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African Health Sciences ; 22(1): 252-262, March 2022. Tables
Article in English | AIM | ID: biblio-1400550


Background: Epilepsy is associated with stigma and negatively impacts the lives of people living with epilepsy (PLWE) and their immediate families. More understanding of the stigma and discrimination experienced by PLWE in sub-Saharan Africa is needed. Methods: In a cross-sectional, mixed methods study, forty- eight PLWE who met the study inclusion criteria were enrolled. In depth interviews and focus group discussions were conducted and were audiotaped and transcribed verbatim. Analysis was conducted using a thematic, constant comparative approach with an emphasis on dominant themes. Perceived stigma was measured using the Kilifi epilepsy stigma score. Associations between socio-demographic factors and Kilifi epilepsy stigma score were assessed. Results: The median age of the study participants was 25 years, with median age (IQR) of epilepsy onset of 12 (6-18) years. The prevalence of high-perceived stigma was 31.9% (15/48). Seizure frequency was associated with high levels of perceived stigma (p-value of 0.038). Psychological abuse, rejections at home, places of employment and schools, poor relationships and intimacy and unmet engagements in social activities were cited as the perceived stigmatizing aspects among PLWE. Conclusion: In this Ugandan sample perceived stigma remains unacceptably high and interventions to address it are urgently needed in our settings.

Discrimination, Psychological , Epilepsy , Social Stigma , Anthropogenic Effects , Uganda
African Journal of Disability ; 11: 1-11, 2022. Figures
Article in English | AIM | ID: biblio-1397069


Disability, and everything it encompasses, presents major challenges to individuals, families and communities worldwide. Children with disabilities (CWD) are marginalised and excluded in most societies. Discrimination and prejudice towards CWD are compounded by poverty, lack of essential services and support and sometimes a hostile and inaccessible environment. Objectives: The study sought to examine the psychosocial challenges experienced by CWD in the Sekhukhune district of Limpopo province, South Africa. Based on the identified, articulated and expressed challenges, the study sought to recommend improvement of the existing Integrated National Disability Strategy (INDS) for greater responsiveness to the needs of CWD at both provincial and local levels. Method: The interpretivist qualitative mode of enquiry was the chosen methodology for this study. Phenomenology and descriptive research designs guided the study. Purposive sampling was employed, and data were collected from 36 participants using three triangulated methods: individual in-depth interviews, focus group discussions and key informant interviews. Thematic data analysis was used to analyze data. Results: The findings revealed that CWD in Sekhukhune experienced numerous challenges which affected their social functioning, development and general well-being. Aggravating factors included stigma, labelling and discrimination; disability-specific discrimination and bullying; exclusive education; sexual exploitation; lack of governmental support and poor implementation of disability-specific policies, amongst others. Conclusion: The provisions of the INDS to promote inclusion, integration, mainstreaming and equitable access to resources and services remained an ideal rather than a reality for CWD in Sekhukhune.

Developmental Disabilities , Disabled Children , Discrimination, Psychological , Intellectual Disability , Prejudice , South Africa
Psicol. ciênc. prof ; 42(spe): e263525, 2022.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1386991


Este estudo tem como objetivo realizar algumas reflexões sobre as contribuições da(o) psicóloga(o) escolar na educação inclusiva, bem como discutir brevemente acerca das perspectivas futuras da profissão no Brasil. Para tanto, foi realizado um estudo teórico documental de natureza crítico-reflexiva. Foram utilizadas fontes de dados nacionais e internacionais, tais como: livros, artigos de periódicos, páginas eletrônicas, legislações e documentos oficiais. Apresentam-se, neste texto, quatro seções: a) Conhecendo o contexto da educação inclusiva no Brasil: breve percurso histórico e marcos legais; b) Breves reflexões sobre a psicologia escolar e sua interlocução com a educação inclusiva no Brasil; c) Contribuições da(o) psicóloga(o) escolar na educação inclusiva brasileira: dos caminhos trilhados aos desafios; e d) Reflexões finais em torno da atuação da(o) psicóloga(o) escolar na educação inclusiva brasileira: conquistas, desafios e perspectivas futuras. Diante do exposto nessas seções, para que haja escolas inclusivas no país, é necessário confrontar as práticas discriminatórias e criar alternativas que as modifiquem, para que assim a educação inclusiva assuma lugar central nas discussões da comunidade escolar. Para tanto, se reconhece o papel de importância da(o) psicóloga(o) e da escola na superação e modificação da lógica da exclusão. Nessa direção, defende-se que a(o) psicóloga(o) escolar, em sua futura prática profissional, utilize métodos de avaliação para identificar pontos fortes e necessidades das(os) estudantes com deficiência, de maneira que seja possível o desenvolvimento de intervenções, serviços e programas eficazes na promoção de inclusão escolar.(AU)

