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      • Dysphagia Associated with Risk of Depressive Symptoms among Stroke Survivors after Discharge from a Cluster of Inpatient Rehabilitation Facilities

        Kevin T. Pritchard,Kimberly P. Hreha,Ickpyo Hong 대한연하재활학회 2020 Swallowing Rehabilitation Vol.3 No.1

        Objectives: To examine the association of stroke-induced dysphagia during an inpatient rehabilitation facility (IRF) stay and depressive symptoms at a 3-month follow-up. Methods: A retrospective cross-sectional design using the Stroke Recovery in Underserved Populations 2005-2006 study database. Hierarchical logistic regression models were utilized to examine if stroke-induced dysphagia is a significant predictor for depressive symptoms at 3-month follow-up across the stepwise introduction of the demographics and clinical characteristics at the IRF discharge and 3-month follow-up. Multiple imputations with Markov-chain Monte Carlo method was used to address the covariates with missing observations. Results: In a total of 1,045 stroke survivors, 335 (32.1%) stroke survivors had dysphagia and 710 (67.9%) stroke survivors did not have dysphagia during the IRF stay. The adjusted logistic regression model and multiple imputation method revealed that stroke survivors with dysphagia are more likely to have depressive symptoms at 3-month follow-up (Odds ratio [OR] 3.169, 95% confidence interval [CI] 1.379-7.283; OR 1.746, 95% CI 1.153-2.642, respectively). A high level of functional and cognitive status, functional support, and community participation at the 3-month follow-up was inversely associated with depressive symptoms (OR 0.973, 95% CI 0.951- 0.995; OR 0.884, 95% CI 0.829-0.942; OR 0.793, 95% CI 0.714-0.882). Discussion: Stroke survivors experiencing dysphagia during the IRF stay had a higher risk of developing depressive symptoms compared to those without dysphagia at 3-month follow-up. Healthcare providers should pay attention to dysphagia care in IRFs which might prevent the development of depressive symptoms when the stroke survivors are discharged and back in their communities.

      • KCI등재후보

        Monitoring of Corporate Groups by Independent Directors

        ( A. C. Pritchard ) 서울대학교 법학연구소 2010 Journal of Korean Law Vol.9 No.1

        Both the United States and Korea have reformed their corporate governance in recent years to put increasing responsibilities on independent directors. Independent directors have been found to be an important force protecting the interests of shareholders when it comes time to make certain highly salient decisions, such as firing a CEO or selling the company. This article compares the role of independent directors in the US and Korean systems. I argue that the US may have placed regulatory burdens on independent directors that they are unlikely to be able to satisfy, given their part-time status. By contrast, in the chaebol system of Korea, independent directors may have a critical role to play in limiting self dealing by controlling shareholders. Given the dominance of these controlling shareholders in the Korean economy, independent directors will need strong backing to be effective in protecting the interests of public shareholders.

      • KCI등재

        Nutritional composition and techno-functional properties of sago palm weevil (Rhynchophorus ferrugineus) larvae protein extract

        Kavle Ruchita Rao,Pritchard Ellenna Tamsin Maree,Carne Alan,Bekhit Alaa El-Din Ahmed,Morton James David,Agyei Dominic 한국응용곤충학회 2023 Journal of Asia-Pacific Entomology Vol.26 No.2

        The present study investigated nutritional composition and techno-functional properties of Rhynchophorus fer rugineus larvae (sago grubs) protein extract (SGPE). The fat, carbohydrate, and protein contents of sago grubs were 58.79 %, 18.67 %, and 15.65 %, respectively. SGPE exhibited an isoelectric pH of ~ 4 based on alkaline solubilisation and pH precipitation. Total essential amino acid (EAA) content and essential amino acid index (EAAI) of SGPE were 223.2 mg/g protein and 0.84 respectively. SDS-PAGE of SGPE displayed proteins in the 10–110 kDa molecular weight range, with substantial protein bands < 20 kDa. As expected for a protein extract, FTIR analysis of SGPE indicated five distinct regions (amides I, II, III, and amide A and B peaks). Technofunctional analysis of SGPE indicated a high foaming capacity (87.3 %) and emulsion stability (96.8 % after 60 min). Heat coagulation of SGPE was higher at pH 7.0 (19.5 %) than that at the pI of 4.0 (4.83 %), corrob orating the pH-solubility profile, and relatively high surface hydrophobicity (294.5). The heat enthalpy of the SGPE (59.8 J/g) was lower than that reported for H. illucens and A. cordifera. These findings demonstrate the suitability of SGPE for food technology applications in relation to to the reported techno-functional properties and amino acid profiles.

