Background: Older patients aged ≥75 years are underrepresented in major statin trials, leaving the optimal statin intensity after acute ischemic stroke (AIS) undefined. We aimed to compare functional outcomes and short-term safety between high-intensity statin therapy (HIST) and moderate-intensity statin therapy (MIST) in patients aged ≥75 years with AIS or transient ischemic attack. Methods: Using a prospective stroke registry at a single tertiary center (2019–2022), we retrospectively analyzed 337 patients aged ≥75 years with AIS or transient ischemic attack who maintained statin therapy for 3 months (HIST n=117; MIST n=220). The primary outcome was a favorable 3-month functional outcome (modified Rankin Scale score 0–2). Secondary outcomes included stroke recurrence, adverse effects, and statin discontinuation. Multivariable logistic regression with pre-specified sensitivity analyses was performed. Results: Favorable outcomes at 3 months were more frequent with HIST (70.9% vs. 55.9%; p=0.010). After multivariable adjustment, HIST was independently associated with a favorable outcome (adjusted odds ratio [aOR]=2.03, 95% confidence interval [CI] 1.17–3.53), consistent across sensitivity analyses: per-protocol (aOR=3.48, 95% CI 1.97–6.17) and atrial fibrillation-adjusted (aOR=2.21, 95% CI 1.26–3.89). No significant differences were observed in statin discontinuation, stroke recurrence, or adverse effects. Conclusion In older patients with AIS, HIST was independently associated with better functional outcomes without evidence of increased harm, broadly consistent with current guideline recommendations for HIST when tolerated. Prospective studies are needed to confirm a causal relationship.

Objective: This study aimed to evaluate the utility of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in hospital settings and to identify items sensitive for detecting autism spectrum disorder (ASD) trait. Methods: The Q-CHAT was administered to a clinical sample of children presenting with developmental delays with a high probability of ASD in a hospital setting (n=37), as well as to typically developing community children (n=67), aged 12 to 54 months. Results: The mean Q-CHAT total score in the hospital sample (42.0±13.6) was significantly higher than in the community sample (29.9±7.8), with maximized sensitivity and adequate specificity at 32.5 (sensitivity=0.811, specificity=0.687). The internal consistency of Q-CHAT was 0.764 for the overall sample and 0.825 for the hospital sample. Q-CHAT total scores and item scores in the hospital sample remained stable across age groups, indicating age-invariant properties. The hospital sample showed higher endorsement of less favorable development in social interaction and reciprocity items compared to community sample. No difference in the Q-CHAT item scores was present among age groups in the hospital samples. In the community samples, item scores, such as comprehending a child’s speech, using the hand of others as a tool, adapting to a change in routine, repeating the same action, and making unusual finger movements, decreased with the advance of age. Conclusion The Korean version of the Q-CHAT demonstrates good validity and reliability and is effective in discriminating autistic traits even in children older than 24 months. The items endorsed for hospital samples varied from community samples, implying item-specific sensitivity for hospital samples.

Objective: This study aimed to evaluate the utility of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in hospital settings and to identify items sensitive for detecting autism spectrum disorder (ASD) trait. Methods: The Q-CHAT was administered to a clinical sample of children presenting with developmental delays with a high probability of ASD in a hospital setting (n=37), as well as to typically developing community children (n=67), aged 12 to 54 months. Results: The mean Q-CHAT total score in the hospital sample (42.0±13.6) was significantly higher than in the community sample (29.9±7.8), with maximized sensitivity and adequate specificity at 32.5 (sensitivity=0.811, specificity=0.687). The internal consistency of Q-CHAT was 0.764 for the overall sample and 0.825 for the hospital sample. Q-CHAT total scores and item scores in the hospital sample remained stable across age groups, indicating age-invariant properties. The hospital sample showed higher endorsement of less favorable development in social interaction and reciprocity items compared to community sample. No difference in the Q-CHAT item scores was present among age groups in the hospital samples. In the community samples, item scores, such as comprehending a child’s speech, using the hand of others as a tool, adapting to a change in routine, repeating the same action, and making unusual finger movements, decreased with the advance of age. Conclusion The Korean version of the Q-CHAT demonstrates good validity and reliability and is effective in discriminating autistic traits even in children older than 24 months. The items endorsed for hospital samples varied from community samples, implying item-specific sensitivity for hospital samples.

