The Cloninger Temperament and Character Inventory (TCI) and the Millon Clinical Multiaxial Inventory (MCMI-II) are both self-report inventories that can be used to assess personality reliably in clinical samples. Both instruments were administered to 103 consecutive psychiatric out-patients with or without personality disorders. The goals were to assess the convergent validity of the two instruments, to replicate the findings of Svrakic et al. (1993) Archives of General Psychiatry, 50, 991-999, about the differential diagnosis of Axis II disorders, and to analyse the relations of Millon's measures of Axis I disorders with Cloninger's measures. We observed a strong convergent validity between the instruments; the seven dimensions of the TCI accounted for most of the variance in MCMI-II measures of both Axis 1 and Axis 2 disorders. As reported by Svrakic et al. (1993) Archives of General Psychiatry, 50, 991-999, in in-patients, low self-directedness and low cooperativeness were confirmed to be the essential features of all personality disorders in out-patients. In addition, self-transcendence, the third of Cloninger's character dimensions, was observed to be a strong correlate of severe Axis-1 psychopathology, including manic and delusional disorders.

Adolescent↗

PubMedDate not supplied

Demographic methods to assess food insecurity: a North Korean case study.

UNLABELLED: In complex emergencies, especially those involving famine and/or widespread food insecurity, assessments of malnutrition are critical to understanding the population's health status and to assessing the effectiveness of relief interventions. Although the Democratic People's Republic of Korea (DPRK) has benefited from some of the largest, most sustained appeals in the history of the World Food Program (WFP), the government in Pyongyang has placed restrictions on international efforts to gather data on the health and nutritional status of the affected population. QUESTION: Lacking direct means to assess the nutritional status of the North Korean populace, what other methodologies could be employed to measure the public health impacts of chronic food shortage? The paper begins with a review of methods for assessing nutritional status, particularly in emergencies; a brief history of the North Korean food crisis (1995-2001), and a review of the available nutritional and health data on the DPRK. The main focus of the paper is on the results of a survey of 2,692 North Korean adult migrants in China. Recognizing certain biases and limitations, the study suggests that sample households have experienced an overall decline in food security, as evidenced by both the decline in government rations from an average of 120 grams per person per day to less than 60 grams per day, and by the increase in the percentage of households relying on foraging or bartering of assets as their principal source of food. It also is apparent that the period 1995-1998 has been marked by elevated household mortality, declining fertility, and steadily rising out-migration. Taken together, the signs point toward famine, whether that is defined as a discrete event--that is, as a regional failure in food production or distribution leading to elevated mortality from starvation and associated disease--or as a more complex social process whose sub-states include not only elevated mortality, but declining fertility, eating of alternative 'famine foods', transfer of assets, and the uprooting and separation of families.

Adult↗

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Alu insertions versus blood group plus protein genetic variability in four Amerindian populations.

BACKGROUND: Do the population relationships obtained using DNA or blood group plus protein markers remain the same or do they reveal different patterns, indicating that the factors which influence genetic variation at these two levels of analysis are diverse? Can these markers shed light on the biological classification of the Aché, a Paraguayan tribe which only recently established more permanent contacts with non-Indians? SUBJECTS AND METHODS: To consider these questions we typed 193 individuals from four Amerindian tribes in relation to 12 Alu polymorphisms (five of them never studied in these populations), while 22 blood group plus protein systems were studied among the Aché. These data were then integrated with those previously available (blood groups plus proteins) for the three other populations. DNA extraction and amplification, as well as the other laboratory procedures, were performed using standard methods currently in use in our laboratory. The genetic relationships were obtained using the D(A) distance, and the trees were constructed by the neighbour-joining method, both developed by M. Nei and collaborators. Reliability of the trees was tested by bootstrap replications. Other population variability values were also determined using Nei's methods. RESULTS: Alu polymorphism was observed in all populations and for most of the loci; in the seven systems from which we could compare our results with those of other Amerindian groups agreement was satisfactory. Unusual findings on the blood group plus protein systems of the Aché were a very low (5%) HP*1 frequency and the presence of the C(W) phenotype in the Rh blood group. The intertribal patterns of relationship and other aspects of their variation were remarkably congruent in the two sets (Alu; blood group plus protein) of systems. CONCLUSIONS: The answer to the first question posed above is affirmative. However, the problem of whether the Aché derived from a Gê group that preceded the Guarani colonization of Paraguay, or are just a differentiated Guarani group, could not be answered with the genetic information available; the second hypothesis seems more likely at present, but the point to be emphasized is the striking genetic distinctiveness of the Aché as compared to other Amerindians.

