and Attitudes toward AIDS among Military Personnel in Korea)

  • 김남초;오정아;한혜자;김미혜;김준권;이혜자;김미정
    • 한국보건간호학회지
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    • 제16권2호
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    • pp.225-238
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    • 2002
  • The purpose of this descriptive study was to assess sexual orientation and Knowledge and attitudes with regards to AIDS in military personnel, and to provide basic data for developing a further sex education program for them. The data were collected in June 2002 on 242 service members of A Branch of the Ground Army located in Chung-Chung Do Region. They responded to a survey questionnaire that consisted of 68 items: 14 items on sexual orientation. 39 items on knowledge about AIDS, and 15 items on attitudes toward AIDS. The data were analyzed using SAS program. The study results are as follows: 1. Sexual orientation of the military personnel 1) In terms of sexual orientaion, harassment and assault, only $26.4\%$ of the subjects responded as, 'know well'. Appropriate awareness of the legal liability was reported by $21.6\%$ of the subjects regarding sexual harassment and $78.1\%$ of the subjects regarding sexual assault. 2) Pre-marital cohabitant was supported by $89.2\%$ of the subjects. 3) The Korean military personnel showed liberal attitudes toward sexuality as $46.4\%$ of them reported having sexual-relationship with the dating partner is acceptable. 4) The attitudes of the most subjects toward homosexuality was found to be unfavorable. 5) Subjects were m the need of appropriate sex education. of which substantial knowledge on sexual intercourse was the most needy area. 2. Knowledge and attitudes toward AIDS of the military personnel 1) The subjects' level of knowledge on AIDS was relatively low, showing the average score of $22.31\pm7.23$ points (range: 0-39 points). The higher level of knowledge was reported by those who had high level of education, father alive. and less number of brothers in their family. 2) The subjects' attitudes toward AIDS was relatively positive. The attitude toward AIDS was also found to be more positive in those who had high level of education and less number of brothers. 3) There was a positive but weak correlation between knowledge and attitude toward AIDS. The study finding showed that the sexual orientaion of the Korean military personnel was moderately positive and liberal. However, their awareness of sexual harassment and assault and AIDS was still found to be low. As Korean enlisted military service men are likely to be in the ages with strong sexual desire, it may be important for them to have appropriate sexual orientation and attitudes toward AIDS. Therefore, it is recommended to develop further practical and sound sex education programs within the military unit in order to meet their education needs as well as to utilize sex education specialists as the instructors of those programs.

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Association of Interleukin-27 rs 153109 Single Nucleotide Polymorphism with Spontaneous Resolution of Hepatitis C Virus - Genotype 4a Infection in Egyptian Patients

  • Fawzy, Mariam M;Wahid, Ahmed;Nazmy, Maiiada H;Hashem, Mohamed;Waked, Imam;Abdelwahab, Sayed F
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.2093-2097
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    • 2016
  • Background: HCV is a major global health problem. IL-27 is a member of the IL-6/IL-12 cytokine family with a broad range of anti-inflammatory properties. Recent studies highlighted the effect of a SNP in the IL-27 promoter region on modulating the progression of infectious diseases and individual responses to therapy. Aim of the work: The present study investigated the potential role of (-964 A/G) SNP in the promoter region of IL-27p28 gene (alleles rs153109) on the outcome of HCV infection among genotype 4a infected patients. Materials and Methods: HCV genotyping confirmed that all of the HCV-infected patients had genotype 4a infection. Genomic DNA was extracted from 111 patients with chronic HCV infection, 42 spontaneous resolvers (SR) and 16 healthy controls. IL- 27p28.rs153109 genotyping was assessed using PCR-RFLP then confirmed by DNA sequencing. Results: The frequency of IL-27-p28.rs153109AA, AG, and GG genotypes among chronically infected subjects were 74.8 %, 25.2%, and 0% while among the SR, they were 57.1%, 35.7%, and 7.14%, respectively. Our data show the unique presence of G/G genotype in the SR group (3 patients; 7.14%). Moreover, the "G" allele frequencies among chronic and resolved subjects were 12.6% and 25.0%, respectively (p=0.0136). Importantly, subjects with the GG genotype were more likely to clear their HCV infection than those with the AA genotype (p=0.0118). Conclusions: HCV genotype 4a subjects with the IL-27-p28.rs153109 A/G and G/G genotype were more likely to clear their HCV infection. Therefore, we propose IL- 27p28.rs153109SNPas a genetic biomarker for predicting HCV infection outcome.