Etiologies underlying sex bias in autism spectrum disorder: a narrative review of preclinical rodent models / 이화의대지

Neurodevelopmental disorders, which emerge early in development, include a range of neurological phenotypes and exhibit marked differences in prevalence between sexes. A male predominance is particularly pronounced in autism spectrum disorder (ASD). Although the precise cause of ASD is still unknown, certain genetic variations and environmental influences have been implicated as risk factors.Preclinical ASD models have been instrumental in shedding light on the mechanisms behind the sexual dimorphism observed in this disorder. In this review, we explore the potential processes contributing to sex bias by examining both intrinsic differences in neuronal mechanisms and the influence of external factors. We organize these mechanisms into six categories: 1) sexually dimorphic phenotypes in mice with mutations in ASD-associated genes related to synaptic dysfunction; 2) sex-specific microglial activity, which may disrupt neural circuit development by excessively pruning synapses during critical periods; 3) sex steroid hormones, such as testosterone and allopregnanolone, that differentially influence brain structure and function; 4) escape from X chromosome inactivation of the O-linked-Nacetylglucosamine transferase gene in the placenta; 5) sexually dimorphic activation of the integrated stress response pathway following maternal immune activation; and 6) immunological responses that are differentially regulated by sex. Understanding these mechanisms is essential for deciphering the underlying causes of ASD and may offer insights into other disorders with notable sex disparities.

Reliability and Validity of an Instrument Assessing Advance Directives for Nurse / 한국호스피스완화의료학회지

PURPOSE: This methodological study was conducted to test the reliability and validity of an instrument that measures attitudes of advance directives (ADs) among nurses. METHODS: 1) Sixteen items related to attitudes in the English version of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) were forward/backward translated into Korean. 2) The content was validated by an expert panel (three nursing professors and eight hospice nursing specialists). 3) The preliminary 12 items were selected as a tool to assess the Korean version of Nurses' Attitudes towards Advance Directives (NAAD-K). 4) The instrument was validated by a survey (n=216). 5) It was confirmed to use the 12 items for the final version of the instrument. RESULTS: NAAD-K was shown to be valid in terms of factors, items and content. The three factors extracted from the factor analysis were named as follows: Caring for patients with an AD (factor 1), nurses' role in informing patients (factor 2) and patient right (factor 3). The three factors explained total variance 57.796%. Factor loadings of the 12 items ranged from 0.47 to 0.93. For the 12 items, Cronbach's alpha was 0.81, and Guttman split-half coefficient was 0.78. CONCLUSION: This instrument was identified to be applicable with satisfactory reliability and validity for further use in measuring nurses' attitudes towards ADs in hospice and palliative care.

An Ethnography on the Healthy Life of the Aged Women Participating the Senior Centers

PURPOSE: This ethnography was performed to explore patterns and meanings of healthy life among aged women using senior centers. METHODS: The informants were 21 individuals aged 65 years and older at 2 community-based senior centers. Data were collected from iterative fieldwork through in-depth interviews and participant observations and analyzed using text analysis and taxonomic methods developed by Spradley. Field notes were used with follow-up interviews and dialogue between authors to enhance interpretation. RESULTS: Patterns of healthy life among aged women using senior centers were categorized by age groups within the context of the four cultural elements of taking care of the body, relationality, temporality, and spatiality: active and passive control, maintenance of interdependence and individuality, expansion and maintenance of the daily routine, unity of peer relations and sustenance of family relations, spending time productively and tediously, and complementary and alternative space of the family relations. CONCLUSION: The informants in this study demonstrated healthy life by maintaining and strengthening continuous relationships developed in the senior centers without being isolated from the family and society. Patterns of their healthy life differed across age groups within the socio-cultural context. Therefore, interventions should be tailored to address age groups and community needs.