Objective: This study aimed to evaluate the utility of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in hospital settings and to identify items sensitive for detecting autism spectrum disorder (ASD) trait. Methods: The Q-CHAT was administered to a clinical sample of children presenting with developmental delays with a high probability of ASD in a hospital setting (n=37), as well as to typically developing community children (n=67), aged 12 to 54 months. Results: The mean Q-CHAT total score in the hospital sample (42.0±13.6) was significantly higher than in the community sample (29.9±7.8), with maximized sensitivity and adequate specificity at 32.5 (sensitivity=0.811, specificity=0.687). The internal consistency of Q-CHAT was 0.764 for the overall sample and 0.825 for the hospital sample. Q-CHAT total scores and item scores in the hospital sample remained stable across age groups, indicating age-invariant properties. The hospital sample showed higher endorsement of less favorable development in social interaction and reciprocity items compared to community sample. No difference in the Q-CHAT item scores was present among age groups in the hospital samples. In the community samples, item scores, such as comprehending a child’s speech, using the hand of others as a tool, adapting to a change in routine, repeating the same action, and making unusual finger movements, decreased with the advance of age. Conclusion The Korean version of the Q-CHAT demonstrates good validity and reliability and is effective in discriminating autistic traits even in children older than 24 months. The items endorsed for hospital samples varied from community samples, implying item-specific sensitivity for hospital samples.

Objective: This study aimed to evaluate the utility of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in hospital settings and to identify items sensitive for detecting autism spectrum disorder (ASD) trait. Methods: The Q-CHAT was administered to a clinical sample of children presenting with developmental delays with a high probability of ASD in a hospital setting (n=37), as well as to typically developing community children (n=67), aged 12 to 54 months. Results: The mean Q-CHAT total score in the hospital sample (42.0±13.6) was significantly higher than in the community sample (29.9±7.8), with maximized sensitivity and adequate specificity at 32.5 (sensitivity=0.811, specificity=0.687). The internal consistency of Q-CHAT was 0.764 for the overall sample and 0.825 for the hospital sample. Q-CHAT total scores and item scores in the hospital sample remained stable across age groups, indicating age-invariant properties. The hospital sample showed higher endorsement of less favorable development in social interaction and reciprocity items compared to community sample. No difference in the Q-CHAT item scores was present among age groups in the hospital samples. In the community samples, item scores, such as comprehending a child’s speech, using the hand of others as a tool, adapting to a change in routine, repeating the same action, and making unusual finger movements, decreased with the advance of age. Conclusion The Korean version of the Q-CHAT demonstrates good validity and reliability and is effective in discriminating autistic traits even in children older than 24 months. The items endorsed for hospital samples varied from community samples, implying item-specific sensitivity for hospital samples.

Objective: This study aimed to evaluate the utility of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in hospital settings and to identify items sensitive for detecting autism spectrum disorder (ASD) trait. Methods: The Q-CHAT was administered to a clinical sample of children presenting with developmental delays with a high probability of ASD in a hospital setting (n=37), as well as to typically developing community children (n=67), aged 12 to 54 months. Results: The mean Q-CHAT total score in the hospital sample (42.0±13.6) was significantly higher than in the community sample (29.9±7.8), with maximized sensitivity and adequate specificity at 32.5 (sensitivity=0.811, specificity=0.687). The internal consistency of Q-CHAT was 0.764 for the overall sample and 0.825 for the hospital sample. Q-CHAT total scores and item scores in the hospital sample remained stable across age groups, indicating age-invariant properties. The hospital sample showed higher endorsement of less favorable development in social interaction and reciprocity items compared to community sample. No difference in the Q-CHAT item scores was present among age groups in the hospital samples. In the community samples, item scores, such as comprehending a child’s speech, using the hand of others as a tool, adapting to a change in routine, repeating the same action, and making unusual finger movements, decreased with the advance of age. Conclusion The Korean version of the Q-CHAT demonstrates good validity and reliability and is effective in discriminating autistic traits even in children older than 24 months. The items endorsed for hospital samples varied from community samples, implying item-specific sensitivity for hospital samples.