This study reflects on the contributions brought by the school psychologist to inclusive education, and discuss, albeit briefly, the future prospects of the profession in Brazil. For this purpose, a theoretical-documentary, reflexive-critical study was carried out. Data were collected from national and international sources, such as: books, journal articles, websites, legislation and official documents. This text is divided into four sections: a) The context of inclusive education in Brazil: a brief historical overview and legal milestones; b) Brief reflections on school psychology and its intersection with inclusive education in Brazil; c) Contributions of the school psychologist in Brazilian inclusive education: from the paths taken to the challenges; and d) Final reflections on the performance of the school psychologist in Brazilian inclusive education: achievements, challenges and future prospects. Based on this discussion, inclusive schools can only thrive in the country if we confront discriminatory practices and create alternatives to them, thus placing inclusive education in the center of school community debates. In such a process, the psychologist and the school play an important role in overcoming and changing this logic of exclusion. In this regard, the school psychologist in their future professional practice must use assessment methods to identify the strengths and needs of students with disabilities, so that they can develop effective interventions, services and programs to promote school inclusion.(AU)

Este estudio pretende hacer algunas reflexiones sobre las contribuciones del(la) psicólogo(a) escolar en la educación inclusiva, así como discutir brevemente sobre las perspectivas futuras de la profesión en Brasil. Para ello, se realizó un estudio teórico-documental, de carácter reflexivo-crítico. Se utilizaron fuentes de datos nacionales e internacionales, como libros, artículos de revistas, páginas electrónicas, legislación y documentos oficiales. Este texto está dividido en cuatro secciones: a) Conocer el contexto de la educación inclusiva en Brasil: breve recorrido histórico e hitos legales; b) Breves reflexiones sobre la psicología escolar y su interlocución con la educación inclusiva en Brasil; c) Contribuciones del(la) psicólogo(a) escolar en la educación inclusiva brasileña: de los caminos recorridos a los desafíos; y d) Reflexiones finales en torno a la actuación del(la) psicólogo(a) escolar en la educación inclusiva brasileña: logros, desafíos y perspectivas de futuro. Teniendo en cuenta estos apartados, la existencia de escuelas inclusivas en el país está condicionada al enfrentamiento de las prácticas discriminatorias y la creación de alternativas que las cambien, para que la educación inclusiva ocupe un lugar central en las discusiones de la comunidad escolar. Por ello, se reconoce el importante papel del(la) psicólogo(a) y de la escuela en la superación y cambio de la lógica de la exclusión. En esta dirección, se defiende que del(la) psicólogo(a) escolar en su futura práctica profesional utilice métodos de evaluación para identificar los puntos fuertes y las necesidades de los(las) alumnos(as) con discapacidad, de manera que sea posible el desarrollo de intervenciones.(AU)

Humans , Male , Female , Child, Preschool , Child , Adolescent , Psychological Theory , Psychology , Psychology, Educational , Acting Out , Mainstreaming, Education , Play and Playthings , Professional Practice , Research , Social Isolation , Social Problems , Child , Child Welfare , Public Health , Adolescent , Early Intervention, Educational , Education, Primary and Secondary , Discrimination, Psychological , Education , Empathy , Social Discrimination , Technology Addiction , Human Rights , Learning Disabilities
Rev. bras. educ. méd ; 45(2): e097, 2021. tab, graf
Article in English | LILACS | ID: biblio-1279836


Abstract: Introduction: Mental disorders are accountable for the segregation of patients in many diverse cultures and historical moments worldwide. The evolution of neuroscience, technologies and advances in the psychosocial sphere have not been enough to change this paradigm. Many people still fear having social relations with someone with a psychiatric disorder, despite scientific progress and efforts to reduce prejudice in recent decades. Objective: The aim of this study was to assess the training in mental health during the undergraduate course offered to residents in Internal Medicine and analyze the feelings, perceptions, and stigmas of these physicians regarding the care offered to patients with mental disorders. Method: This study has a qualitative, quantitative approach and descriptive, cross-sectional design. Thirty-two residents in Internal Medicine participated and, for comparison, the questionnaires were also answered by 8 residents in Psychiatry. Two instruments were applied: one for the characterization of the participants' sociodemographic profile and the attribution questionnaire (AQ-26B). Qualitative data were obtained through a focus group with 14 residents and the content analysis was used for categorization. The most frequent categories were illustrated with Pareto charts. Results: The results demonstrated that residents in internal medicine showed higher indexes of stigma regarding aspects such as fear and intolerance. It was also possible to infer gaps related to training in mental health, low perception of care responsibility, in addition to the difficulty in legitimizing complaints and showing negative feelings. Conclusion: One can conclude the need for educational interventions that promote the decrease of the stigma and the search for training regarding comprehensive and empathic care for patients with mental disorders.

