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PubMed1994

Use of discriminant analysis to assess disease activity in pulmonary tuberculosis with a panel of specific and nonspecific serum markers.

Several cell activation markers, acute phase reactants, enzymes, and antituberculous antibody serum levels have been proposed as possible markers to monitor disease activity in patients with tuberculosis. They have all shown limited sensitivity or specificity. The authors therefore attempted to generate a canonical variable using discriminant analysis, including sensitive and specific parameters, to be a reliable marker in classifying patients correctly during the course of pulmonary tuberculosis. The following parameters were selected: two soluble cell activation markers (soluble interleukin-2 receptor and sCD8); the levels of immunoglobulin (Ig) G and IgM antibodies against the A60 antigen complex; and the presence of specific antibodies directed to eight different A60 components, revealed by Western blot analysis. The tests were performed on sera from three groups of patients with pulmonary tuberculosis. The first group comprised 25 patients with onset tuberculosis, clinically active (OTCA), evaluated at the time of admission. The second group included 28 patients with chemotherapy-treated tuberculosis, clinically active (CTCA), 2 months after therapy had begun. The third group included 20 patients with tuberculosis, nonclinically active (TNCA), who had had at least 1 year of effective therapy. The authors obtained an 80.9% rate of correct classification for the three groups and a rate of 100% when OTCA and TNCA were compared. The patients with CTCA were scarcely differentiated and tended to be distributed into the two other groups. To improve the separation between patients with CTCA and those with OTCA, a second canonical variable was generated with a 91.7% rate of correct classification, as compared with 71% obtained using the sCD8 as the best single variable. The mean values of the last canonical variable were statistically different (Mann-Whitney test, P = .049) when stratified for acid fast bacilli-positive or negative CTCA patients (microscopic detection). Three patients, followed during the entire course their disease, were, as expected, correctly positioned with respect to the subsequent disease phases.

Adult↗
PubMed2003

A psychometrically derived impulsive trait related to a polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in a Japanese nonclinical population: assessment by the Barratt impulsiveness scale (BIS).

Although a number of studies have shown that human impulsive traits are associated with indices of central serotonin function, few researchers have investigated the relationship between a polymorphism in the serotonin transporter gene-linked region (5-HTTLPR) and a psychometrically derived impulsive trait. We determined the 5-HTTLPR polymorphism in 123 employed Japanese male adults using the polymerase chain reaction. The distribution of allelic frequency was determined and also investigated the relationship of the 5-HTTLPR polymorphism to a impulsive trait as measured by the Barratt Impulsiveness Scale, 11th version (BIS-11). The distribution of allelic frequency was found to be almost identical to that previously reported in Japanese (the frequency for the long (L)/L, L/short (S), and S/S genotypes was: 3, 28, and 68%, respectively). In a comparison between the genotype groups, the S/S genotype group significantly higher scored for the total BIS-11 and the subscale attentional impulsiveness than the L/S + L/L genotype group. These findings suggest that individuals with a homozygous S-allele may be more impulsive than those with the other genotype.

Carrier Proteins↗
PubMed2004

Snoring and sleep-disordered breathing in young children: subjective and objective correlates.

STUDY OBJECTIVES: We sought to assess the predictive validity of parental report of snoring and other behaviors by comparing such reports with objective findings from overnight polysomnography for the evaluation of sleep-disordered breathing in 2 nonclinical samples, namely, at-risk preschoolers and an older group reflective of the general community. Predictive validity of snoring alone and a score based on multiple child behaviors were compared to outcome at different levels of severity of sleep-disordered breathing. DESIGN: Retrospective observational study. SETTING: Questionnaires were distributed through school programs; polysomnography was performed at Kosair Children's Hospital in Louisville, Kentucky. PARTICIPANTS: One hundred twenty-two preschoolers and 172 5- to 7-year-olds, and their parents, participated in both subjective-report and objective-recording portions of the study. MEASUREMENTS AND RESULTS: Compared to the presence of snoring on polysomnography, parental report of frequent snoring was highly sensitive and specific for both age groups. At all but the lowest level of severity of sleep-disordered breathing, predictive ability was higher for both groups when a parental-report score based on multiple measures of child behavior was applied, compared to parental report of snoring alone. The profiles of these predictive child behaviors differed between the 2 groups, as did their sensitivity and specificity, at their high ranges of parental report. CONCLUSIONS: Scores derived from parental-report questionnaires of children's snoring and other sleep and wake behaviors can be used as surrogate predictors of snoring or sleep-disordered breathing in children. However, design and interpretation should consider age, risk status, and the purpose of the screening assessment.

Child↗
PubMed2001

The nature and frequency of reported cases of teacher perpetrated child sexual abuse in rural primary schools in Zimbabwe.