Alleles↗

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Extremely limited mitochondrial DNA variability among the Aché Natives of Paraguay.

BACKGROUND: The Aché Natives are an especially interesting group of people, due to their distinctive morphological aspect and the fact that only in the last three decades have they established more permanent contact with outside populations. The objectives of the present study were: (a) to verify their distinctiveness in relation to mitochondrial DNA (mtDNA) variability; (b) to ascertain whether the pattern observed was congruent with other genetic studies performed among them; and (c) to establish historical inferences that would explain the eventual similarities or differences. SUBJECTS AND METHODS: Sample collection was made at two localities in eastern Paraguay. DNA from 64 maternally unrelated subjects were tested in relation to the mtDNA hypervariable segment 1 (HVS-1) by automatic sequencing. RESULTS: Fifty-six individuals presented exactly the same haplogroup B founder haplotype; another differed from it by a single transition polymorphism at site 16362, while six other subjects showed an identical haplogroup A founding haplotype. An A/G heteroplasmy at the 16269 site was seen in one haplogroup B individual, probably due to a somatic mutation. CONCLUSIONS: The Aché present distinctive differences and reduced mtDNA HVS-1 variability compared to other South American Natives. Similar differences were observed for other genetic systems. At present it is not clear whether their peculiarities already existed in their founding populations or whether they were secondarily acquired due to a long period of isolation in the humid, subtropical forest.

DNA, Mitochondrial↗

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APOE polymorphism distribution among Native Americans and related populations.

BACKGROUND: Apolipoprotein E (apoE, protein; APOE, gene) plays a central role in lipid metabolism. Three common alleles, E*2, E*3 and E*4 have quantitative effects on lipid and lipoproteins levels, which are major risk determinants of cardiovascular diseases in several populations. Given their clinical significance, it is of interest to know the distribution of APOE variants in populations from diverse ethnic groups, as well as to determine if this polymorphism presents variations that might be associated with given evolutionary factors. AIM: We report the distribution of APOE polymorphisms in Native American populations from South America, comparing it with other native populations of the Americas and Siberia. SUBJECTS AND METHODS: The sample consisted of 315 individuals from nine Native American populations living at subtropical latitudes of Argentina, Brazil and Paraguay. The extended analysis included 50 populations across South and North America, Greenland and Siberia. The geographic patterns of the variation were investigated through correlation analysis, spatial autocorrelation and analysis molecular of variance (AMOVA). RESULTS: The incidence of the most common allele (APOE*3) in the sample analysed ranged from 0.78 to 0.98. The second allele in prevalence, APOE*4, varied from 0.00 to 0.17. The rare allele APOE*2 was found in five of the nine populations investigated. This variant was found in a male with both maternal and paternal Native American lineages, suggesting that this allele is present in Native Americans and hence should not be used as an indicator of admixture. APOE*3 and APOE*4 present, respectively, positive and negative associations with latitude, although the pattern is much more pronounced in the Northern Hemisphere than in South America. APOE*2 increases its frequency with latitude but this pattern is statistically significant only in South America. CONCLUSION: The overall APOE spatial pattern seems, in general, compatible with a directional demographic expansion which occurred in north-eastern Asia and much of the New World. The APOE*2 allele shows this pattern in South America but a random distribution in the Northern Hemisphere, suggesting that the possibility of selection should not be discarded.

Apolipoproteins E↗

PubMedDate not supplied

Assessment of the pregnant trauma patient.

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Female↗

PubMedDate not supplied

Reciprocity, emotional well-being, and family functioning as determinants of family satisfaction in caregivers of elderly parents.

