ObjectiveThe Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) is a scale used to clinically evaluate disturbances in biological rhythm. In this study, we aimed to examine the reliability and validity of the Korean version of the BRIAN (K-BRIAN) in a Korean population. MethodsA total of 181 participants, including 141 outpatients with bipolar disorder (BD; type I, 62; type II, 79) and 40 controls, were recruited. Construct validity was tested by comparing the mean K-BRIAN scores of the BD patients and control subjects. Concurrent validity was tested by evaluating the association between the K-BRIAN and the Morningness-Eveningness Questionnaire (MEQ). ResultsThe mean K-BRIAN scores of the control subjects and patients with BD differed significantly (p<0.001). Particularly, the mean K-BRIAN score was considerably lower among control subjects (mean±standard deviation=35.00±8.88) than among patients with BD type I (41.19±12.10) and type II (50.18±13.73). The Cronbach’s alpha for the K-BRIAN was 0.914. The K-BRIAN was found to correlate with the MEQ (r=-0.45, p<0.001). ConclusionThe findings affirm that the K-BRIAN has good construct validity and internal consistency. This suggests that the K-BRIAN can be used to assess biological rhythms in the Korean population, especially for patients with mood disorder.

With proper guidance, virtual reality (VR) can provide psychiatric therapeutic strategies within a simulated environment. The visuo-haptic-based multimodal feedback VR solution has been developed to improve anxiety symptoms through immersive experience and feedback. A proof-of-concept study was performed to investigate this VR solution. Nine subjects recently diagnosed with panic disorder were recruited, and seven of them eventually completed the trial. Two VR sessions were provided to each subject. Depression, anxiety, and VR sickness were evaluated before and after each session. Although there was no significant effect of the VR sessions on psychiatric symptoms, we could observe a trend of improvement in depression, anxiety, and VR sickness. The VR solution was effective in relieving subjective anxiety, especially in panic disorder without comorbidity. VR sickness decreased over time. This study is a new proof-of-concept trial to evaluate the therapeutic effect of VR solutions on anxiety symptoms using visuo-haptic-based multimodal feedback simultaneously.

Purpose: The purpose of this study was to confirm the influence of hematoonchology unit nurses' positive psychological capital and death awareness on their terminal care performance. Methods: This descriptive study data were collected from self-reported questionnaire filled by 127 oncology nurses at a tertiary hospital in Seoul, Korea. The variables were positive psychological capital, death awareness, and terminal care performance. Data were analyzed using SPSS version 22.0 software. Results: The participants scored 3.93±0.83 on positive psychological capital, 3.68±0.99 on death awareness and 2.86±0.65 on terminal care performance. The three variables were positively correlated. The factors affecting the nurses' terminal care performance were hope and resilience in the subcategory of positive psychological capital and experience of death of family members, relatives or friends within the past year; The explanatory power was 32.1%. Conclusion: It is necessary to develop educational programs to foster hope, resilience, etc. in hematooncology unit nurses to improve their quality of terminal care performance.

BackgroundThe porion (Po) is used to construct the Frankfort horizontal (FH) plane for cephalometrics, and the external auditory meatus (EAM) is to transfer and mount the dental model with facebow. The classical assumption is that EAM represents Po by the parallel positioning. However, we are sometimes questioning about the possible positional disparity between Po and EAM, when the occlusal cant or facial midline is different from our clinical understandings. The purpose of this study was to evaluate the positional parallelism of Po and EAM in facial asymmetries, and also to investigate their relationship with the maxillary occlusal cant.MethodsThe 67 subjects were classified into three groups. Group I had normal subjects with facial symmetry (1.05 ± 0.52 mm of average chin deviation) with minimal occlusal cant (<1.5 mm). Asymmetry group II-A had no maxillary occlusal cant (average 0.60 ± 0.36), while asymmetry group II-B had occlusal cant (average 3.72 ± 1.47). The distances of bilateral Po, EAM, and mesiobuccal cusp tips of the maxillary first molars (Mx) from the horizontal orbital plane (Orb) and the coronal plane were measured on the three-dimensional computed tomographic images. Their right and left side distance discrepancies were calculated and statistically compared.ResultsEAM was located 10.3 mm below and 2.3 mm anterior to Po in group I.  The vertical distances from Po to EAM of both sides were significantly different in group II-B (p = 0.001), while other groups were not. Interside discrepancy of the vertical distances from EAM to Mx in group II-B also showed the significant differences, as compared with those from Po to Mx and from Orb to Mx.ConclusionsThe subjects with facial asymmetry and prominent maxillary occlusal cant tend to have the symmetric position of Po but asymmetric EAM. Some caution or other measures will be helpful for them to be used during the clinical procedures.

ObjectiveThe Epworth Sleepiness Scale is a measure used for the diagnosis of sleep disorders including obstructive sleep apnea (OSA) syndrome, insomnia, and narcolepsy. Although a Korean version has been developed (the KESS), Korean lifestyle such as the floor culture and low driving rates has not been considered. We aim to develop and validate a modified KESS (mKESS) that reflects the Korean lifestyle. MethodsThe sample consisted of 795 healthy participants and 323 OSA patients. The mKESS was developed by modifying several questions to concern the floor culture (questions 1, 2, 6, and 7) and low driving rates (question 8). Feasibility of the modification was tested by comparing the KESS and mKESS using paired samples t-test and by examining internal consistency reliability. Then, mKESS scores of the OSA patients and general participants were compared to test its validity. ResultsQuestions 1, 2, 7, and 8 were significantly different when comparing the performances of the general population on both scales. Especially, the mean scores on question 8 were significantly different in the non-driver group, but not in the driver group. Cronbach’s alpha of the mKESS was relatively higher than that of the KESS. Total mKESS scores of the OSA patients were significantly higher than that of the general population. ConclusionThe mKESS is more universally applicable for the clinical evaluation of people that live in Korea. Results support that the mKESS can be administered to measure the average daytime sleep propensity of the Korean population as an alternative to the KESS.