The Text-Picture Integration Scale for Perspectives on Mental Illness: Development and Validation.

IMPORTANCE: Understanding the root cause of mental illness stigma is necessary to adopt effective management strategies. OBJECTIVE: To establish a stable and effective text-picture integration rating scale to predict public perspectives on mental illness and to examine its reliability and validity. DESIGN: Descriptive cross-sectional study using internet survey data. SETTING: Online. PARTICIPANTS: Two hundred volunteers. RESULTS: The 10-item the Text-Picture Integration Scale for Perspectives on Mental Illness was developed. The authors conducted data analysis using SPSS to evaluate the reliability and criterion-related validity of the Mental Health Literacy Scale (MHLS). The Text-Picture Integration Scale's item-level content validity index ranged from 0.83 to 1.00, and the scale-level content validity index was 0.97. The scale demonstrated acceptable reliability (Cronbach's α = .80). The mean value of individual items ranged from 3.18 to 4.48, and the mean total score was 39.44 (SD = 8.47). The Text-Picture Integration Scale exhibited satisfactory criterion-related validity with the MHLS (r = .76, p < .001). CONCLUSIONS AND RELEVANCE: Preliminary analyses support that the Text-Picture Integration Scale is a stable and effective rating scale to determine public perspectives on mental illness and is appropriate for evaluating destigmatization efforts. Plain-Language Summary: The study findings support the use of the Text-Picture Integration Scale as a stable and effective rating scale to determine public perspectives on mental illness. The scale is also appropriate for evaluating ways to address the stigmas that people associate with mental illness, which pose challenges for people in recovery. Occupational therapists can leverage their understanding of public perspectives on mental illness when choosing interventions to support the overall well-being of their clients with mental illness.

Developing of Multidimensional Perspectives Checklist of Professionalism for Undergraduate Occupational Therapy Students in Assistive Technology Service: Delphi Study.

Professionalism is a critical attribute that occupational therapy students must establish throughout education, especially in the context of assistive technology (AT). This study aimed to construct a multidimensional perspectives checklist (MPC) from the stakeholders to reflect professionalism development in the AT service courses. Fifteen experts in AT clinical practice and educators (N = 15) consented to and completed three rounds of the Delphi survey. Data were qualitatively analyzed to form a preliminary checklist in the first round. In rounds two and three, participants rated their level of agreement with the MPC items. A descriptive analysis of consensus was performed. Thirty items were classified into five subscales (teachers, therapists, patients, peers, learners) and fit into a framework with three dimensions and seven categories. After the Delphi survey, the MPC achieved high consensus, convergence, and stability. Two additional categories of professionalism emerged in the study, namely aesthetic and personal characteristics and reflection. The MPC developed in this study reflects the perspectives of various stakeholders in occupational therapy practice, providing helpful information for students to prepare themselves. Therefore, the MPC could contribute to expanding and developing the scope of professionalism in occupational therapy, especially in AT service.

The Literacy-Based Scale for Measuring Reflections on a University Social Responsibility Curriculum: Development and Validation.

University Social Responsibility (USR) enhances educational development and the impact of universities on society. As a stakeholder in USR, it is imperative to develop a comprehensive literacy scale that reflects the development of students' citizenship in social engagement. Thus, this study aims to develop and validate the Health Promotion Literacy-based Scale for students in USR (HPLS-USR). A total of 200 students from USR with an average age of 19.27 participated in the study. The Exploratory Factor Analysis (EFA) was used to verify the scale's construct validity. Twenty-two items were maintained in EFA with an internal consistency Cronbach's α of 0.92. Construct validity was supported by EFA results, confirming that the four-factor structure of the 22-item scale (personal growth, responsibility of citizenship, social interaction, and intellectual growth) have reasonable correlations to each other, explaining 61.83% of the variance in the scale. The Kaiser-Meyer-Olkin index values of 0.908 and Bartlett's Test of Sphericity (p = 0.001) verified the normal distribution of the EFA and the adequacy of the EFA sampling. These items achieved adequate factor loadings ranging between 0.44 and 0.82. This study demonstrated that the HPLS-USR has satisfactory construct validity and reliability in measuring students' literacy abilities developed in USR participation.

Investigating the Effectiveness of Using a Situated Simulation-Based Program to Improve Occupational Therapy Students' Interactions and Observation Skills with Children.

