Bih Ching Shu

The effect of breast reconstruction surgery on body image among women after mastectomy: a meta-analysis

The purpose of this study was to analyze the available evidence concerning the effects of breast reconstruction (BR) on body image of women with breast cancer. BR is a potential intervention to improve the body image of women with breast cancer. Conflicting research findings about the effects of breast reconstructive surgery on body image compared to breast conservative surgery (BCS) or mastectomy exist. A meta-analysis of studies found in MEDLINE, CINAHL, PsychINFO, PubMed as well as PQDT (dissertation and theses), and other unpublished literature resources from 1970 to 2010 were searched. Comparable studies that examined the difference of body image between breast cancer women receiving mastectomy plus BR and those with BCS were included. A clear definition about the domains of body image including body stigma, body concern, and transparency were identified. Mean effect sizes were calculated. Twelve studies were included in the meta-analysis. Women with BR and BCS were no different on the body concern domain of body image. However, women with BR had a significantly worse score on body stigma domain of body image than women receiving BCS. Women with BR had a better body image score than women with mastectomy. Women who are satisfied with their body shape may still perceive deficiencies because of the stigma of mastectomy and affect on body image. Consistent application of valid and reliable measures of body image specific to breast cancer women is needed.

Predictive validity of Bayley scale in language development of children at 6-36 months.

Background:  The aim of the present study was to investigate the prediction of development among 6‐, 18‐, and 36‐month‐old infants on the Bayley Scale of Infant Development (BSID).

Gender differences of children's developmental trajectory from 6 to 60 months in the Taiwan Birth Cohort Pilot Study

The parental report instrument is the most efficient developmental detection method and has shown high validity with professional assessment instruments. The reliability and validity of the Taiwan Birth Cohort Study (TBCS) 6-, 18- and 36-month scales have already been established. In this study, the reliability and validity of the 60-month scale was tested. The gender differences in childrens longitudinal gross motor, fine motor, language and social development were also investigated. Using the dataset from the Taiwan Birth Cohort Pilot Study (TBCS-p), 2048 infants were followed up when they were 6-, 18-, 36- and 60-month-old. At the final stage, 1620 children were followed up. Development of the children was measured using the TBCS 6-, 18-, 36-, and 60-month developmental scales. The reconstructed TBCS 60-month scale yielded 16 items measuring childrens development in the four dimensions of gross motor, fine motor, language and social. The scale yielded an internal consistency of 0.39-0.71. Structural equation modeling also showed good construct and predictive validity, in that the 6-, 18-, and 36-month scales were predictive of the 60-month scale. No gender differences between the gross motor dimension was found. Gender had an effect on the fine motor dimension at 36 and 60 months, language dimension at 36 months, and social dimension at 18, 36 and 60 months. Gender had a transient effect in language development and social development a continuous effect from 18 to 60 months. Thus different gender norms may need to be established to prevent misdiagnosis. The TBCS scale is a valid and reliable developmental screening instrument that can be used in continuous surveillance of childrens development in community and clinical settings from 6 months to 5 years of age.

Efficient developmental screening instrument for 6-and 18-month-old children in the Taiwan Birth Cohort Pilot Study

Aim: To develop an efficient developmental screening instrument for interview purposes.

Parental mental health, education, age at childbirth and child development from six to 18 months.

Aim: To investigate the effect six‐month parental mental health has on childrens six and 18‐month development. Parental covariates of age and education were also analysed.

Intronic single nucleotide polymorphisms of engrailed homeobox 2 modulate the disease vulnerability of autism in a han chinese population

Background: Autism is a neurodevelopmental disorder with a strong genetic background that has been suggested to be associated with a susceptibility gene, engrailed homeobox 2(EN2), which maps to chromosome 7q36. Our study was aimed to explore the association between EN2 intronic single nucleotide polymorphisms (SNPs) with autism in an ethnic Han Chinese population. Methods: A total of 193 autism cases and 309 controls were recruited. Five SNPs including rs3824068, rs3824067, rs1861972, rs1861973 and rs3830031 in the intron 1 region were genotyped by using the TaqMan SNP assay. Results: Both the allelic frequencies and genotype distribution of the EN2 intronic SNPs were found to have statistically significant differences between cases and controls, except rs1861972, rs3024067 and rs3824068. According to the constructed linkage disequilibrium plot using genotype data, it was suggested that further haplotypic analyses can be performed on rs3824068, rs1861972 and rs1861973. After completed analyses by the Unphased and Phase programs and logistic regression analysis, one 2-marker haplotype A-C (β = –2.897; p = 0.013; OR = 0.055) and one 3-marker haplotype G-A-C (β = –0.491; p = 0.015; OR = 0.612) were identified that were plausibly associated with autism in the ethnic Chinese population. Conclusions: The haplotype A-C of rs1861972 and rs1861973 is the core element of the observed haplotype association in this study, which plays a role as a protective factor against autism; in addition, the haplotype G-A-C is less frequent in male cases compared to controls (38.64 vs. 52.51%), which plausibly modulate disease vulnerability to autism. However, further evidence of the haplotype association of EN2 intronic SNPs and uncertain transcription factor interaction is warranted for further clarification.

The interleukin 10 promoter haplotype ACA and the long-form variant of the DRD4 uVNTR polymorphism are associated with vulnerability to schizophrenia

A total of 934 patients with schizophrenia and 433 controls were genotyped for the interleukin-10 (IL-10) promoter and DRD4 uVNTR polymorphisms. DRD4 long-form variants (namely, those with ≥5 repeats), homozygosity for the 4-repeat allele, and the IL-10 haplotype ACA were associated with schizophrenia, respectively. No obvious interactions among the potential polymorphisms were found, which suggests that IL-10 and DRD4 confer vulnerability to schizophrenia independently.

