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Mental illnesses constitute a large and escalating portion of the global burden of disease, particularly in low- and middle-income countries like Uganda. Understanding community perceptions towards mental illness is crucial for developing effective interventions.
Aims
To explore beliefs about the perceived causes and treatment of common mental illnesses (depression, anxiety, alcohol use disorder) and suicidality in rural eastern Uganda.
Method
Qualitative study using 31 in-depth interviews and 4 focus group discussions with healthcare workers, community health workers, community leaders and general community members in Buyende District, Uganda. Vignettes were used to depict mental illnesses to elicit perceptions, and data were analysed using the framework method.
Results
Two main themes emerged: perceived causes and treatment of mental illness. Participants identified three primary perceived causes: psychosocial (predominantly financial stress), biological and supernatural. Community support was most frequently endorsed as a perceived effective treatment, followed by biomedical interventions and alternative therapies.
Conclusions
This study identifies common beliefs regarding the causes and perceptions of mental illness in rural Uganda. The predominant focus on financial stressors as a cause of mental illness, coupled with strong emphasis and belief in the effectiveness of community-based support as treatment, highlights the need for context-specific mental health interventions.
Depression is a complex mental health disorder with highly heterogeneous symptoms that vary significantly across individuals, influenced by various factors, including sex and regional contexts. Network analysis is an analytical method that provides a robust framework for evaluating the heterogeneity of depressive symptoms and identifying their potential clinical implications.
Objective:
To investigate sex-specific differences in the network structures of depressive symptoms in Asian patients diagnosed with depressive disorders, using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3, which was conducted in 2023.
Methods:
A network analysis of 10 depressive symptoms defined according to the National Institute for Health and Care Excellence guidelines was performed. The sex-specific differences in the network structures of the depressive symptoms were examined using the Network Comparison Test. Subgroup analysis of the sex-specific differences in the network structures was performed according to geographical region classifications, including East Asia, Southeast Asia, and South or West Asia.
Results:
A total of 998 men and 1,915 women with depression were analysed in this study. The analyses showed that all 10 depressive symptoms were grouped into a single cluster. Low self-confidence and loss of interest emerged as the most central nodes for men and women, respectively. In addition, a significant difference in global strength invariance was observed between the networks. In the regional subgroup analysis, only East Asian men showed two distinct clustering patterns. In addition, significant differences in global strength and network structure were observed only between East Asian men and women.
Conclusion:
The study highlights the sex-specific differences in depressive symptom networks across Asian countries. The results revealed that low self-confidence and loss of interest are the main symptoms of depression in Asian men and women, respectively. The network connections were more localised in men, whereas women showed a more diverse network. Among the Asian subgroups analysed, only East Asians exhibited significant differences in network structure. The considerable effects of neurovegetative symptoms in men may indicate potential neurobiological underpinnings of depression in the East Asian population.
The United States suffered a serious financial deficit as a result of the Korean War in the 1950s. To solve this problem, it moved to reduce the sizes of US forces in Korea and the South Korean military which depended on U.S. financial aid. As President Rhee Syng-man opposed this plan, the U.S. introduced nuclear weapons into South Korea in January 1958. For this purpose, the UN Command removed NNSC personnel from South Korea in June 1956, and nullified part of the Armistice Agreement in June 1957.
As nuclear weapons were deployed in South Korea, North Korea began a massive program of underground construction in the 1960s and deployed its conventional forces in forward positions. North Korea asked the Soviet Union in 1963 and China in 1964 for help in developing nuclear weapons of its own, but was rebuffed. South Korea prepared to develop its own nuclear weapons in 1974 and North Korea began to develop its own program in the late 1970s.
North Korea seeks, through development of nuclear weapons, to secure international recognition as well as economic aid and national security. Thus for the denuclearization of the Korean Peninsula, provision must be made for North Korea to dismantle its nuclear weapons without a sense of insecurity. In addition, it is unrealistic to urge North Korea to unilaterally dismantle its nuclear weapons without a breakthrough in U.S.-North Korea relations, preparing the withdrawal of US forces in South Korea, eliminating the U.S. nuclear umbrella for South Korea, and abolishing the U.S.-South Korea Alliance.
