The Cost Effectiveness of CETA in Kansas

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The Content Analysis of Rorschach in Attesting the Sex Offenders

The Rorschach test is one of the psychological tests widely used in various assessment settings, including in studies related to sexual offenses. However, such research is scarce, although the level of sexual violence in Indonesia increases yearly. Sexual violence is often associated with the sexual drives that humans have in themselves. In this case, Rorschach can provide an overview of the individual's drives, ideas, and social relationships. The current study aims to find the personality profiles of sex offenders. Therefore, this study collected Rorschach data from 46 male sex offenders over 11 years in Depok City, Indonesia. Based on content analysis, this study found several prominent characteristics of sex offenders, such as exhibited difficulties in adaptation due to low intellectual capacity, poor emotional regulation, and empathy that other causes difficulty to build strong relationships with others. They also suppress sexual urges, but they were more likely to express it impulsively with low intellectual capacity and emotional regulation. These various personality characteristics possessed by sex offenders will undoubtedly impact the intervention process they go through to gain insight from their experience. The results are expected to be an input for developing interventions for sex offenders not to repeat their actions in the future

Pelatihan Peningkatan Self-Esteem pada Mahasiswa Universitas Indonesia yang Mengalami Distres Psikologis

Undergraduate students with high levels of self-esteem tend to have good adjustments in lectures. They will have the ability to deal with college problems and automatically reduce their psychological distress. This study used a quasi experimental method which is conducted to determine the increase of self-esteem in students who experience psychological distress. Participants of this study were 8 undergraduate students from Universitas Indonesia aged 18-23 years with a level of self-esteem below the value of 29 as measured by Rosenberg self-esteem scale (RSES), and had a level of psychological distress above the value of 1.75 as measured by HSCL-25. Participants were involved in the intervention of increasing self-esteem consisting of 5 main sessions for two consecutive days (about 6 hours a day). Four weeks after the second day of training, the participant's level of self-esteem and psychological distress were measured. The result of pre and posttest intervention showed that the participant’s mean score of self-esteem increased and the mean score of psychological distress decreased. The result of Wilcoxon test also showed a significant change in both variables (Z RSES = -2.246; Z HSCL-25 = -2.366; p < .05). This study shows that training intervention is effective in increasing the level of self-esteem and reducing the level of psychological distress for undergraduate students at Universitas Indonesia. Participants also commented that they gained new knowledge about self-esteem and new skills to communicate assertively and think positively.Mahasiswa dengan tingkat self-esteem yang tinggi cenderung memiliki penyesuaian yang baik di perkuliahan. Mereka akan memiliki kemampuan untuk menangani masalah kuliah dan secara otomatis mengurangi distres psikologis mereka. Penelitian ini menggunakan metode eksperimental kuasi yang dilakukan untuk mengetahui peningkatan self-esteem pada mahasiswa yang mengalami distres psikologi. Partisipan penelitian ini adalah 8 mahasiswa S1 Universitas Indonesia yang berusia 18-23 tahun dengan tingkat self-esteem di bawah nilai 29 yang diukur dengan Rosenberg self-esteem scale (RSES), dan memiliki tingkat distres psikologi di atas nilai 1.75 yang diukur dengan HSCL-25. Partisipan terlibat dalam intervensi peningkatan self-esteem yang terdiri dari 5 sesi utama selama dua hari berturut-turut (sekitar 6 jam dalam sehari). Empat minggu setelah hari kedua pelatihan, tingkat self-esteem dan distres psikologis responden diukur. Hasil pengukuran sebelum dan sesudah intervensi pelatihan menunjukkan bahwa skor mean self-esteem peserta mengalami peningkatan dan skor mean distres psikologis mengalami penurunan. Hasil uji Wilcoxon juga menunjukkan perubahan yang signifikan pada kedua variabel (Z RSES = -2.246; Z HSCL-25 = -2.366; p < .05). Penelitian ini menunjukkan bahwa intervensi pelatihan efektif dalam meningkatkan self-esteem dan menurunkan distres psikologis bagi mahasiswa S1 Universitas Indonesia. Peserta juga berkomentar bahwa mereka memperoleh pengetahuan baru mengenai self-esteem dan keterampilan baru untuk berkomunikasi secara asertif dan berpikir positif

An innovative technique to improve safety of volatile anesthetics suction from the cardiopulmonary bypass circuit

Context: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB. Aims: The aim of this study is to improve the safe administration of volatile anesthesia during CPB. Settings and Design: Tertiary teaching hospital. Subjects and Methods: We describe an original device that collects and disposes of any volatile anesthetic vapors present in the exit stream of the oxygenator, hence preventing its dispersal into the operating theatre environment and adaptively regulates pressure of oxygenator chamber in the CPB circuit. Results: We have so far applied a prototype of this device in more than 1300 adult cardiac surgery patients who received volatile anesthetics during the CPB phase. Conclusions: Widespread implementation of scavenging system like the one we designed may facilitate the perfusionist and the anesthesiologist in delivering these cardioprotective drugs with beneficial impact on patients' outcome without compromising on safety

