Psychoeducational Profile-Revised, Korean Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition, and the Vineland Adaptive Behavior Scale, Second Edition: Comparison of Utility for Developmental Disabilities in Preschool Children

Objectives@#This study aimed to compare the utility of the Psychoeducational Profile-Revised (PEP-R), Korean Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (K-WPPSI-IV), and Vineland Adaptive Behavior Scale, Second Edition (VABS-II) for evaluating developmental disabilities (DD) in preschool children. Additionally, we examined the correlations between the PEP-R, KWPPSI-IV, and VABS-II. @*Methods@#A total of 164 children aged 37–84 months were assessed. Children’s development was evaluated using the PEP-R, K-WPPSIIV, VABS-II, Preschool Receptive-Expressive Language Scale, and Korean Childhood Autism Rating Scale, Second Edition. @*Results@#Of the 164 children, 103 had typical development (TD) and 61 had DD. The mean of the PEP-R Developmental Quotient (DQ), K-WPPSI-IV Full-Scale Intelligence Quotient (FSIQ), and VABS-II Adaptive Behavior Composite (ABC) scores were significantly higher in the TD group than in the DD group (p<0.001). The estimated area under the curve of the PEP-R DQ, K-WPPSI-IV FSIQ, and VABS-II ABC scores was 0.953 (95% confidence interval [CI]=0.915–0.992), 0.955 (95% CI=0.914–0.996), and 0.961 (95% CI=0.932– 0.991), respectively, which did not indicate a statistically significant difference. The PEP-R DQ scores were positively correlated with the K-WPPSI-IV FSIQ (r=0.90, p<0.001) and VABS-II ABC scores (r=0.84, p<0.001). A strong correlation was observed between the KWPPSI-IV FSIQ and VABS-II ABC scores (r=0.89, p<0.001). @*Conclusion@#This study found that the PEP-R, K-WPPSI-IV, and VABS-II effectively distinguished DD from TD in preschool children, and no significant differences in utility were observed between them.

Shifting of Centricity: Qualitative Meta Synthetic Approach on Caring Experience of Family Members of Patients with Dementia

PURPOSE: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. METHODS: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). RESULTS: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. CONCLUSION: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.

Decision Making Experience on Breast Reconstruction for Women with Breast Cancer

PURPOSE: The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy. METHODS: Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction. RESULTS: Five theme clusters emerged. First, “expected loss of sexuality and discovery of autonomy” illustrates various aims of breast reconstruction. Second, “holding tight to the reputation of doctors amid uncertainty” specifies the importance of a trust relationship with their physician despite a lack of information. Third, “family members to step back in position” describes support or opposition from family members in the decision making process. Fourth, “bewilderment due to the paradox of appearance-oriented views” illustrates paradoxical environment, resulting in confusion and anger. Lastly, “decision to be made quickly with limited time to oneself” describes the crazy whirling process of decision making. CONCLUSION: Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.

Variables Affecting to Attitudes towards Suicide among General Adult Population in the City of Bucheon / 신경정신의학

OBJECTIVES: The goal of this study was to investigate variables affecting attitudes toward suicide among the general adult population in the city of Bucheon, Korea. METHODS: Study participants included 1000 subjects over 18 years old who visited public offices in Bucheon, Gyeonggi Province, South Korea. Subjects completed a series of questionnaires covering demographic characteristics, clinical characteristics, and prior suicidal ideation and attempts. The Attitudes Toward Suicide-20 and the Center for Epidemiologic Studies-Depression Scales were used to assess attitudes toward suicide and the severity of depression, respectively. Exploratory factor analysis of the responses was performed. RESULTS: Analysis of responses on the Attitudes Toward Suicide-20 Scale revealed four important factors : permissiveness and unpredictability, attitudes toward suicide prevention, relationship between suicide causes and processes, and lack of comprehension of suicide. We assessed relationships among clinical and demographic variables by assessing scores on the Attitudes toward Suicide scale. Demographic characteristics (sex, age, marital status, education, economic status, and religion), clinical characteristics (physical and psychological health), and prior suicidal ideation and attempts affected respondents attitudes toward suicide. CONCLUSION: The variables identified as affecting attitudes toward suicide in this study were similar to those reported in previous studies (i.e., sex, age, religion, education, physical, and psychological health, prior suicidal ideation and attempts). In support of previous research results, we suggest that identifying groups that exhibit variables associated with attitudes toward suicide is an important step in suicide prevention, as such attitudes may influence subsequent behavior. Educational campaigns aimed at suicide prevention can be enhanced by focusing on attitudes toward suicide.

Factors Influencing Empathy in Nursing Students in Korea / 한국간호교육학회지

PURPOSE: The purpose of the study was to explore the levels of self-awareness, assertiveness, life stress, and empathy in nursing students and identify influential factors on empathy. METHODS: A predictive correlational design was used. The data was collected by questionnaires from a convenience sample of 319 nursing students in 2014 in Korea. The data was analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The mean items scores of self-awareness, assertiveness, life stress, and empathy were 3.49, 3.02, 2.20 and 3.58, respectively, of a possible score ranging from 1 to 5. Empathy significantly differed by gender, grade, satisfaction with nursing as a major, and clinical practice experience. Empathy was correlated with self-awareness and interpersonal relationship stress. As a result of multiple regression analysis, empathy accounted for 20.1% of the variance by self-awareness, gender, clinical practice experience and interpersonal relationship stress. The most important factor was self-awareness, which explained 11.6% of the variation. CONCLUSION: The results of the study reveal that strengthening self-awareness and relieving interpersonal relationship stress ought to be integrated in developing effective educational intervention for enhancing empathy in nursing students.

