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A Study on Genetic Counseling Curriculum, Accreditation of the Training Program, and the Certification Process of Genetic Counselors in Korea (유전상담 교육프로그램 개발과 전문유전상담사 학회인증제도에 관한 연구)

  • Choi, Jee-Yeong;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.38-55
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    • 2009
  • Purpose: This study was undertaken to provide the framework for development of a genetic counseling training program, and an accreditation and certification process suitable for non-M.D. genetic counselors in Korea. Materials and Methods: Global standards of genetic counseling curriculums, training program accreditation (TPA), and the certification process for genetic counselors (CPGC) in the U.S.A and Japan were reviewed, and a questionnaire survey was performed to elicit opinions among health-care providers including physicians, nurses, technicians, researchers, and educators. In addition, input from professional communities, including the Korean Society of Medical Genetics (KSMG) and Institute for Genetic Testing Evaluation, was sought in formulating the framework of this study. Results: Comparison of U.S.A. and Japan educational systems showed similarities in curriculum, accreditation, and certification programs. Analysis of 117 respondents opinions showed a high level of agreement in the area of global standards; 88% indicated that KSMG should be in charge of TPA and CPGC, while 77% favored a certification exam composed of both written exam and interview components. Conclusion: Based upon this study we propose that the KSMG should be in charge of providing the TPA and CPGC for non-MD genetic counselors. Requirements for the entrance to a Master's degree genetic counseling program should be open to successful four year undergraduate students in all areas, provided the candidates demonstrate the abilities to master the graduate level of study in human genetics, clinical genetics, statistics, psychology, and other required subjects. Eligibility for certification should include qualified candidates of genetic counseling with no formally approved education, but a sufficient amount of clinical experience, in addition to accredited program graduates. Certification examinations should be carried out every two years and the certification should be good for five years, as is the case in Japan.

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The Effects of Spaced Retrieval Training with Errorless Learning on Memory, IADL, Depression in Mild Cognitive Impairment: Single-Subject Design (오차배제훈련을 병행한 시간차 회상훈련이 경도인지장애 환자의 기억력에 미치는 효과와 수단적 일상생활(IADL) 및 우울에 미치는 영향: 단일대상연구)

  • Kim, Yeonju;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.4 no.2
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    • pp.73-83
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    • 2015
  • Objective: The purpose of this study was to examine the effect of the Spaced Retrieval Training (SRT) with Errorless learning on the elderly with Mild Cognitive Impairment (MCI)'s memory, Instrumental Activities Daily Living, Depression symptom. Methods: A single subject experimental research with ABA design was conducted in this study on the 78-years-old person who was enrolled in day-care center. The total experimental sessions were 16 which composed of 3 sessions for baseline, 10 sessions for intervention and 3 sessions for second baseline. K-Auditory Verbal Learning Test (K-AVLT) was measured for the memory each session. For the measurement of cognitive function, IADL, depression Symptom, Korean version of Montreal Cognitive Assessment (MoCA-K), Philadelphia Geriatric Center Instrumental Activities Daily Living (PGC IADL), Geriatric Depression Scale Korean Version (GDS-K) was measured at pre-post test. Results: Memory at the phase B was improved than Phase A. At the phase B, the scores trend was ascending, but after the intervention at the phase A', the scores trend was descending. The scores of MoCA-K were improved, PGC IADL were maintained, GDS-K were decreased. Conclusion: This results support the evidence of the SRT with EL on the elderly with MCI in the clinical setting. In the future, the correlation researches about MCI's memory and other functional factors will be needed for effective occupational therapy service.

