Biomedical subjects

L Schmidt

Publications and source records attributed to L Schmidt.

At least 19 recordsLinked to original sources

PubMed2005

Communication and coping as predictors of fertility problem stress: cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment.

BACKGROUND: We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment. METHODS: We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up. Data were based on self-administered questionnaires measuring communication with partner and with other people, coping strategies: active-avoidance coping, active-confronting coping, passive-avoidance coping, meaning-based coping, and fertility problem stress. The study population included those participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up. RESULTS: Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09-5.76; odds ratio for men, 3.69, 95% confidence interval 2.09-6.43). Active-avoidance coping (e.g. avoiding being with pregnant women or children, turning to work to take their mind off things) was a significant predictor of high fertility problem stress. Among men, high use of active-confronting coping (e.g. letting feelings out, asking other people for advice, seeking social support) predicted low fertility problem stress in the marital domain (odds ratio 0.53, 95% confidence interval 0.28-1.00). Among women, medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain. CONCLUSION: The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment.

Adaptation, Psychological↗

PubMed2005

Evaluation of a communication and stress management training programme for infertile couples.

OBJECTIVE: This study evaluates a patient education programme focussed on improving communication and stress management skills among couples in fertility treatment. METHODS: In total, 37 couples completed the intervention. Two teachers conducted all the five courses offered. The effectiveness regarding communication and infertility-related stress was assessed by questionnaires immediately before (time T1) and after the intervention (time T2). Seeking of information and professional support was assessed at a 12-month follow-up (time T3); response rates were: T1, 93.2%; T2, 85.1%; T3, 74.3%. Data were compared at baseline (T1) and at the 12-month follow-up (T3) with a prospective cohort of Danish people in fertility treatment. RESULTS: There were no differences in infertility-related stress at base line between the two groups studied. We estimated the bi-directional changes in communication, e.g., changes from talking often to talking less frequently and vice versa. More intervention participants started to talk often with their partner about infertility and its treatment after the intervention compared to those who stopped to talk often. Women and men changed occurrence, frequency and content of communication with close other people. Among women marital benefit increased significantly. Infertility-related stress was not reduced significantly. Significantly more intervention participants than in the comparison group had contacted support groups, a psychologist and/or agencies for adoption at the 12-month follow-up. CONCLUSION: The intervention resulted in important perceived improvement in the participants' competence to actively manage changes in marital communication and in communication in different social arenas. PRACTICE IMPLICATIONS: We recommend fertility clinics to develop and evaluate different interventions for those fertility couples who ask for more psychosocial support.

Adaptation, Psychological↗

PubMed2004

The social epidemiology of coping with infertility.

BACKGROUND: To analyse the cross-sectional association between coping responses with infertility and occupational social class. Infertility is evenly distributed across social classes in Denmark, and there is free access to high-quality assisted reproduction technology. METHODS: Data were based on a questionnaire in a consecutive sample of 1169 women and 1081 Danish men who were about to begin assisted reproduction treatment. The coping measure was developed from an adaptation of Lazarus and Folkman's Ways of Coping Questionnaire and based on results from interviews with infertile people. The measure was developed in four categories: active-avoidance coping; active-confronting coping; passive-avoidance coping; meaning-based coping. These subscales were later confirmed by factor analysis. Occupational social class was measured in a standardized way. RESULTS: Contrary to expectations, the logistic regression analyses showed that women from lower social classes V + VI and men from social classes III + IV used significantly more active-confronting coping. Women from lower social classes V + VI used significantly more meaning-based coping. Both men and women from social classes III - VI used significantly more passive-avoidance coping and significantly less active-avoidance coping. CONCLUSION: Due to the significant social differences in coping with infertility, the study suggested that elements of coping may be learned from one's social network and reference group.

Adaptation, Psychological↗

PubMed2004

Surface field activated fragmentation of arginine oligomers.

