Family Relationships and Depression among Elderly Korean Immigrants

The purposes of the study were to describe family relationships within the context of living arrangements (living with adult children or without adult children) and support network, and to further determine associations of these factors to depression in elderly Korean immigrants. Over 70% (N = 160) of Korean elders were found to live apart from their adult children. However, Korean elders who were living independently reported higher levels of depression in spite of their expressed desire to live independently and to be less dependent upon their adult children. These findings suggest that family support and close relationships with their adult children play a central role in adjusting to a new life and in preventing and/or lessening depression in elderly Korean immigrants

Racial Microaggressions within the Field of Nursing

Racial microaggressions (RM) have transitioned into a subtle form of contemporary racism and are potentially involved within our communication as healthcare providers. Though cultural competency is addressed within nursing education, this RM phenomenon continues to happen in everyday discourse and can occur with little or no awareness on the part of Caucasians. The aim of this study was to gain a better understanding of how RMs against African Americans exist within the field of nursing and how their underlying discrimination increases the marginalization of this community. A detailed search was conducted using CINAHL, PsycInfo and ProQuest databases using the keywords: racial microaggressions, subtle racism, African Americans, nursing, health disparities, health outcomes, healthcare, cultural competency. Peer-reviewed studies written in English and published between 2008 to 2017 were considered. This review discusses the chronic presence of RMs against the African American population and identified the defining characteristics of RM within the nursing literature. Their effect on the marginalization of this community was organized into two major pathways of stress suffered by the individual: psychological stress and biological stress. RMs within an institutionalized healthcare system were associated with decreased level of care and ultimately contribute to the ongoing health disparities suffered on the part by the African American population

Evaluation of Health Literacy and Depression Literacy Among Korean Americans

Low health literacy is closely related to a higher rate of hospitalization and of emergency services usage, leading to billions of dollars in avoidable health care costs and contributing to individuals’ poor physical and mental health. While Korean Americans (KAs) have a high prevalence of general health and mental health problems, relatively little is known about their health and mental health literacy, specifically their depression literacy. This study aims to evaluate KAs’ health literacy and depression literacy, as related to sociodemographic characteristics. An exploratory study was conducted with 681 community-residing adult KAs using the Center for Epidemiologic Studies Depression (CES-D) Scale, the Depression Literacy Questionnaire (D-Lit), and the One-Question Health Literacy Scale. Data analyses were performed using one-way analysis of variance and ordinal logistic regression of health literacy, a multiple linear regression model of depression literacy. Findings indicate a positive correlation between depression literacy and health literacy. Health literacy was also significantly related to religion, English language proficiency, income, education, and perceived physical health. Additionally, depression literacy was significantly related to age, Korean language preference over English, and education. Health literacy and depression literacy education are warranted to address low health literacy and depression literacy among KAs to reduce their health and mental health disparities

Depression, Depression Literacy, and Sociodemographic Characteristics of Korean Americans: A Preliminary Investigation

Despite the rapid growth in the number of Korean Americans (KAs) and the alarmingly high prevalence of depression in this population, relatively little is known about the impact of depression literacy on KAs’ depression. This study investigated the prevalence of depressive symptoms among a community-based sample of KA adults; the associations among socio-demographic characteristics, depression literacy, and depressive symptoms; and predictors related to depressive symptoms. A sample of 600 KAs completed depression and depression literacy scales, as well as socio-demographic questionnaires. Data analyses were conducted to assess the association between depressive symptoms, depression literacy, and the covariates. Forty-five percent of participants showed elevated depressive symptoms. Marital status attained educational level, perceived mental health, and depression literacy were significant predictors of depressive symptoms. Given the high prevalence of depressive symptoms in this population, future research should investigate the causal relationships of various predictors of depression and depression literacy, which will facilitate the development of culturally-appropriate interventions and policies concerning mental health for KAs, and early mental health screening for them

Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit

<p>Abstract</p> <p>Background</p> <p>Epidemic outbreaks of multi-drug resistant (MDR) <it>Acinetobacter baumannii </it>(AB) in intensive care units (ICUs) are increasing. The incidence of MDR AB bacteremia, which develops as a result of colonization, is increasing through widespread dissemination of the pathogen, and further colonization. We sought to determine risk factors for MDR AB bacteremia in patients colonized with MDR AB in the ICU.</p> <p>Methods</p> <p>We conducted a retrospective, observational study of 200 patients colonized with MDR AB in the ICU at Severance Hospital, South Korea during the outbreak period between January 2008 and December 2009.</p> <p>Results</p> <p>Of the 200 patients colonized with MDR AB, 108 developed MDR AB bacteremia, and 92 did not. APACHE II scores were higher in bacteremic than non-bacteremic patients at the time of ICU admission and colonization (24.0 vs. 21.6; <it>P </it>= 0.035, 22.9 vs. 16.8; <it>P </it>< 0.001, respectively). There was no difference between the two groups in the duration of time from ICU admission to colonization (7.1 vs. 7.2 days; <it>P </it>= 0.923), but the duration of time at risk was shorter in bacteremic patients (12.1 vs. 6.0 days; <it>P </it>= 0.016). A recent invasive procedure was a significant risk factor for development of bacteremia (odds ratio = 3.85; 95% CI 1.45-10.24; <it>P </it>= 0.007). Multivariate analysis indicated infection and respiratory failure at the time of ICU admission, maintenance of mechanical ventilation, maintenance of endotracheal tube instead of switching to a tracheostomy, recent central venous catheter insertion, bacteremia caused by other microorganism after colonization by MDR AB, and prior antimicrobial therapy, were significant risk factors for MDR AB bacteremia.</p> <p>Conclusions</p> <p>Patients in the ICU, colonized with MDR AB, should be considered for minimizing invasive procedures and early removal of the invasive devices to prevent development of MDR AB bacteremia.</p

Successful side-viewing endoscopic hemoclipping for Dieulafoy-like lesion at the brim of a periampullary diverticulum

<p>Abstract</p> <p>Background</p> <p>Duodenal Dieulafoy's lesions are rare and only several cases were reported so far. Their characteristic appearance and location make it difficult to be diagnosed in the clinical practice. Massive bleeding often results from these lesions and can impede the accurate early treatment.</p> <p>Case presentation</p> <p>67 years old male patient suffered a fatal bleeding from Dieulafoy-like lesion located at the mouth of the periampullary diverticulum. Inintial endoscopic therapy and radiologic embolization failed to stop the bleeding, while direct observation and hemoclipping by the side viewing endoscopy successfully established correct diagnosis and permanent cure of the lesion.</p> <p>Conclusion</p> <p>Aggressive endoscopic examinations combined with the accurate endoscopic threatment should be adopted when Dieulafoy-like lesion is suspected as a possible cause of the proximal small bowel hemorrahge. Verification of the diagnosis and definitive treatment often needed repeated examination by side-viewing endoscope as well as stabilization of the patient.</p

'Big Tigers, Big Data:' Learning Social Reactions to China’s Anticorruption Campaign through Online Feedback

This study examines the effect of campaign-style anticorruption on political support using the case of China’s most recent anticorruption drive, which stands out for its harsh crackdown on high-ranking officials, or the “big tigers.” An exploratory text analysis of over 370,000 online comments on the downfall of the first 100 big tigers, from 2012 to 2015, reveals that public support for the top national leader who initiated the campaign significantly exceeds that afforded to anticorruption agencies and institutions. Further regression analyses show that support for the leaders vis-à-vis intuitions increases with the tigers’ party ranking. Findings suggest that while campaign-style enforcement can reinforce the central authority and magnify support for individual leaders, it may also marginalize the role of legal institutions crucial to long-term corruption control.published_or_final_versio

The Epstein-Barr Virus G-Protein-Coupled Receptor Contributes to Immune Evasion by Targeting MHC Class I Molecules for Degradation

Epstein-Barr virus (EBV) is a human herpesvirus that persists as a largely subclinical infection in the vast majority of adults worldwide. Recent evidence indicates that an important component of the persistence strategy involves active interference with the MHC class I antigen processing pathway during the lytic replication cycle. We have now identified a novel role for the lytic cycle gene, BILF1, which encodes a glycoprotein with the properties of a constitutive signaling G-protein-coupled receptor (GPCR). BILF1 reduced the levels of MHC class I at the cell surface and inhibited CD8+ T cell recognition of endogenous target antigens. The underlying mechanism involves physical association of BILF1 with MHC class I molecules, an increased turnover from the cell surface, and enhanced degradation via lysosomal proteases. The BILF1 protein of the closely related CeHV15 c1-herpesvirus of the Rhesus Old World primate (80% amino acid sequence identity) downregulated surface MHC class I similarly to EBV BILF1. Amongst the human herpesviruses, the GPCR encoded by the ORF74 of the KSHV c2-herpesvirus is most closely related to EBV BILF1 (15% amino acid sequence identity) but did not affect levels of surface MHC class I. An engineered mutant of BILF1 that was unable to activate G protein signaling pathways retained the ability to downregulate MHC class I, indicating that the immune-modulating and GPCR-signaling properties are two distinct functions of BILF1. These findings extend our understanding of the normal biology of an important human pathogen. The discovery of a third EBV lytic cycle gene that cooperates to interfere with MHC class I antigen processing underscores the importance of the need for EBV to be able to evade CD8+ T cell responses during the lytic replication cycle, at a time when such a large number of potential viral targets are expressed