Tricuspid atresia with absent pulmonary valve and intact ventricular septum is an exceedingly rare CHD. Only few cases with completed single ventricle palliation have been reported in the literature. We present the follow-up case of a 4-year-old child with this cardiac anomaly who underwent Fontan operation after complete exclusion of the right ventricle.
Objectives/Goals: Lung transplant is a life-saving surgery for patients with advanced lung diseases yet long-term survival remains poor. The clinical features and lung injury patterns of lung transplant recipients who die early versus those who survive longer term remain undefined. Here, we use cell-free DNA and rejection parameters to help elucidate this further. Methods/Study Population: Lung transplant candidacy prioritizes patients who have a high mortality risk within 2 years and will likely survive beyond 5 years. We stratified patients who died within 2 years of transplant as early death (n = 50) and those who survived past 5 years as long-term survivors (n = 53). Lung transplant recipients had serial blood collected as part of two prospective cohort studies. Cell-free DNA (cfDNA) was quantified using relative (% donor-derived cfDNA {%ddcfDNA}) and absolute (nuclear-derived {n-cfDNA}, mitochondrial-derived {mt-cfDNA}) measurements. As part of routine posttransplant clinical care, all patients underwent pulmonary function testing (PFT), surveillance bronchoscopy with bronchoalveolar lavage (BAL), transbronchial biopsy (TBBx), and donor-specific antibody testing (DSA). Results/Anticipated Results: Over the first 2 years after transplant, the number of episodes of antibody-mediated rejection (p) Discussion/Significance of Impact: Clinically, early-death patients perform worse on routine surveillance PFTs and experience a worse degree of CLAD. These patients also have higher levels of cfDNA as quantified by n-cfDNA and mt-cfDNA. These results provide preliminary evidence that early-death patients have worse allograft rejection, dysfunction, and molecular injury.
Why is solidarity between people of color (PoC) so difficult to achieve? New evidence suggests solidarity can be activated through a sense of shared discrimination between PoC. Yet other research highlights many real-world obstacles to this solidarity, including recurring inter-minority conflicts. We consider system justification as one possible mechanism that undercuts PoC solidarity. System justification is a human motive to bolster the status quo. System justifiers who are PoC condone racial inequalities as stable, predictable, and just—which alleviates mental stressors associated with their own racially stigmatized status. We investigate system justification’s impacts on Asian Americans: a key party to many coalitions and conflicts with Black and Latino people. Using national survey data, we find that system justification is significantly associated with Asian opposition to solidarity with Black Lives Matter, net of racial resentment, and other key covariates. We then refine this result experimentally by exposing Asian adults to the model minority myth—a system-legitimizing ideology. Exposure to this myth triggers system justification, which then increases Asian opposition to pro-Black and pro-Latino policies, among other solidarity-based outcomes. Both results are primarily driven by conservative Asian Americans, highlighting a need to better appreciate Asian Americans’ ideological diversity in U.S. racial politics.
This article exposes human rights violations committed at Brothers Home in Busan, South Korea in the 1970s and 1980s, identifying their structural causes and discussing Korean society's efforts to address them. From 1975 to 1987, Brothers Home was the largest group residential facility for the homeless, the ill, the disabled, and the poor—a program that was even commended by the Korean government. However, over the years, various human rights abuses led to the death of 657 residents. While these violations remained hidden from public view for almost 25 years, survivors and supporters waged a long battle to bring them to light. Recently, the Truth and Reconciliation Commission investigated and confirmed the human rights violations as state violence. In this essay, the authors assess the significance this case holds for Korean society.