Protonated arginine oligomers produced by matrix-assisted laser desorption/ionization (MALDI) graze at a kinetic energy of 350 eV along a surface of fluorinated hydrocarbon or mineral oil. The cation fragments activated by excitation processes during the slide on the surface are analyzed by time-of-flight mass spectrometry. The resulting fragment ion mass spectra are interpreted by applying a theoretical concept of excimol accumulation and trap bond dissociation, suggested earlier. According to this theory, energy is accumulated and fragments are formed independently by each arginine residue of a sliding oligomer ion. It is concluded that the observed variation in the fragment ion spectra of the oligomers is a consequence of different oligomer velocities and not a fingerprint of different ion structures.

Arginine↗

PubMed2003

Photoelectron-photoion momentum spectroscopy as a clock for chemical rearrangements: isomerization of the di-cation of acetylene to the vinylidene configuration.

We have used complete correlated momentum mapping of the photoelectron and heavy ion products from the dissociation of the di-cation of acetylene, induced by photoionizing the carbon K shell of one of the atoms, to map out the angular correlation between the electron and the axis of the target molecule. The (quasi-) symmetric decay is found to proceed through both acetylene and vinylidene configurations. By using the strongly peaked photoelectron emission to "start a clock," an upper limit of 60 fs is placed on the isomerization time from the acetylene to the vinylidene configuration.

Journal Article↗

PubMed2003

Auger electron emission from fixed-in-space CO.

We have measured the angular distribution of carbon K-Auger electrons from fixed in space, core-ionized, CO molecules in coincidence with the kinetic energy release of the C+ and O+ fragments. We find a very narrow ejection of Auger electrons in the direction of the oxygen and an oscillatory diffraction pattern. Even for similar electron energies, the angular distribution strongly depends on the symmetry of the final state.

Journal Article↗

PubMed2003

Patients' attitudes to medical and psychosocial aspects of care in fertility clinics: findings from the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme.

BACKGROUND: The aims were (i) to identify gender differences in motivations to seek assisted reproduction and gender differences in expectations about medical and psychosocial services and (ii) to examine factors that predict the perceived importance of, and intention to use, psychosocial services among infertile people. METHODS: We conducted an epidemiological study based on questionnaires among all new couples attending five fertility clinics with a response rate of 80.0% and a total of 2250 patients. RESULTS: The vast majority of both men and women considered a high level of medical information and patient-centred care as important. Fewer respondents (women 10.0-20.8%, men 4.1-8.9%) felt that professional psychosocial services were important and/or had the intention to use these services. The main predictor of perceived importance of patient-centred care and professional psychosocial services for both men and women was high infertility-related stress in the marital, personal and social domain. CONCLUSIONS: A supportive attitude from medical staff and the provision of both medical and psychosocial information and support should be integral aspects of medical care in fertility clinics. Although only a minority of the participants perceived professional psychosocial services as important, they should be available for patients whose infertility causes them much strain, especially for patients whose marital relationship suffered much because of infertility.

Attitude to Health↗

PubMed2003

High ratings of satisfaction with fertility treatment are common: findings from the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme.

BACKGROUND: The aims were: (i). to identify gender differences in evaluation of medical and patient-centred (psychosocial) care in fertility clinics and (ii). to identify predictors of satisfaction. METHODS: An epidemiological prospective study based on questionnaire responses among all new couples attending five fertility clinics. The response rate at the 12 month follow-up was 87.7% and included a total of 1934 patients. RESULTS: During the follow-up period about two-thirds had achieved a pregnancy and about a third became parents. The participants were satisfied with both the medical and patient-centred (psychosocial) services. There were no sex differences in the evaluation of treatment except that women were more satisfied than men with how the staff had performed their medical examinations. Satisfaction with medical and patient-centred services was positively associated with a treatment-related pregnancy/delivery and the report of marital benefits resulting from the infertility experience. Lower social class was a significant predictor for satisfaction. CONCLUSIONS: Both men and women in fertility treatment had high ratings on medical and patient-centred care. It seemed that satisfaction with the psychosocial services was higher than in earlier studies from other countries.

Denmark↗

PubMed2002

Double-to-single target ionization ratio for electron capture in fast p-He collisions.