Association of DRD4 uVNTR and TP53 codon 72 polymorphisms with schizophrenia: a case-control study

BackgroundThe tumour supressor gene TP53 is thought to be involved in neural apoptosis. The polymorphism at codon 72 in TP53 and the long form variants of the upstream variable number of tandem repeats (uVNTR) polymorphism in the dopamine D4 receptor (DRD4) gene are reported to confer susceptibility to schizophrenia.MethodsWe recruited 934 patients with schizophrenia and 433 healthy individuals, and genotyped the locus of the TP53 codon 72 and DRD4 uVNTR polymorphisms by combining the polymerase chain reaction-restriction fragment length polymorphism method (PCR-RFLP) with direct sequencing.ResultsNo significant differences were found in the frequency of the genotype of the TP53 codon72 polymorphism between patients with schizophrenia and their controls. However, the long form alleles (≥ 5 repeats) of the DRD4 uVNTR polymorphism were more frequent in patients with schizophrenia than in controls (p = 0.001). Hence, this class of alleles might be a risk factor for enhanced vulnerability to schizophrenia (odds ratio = 3.189, 95% confidence interval = 1.535-6.622). In the logistic regression analysis, the long form variants of the DRD4 polymorphism did predict schizophrenia after the contributions of the age and gender of the subjects were included (p = 0.036, OR = 2.319), but the CC and GG genotypes of the codon 72 polymorphism of TP53 did not.ConclusionsThe long form variants of the uVNTR polymorphism in DRD4 were associated with schizophrenia, in a manner that was independent of the TP53 codon 72 polymorphism. In addition, given that the genetic effect of the TP53 codon 72 polymorphism on the risk of developing schizophrenia was very small, this polymorphism is unlikely to be associated with schizophrenia. The roles that other single nucleotide polymorphisms (SNPs) in the TP53 gene or in other apoptosis-related genes play in the synaptic dysfunction involved in the pathogenesis of schizophrenia should be investigated.

Multilevel Analysis of Air Pollution and Early Childhood Neurobehavioral Development

To investigate the association between the ambient air pollution levels during the prenatal and postnatal stages and early childhood neurobehavioral development, our study recruited 533 mother-infant pairs from 11 towns in Taiwan. All study subjects were asked to complete childhood neurobehavioral development scales and questionnaires at 6 and 18 months. Air pollution, including particulate matter ≤10 μm (PM10), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and hydrocarbons, was measured at air quality monitoring stations in the towns where the subjects lived. Multilevel analyses were applied to assess the association between air pollution and childhood neurobehavioral development during pregnancy and when the children were 0 to 6 months, 7 to 12 months, and 13 to 18 months old. At 18 months, poor subclinical neurodevelopment in early childhood is associated with the average SO2 exposure of prenatal, during all trimesters of pregnancy and at postnatal ages up to 12 months (first trimester β = −0.083, se = 0.030; second and third trimester β = −0.114, se = 0.045; from birth to 12 months of age β = −0.091, se = 0.034). Furthermore, adverse gross motor below average scores at six months of age were associated with increased average non-methane hydrocarbon, (NMHC) levels during the second and third trimesters (β = −8.742, se = 3.512). Low-level SO2 exposure prenatally and up to twelve months postnatal could cause adverse neurobehavioral effects at 18 months of age. Maternal NMHC exposure during the 2nd and 3rd trimesters of pregnancy would be also associated with poor gross motor development in their children at 6 months of age.

Mental health of female foreign spouses in transnational marriages in southern Taiwan

BackgroundThe aim of this study was to investigate the mental health status, and the risk factors associated with mild psychiatric disorders, of female foreign spouses (from Vietnam, Indonesia, and mainland China) in southern Taiwan, and to understand the mental health needs of these women.MethodsOne hundred and twenty nine participants were willing to participate in this study. All participants fulfilled all questionnaires which included demographic information, the Chinese Health Questionnaire (CHQ), the Eysenck Personality Questionnaire (EPQ), and the Mental Health Care Needs Questionnaire (MHCNQ).ResultsBy multiple linear regression, neuroticism characteristics (p = 0.000), the dimension of knowledge of the level of their own psychological disturbance (p = 0.001), dimension of friends assistance (p = 0.033), and dimension of religion comfort (p = 0.041) in mental health care needs could be used to predict possible mild psychiatric disorders. Furthermore, SEM model showed that Indonesian or Vietnamese spouses have more likely degree in mental health care needs (β = -0.24, p = 0.003), compared with Chinese ones. A higher level of neuroticism was associated with a greater likelihood of mild psychiatric disorder (β = 0.54, p < 0.001), and of mental health care needs (β = 0.21, p = 0.013). A higher degree of mental health care needs was related to a greater likelihood of mild psychiatric disorder (β = 0.14, p = 0.05).ConclusionIn conclusion, we have obtained a better understanding of the mental health status of female foreign spouses in transnational marriages, who face many difficulties. Indonesian or Vietnamese spouses tend to more likely degree in mental health care needs than Chinese spouses, and then indirectly influenced their mental health status. Some individuals with a neurotic personality are exposed to high risk and might suffer from mild psychiatric symptoms. The needs for psychological counseling and religion therapy were the first priority for these women, particularly the Indonesian and Vietnamese spouses. From these findings, we have a better understanding of how to assist these female foreign spouses in future.