The Survey on the Drug use status, Knowledge and Attitude of College Students (Seoul and Northern Part of the Kyunggi-do) (대학생의 약물 사용 실태.지식 및 태도(서울 및 경기 북부지역))

  • Han, Kyoung-Soon;Moon, Sun-Young;Park, Hyun-Ok;Park, Eun-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.2
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    • pp.376-389
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    • 2000
  • The Purpose of this study was to grasp the status of drug uses in college students, and to investigate the knowledge and attitude when they use it. We collected through questionnaires from Sep. 1 to Oct. 30 in 1999. The subjects were 490 college students in Seoul and northern of the Kyunggi-do. The data analysis was performed using SPSS (version 7.0) and ANOVA. The results of this study were as follows. 1. There was no correlation for all factors in the relationship between general characteristics of subjects and knowledge for drugs. On the contrary, in the relation of the general characteristics and attitude for drug of subjects, some factors are statistically significant e.g., department (F=3.049, p<.010), satisfaction for school life (F=6.167,p<.002), body shape(F=8.092, p<.000), and the relationship with ones parents (F=3.728, p<.005). 2. In the analysis of drug use status and knowledge, only in the factor of administration control was statistically significant(F=4.304, p<.014) and in the relation of attitude for drug uses, drug administration was statistically significant (F=4.521, p<.004). 3. In the mean scores for the drug knowledge analysis, the highest factor was 'A narcotic make deformed persons through poisoning of physical and mental' (M=4.14), the lowest factor was 'If catch the flu during the pregnancy, should be take drug as possible as quickly to reduce negative effect for fetal' (M=1.94). 4. In the analysis for drug attitude, the highest factor was 'A drug is alike a poison' (M=3.48), 'Should be keep the usage and dosage of drug' was the lowest (M=1.48). 5. From the investigation for status of drug use, it was revealed that the most subjects (73.6%) were purchase drugs after explain their symptoms to pharmacist. And they take drugs only when they felt painful in 43.1%. The most students (70.4%) were experienced control of drug administration. It was inquired that subjects were mainly obtained information about drugs from pharmacist and television (or radio) advertisement, 33.5% and 33.1%, respectively. In the examination for existence of long-term administrators in their family, 'none' and 'only parents' are 49.6% and 37.3%, respectively. When their parents have illness, the persons go to drugstore and hospital for heath-care, 47.8% and 44.3%, respectively. On the basis of results of this study, we suggest as follows. 1. This study was analyzed data from questionnaires for college students in a part of local areas, so we suggest that the next research should be perform for national-wide students as subjects to generalize the results. 2. It is need more intensive research methodologies such as interview and observation. 3. Additional research is required for knowledge and behaviors of drug uses that will how impact on ones health behavior.

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Association Analysis of Single Nucleotide Polymorphisms in miR-146a and miR-196a2 on the Prevalence of Cancer in Elderly Japanese: A Case-Control Study

  • Parlayan, Cuneyd;Ikeda, Shinobu;Sato, Noriko;Sawabe, Motoji;Muramatsu, Masaaki;Arai, Tomio
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2101-2107
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    • 2014
  • Background: Single nucleotide polymorphisms (SNPs) affecting microRNA (miR) sequences may influence carcinogenesis. Our current study primarily aimed to confirm previously conducted association studies between rs2910164 found on miR-146a, and rs11614913 located on miR-196a2 polymorphisms and cancer phenotypes in the Japanese elderly population. rs2910164 (G/C) and rs11614913 (T/C) polymorphisms were determined by genotyping on the samples collected from 1,351 consecutive autopsy cases registered in the Japanese SNPs for geriatric research (JG-SNP) data base. Cancer samples were systematically reviewed, pathologically verified and assessed with respect to miR-146a and miR-196a2 genotypic variation. The current study covered 726 males and 625 females with a mean age of $80.3{\pm}8.9$ years. The study included 524 subjects without cancer and 827 subjects with at least one type of cancer, such as gastric (n=160), lung (n=148), colorectal (n=116) or others. Males with cancers (n=467) were more numerous than females (n=360). Both rs11614913 (CT: TT adjusted odds ratio (OR) 95% confidence interval (95%CI)=0.98 (0.75-1.28), p=0.873, CC: TT adjusted OR (95%CI)=1.06 (0.76-1.47), p=0.737, CT+CC: TT, adjusted OR (95%CI)=0.99 (0.77-1.29), p=0.990), and rs2910164 (CG: CC adjusted OR (95%CI)=1.12 (0.87-1.44), p=0.383, GG: CC adjusted OR (95%CI)=1.03 (0.71-1.48), p=0.887, CG+GG: CC adjusted OR (95%CI)=1.10 (0.87-1.39), p=0.446) polymorphisms did not show significant association with overall cancer in all subjects. However, "CC" genotype in rs11614913 polymorphism was significantly associated with increased gastric cancer (n=160) in all subjects (CC: CT+TT, adjusted OR (95%CI)=1.50 (1.02-2.22), p=0.040). We found that rs11614913 and rs2910164 do not pose general cancer risk, but rs11614913 may influence gastric cancer in Japanese elderly population. Confirmation of our study results requires further investigations with larger subject populations.

