Married Korean women's responses to domestic violence within the framework of socio-cultural context

This study was designed to test the psychometric properties of two newly developed instruments (the Korean Women's Abuse Screening Tool and the Korean Women's Abuse Intolerance Scale) and a theoretical model that predicts married Korean women's responses to domestic violence. Severity of abuse, Hwabyung, abuse intolerance, psychological relational power, and socio-structural power were examined in the model. The sample consisted of 184 married Korean women who were 20 years of age or older and self-identified as having been physically, psychologically, sexually, or financially abused by their husbands during their marriages. Subjects were recruited from one of three geographic locations (Seoul, Pusan, and Daejon, South Korea) and four different sites including a psychiatric clinic, shelters, home health care centers and the community. The construct validity of the KWAST and KWAIS was partially supported by R2 (.59) and the value of CFI (.967). Women's abuse intolerance (R2 = .86) was accounted for directly by abuse (r = .18, p < .01), Hwabyung (r = .09), and psychological relational power (r = .77, p < .01), and indirectly by psychological relational power through abuse (r = .62, p < .01), and Hwabyung (r = .07), indicating that younger women with higher levels of psychological relational power had higher levels of abuse intolerance

Avaliação de práticas hospitaleres de lactancia de apoio: uma perspectiva comunitária

Objetivos do estudo: (1)  descrever as práticas de lactância hospitalar de apoio em uma importante região urbana e (2) determinar se as práticas de lactância hospitalar de apoio são influenciadas pelas características hospitalares. Métodos: entre os meses de julho de 2009 e março de 2010 foi realizado um questionário telefônico transversal em todos os hospitais com serviços de maternidade (N = 21) no Condado de Maricopa, Arizona (USA). Este importante condado, que inclui Phoenix, é a quarta maior cidade dos Estados Unidos. As práticas de lactância de apoio eram 12 práticas de cuidados de maternidade congruentes com os Dez Passos e Iniciativas Hospitalares Amigáveis para o Bebê da OMS. As características hospitalares medidas foram as seguintes: serviços de lactância disponíveis, propriedade institucional, número de nascimentos por ano, nascimentos pagos por fundos públicos, e o nível de atenção fornecido. Realizaram-se estatísticas descritivas e inferenciais. Resultados: O número total das práticas de apoio variava de 5 a 10 (M = 7.52; SD = 1.53). Aplicaram-se de forma uniforme duas práticas; o resto variava entre níveis de implementação baixo ( and gt; 25%) e moderado (50-75%). Oitenta e seis por cento dos hospitais utilizam amplamente suplementos e dão sacolas de presente que contêm leite formulado. O número de Consultores de Lactância Certificados (IBCLC pelas siglas em inglês) empregados por um hospital foi a única variável que predizia maiores níveis de práticas de apoio. O estado de propriedade da instalação estava amplamente relacionado com o número de IBCLC. Discussão: As diferenças nas práticas hospitalares de apoio entre hospitais sugerem a efetividades do IBCLC quanto à mudança de práticas; contudo, é preciso fazer outras pesquisar para explorar ainda mais esta tese. Os achados deste estudo, únicos para a comunidade estudada, eram congruentes com vários dos achados mostrados por pesquisadores no mundo inteiro.Objetivos del estudio: (1) describir las prácticas de lactancia hospitalaria de apoyo en una gran región urbana y (2) determinar si las prácticas de lactancia hospitalaria de apoyo están bajo la influencia de características hospitalarias. Métodos: entre los meses de julio de 2009 y