Resumo: Introdução: Os transtornos mentais são responsáveis pela segregação de pacientes em diversas culturas e momentos históricos globalmente. A evolução das neurociências, tecnologias e avanços na esfera psicossocial não têm sido suficientes para mudar este paradigma. Muitas pessoas ainda temem ter relações sociais com alguém com transtorno psiquiátrico, apesar dos avanços científicos e dos esforços para reduzir o preconceito nas últimas décadas. Objetivo: Este estudo teve como objetivos avaliar a formação em saúde mental na graduação oferecida a médicos residentes de clínica médica e analisar os sentimentos, as percepções e os estigmas deles ante a assistência a pacientes com transtornos mentais. Método: Trata-se de um estudo com abordagens qualitativas e quantitativas, de natureza descritiva e transversal. Participaram 32 residentes de clínica médica, e, para comparação, os questionários foram respondidos por oito residentes de psiquiatria. Aplicaram-se dois instrumentos: um para a caracterização do perfil sociodemográfico dos participantes e o questionário de atribuição (AQ-26B). Os dados qualitativos foram obtidos por meio de grupo focal com 14 residentes, e empregou-se a análise de conteúdo para categorização. As categorias de maior frequência foram ilustradas com diagramas de Pareto. Resultado: Como os residentes de clínica demonstraram maiores índices de estigma em aspectos como medo e intolerância, intuiu-se que há lacunas na formação em saúde mental, baixa percepção de responsabilidade do cuidado, além de dificuldade em legitimar as queixas e exibir sentimentos negativos. Conclusão: Concluiu-se pela necessidade de intervenções educacionais que fomentem a diminuição do estigma e a busca de capacitação para o cuidado integral e empático de pessoas com transtornos mentais.

Humans , Mental Health/education , Social Stigma , Internship and Residency , Mental Disorders , Socioeconomic Factors , Students, Medical/psychology , Medical Care Statistics , Cross-Sectional Studies , Surveys and Questionnaires , Focus Groups , Discrimination, Psychological , Education, Medical/methods
Rev. colomb. psiquiatr ; 49(3): 216-219, jul.-set. 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1149831


RESUMEN Don Quijote de la Mancha, el pintoresco personaje creado por Miguel de Cervantes Saavedra en su obra inmortal El Ingenioso Hidalgo Don Quijote de la Mancha, presenta varias condiciones neuropsiquiátricas que incluyen tremor, trastornos del sueño, síntomas neuropsiquiátricos, síncope, trastornos de la percepción y traumatismo craneoencefálico. A lo largo de la obra, se presentan episodios en los que se hacen evidentes los diferentes trastornos mencionados. El artículo hace un recuento de ellos a través de la novela y un análisis a la luz de los conocimientos actuales sobre dichas condiciones.

ABSTRACT Don Quixote of La Mancha, the picturesque character created by Miguel de Cervantes Saavedra in his immortal book The Ingenious Nobleman Sir Quixote of La Mancha, presents several neuropsychiatric conditions, including tremor, sleep disturbances, neuropsychiatric symptoms, syncope, perception disorders and traumatic brain injury. Throughout the masterpiece, there are episodes where the aforementioned disorders are evident. This paper makes a list of them and analyses them in the light of the current knowledge of those conditions.

Humans , Perceptual Disorders , Neuropsychiatry , Sleep , Sleep Wake Disorders , Syncope , Discrimination, Psychological
Article in English | WPRIM | ID: wpr-762474


BACKGROUND: The ability of urinary biomarkers to complement established clinical risk prediction models for postoperative adverse kidney events is unclear. We assessed the effect of urinary biomarkers linked to suspected pathogenesis of cardiac surgery-induced acute kidney injury (AKI) on the performance of the Cleveland Score, a risk assessment model for postoperative adverse kidney events. METHODS: This pilot study included 100 patients who underwent open-heart surgery. We determined improvements to the Cleveland Score when adding urinary biomarkers measured using clinical laboratory platforms (neutrophil gelatinase-associated lipocalin [NGAL], interleukin-6) and those in the preclinical stage (hepcidin-25, midkine, alpha-1 microglobulin), all sampled immediately post-surgery. The primary endpoint was major adverse kidney events (MAKE), and the secondary endpoint was AKI. We performed ROC curve analysis, assessed baseline model performance (odds ratios [OR], 95% CI), and carried out statistical reclassification analyses to assess model improvement. RESULTS: NGAL (OR [95% CI] per 20 concentration-units wherever applicable): (1.07 [1.01–1.14]), Interleukin-6 (1.51 [1.01–2.26]), midkine (1.01 [1.00–1.02]), 1-hepcidin-25 (1.08 [1.00–1.17]), and NGAL/hepcidin-ratio (2.91 [1.30–6.49]) were independent predictors of MAKE and AKI (1.38 [1.03–1.85], 1.08 [1.01–1.15], 1.01 [1.00–1.02], 1.09 [1.01–1.18], and 3.45 [1.54–7.72]). Category-free net reclassification improvement identified interleukin-6 as a model-improving biomarker for MAKE and NGAL for AKI. However, only NGAL/hepcidin-25 improved model performance for event- and event-free patients for MAKE and AKI. CONCLUSIONS: NGAL and interleukin-6 measured immediately post cardiac surgery may complement the Cleveland Score. The combination of biomarkers with hepcidin-25 may further improve diagnostic discrimination.

Acute Kidney Injury , Biomarkers , Complement System Proteins , Discrimination, Psychological , Hepcidins , Humans , Interleukin-6 , Kidney , Lipocalins , Pilot Projects , Risk Assessment , ROC Curve , Thoracic Surgery
Yonsei Medical Journal ; : 154-160, 2020.
Article in English | WPRIM | ID: wpr-782196


0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.