PURPOSE: Interaction and observation are critical skills for occupational therapists who work with pediatric clients. The objective of this study was to investigate whether using standardized child patients within a situated simulation-based (SSB) program increases students' knowledge and clinical skills when working with children in occupational therapy. MATERIALS AND METHODS: This controlled trial with multiple measures recruited students from the pediatric occupational therapy curriculum enrolled in an SSB program in consecutive academic years (n = 62). Experimental group students participated in a simulation experience with video training sessions, followed by an SSB exam with standardized child patients; the control group performed the video training simultaneously. Quantitative outcomes included quizzes to measure clinical knowledge, video training scores, and a situated simulation exam to assess clinical skills. RESULTS: The experimental group had a significantly higher postwritten quiz scores than the control group; the video training scores were not significantly different between groups. Linear regression analysis showed a significant association between the SSB exam and postwritten quiz scores (ß = 0.487, p = 0.017). The experimental group had a total pass rate of 65.6% for the SSB exam. The communication and interaction pass rate was 53.1%; the basic evaluation rate was 68.8%, implying that communication/interaction skills are hard to simulate from video training alone; therefore, the authentic fidelity of the SSB program needs to improve further to enhance learning. CONCLUSIONS: The SSB program with standardized child patients improved students' clinical knowledge and skills more than lectures and practice alone. Using standardized child patients in programs or exams appears to positively influence students' performance. Situated simulation-based learning that allows the realistic practice of observation and communication skills may enhance students' clinical competency. Future research should develop standard training methods and evaluation processes in high-fidelity simulations for generalized use in other occupational therapy programs.

Anti-angiogenic effect of hexahydrocurcumin in rat corneal neovascularization.

AIM: This study was to investigate the anti-angiogenic effect of hexahydrocurcumin (HHC) to evaluate gene (p-basic fibroblast growth factor (bFGF)-SAINT-18 & p-vascular endothelial growth factor (VEGF)-SAINT-18 complex)-induced corneal neovascularization (CorNV) in rats. METHODS: CorNV was induced in 24 eyes of 24 rats. Four groups (Group A: 0 µg, B: 0.01 µg, C: 0.1 µg, and D: 1 µg) of HHC were prepared and implanted into the rat subconjunctival substantia propria 1.5 mm from the limbus at temporal side. The 1 µg of p-bFGF-SAINT-18 & p-VEGF-SAINT-18 complex were prepared and implanted into the rat corneal stroma 1.5 mm from the limbus at the same side. Inhibition of CorNV was observed and quantified from day 1 to day 60. bFGF and VEGF protein expression were analyzed by biomicroscopic examination, western blot analysis, and immunohistochemistry. RESULTS: Subconjunctival injection by 1 µg HHC successfully inhibited gene-induced CorNV in rats. bFGF and VEGF protein expression were reduced after 6 days. Meanwhile, the reduction of HLA-DR expression was detected. CONCLUSIONS: Our study showed that the HHC might provide an important anti-angiogenesis factor to inhibit CorNV development at the corneal experimental angiogenesis model.

Acidic stress enhances CovR/S-dependent gene repression through activation of the covR/S promoter in emm1-type group A Streptococcus.

Streptococcus pyogenes (group A Streptococcus) is a clinically important gram-positive bacterium that causes severe diseases with high mortality. Spontaneous mutations in genes encoding the CovR/CovS two-component regulatory system have been shown to derepress expression of virulence factors and are significantly associated with invasiveness of infections. Sensor kinase CovS senses environmental signals and then regulates the levels of phosphorylated CovR. In addition, CovS is responsible for survival of group A Streptococcus under acidic stress. How this system regulates the expression of CovR-controlled genes under acidic stress is not clear. This study shows that the expression of CovR-controlled genes, including hasA, ska, and slo, is repressed under acidic conditions by a CovS-dependent mechanism. Inactivation of CovS kinase activity or CovR protein phosphorylation derepresses the transcription of these genes under acidic conditions, suggesting that the phosphorylation of CovR is required for the repression of the CovR-controlled genes. Furthermore, the promoter activity of the covR/covS operon (pcov) was upregulated after 15min of incubation under acidic conditions. Replacement of pcov with a constitutively activated promoter abrogated the acidic-stress-dependent repression of the genes, indicating that the pH-dependent pcov activity is directly involved in the repression of CovR-controlled genes. In summary, the present study shows that inactivation of CovS not only derepresses CovR-controlled genes but also abrogates the acidic-stress-dependent repression of the genes; these phenomena may significantly increase bacterial virulence during infection.