marzo de 2010 se realizó una encuesta telefónica transversal en todos los hospitales con servicios de maternidad (N = 21) en el Condado de Maricopa, Arizona (USA). Este gran condado urbano, que incluye Phoenix, es la cuarta ciudad más grande de Estados Unidos. Las prácticas de lactancia de apoyo se refirieron a 12 prácticas de cuidados de maternidad acordes con los Diez Pasos e Iniciativas Hospitalarias Amigables para el Bebé de la OMS. Las características hospitalarias medidas fueron: servicios de lactancia disponibles, propiedad institucional, número de nacimiento al año, nacimientos pagados por fondos públicos, y el nivel de atención suministrado. Se realizaron estadísticas descriptivas e inferenciales. Resultados: El número total de las prácticas de apoyo variaba de 5 a 10 (M = 7.52; SD = 1.53). Se aplicaron de forma uniforme dos prácticas; el resto variaba entre niveles de implementación bajo ( and gt; 25%) y moderado (50-75%). Ochenta y seis por ciento de los hospitales utilizan ampliamente suplementos y dan bolsas de regalo con leche de fórmula. El número de de Consultores de Lactancia Certificados (IBCLC por sus siglas en inglés) empleados por un hospital fue la única variable que predecía mayores niveles de prácticas de apoyo. El estatus de propiedad de la instalación estaba ampliamente relacionado con el número de IBCLC. Discusión: Las diferencias en las prácticas hospitalarias de apoyo entre hospitales sugieren la efectividad del IBCLC en cuanto al cambio de prácticas; sin embargo, se necesita investigación adicional para explorar aún más esta tesis. Los hallazgos de este estudio, únicos para la comunidad estudiada, eran consistentes con varios de los hallazgos reportados por investigadores en todo el mundo.Study objectives: (1) describe the existing supportive hospital breastfeeding practices in a major urban region and (2) determine if supportive hospital breastfeeding practices are influenced by hospital characteristics. Methods: A cross-sectional telephone survey of all hospitals with maternity services (N = 21) in Maricopa County, Arizona (USA), was conducted between July 2009 and March 2010. This major urban county, which includes Phoenix, is the fourth largest city in the USA. Supportive breastfeeding practices were 12 maternity care practices consistent with WHO Baby Friendly Hospital Initiative Ten Steps. Hospital characteristics measured were professional breastfeeding services available, institutional ownership, number of births per year, births paid for by public funds, and the level of care provided. Descriptive and inferential statistics were conducted. Results: The total number of supportive practices ranged from 5 to 10 (M = 7.52; SD = 1.53). Two practices were uniformly implemented; the remainder varied from low ( and gt; 25%) to moderate (50-75%) levels of implementation. 86% of hospitals had widespread use of supplements and provided gift bags containing formula. The number of Board Certified Lactation Consultants (IBCLCs) employed by a hospital was the only variable predicting higher levels of supportive practices. Facility ownership status was significantly correlated with the number of IBCLCs. Discussion: The differences in supportive hospital practices among hospitals suggest the effectiveness of IBCLCs in changing practice; however, additional research is needed to further explore this thesis. Findings of this study, while unique to the community studied, were consistent with a number of findings reported by researchers around the globe

Evaluation of supportive breastfeeding hospital practices: a community perspective Evaluación de prácticas hospitalarias de lactancia: una perspectiva comunitaria Avaliação de práticas hospitaleres de lactancia de apoio: uma perspectiva comunitária