Most people with mental illness in low and middle-income countries (LMICs) do not receive biomedical treatment, though many seek care from traditional healers and faith healers. We conducted a qualitative study in Buyende District, Uganda, using framework analysis. Data collection included interviews with 24 traditional healers, 20 faith healers, and 23 biomedical providers, plus 4 focus group discussions. Interviews explored treatment approaches, provider relationships, and collaboration potential until theoretical saturation was reached. Three main themes emerged: (1) Biomedical providers’ perspectives on traditional and faith healers; (2) Traditional and faith healers’ views on biomedical providers; and (3) Collaboration opportunities and barriers. Biomedical providers viewed faith healers positively but traditional healers as potentially harmful. Traditional and faith healers valued biomedical approaches while feeling variably accepted. Interest in collaboration existed across groups but was complicated by power dynamics, economic concerns, and differing mental illness conceptualizations. Traditional healers and faith healers routinely referred patients to biomedical providers, though reciprocal referrals were rare. The study reveals distinct dynamics among providers in rural Uganda, with historical colonial influences continuing to shape relationships and highlighting the need for integrated, contextually appropriate mental healthcare systems.
Particle-laden flow through conduits is ubiquitous in both natural and industrial systems. In such flows, particles often migrate across the main fluid stream, resulting in non-uniform spatial distribution owing to particle–fluid and particle–particle interactions. The most relevant lateral particle migration mechanism by particle–fluid interaction is the Segré–Silberberg effect, which is induced by the inertial forces exerted on a particle, as the flow rate increases. However, methods to suppress it have not been suggested yet. Here, we demonstrate that adding a small amount of polymer to the particle-suspending solvent effectively suppresses the Segré–Silberberg effect in a square channel. To accurately determine the position of the particles within the channel cross-sections, we devised a dual-view imaging system applicable to microfluidic systems. Our analyses show that the Segré–Silberberg effect is effectively suppressed in a square microchannel due to the balance between the inertial and elastic forces at an optimal polymer concentration while maintaining nearly constant shear viscosity.
As astroviral infection rapidly increased in the summer of 2022 in Korea, this study aimed to determine the cause and genotype of astroviruses during this period. From January to December 2022, we tested 43,312 stool samples from patients with acute gastroenteritis utilizing multiplex PCR to detect HAstV. For the HAstV-positive samples, we determined the genotypes of the HAstVs by PCR and sequencing. The monthly positive rate from 2015 to 2022 showed a notable and abrupt increase of HAstV infection between June and August 2022, peaking at 9.8% in July 2022. The annual positivity rate of HAstV remained at 2–3% between 2015 and 2019, and then decreased to 0.5% in 2020, followed by an increase to 1.5% in 2021 and 3.6% in 2022.The genotyped astroviruses in 2022 were all identified as HAstV-1 type, and the nucleotide identity% among them was >99%. The GenBank accession number for the strain genetically closest to the strains identified in our study was ON571597.1, which was HAstV-1 isolated from Pingtan in 2019. Our results provide recent epidemiological data on HAstVs in Korea. The decline and surge in astrovirus positivity in recent years may be related to the COVID-19 pandemic.
Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices.
Methods
We conducted a mixed-methods study in Buyende District, Uganda, involving 67 in-depth interviews and 4 focus group discussions (data collection continued until thematic saturation was reached) with individuals with psychotic disorders, family members, and local leaders. Structured questionnaires were administered to 41 individuals with psychotic disorders.
Results
Three main themes emerged: (1) Positive attitudes towards biomedical providers, (2) Barriers to accessing biomedical care (3) Perceived etiologies of mental illness that influenced care-seeking behaviors. While 81% of participants eventually accessed biomedical care, the median time to first biomedical contact was 52 days, compared to 7 days for any care modality.
Conclusions
Despite a preference for biomedical care, structural barriers and diverse illness perceptions led many to seek pluralistic care pathways. Enhancing access to biomedical services and integrating traditional and faith healers could improve mental health outcomes in rural Uganda.
Mid-aortic syndrome is an uncommon vascular disease characterised by lower thoracic and upper abdominal aorta stenosis and can occur even in neonatal or infant periods. Here, we report an interesting case of a 2-month-old female with diffuse hypoplasia of the lower abdominal aorta and secondary dilated cardiomyopathy. In our patient, her abdominal aortic narrowing spontaneously normalised over time with the administration of consistent and goal-directed heart failure therapy, supporting adequate growth and natural recovery.