The purpose of this study was to test a theoretical model developed to explain family satisfaction among 171 caregivers of elderly parents. Using LISREL to estimate path coefficients, the findings support family satisfaction as directly and indirectly influenced by reciprocity, emotional well-being and family functioning. Explanatory variables accounted for 70% of the variance in predicting family satisfaction. Intrinsic rewards derived from giving care, positive affect, and family functioning contributed to higher levels of family satisfaction, while dysphoria contributed significantly to lower levels. Family satisfaction was also indirectly influenced by positive and negative exchanges received by the parent. Increasing caregivers awareness of the reciprocal nature of their relationships with all family members may be an effective strategy in helping them appreciate their contribution to the well-being of their parents and achieve satisfaction in the caregiving role.

Adaptation, Psychological↗

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Assessment and management of falls in older people.

Falls remain a major cause of mortality and morbidity for older Australians, despite considerable growth in falls prevention activity in recent years. Risk factors for falls are well defined, and there is a growing evidence base from randomized controlled trials in community settings indicating a range of effective individual and multiple strategy interventions to reduce falls and falls injuries. These range from health promotion approaches, such as group exercise programmes, through to multidisciplinary, multifactorial interventions for high-risk populations. Practitioners need to utilize a range of strategies to enhance uptake and sustained participation in falls prevention activities. Future research needs to address important gaps, such as compliance issues, and interventions for people with cognitive impairment, dizziness and vision loss. Further research is also required in residential care and hospital settings, where there is relatively little research evidence to guide practice.

Accidental Falls↗

PubMedDate not supplied

The worker of the future. A system outlines the competencies its employees will need.

In 1993, Sisters of Mercy Health System-St. Louis (SMHS), having asked itself what kind of employees it would need in the twenty-first century, established a Worker of the Future Task Force to develop tentative answers. The task force began by making projections concerning healthcare, studying the strategic plans of SMHS's members, and surveying its employees. It learned that the system should help workers see how change could benefit them. Next, the task force studied the cultural history of the Sisters of Mercy, developing from it Six Guiding Principles for the evaluation of employee performance. From these principles, the task force derived Twelve Competencies that SMHS will seek in future workers. In 1995 the system's education leaders, with the aid of an internal training organization, decided to develop 17 training modules based on these guiding principles and competencies. Since then, more than 85 SMHS employees have been trained to help coworkers develop customer service skills and other competencies. SMHS has also incorporated the competencies in its job descriptions and performance evaluations, added the Worker of the Future curriculum to its orientation program for new employees, and is currently developing Worker of the Future training sessions for human resources personnel who interview prospective employees.

Attitude of Health Personnel↗

PubMedDate not supplied

The use of census data for estimating international migration.

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Age Distribution↗

PubMedDate not supplied

Marriage law and practice in the Sahel.

The legal systems of Sahelian African countries combine customary law, Islamic law, French colonial law, and civil law introduced since independence in 1960. Utilizing a framework developed by the Faculty of Law, University of Dakar, Senegal, and the Development Law and Policy Program, Center for Population and Family Health, Columbia University, the Sahel Institute undertook a comprehensive study of the legal and social status of women in Burkina Faso, Mali, Niger, and Senegal. Since 1960, Burkina Faso, Mali, and Senegal have replaced French family law with national marriage codes. Niger has not yet adopted a family code; the laws on the family inherited from the French remain in force. The postindependence marriage codes have attempted to give young women more say in choosing a husband, to regulate the practice of bride price, and to limit the practice of polygyny. They have done this by integrating customary law and government-passed civil law. Mali, Niger, and Senegal have repealed provisions in their codes prohibiting the distribution of contraception, based on a 1920 French law. Although it has taken no formal legal action, Burkina Faso has adopted family planning policies that effectively nullify the 1920 law.

Burkina Faso↗

PubMedDate not supplied

[Local obliterative hepatic endophlebitis and hepatosclerosis as a consequence of the therapy of infantile leukosis].

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Antineoplastic Agents↗

PubMedDate not supplied

Developing a multidisciplinary protocol for enteral feeding.

The management of planned change is discussed using a change model. Protocols are described and defined. The process of multidisciplinary protocol development is identified. Nurses are encouraged to reflect upon the process of practice change.

Critical Care↗