Study objectives: (1) describe the existing supportive hospital breastfeeding practices in a major urban region and (2) determine if supportive hospital breastfeeding practices are influenced by hospital characteristics. Methods: A cross-sectional telephone survey of all hospitals with maternity services (N = 21) in Maricopa County, Arizona (USA), was conducted between July 2009 and March 2010. This major urban county, which includes Phoenix, is the fourth largest city in the USA. Supportive breastfeeding practices were 12 maternity care practices consistent with WHO Baby Friendly Hospital Initiative Ten Steps. Hospital characteristics measured were professional breastfeeding services available, institutional ownership, number of births per year, births paid for by public funds, and the level of care provided. Descriptive and inferential statistics were conducted. Results: The total number of supportive practices ranged from 5 to 10 (M = 7.52; SD = 1.53). Two practices were uniformly implemented; the remainder varied from low (> 25%) to moderate (50-75%) levels of implementation. 86% of hospitals had widespread use of supplements and provided gift bags containing formula. The number of Board Certified Lactation Consultants (IBCLCs) employed by a hospital was the only variable predicting higher levels of supportive practices. Facility ownership status was significantly correlated with the number of IBCLCs. Discussion: The differences in supportive hospital practices among hospitals suggest the effectiveness of IBCLCs in changing practice; however, additional research is needed to further explore this thesis. Findings of this study, while unique to the community studied, were consistent with a number of findings reported by researchers around the globe.<br>Objetivos del estudio: (1) describir las prácticas de lactancia hospitalaria de apoyo en una gran región urbana y (2) determinar si las prácticas de lactancia hospitalaria de apoyo están bajo la influencia de características hospitalarias. Métodos: entre los meses de julio de 2009 y marzo de 2010 se realizó una encuesta telefónica transversal en todos los hospitales con servicios de maternidad (N = 21) en el Condado de Maricopa, Arizona (USA). Este gran condado urbano, que incluye Phoenix, es la cuarta ciudad más grande de Estados Unidos. Las prácticas de lactancia de apoyo se refirieron a 12 prácticas de cuidados de maternidad acordes con los Diez Pasos e Iniciativas Hospitalarias Amigables para el Bebé de la OMS. Las características hospitalarias medidas fueron: servicios de lactancia disponibles, propiedad institucional, número de nacimiento al año, nacimientos pagados por fondos públicos, y el nivel de atención suministrado. Se realizaron estadísticas descriptivas e inferenciales. Resultados: El número total de las prácticas de apoyo variaba de 5 a 10 (M = 7.52; SD = 1.53). Se aplicaron de forma uniforme dos prácticas; el resto variaba entre niveles de implementación bajo (> 25%) y moderado (50-75%). Ochenta y seis por ciento de los hospitales utilizan ampliamente suplementos y dan bolsas de regalo con leche de fórmula. El número de de Consultores de Lactancia Certificados (IBCLC por sus siglas en inglés) empleados por un hospital fue la única variable que predecía mayores niveles de prácticas de apoyo. El estatus de propiedad de la instalación estaba ampliamente relacionado con el número de IBCLC. Discusión: Las diferencias en las prácticas hospitalarias de apoyo entre hospitales sugieren la efectividad del IBCLC en cuanto al cambio de prácticas; sin embargo, se necesita investigación adicional para explorar aún más esta tesis. Los hallazgos de este estudio, únicos para la comunidad estudiada, eran consistentes con varios de los hallazgos reportados por investigadores en todo el mundo.<br>Objetivos do estudo: (1) descrever as práticas de lactância hospitalar de apoio em uma importante região urbana e (2) determinar se as práticas de lactância hospitalar de apoio são influenciadas pelas características hospitalares. Métodos: entre os meses de julho de 2009 e março de 2010 foi realizado um questionário telefônico transversal em todos os hospitais com serviços de maternidade (N = 21) no Condado de Maricopa, Arizona (USA). Este importante condado, que inclui Phoenix, é a quarta maior cidade dos Estados Unidos. As práticas de lactância de apoio eram 12 práticas de cuidados de maternidade congruentes com os Dez Passos e Iniciativas Hospitalares Amigáveis para o Bebê da OMS. As características hospitalares medidas foram as seguintes: serviços de lactância disponíveis, propriedade institucional, número de nascimentos por ano, nascimentos pagos por fundos públicos, e o nível de atenção fornecido. Realizaram-se estatísticas descritivas e inferenciais. Resultados: O número total das práticas de apoio variava de 5 a 10 (M = 7.52; SD = 1.53). Aplicaram-se de forma uniforme duas práticas; o resto variava entre níveis de implementação baixo (> 25%) e moderado (50-75%). Oitenta e seis por cento dos hospitais utilizam amplamente suplementos e dão sacolas de presente que contêm leite formulado. O número de Consultores de Lactância Certificados (IBCLC pelas siglas em inglês) empregados por um hospital foi a única variável que predizia maiores níveis de práticas de apoio. O estado de propriedade da instalação estava amplamente relacionado com o número de IBCLC. Discussão: As diferenças nas práticas hospitalares de apoio entre hospitais sugerem a efetividades do IBCLC quanto à mudança de práticas; contudo, é preciso fazer outras pesquisar para explorar ainda mais esta tese. Os achados deste estudo, únicos para a comunidade estudada, eram congruentes com vários dos achados mostrados por pesquisadores no mundo inteiro