Area Under Curve , Blood Transfusion , Calibration , Cesarean Section , Cohort Studies , Discrimination, Psychological , Early Intervention, Educational , Erythrocytes , Female , Humans , Logistic Models , Maternal Age , Nomograms , Placenta Previa , Placenta , Placentation , Postpartum Hemorrhage , Pregnancy , ROC Curve , Ultrasonography
Article in English | WPRIM | ID: wpr-787141


Neuroinflammation is an important process underlying a wide variety of neurodegenerative diseases. Carvacrol (CAR) is a phenolic monoterpene commonly used as a food additive due to its antibacterial properties, but it has also been shown to exhibit strong antioxidative, anti-inflammatory, and neuroprotective effects. Here, we sought to investigate the effects of CAR on inflammation in the hippocampus and prefrontal cortex, as well as the molecular mechanisms underlying these effects. In our study, lipopolysaccharide was injected into the lateral ventricle of rats to induce memory impairment and neuroinflammation. Daily administration of CAR (25, 50, and 100 mg/kg) for 21 days improved recognition, discrimination, and memory impairments relative to untreated controls. CAR administration significantly attenuated expression of several inflammatory factors in the brain, including interleukin-1β, tumor necrosis factor-α, and cyclooxygenase-2. In addition, CAR significantly increased expression of brain-derived neurotrophic factor (BDNF) mRNA, and decreased expression of Toll-like receptor 4 (TLR4) mRNA. Taken together, these results show that CAR can improve memory impairment caused by neuroinflammation. This cognitive enhancement is due to the anti-inflammatory effects of CAR medicated by its regulation of BDNF and TLR4. Thus, CAR has significant potential as an inhibitor of memory degeneration in neurodegenerative diseases.

Animals , Brain , Brain-Derived Neurotrophic Factor , Cyclooxygenase 2 , Cytokines , Discrimination, Psychological , Food Additives , Hippocampus , Inflammation , Lateral Ventricles , Lipopolysaccharides , Memory , Necrosis , Neurodegenerative Diseases , Neuroprotective Agents , Phenol , Prefrontal Cortex , Rats , RNA, Messenger , Toll-Like Receptor 4
Acta colomb. psicol ; 22(1): 52-60, ene.-jun. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-989075


Resumen Seis grupos de estudiantes de preparatoria se expusieron a una tarea de igualación de la muestra de segundo orden y a pruebas de generalización con estímulos familiares y no familiares, así como con una nueva relación de igualación. Para dos grupos, las respuestas de igualación correctas e incorrectas produjeron la retroalimentación correspondiente de acuerdo con un programa continuo y uno intermitente, respectivamente. Las respuestas correctas produjeron retroalimentación y las respuestas incorrectas produjeron pantallas en blanco y viceversa para otros dos grupos, respectivamente. Dos grupos adicionales estuvieron expuestos a combinaciones similares de retroalimentación y pantallas en blanco, pero se instruyó a los participantes sobre el "significado" de las pantallas antes del entrenamiento. Se observó igualación de la muestra generalizada extra-relacional con estímulos familiares o no familiares solo después de las condiciones de entrenamiento en las que se programó retroalimentación intermitente Correcto-Incorrecto, así como cuando las respuestas de igualación incorrectas produjeron pantallas en blanco y las respuestas correctas produjeron la retroalimentación correspondiente. Las instrucciones sobre el significado de las pantallas en blanco produjeron ejecuciones generalizadas ligeramente superiores a las observadas después de la retroalimentación continua Correcto-Incorrecto, las cuales a su vez fueron similares a las ejecuciones observadas después de la condición Correcto-Pantalla en blanco, sin instrucción. Los resultados confirman una tendencia inicial a tratar las pantallas en blanco como retroalimentación para respuestas correctas y sugieren un proceso común de "desligamiento" entre la retroalimentación intermitente y la retroalimentación Incorrecto-Pantalla en blanco.

Resumo Seis grupos de estudantes de vestibular foram expostos a uma tarefa de igualação da amostra de segunda ordem e a testes de generalização com estímulos familiares e não familiares, bem como a uma nova relação de igualação. Para dois grupos, as respostas de igualação corretas e incorretas produziram a retroalimentação correspondente de acordo com um programa contínuo e um intermitente, respectivamente, em que as respostas corretas produziram retroalimentação e as incorretas, ecrãs brancos - e vice-versa para outros dois grupos. Dois grupos adicionais estiveram expostos a combinações semelhantes de retroalimentação e ecrãs brancos, mas foi instruído aos participantes o "significado" das telas antes do treinamento. Foi observada igualação da amostra generalizada extrarrelacional com estímulos familiares e não familiares somente depois das condições de treinamento nas quais foi programada a retroalimentação intermitente Correto-incorreto, bem como quando as respostas de igualação incorretas produziram ecrãs brancos, e quando as respostas corretas produziram a retroalimentação correspondente. As instruções sobre o significado dos ecrãs brancos produziram execuções generalizadas levemente superiores às observadas após a retroalimentação contínua Correto-incorreto, as quais, por sua vez, foram similares às execuções observadas depois da condição Correto-ecrã branco, sem instrução. Os resultados confirmam uma tendência inicial a tratar os ecrãs brancos como retroalimentação para respostas corretas e sugerem um processo comum de "desligamento" entre a retroalimentação intermitente e a retroalimentação Incorreto-ecrã branco.