Spatial Information Application Case for Appropriate Location Assessment of PM10 Observation Network in Seoul City (서울시 미세먼지 관측망 위치 적정성 평가를 위한 공간정보 활용방안)

  • Jeong, Jong-Chul
    • Journal of Cadastre & Land InformatiX
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    • v.47 no.2
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    • pp.175-184
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    • 2017
  • Recently, PM10 is becoming a main issue in Korea because it causes a variety of diseases, such as respiratory and ophthalmologic diseases. This research studied to spatial information application cases for evaluating the feasibility of the location for PM10 observation stations utilizing Geogrphic Information System(GIS) spatial analysis. The spatial Information application cases for optimal location assessment were investigated to properly manage PM10 observation stations which are closely related with public spatial data and health care. There are 31 PM10 observation stations in Seoul city and the observed PM10 data at these stations were utilized to understand the overall assessment of PM10 stations to properly manage using interpolation methods. The estimated PM10 using Inverse Distance Weighted(IDW) and Kriging techniques and the map of PM10 concentrations of monitoring stations in Seoul city were compared with public spatial data such as precipitation, floating population, elementary school location. On the basis of yearly, seasonal and daily PM10 concentrations were used to evaluate the feasibility analysis and the location of current PM10 monitoring stations. The estimated PM10 concentrations were compared with floating population and calculated 2015 PM10 distribution data using zonal statistical methods. The national spatial data could be used to analyze the PM10 pollution distribution and additional determination of PM10 monitoring sites. It is further suggested that the spatial evaluation of national spatial data can be used to determine new location of PM10 monitoring stations.

Vulnerability Assessment of the Air Pollution Using Entropy Weights : Focused on Ozone (엔트로피 가중치를 활용한 대기오염 취약성 평가 - 오존을 중심으로 -)

  • Lee, Sang-hyeok;Kang, Jung Eun;Bae, Hyun Joo;Yoon, Dong Keun
    • Journal of the Korean association of regional geographers
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    • v.21 no.4
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    • pp.751-763
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    • 2015
  • Both the selection of indicators and weights for them are critical issues in the vulnerability assessment. This study is to assess the air pollution vulnerability focused on ozone for 249 local jurisdictions using weights calculated by the entropy methodology and then examine the applicability of the methodology. We selected indicators for air pollution vulnerability assessment and standardized them. Subsequently, we calculated weights of each indicator using the entropy method and then integrated them into the vulnerability index. The exposure indicators consider meteorological and air pollution factors and the sensitivity of the local jurisdiction include variables on vulnerable areas and environments. The adaptive capacity contains socio-economic characteristics, health care capacities and air pollution managemental factors. The results show that Hwaseong-si, Gwangjin-gu, Gimpo-si, Gwangju-si, Gunpo-si are among the highest vulnerabilities based on the simple aggregation of indicators. And vulnerability-resilience (VRI) aggregation results indicates the similar spatial pattern with the simple aggregation outcomes. This article extends current climate change vulnerability assessment studies by adopting the entropy method to evaluate relative usefulness of data. In addition, the results can be used for developing customized adaptation policies for each jurisdiction reflecting vulnerable aspects.