We aimed to analyse the evolving trends in macronutrient intake and dietary composition among Korean children and adolescents over a 10-year period.
Design:
We utilised cross-sectional data from the Korean National Health and Nutrition Examination Survey (KNHANES) spanning the years 2010–2020. Overall, the study included 11 861 participants aged 6–18 years who completed the 24-h dietary recall survey. Subsequently, we assessed trends in energy consumption and macronutrient intake across population subgroups, including age, sex and obesity status. Survey-weighted linear regression was employed to determine the β coefficient and P-value for trends in dietary nutrient consumption, treating the survey year as a continuous variable.
Setting:
KNHANES from 2010 to 2020.
Participants:
11 861 children and adolescents aged 6–18 years.
Results:
Total energy intake significantly decreased across the 10-year survey period, with a corresponding decline in the percentage of energy intake from carbohydrates. Conversely, the proportion of energy intake from fat increased during the same period. Subgroup analysis revealed changes in the composition of energy intake across age, sex and obesity status, with a consistent increase in total fat intake observed across all subgroups. Upon analysing data on dietary fibres, total sugars and fat subtypes intake, we found insufficient dietary fibre intake and increased intake of all fat subtypes.
Conclusions:
This study underscores the gradually changing dietary intake patterns among Korean children and adolescents. Our findings revealed that these transitions in dietary nutrient consumption may pose potential risks of diet-related diseases in the future.
Recent studies have suggested an increased incidence of myocarditis and pericarditis following mRNA vaccination or COVID-19. However, the potential interaction effect between vaccine type and COVID-19 on heart disease risk remains uncertain. Our study aimed to examine the impact of COVID-19 status and vaccine type following the first dose on acute heart disease in the Korean population, using data from the National Health Insurance Service COVID-19 database (October 2018–March 2022). We sought to provide insights for public health policies and clinical decisions pertaining to COVID-19 vaccination strategies. We analysed heart disease risk, including acute cardiac injury, acute myocarditis, acute pericarditis, cardiac arrest, and cardiac arrhythmia, in relation to vaccine type and COVID-19 within 21 days after the first vaccination date, employing Cox proportional hazards models with time-varying covariates. This study included 3,350,855 participants. The results revealed higher heart disease risk in individuals receiving mRNA vaccines than other types (adjusted HR, 1.48; 95% CI, 1.35–1.62). Individuals infected by SARS-CoV-2 also exhibited significantly higher heart disease risk than those uninfected (adjusted HR, 3.56; 95% CI, 1.15–11.04). We found no significant interaction effect between vaccine type and COVID-19 status on the risk of acute heart disease. Notably, however, younger individuals who received mRNA vaccines had a higher heart disease risk compared to older individuals. These results may suggest the need to consider alternative vaccine options for the younger population. Further research is needed to understand underlying mechanisms and guide vaccination strategies effectively.
Attitudes toward risk and ambiguity significantly influence how individuals assess and value rewards. This fMRI study examines the reward valuation process under conditions of uncertainty and investigates the associated neural mechanisms in individuals who engage in nonsuicidal self-injury (NSSI) as a coping mechanism for psychological pain.
Methods
The study involved 44 unmedicated individuals who reported five or more NSSI episodes in the past year, along with 42 age-, sex-, handedness-, IQ-, and socioeconomic status-matched controls. During the fMRI scans, all participants were presented with decision-making scenarios involving uncertainty, both in terms of risk (known probabilities) and ambiguity (unknown probabilities).
Results
In the NSSI group, aversive attitudes toward ambiguity were correlated with increased emotion reactivity and greater method versatility. Whole-brain analysis revealed notable group-by-condition interactions in the right middle cingulate cortex and left hippocampus. Specifically, the NSSI group showed decreased neural activation under ambiguity v. risk compared to the control group. Moreover, reduced hippocampal activation under ambiguity in the NSSI group was associated with increased emotion regulation problems.