Abstract Six groups of high-school students were exposed to a second-order matching-to-sample task and generalization tests trials using familiar and unfamiliar stimuli as well as a new matching relation. For two groups correct and incorrect matching responses produced the corresponding feedback according to continuous and intermittent schedules, respectively. Correct responses produced feedback and incorrect responses produced blanks and vice versa for other two groups, respectively. Two additional groups were exposed to similar feedback-blanks combinations but participants were instructed about the "meaning" of blanks before training. Extra-relational generalized matching-to-sample performance with either familiar or unfamiliar stimuli was observed after training conditions in which intermittent right-wrong feedback was scheduled, as well as when incorrect matching responses produced blanks and correct responses produced the corresponding feedback. Instructions about the meaning of blanks produced generalized performances slightly higher to those observed after continuous right-wrong feedback, which in turn were similar to performances observed after the uninstructed right-blank feedback combination condition. Results confirm an initial tendency to treat blanks as if they mean right and suggest a common "detachment" processes between intermittent feedback and the wrong-blanks feedback combination.

Humans , Male , Female , Adolescent , Discrimination, Psychological , Program for Incentives and Benefits , Family Relations
Article in English | WPRIM | ID: wpr-764104


Prostate cancer (CaP) is the most common cancer diagnosed among men in the United States and the fifth most common cancer among men in Korea. Unfortunately, the early stages of CaP may have no symptoms. Thus, early detection is very important and physicians managing voiding dysfunction must have awareness about CaP. The traditional tests used for early detection of CaP are the prostate-specific antigen (PSA) blood test and digital rectal examination. However, a high PSA level is not specific for CaP. Benign prostatic hyperplasia, prostatitis, urinary tract infection, and urinary retention can all cause a high PSA level. Thus, no test shows sufficient accuracy to truly be useful for screening men for CaP. A prostate biopsy is the only method that yields a definitive diagnosis of CaP; however, this test is invasive and uncomfortable. Recently, new biomarkers for CaP detection have been proposed to improve the accuracy of the PSA test. In this review, we summarize our knowledge of various new biomarkers, including PSA-associated biomarkers (the prostate health index and 4Kscore), molecular biomarkers (PCA3, TMPRSS2: ERG fusion gene, and various miRNAs), and proteomics-associated biomarkers, and the ways in which they may improve the detection rate of CaP. Accordingly, this review can raise awareness about CaP to physicians managing voiding dysfunction and be a good reference for them.

Biomarkers , Biopsy , Diagnosis , Digital Rectal Examination , Discrimination, Psychological , Early Detection of Cancer , Hematologic Tests , Humans , Korea , Male , Mass Screening , Methods , Prostate , Prostate-Specific Antigen , Prostatic Hyperplasia , Prostatic Neoplasms , Prostatitis , United States , Urinary Retention , Urinary Tract Infections
Article in Korean | WPRIM | ID: wpr-761581


Estimating the risk of Helicobacter pylori (H. pylori)-induced gastric cancer during endoscopic examination is important. Owing to recent advances in gastrointestinal endoscopy, the gross appearance of the background gastric mucosa has enabled discrimination of subjects with active, chronic, and past H. pylori infection from those with no history of infection. To provide subjective criteria for H. pylori infection-related endoscopic findings with increased risk of gastric cancer, the Kyoto classification of gastritis was proposed at the 85th annual meeting of the Japanese Society for Gastrointestinal Endoscopy in May 2013 in Kyoto. The main contents focus on determining the gastric cancer risk by scoring the endoscopic findings of the background gastric mucosa from 0 to 8. These important findings are not described in the Kyoto Global Consensus Conference proceedings published in English. To better estimate the gastric cancer risk during screening endoscopy in an H. pylori-prevalent population, knowledge of the Japanese version of the Kyoto classification is important. This new classification emphasizes the discrimination of subjects with H. pylori infection by assessing 19 endoscopic findings (presence of atrophy, intestinal metaplasia, diffuse redness, spotty redness, mucosal swelling, enlarged folds, sticky mucus, chicken skin-like nodularity, foveolar-hyperplastic polyp, xanthoma, depressed erosion, regular arrangement of collecting venules, fundic gland polyp, linear red streak, raised erosion, hematin deposit, multiple white and flat-elevated lesions, patchy redness, and map-like redness). In this review, the validity of the Kyoto classification is summarized in conjunction with several suggestions to resolve emerging H. pylori infection-related problems in Korea.

