1Self-stigma instruments investigate how people with mental illness internalize public 2 stigma. However, information is limited for the psychometric properties of their scores, 3 especially cross-validating scores from different instruments. Thus, we used confirmatory 4 factor analyses (CFAs) and item-response theory (IRT) models to examine the Internalized 5 Stigma Mental Illness scale (ISMI) and the Self-Stigma Scale-Short (SSS-S). Participants 6 with mental illness (n=347) completed both instruments. The CFAs that simultaneously 7 accounted for both the instrument (ISMI and SSS-S) and the trait (Affect, Cognitive, and 8Behavior concepts) effects outperformed those that accounted only for the instrument effect 9 or only the trait effect. All item scores fit the IRT model, and were fit with ordered, 10 progressing hierarchies in their step difficulties. We conclude that both instruments are 11 feasible for measuring the self-stigma, and that future research can combine the items of both. 12 13

The aims of this study are to verify this sequential structure and to determine if self-stigma is associated with lower quality of life (QoL) and depression. A total of 160 patients with schizophrenia participated in this study. Each completed the Self-Stigma Scale-Short Form (SSS-S), the World Health Organization (WHO) questionnaire on the Quality of Life, Brief Form (WHOQOL-BREF), and the Depression and Somatic Symptoms Scale (DSSS) instruments. Dynamic changes of the measures of self-stigma and related QoL were analyzed using a kernel-type smoother. The effects of self-stigma on QoL and depression were assessed using multiple regression models. The dynamic changes of self-stigma scores seem to support a sequential structure. The general pattern is elevated for around 12 months, exceeds 2.5 after 54 months, and reaches a peak of about 90 months after diagnosis of schizophrenia, then declines and appears to be stabilized later on. While the DSSS scores synchronize with those of self-stigma, those of the WHOQOL-BREF seem to show an opposite trend. Self-stigma appears to be a dominator for QoL and depression for people with schizophrenia. Patients with schizophrenia may develop self-stigma around 1 year after diagnosis. Early detection and management may improve patient QoL and minimize depression. However, the results of this pilot study should be interpreted with caution because of the cross-sectional design.

The purpose of this study is to create a Visualized Online Simple Sequencing Authoring Tool (VOSSAT) that provides an easy-to-use and web-based interface to help instructors edit existing SCORM-compliant content packages. With vigorous development of the Internet, web-based e-learning systems have become more and more popular. Sharable Content Object Reference Model (SCORM) 1.3, the most popular standard for the consistency of course format among different web-based e-learning systems, provides the Simple Sequencing Specification (SSS). Like supply chain management, the inputs of VOSSAT are SCORM-compliant content packages; the outputs of VOSSAT are content packages to be delivered at SCORM-compliant Learning Management System. In terms of authoring processes of metadata file, a teacher needs to only fill some options in the annotation windows. Then, the VOSSAT automatically and dynamically generates the paragraphs needed for presenting the sequencing of learning path properly. The methodology of this study is to analyze the IMS SSS behaviors and to propose VOSSAT as a module on Content Repository Management System (CRMS). The results of this study are shown by scenarios. Finally, the implications of this study for education are also included.

Background: To evaluate the change of erectile function (EF) in sexually active male overactive bladder (OAB) patients treated with Mirabegron. Mirabegron, a selective β3 adrenoceptor agonist, approved for the treatment of OAB, has been reported to relax human and rat corpus cavernosum and might have beneficial effect on EF. Methods: A total of 128 consecutive men with lower urinary tract symptoms attended urology outpatient clinic were evaluated for OAB and EF. Thirty-four sexually active OAB patients were prospectively enrolled in this study and received mirabegron 50 mg oral once a day. The evaluation of EF and OAB was based on a self-administered questionnaire containing International Index of Erectile Function (IIEF-5) and OAB symptom score (OABSS), respectively. Men with an OABSS urgency score of ≥2 and sum score of ≥3 were considered to have OAB. The therapeutic outcomes were assessed at baseline, 4, and 12 weeks. Results: Mirabegron usage was associated with a statistically significant improvement of OAB symptoms (OABSS 32.1% decrease) at 4-week follow-up and the therapeutic effects were maintained at 12-week follow-up. Mirabegron usage did not improve EF (IIEF-5 4.9% decrease at 4-week; p = 0.106, and 9.1% decrease at 12-week follow-up; p = 0.077). However, the IIEF-5 was significantly decreased in the higher baseline IIEF-5 (≥17) group (11.7% decrease; p = 0.044), noncoronary artery disease (13.2%; p = 0.007), or non-DM group (13.9% decrease; p = 0.021) at 12-week follow-up. Conclusion: This preliminary study demonstrates that mirabegron treatment of men with OAB improved OAB symptoms, but has no beneficial effect on EF.