This paper focuses on a central paradox in the childrearing advice of American pediatrician and beloved “baby doctor” Benjamin Spock: his seemingly permissive approach to control, fostered through a new psychology, in fact represented a new mode of control. The study explores this paradox by closely examining how Spock developed his ideas on parental self-control. By shifting the foundation of self-control, his advice supported the emergence of a new form of authority—strengthened by more internalized and elaborate guidelines. Challenging the widespread belief that Spock’s methods were simply looser or more lenient, this study traces the transformation of his childrearing ideas from authoritative and visible forms of control to subtle and internal ones in the mid-twentieth-century United States.
Spock’s influential The Common Sense Book of Baby and Child Care revolutionized twentieth-century parenting by emphasizing parents’ confidence in their own judgment and the critical role of emotional maturity in childrearing. Rather than advocating rigid rules or permissiveness, Spock focused on how parents could cultivate self-control and emotional regulation to promote healthier parent-child relationships. A core tenet of his philosophy was distinguishing between controllable and uncontrollable aspects of parenting, which helped alleviate feelings of helplessness and inadequacy among parents. By fostering mothers’ self-awareness and encouraging recognition of their individual limits, Spock provided a framework that enhanced emotional comfort and a sense of control during childcare—benefiting both parents and their children alike.
Spock’s psychoanalytic interests deeply influenced his focus on parental emotional control, particularly the mother’s crucial role in fostering a child’s emotional growth and self-confidence. He maintained that a mother’s unconditional love and consistent presence were indispensable, warning parents against showing dissatisfaction with their child’s flaws, as such expressions could undermine the child’s self-esteem. Parents were encouraged to regulate negative emotions—such as disappointment and frustration—especially in challenging contexts like feeding difficulties or toilet training, where parental negativity might provoke defiance or resistance. For Spock, emotional maturity, characterized by patience and measured reactions, was essential for effective discipline and for mitigating undesirable behaviors in children.
Spock’s broader influence challenged prevailing mid-twentieth-century norms that often prioritized strict discipline and emotional restraint. He promoted a flexible, affectionate approach that recognized children as individuals with unique needs and personalities. This philosophy invited parents to trust their instincts while balancing emotional regulation, enabling them to respond sensitively and effectively to their children. Spock’s work fostered a cultural shift toward more humane and psychologically informed parenting, shaping generations of families with its blend of psychoanalytic insight and practical advice.

Background: Hospital environments, particularly shared rooms, are vulnerable to the transmission of carbapenem-resistant Enterobacterales (CRE). The incidence of CRE colonization in the Korean homeless population remains unknown. This study aimed to analyze the impact of targeted active surveillance of CRE in hospital wards following two outbreaks. Methods: This retrospective study was conducted in a homeless ward with shared rooms at a municipal hospital in Seoul. The CRE incidence was calculated from October 1, 2023, to May 31, 2024. Active surveillance was initiated on January 22, 2024. Poisson regression analysis was used to compare CRE incidence events at three months before and four months after the intervention. The risk factors for CRE colonization were also analyzed. Results: The CRE colonization rate decreased from 1.149 to 0.815 per 1,000 patient-days post-intervention; however, the change was not statistically significant (rate ratio: 0.986, 95% confidence interval (95% CI): 0.389-2.496, P=0.976). In contrast to the secondary cases, one acquired CRE case was detected after the intervention without an outbreak. The CRE colonization rate was higher in the homeless ward than in the general ward. CRE colonization was significantly associated with age (adjusted odds ratio (aOR), 1.071; 95% CI: 1.014-1.132;P=0.014), previous antibiotic exposure (aOR, 6.796; 95% CI: 1.215-38.029; P=0.029), and co-colonization with other multidrug resistant bacteria (aOR, 7.168; 95% CI: 2.224-23.096;P=0.001). Conclusion A relatively high incidence of CRE colonization was observed in the homeless ward. After active surveillance, no CRE outbreaks occurred following the implementation.

Background: Hospital environments, particularly shared rooms, are vulnerable to the transmission of carbapenem-resistant Enterobacterales (CRE). The incidence of CRE colonization in the Korean homeless population remains unknown. This study aimed to analyze the impact of targeted active surveillance of CRE in hospital wards following two outbreaks. Methods: This retrospective study was conducted in a homeless ward with shared rooms at a municipal hospital in Seoul. The CRE incidence was calculated from October 1, 2023, to May 31, 2024. Active surveillance was initiated on January 22, 2024. Poisson regression analysis was used to compare CRE incidence events at three months before and four months after the intervention. The risk factors for CRE colonization were also analyzed. Results: The CRE colonization rate decreased from 1.149 to 0.815 per 1,000 patient-days post-intervention; however, the change was not statistically significant (rate ratio: 0.986, 95% confidence interval (95% CI): 0.389-2.496, P=0.976). In contrast to the secondary cases, one acquired CRE case was detected after the intervention without an outbreak. The CRE colonization rate was higher in the homeless ward than in the general ward. CRE colonization was significantly associated with age (adjusted odds ratio (aOR), 1.071; 95% CI: 1.014-1.132;P=0.014), previous antibiotic exposure (aOR, 6.796; 95% CI: 1.215-38.029; P=0.029), and co-colonization with other multidrug resistant bacteria (aOR, 7.168; 95% CI: 2.224-23.096;P=0.001). Conclusion A relatively high incidence of CRE colonization was observed in the homeless ward. After active surveillance, no CRE outbreaks occurred following the implementation.