Predictors of intermediate-term survival with destination locoregional therapy of hepatocellular cancer in patients either ineligible or unwilling for liver transplantation

Intra-arterial or percutaneous locoregional therapies (LRT) are often employed to maintain potential liver transplant (LT) recipients with hepatocellular carcinoma (HCC) within T2/Milan criteria. Predictors of survival when LRT is used as destination therapy in those who are either ineligible or unwilling for LT remain poorly defined. We evaluated predictors of 3-year survival with destination LRT in a population of cirrhotic patients diagnosed with HCC, presenting within T2 criteria, and either ineligible or unwilling for LT. The cohort surviving 3 years had a significantly lower model for end-stage liver disease (MELD) score at HCC diagnosis (9.7 vs. 11.4, P= 0.037) and MELD following initial locoregional therapy (10.7 vs. 13.3, P= 0.008) compared to those not surviving three years despite similar demographic, tumor, and treatment variables. LRT as destination therapy results in modest intermediate term survival, with liver function at presentation and immediately following initiation of LRT predicting intermediate survival with this approach.Open Access JournalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Predictors of intermediate-term survival with destination locoregional therapy of hepatocellular cancer in patients either ineligible or unwilling for liver transplantation

Intra-arterial or percutaneous locoregional therapies (LRT) are often employed to maintain potential liver transplant (LT) recipients with hepatocellular carcinoma (HCC) within T2/Milan criteria. Predictors of survival when LRT is used as destination therapy in those who are either ineligible or unwilling for LT remain poorly defined. We evaluated predictors of 3-year survival with destination LRT in a population of cirrhotic patients diagnosed with HCC, presenting within T2 criteria, and either ineligible or unwilling for LT. The cohort surviving 3 years had a significantly lower model for end-stage liver disease (MELD) score at HCC diagnosis (9.7 vs. 11.4, P= 0.037) and MELD following initial locoregional therapy (10.7 vs. 13.3, P= 0.008) compared to those not surviving three years despite similar demographic, tumor, and treatment variables. LRT as destination therapy results in modest intermediate term survival, with liver function at presentation and immediately following initiation of LRT predicting intermediate survival with this approach.Open Access JournalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Lymphovascular invasion on explant is associated with presenting tumor characteristics and not direct acting antiviral utilization in hepatitis C candidates undergoing liver transplantation

Aim of the study: Utilization of direct acting antiviral (DAA) therapy in candidates with well-compensated hepatitis C virus (HCV) cirrhosis and hepatocellular carcinoma (HCC) accruing end stage liver disease (MELD) exception points is highly variable among transplant centers based on center location, local organ procurement dynamics, HCV(+) organ availability, and patient preference. The association between DAA utilization prior to transplant and incidence of lymphovascular invasion on explant is unknown. Material and methods: Retrospective evaluation from 2013-2017 of patients on a liver transplant (LT) waitlist with HCV-related cirrhosis, MELD-Na 250 ng/ml (p = 0.003) and multifocal HCC (> 1 lesion) (p = 0.006) were associated with lymphovascular invasion on explant while DAA therapy was not (p = 0.578). Conclusions: DAA therapy for waitlist active HCV candidates accruing MELD exception points has no deleterious effects on bridging LRT, nor is it associated with increased frequency of lymphovascular invasion on explant. The latter appears driven by tumor related characteristics (AFP and number of lesions) irrespective of DAA utilization prior to LT.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Pretransplant Factors and Associations with Postoperative Respiratory Failure, ICU Length of Stay, and Short-Term Survival after Liver Transplantation in a High MELD Population