Asians , Atrophy , Chickens , Classification , Consensus , Discrimination, Psychological , Endoscopy , Endoscopy, Gastrointestinal , Gastric Mucosa , Gastritis , Helicobacter pylori , Helicobacter , Hemin , Humans , Korea , Mass Screening , Metaplasia , Mucus , Polyps , Stomach Neoplasms , Venules , Xanthomatosis
Article in Korean | WPRIM | ID: wpr-741216


PURPOSE: This study analyzed a path through which factors influencing death anxiety in the community-dwelling elderly, assuming personal organismic factors and microsystemic factors based on the ecology model purported by Belsky (1980). METHODS: This study was performed with 189 elderly people. Data were collected through a self-report questionnaire. The data were analyzed using the SPSS and AMOS programs. RESULTS: The factors influencing death anxiety in the elderly were depression, family support, social network, and familism value, and the explanatory power of these variables was 22%. Death anxiety increased with higher depression, higher familism value, larger social network, and lower family support. Spiritual well-being and elderly discrimination experience had indirect effects on death anxiety, and these effects were mediated by depression. CONCLUSION: Depression, family support, social network, and familism value were found to influence death anxiety in the elderly, and the strongest effect came from depression. To reduce death anxiety in the elderly, it is important to improve their relationship with their family and friends. Moreover, support should be provided by establishing local systems, and intervention should be provided to alleviate depression.

Aged , Anxiety , Depression , Discrimination, Psychological , Ecology , Friends , Humans
Article in English | WPRIM | ID: wpr-740705


PURPOSE: This study investigated the relationship between the item response time (iRT) and classic item analysis indicators obtained from computer-based test (CBT) results and deduce students' problem-solving behavior using the relationship. METHODS: We retrospectively analyzed the results of the Comprehensive Basic Medical Sciences Examination conducted for 5 years by a CBT system in Dankook University College of Medicine. iRT is defined as the time spent to answer the question. The discrimination index and the difficulty level were used to analyze the items using classical test theory (CTT). The relationship of iRT and the CTT were investigated using a correlation analysis. An analysis of variance was performed to identify the difference between iRT and difficulty level. A regression analysis was conducted to examine the effect of the difficulty index and discrimination index on iRT. RESULTS: iRT increases with increasing difficulty index, and iRT tends to decrease with increasing discrimination index. The students' effort is increased when they solve difficult items but reduced when they are confronted with items with a high discrimination. The students' test effort represented by iRT was properly maintained when the items have a 'desirable' difficulty and a 'good' discrimination. CONCLUSION: The results of our study show that an adequate degree of item difficulty and discrimination is required to increase students' motivation. It might be inferred that with the combination of CTT and iRT, we can gain insights about the quality of the examination and test behaviors of the students, which can provide us with more powerful tools to improve them.

Discrimination, Psychological , Humans , Motivation , Reaction Time , Retrospective Studies
Immune Network ; : e1-2019.
Article in English | WPRIM | ID: wpr-740213


Systemic lupus erythematosus (SLE) is the prototypic systemic autoimmune disease characterized by production of autoantibodies to various nuclear antigens and overexpression of genes regulated by IFN-I called IFN signature. Genetic studies on SLE patients and mutational analyses of mouse models demonstrate crucial roles of nucleic acid (NA) sensors in development of SLE. Although NA sensors are involved in induction of anti-microbial immune responses by recognizing microbial NAs, recognition of self NAs by NA sensors induces production of autoantibodies to NAs in B cells and production of IFN-I in plasmacytoid dendritic cells. Among various NA sensors, the endosomal RNA sensor TLR7 plays an essential role in development of SLE at least in mouse models. CD72 is an inhibitory B cell co-receptor containing an immunoreceptor tyrosine-based inhibition motif (ITIM) in the cytoplasmic region and a C-type lectin like-domain (CTLD) in the extracellular region. CD72 is known to regulate development of SLE because CD72 polymorphisms associate with SLE in both human and mice and CD72−/− mice develop relatively severe lupus-like disease. CD72 specifically recognizes the RNA-containing endogenous TLR7 ligand Sm/RNP by its extracellular CTLD, and inhibits B cell responses to Sm/RNP by ITIM-mediated signal inhibition. These findings indicate that CD72 inhibits development of SLE by suppressing TLR7-dependent B cell response to self NAs. CD72 is thus involved in discrimination of self-NAs from microbial NAs by specifically suppressing autoimmune responses to self-NAs.

Animals , Antigens, Nuclear , Autoantibodies , Autoantigens , Autoimmune Diseases , Autoimmunity , B-Lymphocytes , Cytoplasm , Dendritic Cells , Discrimination, Psychological , Humans , Immunoreceptor Tyrosine-Based Inhibition Motif , Lectins, C-Type , Lupus Erythematosus, Systemic , Mice , RNA
Asian Nursing Research ; : 69-75, 2019.
Article in English | WPRIM | ID: wpr-739595


PURPOSE: The Maternal Role Attainment Scale Form B (MRAS-Form B) was developed based on Mercer's theory and widely used to assess maternal role attainment among Thai mothers in hospitals. To assess the maternal identity among primiparous adolescent mothers in communities, MRAS-Form B remains indistinguishable due to differences in both mothers' ages and circumstances andwas modified to the Maternal Identity Scale (MIS). Therefore, the aim of this study was to examine the validity and reliability of the MIS. METHODS: A cross-sectional study was conducted among 397 primiparous Thai teenagers residing with their infants aged 4−12 months. Data were collected using self-administered questionnaires. Confirmatory factor analysis was performed to confirm the construct validity using Mplus Software. RESULTS: The overall model provided fit well to the empirical data (χ²/df = 2.23, comparative fit index = .93, TuckereLewis index = .92, root mean square error of approximation = .06, standardized root mean square residual = .05). About 33−66% of the variance among MIS items could be explained by three constructs of maternal identity. Convergent validity showed item loadings ranging from .58 to .81; in addition, average variance extracted and composite reliability ranged from .44 to .54 and .82 to .92, respectively. Discriminant validity correlations between constructs were ranging from .74 to .87. The MIS exhibited very good item discrimination values (.52 ≤ corrected item-total correlation ≤.70) and an excellent reliability (Cronbach's α = .95). CONCLUSION: Appropriately for community health nursing, the MIS was a valid and reliable tool, assessing maternal identity among primiparous teenage mothers one year after delivery.