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Clinical Application of Model of Human Occupation on Goals Setting of Elderly person With Dementia: A Case Study (치매노인의 목표수립을 위한 인간작업모델 (Model of Human Occupation)의 적용: 사례연구)

  • Lee, Yu-Na;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.66-76
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    • 2013
  • Objective : Based on the Model of Human Occupation (MOHO), this study was to identifies the goals setting of elderly person with dementia. Methods : For 5 weeks from May to June of 2012, MOHO-based interviews and Occupational Questionnaire(OQ), Interest checklist(IC), Volitional Questionnaire(VQ), The Assessment of Communication and Interaction Skills(ACIS), Occupational Performance History Interview-II(OPHI-II), Occupational Self Assessment(OSA), The Occupational Circumstances Assessment Interview and Rating(OCAIR) assessment were conducted on elderly person with dementia. Further interviews were conducted with case manager and family. Results : After interviews and assessments were conducted, the results of which showed limitations in social and family relationship, financial issues, general well-being. Conclusion : Applying the MOHO forms a basis for judging the subject in a holistic and general way, changes how the subject is viewed, suggests various strategies. For improving the professinoalism and qualities of occupational therapy service, and may help expand the range of other relevant areas.

Management of Urinary Tract Infections in Children: A Survey of Pediatricians in Daegu City (대구지역 소아청소년과 의사들의 요로감염 관리 실태분석)

  • Lee, Sang Su;Kang, Seok Jeong;Lee, Jae Min;Cho, Min Hyun;Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.95-101
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    • 2012
  • Purpose: Recently, many evidence-based guidelines for the management of urinary tract infection (UTI) have been developed because of the importance of proper management. However, there is a lack of data regarding how pediatricians manage UTIs in Korea. Therefore, we surveyed pediatricians to determine whether they manage UTIs in an appropriate manner. Methods: A postal questionnaire survey of 78 pediatricians practicing in Daegu city was performed. Subjects were asked about diagnosis, imaging studies, treatment, and prevention of UTIs. Results: Most of the respondents (94.8%) performed urinalysis to diagnose UTI in febrile children with an unknown fever focus. However, many preferred inaccurate collection methods, such as bagged urine collection, and did not obtain urine cultures. The most frequently performed imaging modality was renal-bladder ultrasonogram. Orally administered antibiotics were preferred unless admission was needed. After diagnosis of UTI, the pediatricians usually provided information to caregivers about the disease itself and supplementary treatment. Of the respondents, only 28.6% had their own guidelines for management of vesicoureteral reflux. Conclusion: Most pediatricians suspected UTI in febrile children with an unknown focus appropriately. Nevertheless, the fact that many pediatricians preferred inaccurate urine collection methods and did not perform sufficient imaging studies to detect associated abnormalities likely resulted in overtreatment due to false-positive diagnosis of UTI and a low probability of ruling out genitourinary anatomical problems. To improve the quality of management of UTI, pediatricians should follow scientific and evidence-based guidelines.

Inhibitory Efficacy of Black Tea Water Extract on Melanogenesis in Melan-a Cells and Its Action Mechanisms (멜라닌 세포에서 홍차 열수추출물의 멜라닌 합성 저해능과 작용기전)