Changes in distribution policies have increased median MELD at transplant with recipients requiring increasing intensive care perioperatively. We aimed to evaluate association of preoperative variables with postoperative respiratory failure (PRF)/increased intensive care unit length of stay (ICU LOS)/short-term survival in a high MELD cohort undergoing liver transplant (LT). Retrospective analysis identified cases of PRF and increased ICU LOS with recipient, donor, and surgical variables examined. Variables were entered into regression with end points of PRF and ICU LOS > 3 days. 164 recipients were examined: 41 (25.0%) experienced PRF and 74 (45.1%) prolonged ICU LOS. Significant predictors of PRF with univariate analysis: BMI > 30, pretransplant MELD, preoperative respiratory failure, LVEF 6 units, warm ischemic time > 4 minutes, and cold ischemic time > 240 minutes. On multivariate analysis, only pretransplant MELD predicted PRF (OR 1.14, p = 0.01 ). Significant predictors of prolonged ICU LOS with univariate analysis are as follows: pretransplant MELD, FVC 240 minutes. On multivariate analysis, only pretransplant MELD predicted prolonged ICU LOS (OR 1.28, p < 0.001 ). One-year survival among cohorts with PRF and increased ICU LOS was similar to subjects without. Pretransplant MELD is a robust predictor of PRF and ICU LOS. Higher MELDs at LT are expected to increase need for ICU utilization and modify expectations for recovery in the immediate postoperative period.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Genotype specific peripheral lipid profile changes with hepatitis C therapy

AIM To evaluate magnitude/direction of changes in peripheral lipid profiles in patients undergoing direct acting therapy for hepatitis C by genotype. METHODS Mono-infected patients with hepatitis C were treated with guideline-based DAAs at a university-based liver clinic. Patient characteristics and laboratory values were collected before and after the treatment period. Baseline demographics included age, ethnicity, hypertension, diabetes, hyperlipidemia, treatment regimen, and fibrosis stage. Total cholesterol (TCHOL), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TG), and liver function tests were measured prior to treatment and ETR. Changes in lipid and liver function were evaluated by subgroups with respect to genotype. Mean differences were calculated for each lipid profile and liver function component (direction/magnitude). The mean differences in lipid profiles were then compared between genotypes for differences in direction/magnitude. Lipid profile and liver function changes were evaluated with Levene's test and student's t test. Mean differences in lipid profiles were compared between genotypes using ANOVA, post hoc analysis via the Bonferroni correction or Dunnett T3. RESULTS Three hundred and seventy five patients enrolled with 321 (85.6%) achieving sustained-viral response at 12 wk. 72.3% were genotype 1 (GT1), 18.1% genotype 2 (GT2), 9.7% genotype 3 (GT3). Baseline demographics were similar. Significant change in lipid profiles were seen with GT1 and GT3 (Delta GT1, p and Delta GT3, p), with TCHOL increasing (+ 5.3, P = 0.005 and + 16.1, P < 0.001), HDL increasing (+ 12.5, P < 0.001 and + 7.9, P = 0.038), LDL increasing (+ 7.4, P = 0.058 and + 12.5, P < 0.001), and TG decreasing (-5.9, P = 0.044 and -9.80 P = 0.067). Among genotypes (Delta GT1 v.Delta GT2 v.Delta GT3, ANOVA), significant mean differences were seen with TCHOL (+ 5.3 v. + 0.1 v. + 16.1, P = 0.017) and HDL (+ 12.3 v. + 2 v. + 7.9, P = 0.040). Post-hoc, GT3 was associated with a greater increase in TCHOL than GT1 and GT2 (P = 0.028 and P = 0.019). CONCLUSION Successful DAA therapy results in increases in TCHOL, LDL, and HDL and decrease in TG, particularly in GT1/ GT3. Changes are most pronounced in GT3.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]