We have used the ion storage ring CRYRING and its internal gas-jet target and recoil-ion-momentum spectrometer to measure absolute cross sections for transfer ionization (TI: p+He-->H0+He2++e(-)) in 2.5-4.5 MeV p-He collisions with separate Thomas (TTI) and kinematic (KTI) TI contributions. The probability for electron emission in kinematical capture decreases with increasing velocity and appears to approach the photoionization shakeoff value (1.63%) [T. Aberg, Phys. Rev. A 2, 1726 (1970)]]. The velocity dependence of the TTI cross section is consistent with the theoretically predicted v(-11) scaling [J. S. Briggs and K. Taulbjerg, J. Phys. B 12, 2565 (1979)]].

Journal Article↗

PubMed2002

Circular dichroism in K-shell ionization from fixed-in-space CO and N2 molecules.

We have measured the angular distributions of 1s photoelectrons excited by circularly and linearly polarized light from fixed-in-space CO and N2 molecules, in the vicinity of their shape resonances. A strong circular dichroism, i.e., a strong dependence on the sense of rotation of the polarization vector of the photons, is found for both molecules. State-of-the-art one-electron multiple scattering and partially correlated random phase approximation calculations are in good agreement with many, but not all, aspects of the experimental data.

Journal Article↗

PubMed2002

Patient-assessed health outcome measures for diabetes: a structured review.

AIMS: To identify available disease-specific measures of health-related quality of life (HRQL) for diabetes and to review evidence for the reliability, validity and responsiveness of instruments. METHODS: Systematic searches were used to identify instruments. Instruments were assessed against predefined inclusion and exclusion criteria. Letters were sent to authors requesting details of further instrument evaluation. Information relating to instrument content, patients, reliability, validity and responsiveness to change was extracted from published papers. RESULTS: The search produced 252 references. Nine instruments met the inclusion criteria: Appraisal of Diabetes Scale (ADS), Audit of Diabetes-Dependent Quality of Life (ADDQoL), Diabetes Health Profile (DHP-1, DHP-18), Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Measure (DQOL), Diabetes-Specific Quality of Life Scale (DSQOLS), Questionnaire on Stress in Diabetic Patients-Revised (QSD-R), Diabetes-39 (D-39) and Well-being Enquiry for Diabetics (WED). The shortest instrument (ADS) has seven items and the longest (WED) has 50 items. The ADS and ADDQoL are single-index measures. The seven multidimensional instruments have dimensions covering psychological well-being and social functioning but vary in the remainder of their content. The DHP-1 and DSQOLS are specific to Type 1 diabetes patients. The DHP-18 is specific to Type 2 diabetes patients. The DIMS and DQOL have weaker evidence for reliability and internal construct validity. Patients contributed to the content of the ADDQoL, DHP-1/18, DQOL, DSQOLS, D-39, QSD-R and WED. The authors of the ADDQoL, DHP-1/18, DQOL, DSQOLS gave explicit consideration to content validity. The construct validity of instruments was assessed through comparisons with instruments measuring related constructs and clinical and sociodemographic variables. None of the instruments has been formally assessed for responsiveness to changes in health. CONCLUSIONS: Five of the diabetes-specific instruments have good evidence for reliability and internal and external construct validity: the ADDQoL, DHP-1/18, DSQOLS, D-39 and QSD-R. Instrument content should be assessed for relevance before application. The instruments should be evaluated concurrently for validity and responsiveness to important changes in health.

Diabetes Mellitus↗

PubMed2002

Preoperative evaluation of chronic alcoholics assessed for surgery of the upper digestive tract.