Using concept mapping to evaluate knowledge structure in problem-based learning.

BACKGROUND: Many educational programs incorporate problem-based learning (PBL) to promote students' learning; however, the knowledge structure developed in PBL remains unclear. The aim of this study was to use concept mapping to generate an understanding of the use of PBL in the development of knowledge structures. METHODS: Using a quasi-experimental study design, we employed concept mapping to illustrate the effects of PBL by examining the patterns of concepts and differences in the knowledge structures of students taught with and without a PBL approach. Fifty-two occupational therapy undergraduates were involved in the study and were randomly divided into PBL and control groups. The PBL group was given two case scenarios for small group discussion, while the control group continued with ordinary teaching and learning. Students were asked to make concept maps after being taught about knowledge structure. A descriptive analysis of the morphology of concept maps was conducted in order to compare the integration of the students' knowledge structures, and statistical analyses were done to understand the differences between groups. RESULTS: Three categories of concept maps were identified as follows: isolated, departmental, and integrated. The students in the control group constructed more isolated maps, while the students in the PBL group tended toward integrated mapping. Concept Relationships, Hierarchy Levels, and Cross Linkages in the concept maps were significantly greater in the PBL group; however, examples of concept maps did not differ significantly between the two groups. CONCLUSIONS: The data indicated that PBL had a strong effect on the acquisition and integration of knowledge. The important properties of PBL, including situational learning, problem spaces, and small group interactions, can help students to acquire more concepts, achieve an integrated knowledge structure, and enhance clinical reasoning.

Inhibition of corneal neovascularization with the combination of bevacizumab and plasmid pigment epithelium-derived factor-synthetic amphiphile INTeraction-18 (p-PEDF-SAINT-18) vector in a rat corneal experimental angiogenesis model.

Bevacizumab, a 149-kDa protein, is a recombinant humanized monoclonal antibody to VEGF. PEDF, a 50-kDa glycoprotein, has demonstrated anti-vasopermeability properties. In this study, we demonstrated that the combination of bevacizumab and plasmid pigment epithelium-derived factor-synthetic amphiphile INTeraction-18(p-PEDF-SAINT-18) has a favorable antiangiogenic effect on corneal NV. Four groups(Group A: 0 µg + 0 µg, B: 0.1 µg + 0.1 µg, C: 1 µg + 1 µg, and D: 10 µg + 10 µg) of bevacizumab + p-PEDF-SAINT-18 were prepared and implanted into the rat subconjunctival substantia propria 1.5 mm from the limbus on the temporal side. Then, 1 µgof p-bFGF-SAINT-18 was prepared and implanted into the rat corneal stroma 1.5 mm from the limbus on the same side. The inhibition of NV was observed and quantified from days 1 to 60. Biomicroscopic examination, western blot analysis and immunohistochemistry were used to analyze the 18-kDa bFGF, 50-kDa PEDF and VEGF protein expression. No inhibition activity for normal limbal vessels was noted. Subconjunctival injection with the combination of bevacizumab and p-PEDF-SAINT-18 successfully inhibited corneal NV.The bFGF and PEDF genes were successfully expressed as shown by western blot analysis,and a mild immune response to HLA-DR was shown by immunohistochemistry. We concluded that the combination of bevacizumab and p-PEDF-SAINT-18 may have more potent and prolonged antiangiogenic effects, making it possible to reduce the frequency of subconjunctival bevacizumab administration combined with a relatively safe profile and low toxicity.

Cell cycle regulation by bevacizumab in ARPE-19 human retinal pigment epithelial cells.

Bevacizumab, a recombinant humanized monoclonal antibody, binds vascular endothelial growth factor (VEGF) and inhibits its interaction with receptors found on endothelial cells. Bevacizumab has been increasingly used as an off-label treatment for exudative age-related macular degeneration (AMD). Whether or not bevacizumab is capable of arresting the growth of human retinal pigment epithelial cells remains to be clarified. In this study, flow cytometry was used to evaluate whether bevacizumab markedly induced the G1/S phase arrest. The G1/S phase cycle-related protein analysis demonstrated that the expression of cyclin-dependent kinase (CDK)2, 4 and 6 and of cyclin D and E, as well as the phosphorylation of retinoblastoma tumor suppressor protein (ppRB) production were found to be markedly reduced by bevacizumab. By contrast, the protein levels of p53, p16, p21 and p27 were increased in bevacizumab-treated ARPE-19 cells (a human retinal pigment epithelial cell line). These events of G1/S arrest induced by bevacizumab in ARPE-19 cells suggest that a preventive effect of bevacizumab exists in AMD.