Conclusions
This study presents the first evidence of reduced brain activity in specific regions during value-based decision-making under conditions of ambiguity in individuals with NSSI. These findings have important clinical implications, particularly concerning emotion dysregulation in this population. This study indicates the need for interventions that support and guide individuals with NSSI to promote adaptive decision-making in the face of ambiguous uncertainty.
While unemployment is known to increase the risk of suicide, its cumulative effect remains underexplored. This study investigates how unemployment affects suicide mortality and whether the effect varies based on the number of unemployment spells using two years of nationwide data.
Methods
Using the data from the National Statistical Office and Employment Insurance Database for 2018 and 2019, we identified an average of 2365 cases of suicide over two years among 7.76 million workers aged 25–64 years who had been employed within one year before their suicide. The number of unemployment spells was counted using the employment history of the past five years. We calculated crude suicide mortality rates per 100 000 population, age- and sex- standardized mortality rates (SMRs), and proportionate mortality rates (PMRs) for suicide.
Results
Over the two years, the crude suicide rate was 30.0 per 100 000 among the general population and 30.5 among workers. Workers with no unemployment spells in the past five years had a significantly lower SMR (0.44; 0.42–0.46), while those with four or more unemployment spells had a significantly higher SMR (3.13; 2.92–3.35) than the general population. These findings were consistent across all sex and age groups. Additionally, workers with four or more unemployment spells had a significantly higher PMR than the general population.
Conclusion
The impact of unemployment on suicide mortality intensifies as the number of unemployment spells increases. These results underscore the necessity for additional social and psychological support along with economic assistance for individuals facing recurrent unemployment.
This study examines the presence of bacterial contamination on surgical gloves and suggests appropriate measures for an aseptic surgical environment. To prevent glove contamination during surgery, surgeons and assistants should change gloves periodically, and scrub nurses should be careful when opening packages and handing over implants.
The intensity attenuation of a high-power laser is a frequent task in the measurements of optical science. Laser intensity can be attenuated by inserting an optical element, such as a partial reflector, polarizer or absorption filter. These devices are, however, not always easily applicable, especially in the case of ultra-high-power lasers, because they can alter the characteristics of a laser beam or become easily damaged. In this study, we demonstrated that the intensity of a laser beam could be effectively attenuated using a random pinhole attenuator (RPA), a device with randomly distributed pinholes, without changing the beam properties. With this device, a multi-PW laser beam was successfully attenuated and the focused beam profile was measured without any alterations of its characteristics. In addition, it was confirmed that the temporal profile of a laser pulse, including the spectral phase, was preserved. Consequently, the RPA possesses significant potential for a wide range of applications.
The importance of Se in human health has received much attention due to its antioxidant properties when it is consumed at an appropriate level. However, the existing evidence is limited to obtain an effective conclusion for colorectal cancer (CRC). Notably, an adequate intake of Se was reported for Koreans. Furthermore, cytokine secretion and immune function may be affected by dietary Se. Our study aimed to explore whether Se potentially reduces CRC risk and whether the IL10 rs1800871 polymorphism has an effect on this association. We designed a case–control study with 1420 cases and 2840 controls. A semi-quantitative FFQ was used to obtain information on Se intake. We determined IL10 rs1800871 through genetic analysis. Different models were developed to explore Se intake related to CRC risk by calculating OR and 95 % CI using unconditional logistic regression. A reduced risk of CRC was found as Se intake increased, with an OR (95 % CI) of 0·44 (0·35, 0·55) (Pfor trend < 0·001). However, this association seems to be allele-specific and only present among risk variant allele carriers (GA/GG) with a significant interaction between dietary Se and IL10 rs1800871 (Pfor interaction = 0·043). We emphasised that a reduction in CRC risk is associated with appropriate Se intake. However, the IL10 rs1800871 polymorphism has an impact on this reduction, with a greater effect on variant allele carriers. These findings suggest the importance of considering an individual’s genetic characteristics when developing nutritional strategies for CRC prevention.