  • Choi, So-Young;Kim, Young-Chul;Chang, Byung-Soo
    • Applied Microscopy
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    • v.41 no.3
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    • pp.169-177
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    • 2011
  • To evaluate the whitening effect of Camellia sinensis water extract (CSWE), CSWE was treated to melan-a cells. Total polyphenol contents and flavonoid contents of CSWE were 102 mg/g and 87 mg/g, respectively. The electron-donating ability of CSWE revealed a dose-dependent response, showing the excellent ability of 82% at 800 ${\mu}g$/mL, and which was higher than the arbutin (48%). The CSWE significantly (p<0.001) suppressed the melanin synthesis and the development of melanocyte dendrites was inhibited in a dose-dependent manner. The CSWE significantly (p<0.001) inhibited both intra-cellular and cell-extracted tyrosinase activities. And inhibitory efficacies of CSWE on both melanin synthesis and tyrosinase activity were significantly (p<0.001) higher than the arbutin. The tyrosinase protein expression was not influenced by arbutin treatment. However, CSWE treatment significantly (p<0.001) reduced it. Both arbutin and CSWE treatment did not influence on mRNA expressions of tyrosinase, tyrosinase-related protein-1 and tyrosinase related protein-2.

When Dose Losses of Maternal Lymphocytes Response to Trophoblast Antigen or Alloantigen Occur in Women with a History of Recurrent Spontaneous Abortion? (반복유산을 경험한 환자에서 임신중 태반항원과 동종항원에 노출된 모체 림프구면역반응은 언제부터 소실되나?)

  • Choi, Bum-Chae;Hill, Joseph A.
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.2
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    • pp.115-122
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    • 1998
  • The maintenance of a viable pregnancy has long been viewed as an immunological paradox. The deveolping embryo and trophoblast are immunologically foreign to the maternal immune system due to their maternally inherited genes products and tissue-specific differentiation antigens (Hill & Anderson, 1988). Therefore, speculation has arisen that spontaneous abortion may be caused by impaired maternal immune tolerance to the semiallogenic conceptus (Hill, 1990). Loss of recall antigen has been reported in immunosuppressed transplant recipients and is associated with graft survival (Muluk et al., 1991; Schulik et al., 1994). Progesterone $(10^{-5}M)$ has immunosuppressive capabilities (Szekeres-Bartho et al., 1985). Previous study showed that fertile women, but not women with unexplained recurrent abortion (URA), lose their immune response to recall antigens when pregnant (Bermas & Hill, 1997). Therefore, we hypothesized that immunosuppressive doses of progesterone may affect proliferative response of lymphocytes to trophoblast antigen and alloantigen. Proliferative responses using $^3H$-thymidine ($^3H$-TdR) incorporation of peripheral blood mononuclear cells (PBMCs) to the irradiated allogeneic periperal blood mononuclear cells as alloantigen, trophoblast extract and Flu as recall antigen, and PHA as mitogen were serially checked in 9 women who had experienced unexplained recurrent miscarriage. Progesterone vaginal suppositories (100mg b.i.d; Utrogestan, Organon) beginning 3 days after ovulation were given to 9 women with unexplained RSA who had prior evidence of Th1 immunity to trophoblast. We checked proliferation responses to conception cycle before and after progesterone supplementation once a week through the first 7 weeks of pregnancy. All patients of alloantigen and PHA had a positive proliferation response that occmed in the baseline phase. But 4 out of 9 patients (44.4%) of trophoblast antigen and Flu antigen had a positive proliferative response. The suppression of proliferation response to each antigen were started after proliferative phase and during pregnancy cycles. Our data demonstrated that since in vivo progesterone treated PBMCs suppressed more T-lymphocyte activation and $^3H$-TdR incorporation compare to PBMCs, which are not influenced by progesterone. This data suggested that it might be influenced by immunosuppressive effect of progesterone. In conclusion, progesterone may play an important immunological role in regulating local immune response in the fetal-placental unit. Furthermore, in the 9 women given progesterone during a conception cycle, Only two (22%) repeat pregnancy losses occured in these 9 women despite loss of antigen responsiveness (one chemical pregnancy loss and one loss at 8 weeks of growth which was karyotyped as a Trisomy 4). These finding suggested that pregnancy loss due to fetal aneuploidy is not associated with immunological phenomena.

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