Nurses’ behavior regarding pain treatment in an emergency department: A single-center observational study

Purpose: The aim of this prospective study was to assess the behavior of emergency department (ED) nurses with regard to pain and their role in pain management in a real-life clinical setting. Methods: A total of 509 consecutive patients were enrolled during a 6-week period. A case-report form was used to collect data on nurses’ approaches to pain, time to analgesia provision, and patient-perceived quality of analgesia. Results: Triage nurses actively inquired about pain in almost every case, but they did not estimate pain intensity in a third of patients. In the majority of cases, triage nurses did not report pain-related findings to the physician, who was the only professional that could prescribe analgesia to patients. The assignment of the color-coding of triage by nurses appears to be related to the perceived severity of the clinical case and a more comprehensive evaluation of pain. More than half of patients were at least fairly satisfied with analgesia. Conclusion: Pain is increasingly screened during triage, but its comprehensive assessment and management still lack systematic application. We believe that further education and implementation of analgesia protocols may empower nurses to manage ED patients’ pain more effectively and in a more timely manner

Fertility-sparing treatment for endometrial cancer and atypical endometrial hyperplasia in patients with Lynch Syndrome: Molecular diagnosis after immunohistochemistry of MMR proteins

Introduction: Lynch Syndrome (LS) represents the hereditary condition that is most frequently associated with endometrial cancer (EC). The aim of this study is to assess the presence of Lynch Syndrome (LS) in young women with mismatch repair (MMR)-deficient atypical endometrial hyperplasia (AEH) and non-myoinvasive FIGO G1 endometrioid EC and its possible impact on the outcome of conservative treatment. Methods: Six MMR-deficient cases identified from a previous cohort of 69 conservatively treated patients were selected to be screened for germline mutations in MMR genes. In each patient, the outcomes of conservative treatment for AEH and EEC, including response, relapse, progression, and pregnancy, were assessed. Results: Five out of 6 patients underwent genetic test for LS. Three out of these 5 patients showed a positive genetic test. Patient 1 showed the c.942 + 2 T>A heterozygous variant of MSH2 mutation; after 12 months of complete response, she had relapse and progression of disease. Patient 4 showed the c.2459-1G>C variant of MSH2 mutation; after complete response, she failed to achieve pregnancy; she had relapse after 24 months and underwent hysterectomy. Patient 6 showed the c.803 + 1 heterozygous variant of PMS2 mutation; she had relapse of disease after 18 months from the first complete response and then underwent hysterectomy. Conclusions: In this series, 3 out of 6 women with MMR-deficiency had LS. None of the patients achieved pregnancy, and those who responded to treatment had subsequent relapse of disease. Patients undergoing fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer should perform MMR immunohistochemical analysis in order to screen LS

Phylogenetic comparison of huntingtin homologues reveals the appearance of a primitive polyQ in sea urchin

Huntingtin is a completely soluble 3,144 amino acid (aa) protein characterized by the presence of an amino-terminal polymorphic polyglutamine (polyQ) tract, whose aberrant expansion causes the progressively neurodegenerative Huntington's disease (HD). Biological evidence indicates that huntingtin (htt) is beneficial to cells (particularly to brain neurons) and that loss of its neuronal function may contribute to HD. The exact protein domains involved in its neuroprotective function are unknown. Evolutionary analyses of htt primary aa have so far been limited to a few species, but its thorough assessment may help to clarify the functions emerging during evolution. We made an extensive comparative analysis of the available htt protein homologues from different organisms along the metazoan phylogenetic tree and defined the presence of 3 different conservative blocks corresponding to human htt aa 1-386 (htt1), 683-1,586 (htt2), and 2,437-3,078 (htt3), in which HEAT (Huntingtin, Elongator factor3, the regulatory A subunit of protein phosphatase 2A, and TOR1) repeats are well conserved. We also describe the cloning and sequencing of sea urchin htt mRNA, the oldest deuterostome homologue so far available. Multiple alignment shows the first appearance of a primitive polyQ in sea urchin, which predates an ancestral polyQ sequence in a nonchordate environment and defines the polyQ characteristic as being typical of the deuterostome branch. The fact that glutamines have conserved positions in deuterostomes and the polyQ size increases during evolution suggests that the protein has a possibly Q-dependent role. Finally, we report an evident relaxing constraint of the N-terminal block in Ciona and drosophilids that correlates with the absence of polyQ and which may indicate that the N-terminal portion of htt has evolved different functions in Ciona and protostome