      • KCI등재

        Psychometric Properties of the Modified Barthel Index for Children With Rare Disorders

        Yoonjeong Lim,Kevin T. Pritchard,Sanghun Nam,Ickpyo Hong 대한작업치료학회 2020 대한작업치료학회지 Vol.28 No.4

        Objective: The Modified Barthel Index (MBI) measures individuals’ level of independence in performing activities of daily living. The purpose of this study was to examine the internal consistency and construct validity of the MBI for children with rare disorders. Methods: The study participants are children with rare disorders who have muscle weakness including Barth syndrome and congenital muscular dystrophy (N = 113). The MBI was completed by participants in either an online format utilizing the UF Qualtrics system or a pencil-and-paper format. Statistical analysis was conducted to examine the psychometric properties of the MBI. Results: The MBI showed excellent internal consistency for children with Barth syndrome (Cronbach’s α = .91) and congenital muscular dystrophy (Cronbach’s α = .93). Construct validity was supported by a significant difference in MBI scores among participants grouped by diagnoses. MBI score was significantly different between the unaffected group and congenital muscular dystrophy (p < .0001) as well as between the unaffected group and Barth syndrome (p < .0001). Conclusion: The psychometric properties of the MBI present good reliability and construct validity suggesting suitability for use as an outcome measure for children with rare disorders.

      • KCI등재

        Item-Level Psychometrics of the 12 Items of the Coping Orientation to Problems Experienced Scale

        남상훈,Hilton, Claudia L.,이미정,Pritchard, Kevin T.,배수영,홍익표 대한신경계작업치료학회 2022 재활치료과학 Vol.11 No.3

        Objective : This study examined the psychometric properties of the 12-item Coping Orientation to Problems Experienced Scale (COPE) using Rasch analysis. COPE is one of the instruments used to measure stress-coping skills. Methods : The study participants were 480 community-dwelling older adults. We tested the instrument’s unidimensionality assumption using principal component analysis (PCA). Item fit was examined using infit-and-outfit mean-square (MnSq) and standardized fit statistics (ZSTD). The precision and item difficulty hierarchies of the instrument were examined. The item-difficulty hierarchy was investigated to identify the easy and difficult items. We tested differential item functioning (DIF) for sex and age groups. Results : PCA revealed that the instrument met the unidimensionality assumption (eigenvalue = 1.78). Among the 12 items, item 2 was removed because of misfit (Infit MnSq = 1.33, Infit ZSTD = 5.05, Outfit MnSq = 1.56, Outfit ZSTD = 7.15). The remaining 11 items demonstrated a conceptual item-difficulty hierarchy. The person strata value was 3.10, which is equivalent to a reliability index value of 0.81. There was no DIF for the sex and age groups (DIF contrast <0.27). Conclusion : The findings indicated that the revised COPE-11 has adequate item-level psychometric properties and can accurately measure stress coping skills.

      • KCI등재

        Unsupervised Machine Learning to Identify Depressive Subtypes

        Benson Kung,Maurice Chiang,Gayan Perera,Megan Pritchard,Robert Stewart 대한의료정보학회 2022 Healthcare Informatics Research Vol.28 No.3

        Objectives: This study evaluated an unsupervised machine learning method, latent Dirichlet allocation (LDA), as a methodfor identifying subtypes of depression within symptom data. Methods: Data from 18,314 depressed patients were used to createLDA models. The outcomes included future emergency presentations, crisis events, and behavioral problems. One modelwas chosen for further analysis based upon its potential as a clinically meaningful construct. The associations between patientgroups created with the final LDA model and outcomes were tested. These steps were repeated with a commonly-usedlatent variable model to provide additional context to the LDA results. Results: Five subtypes were identified using the finalLDA model. Prior to the outcome analysis, the subtypes were labeled based upon the symptom distributions they produced:psychotic, severe, mild, agitated, and anergic-apathetic. The patient groups largely aligned with the outcome data. For example,the psychotic and severe subgroups were more likely to have emergency presentations (odds ratio [OR] = 1.29; 95% confidenceinterval [CI], 1.17–1.43 and OR = 1.16; 95% CI, 1.05–1.29, respectively), whereas these outcomes were less likely inthe mild subgroup (OR = 0.86; 95% CI, 0.78–0.94). We found that the LDA subtypes were characterized by clusters of uniquesymptoms. This contrasted with the latent variable model subtypes, which were largely stratified by severity. Conclusions:This study suggests that LDA can surface clinically meaningful, qualitative subtypes. Future work could be incorporated intostudies concerning the biological bases of depression, thereby contributing to the development of new psychiatric therapeutics.

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