Adolescent , Asians , Community Health Nursing , Cross-Sectional Studies , Discrimination, Psychological , Factor Analysis, Statistical , Humans , Infant , Mothers , Postpartum Period , Reproducibility of Results
Article in English | WPRIM | ID: wpr-739582


PURPOSE: Many patients with cytology proven node-positive breast cancer receive a neoadjuvant chemotherapy (NAC) treatment. We developed a nomogram to predict the breast and axillary pathologic complete responses (pCR) in patients with a cytologically proven axillary node positive breast cancer with NAC. METHODS: We selected 995 patients who were diagnosed with an invasive breast cancer and axillary lymph nodes metastasis, and who were treated with NAC followed by a curative surgery at the Samsung Medical Center between January 2007 and December 2014. The baseline patient and tumor characteristics, chemotherapy regimen, and tumor and nodal responses were thoroughly analyzed and reviewed. A nomogram was developed using a binary logistic regression model with a cross validation. RESULTS: Axillary pCR was achieved in 47.3% and breast pCR was achieved in 24.3% of the patients after NAC. In this case, the both pCR was associated with an initial clinical tumor stage, negative progesterone receptor status, positive human epidermal growth factor receptor 2 status, and clinical radiologic nodal responses. A nomogram was developed based on the clinical and statistically significant predictors. It had good discrimination performance (area under the curve [AUC], 0.868; 95% confidence interval, 0.84–0.89) and calibration fit as noted in that case. The cross validation had an average AUC 0.853 (0.837–0.869). CONCLUSION: Our nomogram might help to predict breast and axillary pCRs after NAC in patients with an initially node-positive breast cancer. Minimal surgery might be acceptable in patients for whom the nomogram indicates a high probability of achieving pCRs.

Area Under Curve , Breast Neoplasms , Breast , Calibration , Discrimination, Psychological , Drug Therapy , Humans , Logistic Models , Lymph Nodes , Neoadjuvant Therapy , Neoplasm Metastasis , Nomograms , Polymerase Chain Reaction , ErbB Receptors , Receptors, Progesterone
Article in English | WPRIM | ID: wpr-739477


BACKGROUND: Biportal endoscopic spine surgery (BESS) is a recent addition to minimally invasive spine surgery treatments. It boasts excellent magnification and fine discrimination of neural structures. Selective decompression with preservation of facet joints for structural stability is also feasible owing to access to the spinal canal and foramen deeper inside. This study has a purpose to investigate clinical benefits of BESS for spinal stenosis in comparison to the other common surgical treatments such as microscopic decompression-only (DO) and fusion and instrumentation (FI). METHODS: From December 2013 to March 2015, 30 cases of DO, 48 cases of FI, and 66 consecutive cases of BESS for lumbar spinal stenosis (LSS) were enrolled to evaluate the relative clinical efficacy of BESS. Visual analog scale (VAS) for back pain and leg pain, postoperative hemoglobin, C-reactive protein (CRP) changes, transfusion, and postoperative complications were examined. RESULTS: All the patients were followed up until 6 months, and 98 patients (86.7%) for 2 years. At the 6-month follow-up, VAS for back pain improved from 6.8 to 2.8, 6.8 to 3.2, and 6.8 to 2.8 (p = 0.078) for BESS, DO, and FI, respectively; VAS for leg pain improved from 6.3 to 2.2, 7.0 to 2.5, and 7.2 to 2.5 (p = 0.291), respectively. Two cases in the BESS group underwent additional foraminal decompression, but no fusion surgery was performed. Postoperative hemoglobin changes for BESS, DO, and FI were −2.5, −2.4, and −1.3 mL, respectively. The BESS group had no transfusion cases, whereas 10 cases (33.3%) in DO and 41 cases (85.4%) in FI had transfusion (p = 0.000). CRP changes for BESS, DO, and FI were 0.32, 6.53, and 6.00, respectively, at day 2 postoperatively (p = 0.000); the complication rate for each group was 8.6% (two dural tears and one root injury), 6.7% (two dural tears), and 8.3% (two dural tears and two wound infections), respectively. CONCLUSIONS: BESS for LSS showed clinical results not inferior to those of the other open surgery methods in the short-term. Stable hemodynamic changes with no need for blood transfusion and minimal changes in CRP were thought to cause less injury to the back muscles with minimal bleeding. Foraminal stenosis decompression should be simultaneously conducted with central decompression to avoid an additional surgery.