BACKGROUND: Alcoholics are at risk of developing major complications in the postoperative period. Adequate prophylactic treatment, as well as preoperative abstinence, can significantly decrease the rate of complications. However, the preoperative diagnosis of alcoholism is difficult to establish. The purpose of this study was to assess whether three preoperative visits, an alcohol-related questionnaire (CAGE), and the laboratory markers carbohydrate-deficient transferrin (CDT) and gamma-glutamyltransferase (GGT) would increase the rate of detection of chronic alcoholics. METHODS: The study included the Departments of ENT, Facial and Maxillofacial Surgery, and General Surgery of a university hospital; 705 male patients were assessed for tumor surgery of the upper digestive tract and were allocated to 5 different groups. All patients were seen three times, and five different strategies were used to detect chronic alcoholics. The gold standard was the diagnosis of alcohol misuse made by an experienced (blinded) investigator according to the DSM-III-R. The main outcome measurements were the detection rates of the different test strategies. RESULTS: By clinical routine alone, only 16% were detected during the first visit and 34% after three visits. If the CAGE questionnaire was added, sensitivity increased to 64%. The further addition of GGT or CDT led to 80 and 85% detections, respectively. A combination of all tests had a sensitivity of 91%. CONCLUSIONS: To detect more alcoholic patients at risk for major complications, patients should be seen more often, and additional diagnostic tools such as the CAGE, CDT, and GGT should be used before surgery.

Adult↗

PubMed2001

Induction of transplantable mouse renal cell cancers by streptozotocin: in vivo growth, metastases, and angiogenic phenotype.

Interleukin-2-based regimens of biological therapy have shown some clinical promise for the treatment of kidney cancer in humans, although the mechanisms responsible for tumor regression occurring in these patients remain unclear. Preclinical insight into these mechanisms is limited by a paucity of orthotopic animal models of kidney cancer. We have used streptozotocin, an antibiotic and diabetogenic nitrosamine compound derived from Streptomyces achromogenes to induce new kidney tumors in BALB/c mice. Single or multiple doses of streptozotocin induced kidney tumors in up to 25% of mice by 50-90 weeks of age, with up to 18% characterized as renal cell carcinomas (RCCs). Several transplantable lines were obtained from the RCCs, and one of these lines was subsequently cloned. The initial tumor isolates and sublines were histologically reconfirmed to be RCCs, and all grew progressively but slowly (mean survival times, 57 to >100 days) in vivo after intrarenal implant. None of the primary isolates or sublines revealed mutations in either the VHL or Ras genes, although karyotype analysis and chromosome painting revealed the consistent presence of a submetacentric chromosome resulting from the fusion of chromosomes 16 and 19. Biological characterization of these tumors revealed several features analogous to the growth of human kidney cancers, including a propensity for the formation of lung metastases and high vascularity. This hypervascularity is evident by both gross and microscopic analysis and correlates with the expression of several proangiogenic genes. Overall, the features of orthotopic transplantability, slower in vivo growth (relative to the rapid growth rates of other transplantable mouse kidney tumors), propensity for lung metastases, and hypervascularity may make these tumors valuable models for the study of new therapeutic strategies based on antineovascular agents and antitumor cytokines.

Animals↗

PubMed2001

Structural basis of oncogenic activation caused by point mutations in the kinase domain of the MET proto-oncogene: modeling studies.

Missense mutations in the tyrosine kinase domain of the MET proto-oncogene occur in selected cases of papillary renal carcinoma. In biochemical and biological assays, these mutations produced constitutive activation of the MET kinase and led to tumor formation in nude mice. Some mutations caused transformation of NIH 3T3 cells. To elucidate the mechanism of ligand-independent MET kinase activation by point mutations, we constructed several 3D models of the wild-type and mutated MET catalytic core domains. Analysis of these structures showed that some mutations (e.g., V1110I, Y1248H/D/C, M1268T) directly alter contacts between residues from the activation loop in its inhibitory conformation and those from the main body of the catalytic domain; others (e.g., M1149T, L1213V) increase flexibility at the critical points of the tertiary structure and facilitate subdomain movements. Mutation D1246N plays a role in stabilizing the active form of the enzyme. Mutation M1268T affects the S+1 and S+3 substrate-binding pockets. Models implicate that although these changes do not compromise the affinity toward the C-terminal autophosphorylation site of the MET protein, they allow for binding of the substrate for the c-Abl tyrosine kinase. We provide biochemical data supporting this observation. Mutation L1213V affects the conformation of Tyr1212 in the active form of MET. Several somatic mutations are clustered at the surface of the catalytic domain in close vicinity of the probable location of the MET C-terminal docking site for cytoplasmic effectors.