Inhibition of corneal neovascularization with plasmid pigment epithelium-derived factor (p-PEDF) delivered by synthetic amphiphile INTeraction-18 (SAINT-18) vector in an experimental model of rat corneal angiogenesis.

The use of Synthetic Amphiphile INTeraction-18 (SAINT-18) carrying plasmid pigment epithelium-derived factor (p-PEDF) as an anti-angiogenesis strategy to treat corneal neovascularization in a rat model was evaluated. Four partially dried forms (Group A: 0 microg, B: 0.1 microg, C: 1 microg, D: 10 microg) of a p-PEDF-SAINT-18 were prepared and implanted into the rat subconjunctival substantia propria 1.5 mm from the limbus at the temporal side. The 1 microg of plasmid-basic fibroblast growth factor--SAINT-18 (p-bFGF-SAINT-18) (1 microg) was prepared and implanted into the rat corneal stroma 1.5 mm from the limbus on the same side. Inhibition of neovascularization was observed and quantified from day 1 to day 60. PEDF (50-kDa) and bFGF (18-kDa) protein expression were analyzed by biomicroscopic examination, Western blot analysis, and immunohistochemistry. Gene expression in corneal and conjunctival tissue was observed as early as 3 days after gene transfer and stably lasted for over 3 months with minimal immune reaction. Subconjunctival injection of a highly efficient p-PEDF-SAINT-18 successfully inhibited corneal neovascularization. Successful gene expression of bFGF, PEDF and a mild immune response of HLA-DR were shown by immunohistochemistry staining. We concluded that SAINT-18 was capable of directly delivering genes to the ocular surface by way of subconjunctival injection, and delivered sustained, high levels of gene expression in vivo to inhibit angiogenesis.

A novel vector system for gene transfer into the cornea using a partially dried plasmid expressing 18 basic fibroblast growth factor-synthetic amphiphile INTeraction-18 (SAINT-18) complex.

PURPOSE: We describe a novel vector system of nonviral gene transfer into the cornea using a partially dried form of a plasmid expressing 18-kDa basic fibroblast growth factor (p-bFGF)-synthetic amphiphile INTeraction-18 (SAINT-18) complex. METHODS: Corneal neovascularization (NV) was evaluated in 48 eyes of Sprague-Dawley rats after implantation of SAINT-18 containing 2 micro g of plasmid-expressing green fluorescent protein (p-GFP; control group), 0.2 micro g, 2 micro g, or 20 micro g of p-bFGF from day 0 to day 60. bFGF protein expression was analyzed by Western blotting and immunohistochemistry. RESULTS: The p-bFGF-SAINT-18 complex induced dose-dependent corneal neovascularization, which reached a maximum on days 15-21 in the 20-micro g p-bFGF group, days 12-18 in the 2-micro g p-bFGF group, and on days 9-15 in the 0.2-micro g p-bFGF group, and then regressed progressively. No NV was observed in the p-GFP group. CONCLUSIONS: This noninflammatory corneal transfection model using partially dried p-bFGF-SAINT-18 complex allows precise localization of tranfection reagents for producing corneal neovascularization.

Intravascular pyogenic granuloma arising in an acquired arteriovenous malformation: report of a case and review of the literature.

BACKGROUND: Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign vascular skin tumor. Intravascular variant of this vascular tumor is rare and such a variant arising in another hemangioma is extremely unusual. OBJECTIVE: The objective was to present a patient with an intravascular pyogenic granuloma arising in an acquired arteriovenous malformation of the palm. METHODS: We report a case and review the literature. RESULT: A 44-year-old woman presented with an easy-bleeding and ulcerative nodule with a hyperkeratotic collaret on her right palm for 3-4 months. The nodule measured 6 x 6 mm in size and was tender. Under the clinical impression of pyogenic granuloma, the lesion was totally excised and the microscopic examination revealed an intravascular pyogenic granuloma in the papillary dermis with an underlying arteriovenous malformation. CONCLUSION: A rare composite vascular tumor is reported, and our case presented as a red eroded nodule surrounded by a keratotic collaret, which was easily misdiagnosed as pyogenic granuloma clinically. We suggest that any pyogenic granuloma-like lesion should be palpated carefully, and if a nodule is present, surgical excision rather than cryotherapy or laser ablation should be considered.