Risk Factors for Suicidal Ideation in the Elderly / 신경정신의학

OBJECTIVES: This study investigated the factors associated with suicidal ideation in the elderly. METHODS: A total of 136 subjects over 60 years old who visited the public offices in Bucheon-si, Gyeonggi Province in South Korea participated in the study. Subjects completed a series of questionnaires including the following : demographic information ; physical illness ; psychological illness ; suicidal ideation. In addition, Center for Epidemiologic Studies-Depression Scale and Attitudes Towards Suicide-20 were used to assess the severity of depression and the attitude towards suicide, respectively. RESULTS: Multivariate logistic regression analyses were performed to determine the factors that affect suicidal ideation in the elderly. As a result, living alone, depression, having any physical illness, and permissive attitude towards suicide were risk factors for suicidal ideation in the elderly. CONCLUSION: ConclusionZZIn addition to previously identified risks factors (living alone, physical illness, and depression), the study found that permissive attitude towards suicide also serves as a risk factor for suicide in elderly people. Therefore, permissive attitude towards suicide should be addressed and evaluated in order to prevent suicide in the elderly.

Effect of Carvedilol Alone or with Cyclosporine on the Migration of Cultured Rat Vascular Smooth Muscle Cell

PURPOSE: Excessive proliferation and migration of vascular smooth muscle cells (VSMCs), which are triggered by endothelium-derived cytokines or growth factors, play a major role in the chronic transplant vasculopathy or vascular remodeling process after vascular injury. We have reported that carvedilol, a new anti-hypertensive agent, inhibits cytokine-triggered proliferation of cultured rat VSMCs. In this study, we investigate the effect of carvedilol on the migration of rat VSMCs. METHODS: Growth-arrested cultured VSMCs (passage 8-11) from the aorta of rat (Sprague-Dawley) were used. Migration was measured using a microchemotaxis chamber with a polycarbonate membrane. Platelet derived growth factor (PDGF) or angiotensin-II (ANG-II) was used as a stimulator and was added into the lower well of the chamber. A density of 1X104 cells per well with carvedilol and/or cyclosporine A (CsA) was seeded into the upper well of chamber. Degree of migration was assessed by using the number of migrated cells per high power field of light microscopy. RESULTS: PDGF and ANG-II stimulated VSMC chemotaxis effectively. Carvedilol decreased PDGF-induced migration to 88.9 (+/-16.0)% and 37.4 (+/-10.5)% at 1 microM and 10 microM, respectively. Carvedilol inhibited both PDGF and ANG-IIinduced chemotaxis in a concentration-dependent manner. The IC50 of carvedilol in PDGF and ANG-ll-induced VSMC migration was around 10 microM. CsA (100 nM) neither significantly inhibited the migration of VSMC, regardless of the kinds of cytokines, nor affected the inhibitory activities of carvedilol. The pattern of inhibition in the group with a combined addition of carvedilol and CsA was very similar to that of carvedilol alone group, regardless of the kinds of cytokines. CONCLUSION: We demonstrated that carvedilol alone or in the presence of CsA significantly inhibited the cytokine- induced migration of VSMC. These data indicate that carvedilol has a unique potential to reduce the development of chronic transplant vasculopathy when used with CsA in hypertensive renal transplant recipients.

Effect of Carvedilol Alone or with Cyclosporine on the Proliferation of Rat Vascular Smooth Muscle Cell / 대한이식학회지

PURPOSE: Typical pathologic lesions of chronic allograft rejection or transplant vascular sclerosis are similar to arteriosclerotic vascular lesion of non-transplant patients, or vascular remodeling process after vascular injury. Abnormal and excess proliferation of vascular smooth muscle cells (VSMC) which are triggered by endothelium-derived cytokines or growth factors, play a major role during these process. Effective prophylactic or therapeutic strategies against chronic rejection or transplant vasculopathy is not yet clearly established. Recent in vitro cell culture study showed that carvedilol, a novel antihypertensive agent has the significant inhibitory activities against the proliferation of VSMC. METHODS: Using in vitro VSMC culture techniques, we measured anti-proliferative activity of carvedilol alone, or in combination of cyclosporine, a basic immunosuppressive agent for transplantation. Growth-arrested early passage (3-5) cultured VSMC from the aorta of rat (Sprague-Dawley) were exposed to platelet derived growth factor (PDGF), endothelin-l, or antiotensin-ll, respectively. Carvedilol and/or cyclosporine was added as inhibitors. Proliferation was assessed by incorporated [(3)H]-thymidine activity. RESULTS: PDGF stimulated mitogenesis most effectively. Carvedilol inhibited mitogenesis in dose-dependent manner in the presence of PDGF(10ng/ml). Compared to control, proliferation was significantly decreased to 60.3 (+/-10.4)% and 18.3 (+/- 5.9)% in the presence of 1 micro M and 10 micro M of carvidilol, respectively (p<0.05, each). Carvedilol also produced significant concentration-dependent inhibitory activities against VSMC stimulated by endothelin-1 (10 nM) and angiotensin-II (100 nM). The IC50 of carvedilol in PDGF-, endothelin-l, and angiotensin-ll-stimulated VSMC were 1-10 micro M. Cyclosporine (100 nM) did not show significant inhibition of VSMC regardless of the kinds of cytokines. However, combined addition of carvedilol and cyclosporine produced significant VSMC inhibition. The pattern of inhibition in c very similar with that of carvedilol alone group regardless of the kinds of cytokines. CONCLUSION: We demonstrated that carvedilol significantly inhibited the proliferation of VSMC regardless of the kind of cytokines, and even under the presence of cyclosporine in VSMC cultures. These indicated that carvedilol has the unique potential to reduce the development of transplant vasculopathy when used with cyclosporine in hypertensive renal transplant recipients.