Catalytic Domain↗

PubMed2001

[The secrecy aspect of donor insemination].

A literature review among couples treated with donor insemination (DI) showed that almost all participants had planned not to inform the child that this treatment had taken place. Many of the couples had told other people about the treatment, and thus opened up the possibility of a traumatic disclosure. Though secrecy about DI treatment could be taxing for the couple, this strain did not negatively influence the assessment of the relationship, parenthood, or the parent-child relation. Psychosocial development of DI-children was not different from other children's development. It was not possible to show a deleterious effect of keeping the treatment a secret. There is a lack of qualitative studies about the consequences of secrecy for the relationship between DI-parents, for parenthood and for the child. Only one study included adult DI-children.

Adaptation, Psychological↗

PubMed2001

Abrupt rise of the longitudinal recoil ion momentum distribution for ionizing collisions.

We report on the experimental observation of an abrupt rise in the longitudinal momentum distribution of recoil ions created in proton helium collision. The details of this structure can be related to electrons traveling with the velocity of the projectile [electron capture to the continuum (ECC)]. The longitudinal as well as the transverse distribution of the recoil ions can be explained as a continuation of the momentum distribution from ions resulting from electron capture illustrating the smooth transition from the capture to bound states of the projectile to the ECC.

Journal Article↗

PubMed2001

Obstetrician-gynecologists' knowledge and training about antenatal corticosteroids.

OBJECTIVE: To characterize the clinical decisions, knowledge, opinions, and education of obstetricians and gynecologists about antenatal corticosteroids. METHODS: Questionnaires mailed to 1020 ACOG Fellows included items on demographics, knowledge, clinical practice patterns, and educational background regarding antenatal corticosteroids. RESULTS: The survey response rate was 47.8%. Almost all respondents (94%) reported administering antenatal corticosteroids, with reduction of respiratory distress syndrome (82%) as the primary reason for antenatal corticosteroid administration. Most (59.2%) were unaware of newly recognized associations between multiple administrations of corticosteroids and fetal growth restriction. In hypothetical clinical situations, responses by physicians who completed their residency training before 1970 indicated less likelihood to administer corticosteroids when administration is relatively indicated per National Institutes of Health (NIH) and ACOG guidelines than those trained later (P <.001). Only 8% of the entire sample rated their knowledge of antenatal corticosteroids as comprehensive; most (68%) rated it as adequate. Respondents rated residency training as a much better source of antenatal corticosteroid knowledge than medical school. CONCLUSION: Most obstetrician-gynecologists reported using antenatal corticosteroids; however, in general, many were not aware of more recent information regarding potential risks. This survey suggests that a multipronged educational approach is warranted to update obstetrician-gynecologists about antenatal corticosteroids.

Adult↗

PubMed2001

The utility of the Substance Abuse Subtle Screening Inventory-3 for use with individuals with brain injury.

The utility of the Substance Abuse Subtle Screening Inventory (SASSI-3) for the use with individuals with traumatic brain injuries (TBI) was investigated. The SASSI-3 was administered to 78 subjects prior to discharge from inpatient rehabilitation. The SASSI-3 diagnosis of chemical dependency was compared with the diagnosis of staff psychologists. Lower accuracy, sensitivity, and specificity were found in SASSI-3 diagnosis for the subjects with brain injury, as compared to a normative sample of persons with disabilities participating in a vocational rehabilitation programme. When a diagnosis of 'dependence or abuse' was used, accuracy of the SASSI-3 increased. Comparison of diagnosis based on SASSI-3 versus Blood Alcohol Level (BAL) at the time of injury showed comparable accuracy; however, BAL was found to have higher specificity. For dependence or abuse, BAL continued to be more specific than the SASSI-3; however, the SASSI-3 was more sensitive. Based on these findings, a clinical approach to screening using both BAL and the SASSI-3 is discussed.

Adolescent↗