Back Muscles , Back Pain , Blood Transfusion , C-Reactive Protein , Constriction, Pathologic , Decompression , Discrimination, Psychological , Endoscopy , Follow-Up Studies , Hemodynamics , Hemorrhage , Humans , Leg , Lumbar Vertebrae , Minimally Invasive Surgical Procedures , Pain, Postoperative , Postoperative Complications , Spinal Canal , Spinal Stenosis , Spine , Tears , Treatment Outcome , Visual Analog Scale , Wounds and Injuries , Zygapophyseal Joint
Article in English | WPRIM | ID: wpr-739111


Various commercial assays have recently been developed for detecting glutamate dehydrogenase (GDH) and/or toxin A/B to diagnose Clostridioides difficile infection (CDI). We compared the performance of two assays for the simultaneous detection of C. difficile GDH and toxin A/B, using 150 stool samples: C. DIFF QUIK CHEK COMPLETE (QCC; TechLab, Blacksburg, VA, USA) and RIDASCREEN Clostridium difficile GDH (RC-GDH) and Toxin A/B (RC-Toxin A/B; R-Biopharm, Darmstadt, Germany). For GDH detection, QCC and RC-GDH showed satisfactory sensitivity (95.7% and 94.3%, respectively) and specificity (92.5% and 93.8%, respectively) compared with C. difficile culture. For toxin A/B detection, QCC showed higher sensitivity than RC-Toxin A/B (60.0% vs 33.3%, P < 0.001) compared with toxigenic C. difficile culture. When the results of QCC or RC-GDH+RC-Toxin A/B were used as the first step of a two-step algorithm for diagnosing CDI, QCC permitted more accurate discrimination than RC of positive or negative results for CDI (77.3% and 65.3%, respectively). QCC is useful for the simultaneous detection of C. difficile GDH and toxin A/B as a part of the two-step algorithm for diagnosing CDI.

Clostridioides difficile , Discrimination, Psychological , Glutamate Dehydrogenase , Glutamic Acid , Sensitivity and Specificity
Article in English | WPRIM | ID: wpr-763582


BACKGROUND: It is difficult for surgeons to reconstruct soft tissue defects of the great toe. This report aims to evaluate the utility and efficacy of innervated distally based first dorsal metatarsal artery (FDMA) flap with a wide pedicle for reconstruction of soft tissue defects of the great toe. METHODS: This is a retrospective report. Between January 2015 and December 2017, six cases of skin defect of the great toe were reconstructed with an innervated distally based FDMA flap with a wide pedicle. One case was excluded in this report because of chronic pain on the metatarsophalangeal joint due to osteoarthritis before the injury. A total of five cases were evaluated for flap survival and sensory recovery. The sensory recovery was investigated by two-point discrimination and Semmes-Weinstein monofilament tests. The average age of the selected patients was 40 years (range, 36 to 56 years), and the average size of the defect in the toe was 8.3 cm2 (range, 4 to 13.8 cm2). The average follow-up period was 29.4 months (range, 18 to 38 months). RESULTS: All patients survived without any complications. The average two-point discrimination test value was 8.0 ± 0.89 mm (range, 7 to 9 mm), and the average value obtained from the Semmes-Weinstein monofilament test was 4.53 ± 0.33 (range, 4.17 to 4.93). The average residual pain score evaluated with a visual analog scale was 1 (range, 0 to 2). Two patients complained of stiffness in the great toe below 30° of total range of motion during the early stages after surgery, but this stiffness gradually improved after rehabilitation. The average range of motion of three patients with a remaining metatarsophalangeal joint after surgery was 80° (range, 70° to 90°). All five cases could walk regularly without any unique footwear at the final follow-up. CONCLUSIONS: The innervated distally based FDMA flap with a wide pedicle could be a good alternative method for repair of soft tissue defects of the great toe.

Arteries , Chronic Pain , Discrimination, Psychological , Follow-Up Studies , Humans , Metatarsal Bones , Metatarsophalangeal Joint , Methods , Osteoarthritis , Perforator Flap , Range of Motion, Articular , Rehabilitation , Retrospective Studies , Skin , Surgeons , Toes , Visual Analog Scale
Article in English | WPRIM | ID: wpr-763540


Corollary discharge mechanism refers to the suppression of sensory consequences of self-generated actions; a process that serves to distinguish between self and non-self based on discrimination of origination of action. It explains, say for example, why we cannot tickle ourselves. This review discusses how corollary discharge model is an essential neural integration mechanism central to the motor functioning of animal kingdom. In this article, research conducted in the field of corollary discharge has been reviewed to understand the neuroanatomical and neurophysiological basis of corollary discharge and gain insight into the biochemical basis of its dysfunction. This review article also explores the role of corollary discharge and its dysfunction in the presentation of symptoms of schizophrenia, discussing the findings from corollary discharge studies on schizophrenia population. Lastly, the link between schizophrenia psychopathology and corollary discharge dysfunction has been highlighted, and an attempt has been made to establish a case for correction of corollary discharge deficit in schizophrenia through neuromodulation.

Animals , Discrimination, Psychological , Hallucinations , Motor Activity , Psychopathology , Schizophrenia , Transcranial Direct Current Stimulation