OBJECTIVE: The main purpose of this study was to investigate the nature and magnitude of reported cases of teacher perpetrated child sexual abuse of rural primary school pupils in Zimbabwe. The study also determined the distribution of reported cases of child sexual abuse according to the characteristics of victims and perpetrators. METHOD: This is a retrospective case series study of reported cases of child sexual abuse drawn from six randomly selected educational jurisdictions. The study covered an 8-year period (1990-1997) and used a study sample of 110 nonclinical case files of teacher perpetrators. Descriptive statistics were used to analyze the findings. RESULTS: Gender-wise, 108 (98%) of the victims were girls, while all perpetrators were male teachers. Penetrative sex was the most prevalent (70%) type of sexual abuse. Meanwhile, the modal age for sexual abuse in the study sample was 12 years, which represents 46% of reported cases, while the most vulnerable age group comprised pubertal (11-13 years) children, who accounted for 69% of all sexual abuse cases. On the one hand, beginning teachers (0-5 years), who comprised 63% of the study sample, were most at risk of sexually abusing school children. Finally, 78% of 32 cases handled by the courts resulted in convictions, while 83% of all teacher perpetrators were dismissed from the teaching service. CONCLUSION: The results of the study clearly indicate that the problem of teacher perpetrated child sexual abuse is not uncommon among rural primary schools in Zimbabwe. The study has also shown that the perpetrators of child sexual abuse in rural primary schools are generally male teachers; a majority of them are young and inexperienced. Finally, this study showed that penetrative sex was the most prevalent form of abuse (70%), perpetrated on predominantly female victims (98%), and that all perpetrator teachers were males, and may clearly reflect Zimbabwe's highly patriarchal society.

Child↗
PubMed2001

Nonclinical and early clinical development of tacrolimus ointment for the treatment of atopic dermatitis.

Tacrolimus ointment, formulated for the treatment of atopic dermatitis, is the first in a class of topical immunomodulators. Its mechanism of action is based on calcineurin inhibition, which results in suppression of antigen-specific T-cell activation and inhibition of inflammatory cytokine release. Animal and human studies have shown that topically applied tacrolimus is minimally absorbed into the systemic circulation, the fraction that is absorbed is extensively distributed, and tacrolimus does not accumulate in tissues following repeated topical application. In addition, tacrolimus ointment is not inherently irritating, sensitizing, phototoxic, or photoallergenic when applied to intact skin. Unlike some topical corticosteroids, tacrolimus ointment does not cause a decrease in collagen synthesis or skin thickness, nor does it produce skin abnormalities or depigmentation. In animal studies, repeated daily application of tacrolimus ointment up to 1 year is associated with dermal findings similar to those following vehicle application (mild to moderate dermal irritation and microscopic findings of acanthosis, hyperkeratosis, and superficial inflammation). In a 52-week study with Yucatan micropigs, no noteworthy macroscopic or microscopic changes (either dermal or systemic) related to the application of tacrolimus ointment (0.03% to 0.3% concentrations) were observed. Tacrolimus ointment was shown to be safe and effective in phase 2 and early phase 3 studies. Significant improvements in atopic dermatitis were observed in the majority of patients treated with tacrolimus ointment. The most common adverse events associated with its use were a transient burning sensation and pruritus at the site of application. Blood tacrolimus concentrations were below the limit of quantitation in most patients.

Animals↗
PubMed2006

Sexual functioning in women with chronic pelvic pain: the impact of depression, support, and abuse.

Many studies have documented associations between sexual functioning, depression, experiences of childhood sexual abuse, relationship support, and chronic pelvic pain, but none have addressed the interrelationships among all of these variables in a unified model. The aim of this preliminary study was to construct an integrative model predicting sexual functioning for women with chronic pelvic pain. Sixty-three women with chronic pelvic pain completed measures of sexual functioning for use as the criterion variable, and measures of the impact of chronic pain, depression, experiences of sexual abuse, and relationship support as predictors. The primary finding was that depression mediated the effects of child sexual abuse and partially mediated the effects of relationship support on sexual behavior and satisfaction with the sexual relationship. In addition to its indirect relationship through depression, relationship support also independently predicted sexual function. Thus, in this nonclinical sample, the effects of child sexual abuse on sexual function depended on the extent of depressive symptoms, while the influence of relationship support depended in part on depression.

Adult↗
PubMed1998

What does early antisocial behaviour predict? A follow-up of 4- and 5-year-olds from the Ontario Child Health Study.

OBJECTIVE: To examine the predictive accuracy of antisocial behaviours among 4- and 5-year-old children for problem behaviours 4 years later (ages 8 and 9 years). METHOD: Data from the Ontario Child Health Study (1983) and Follow-up (1987) are used. Predictive accuracy is conceptualized using positive predictive value (PPV) and sensitivity. The predictive accuracy of early antisocial behaviors for the 1987 outcomes is examined overall, by gender, by variable thresholds of predictor and outcome be gender, and by using contextual variables alone or in combination with antisocial behaviour recorded in 1983. Resulting: The predictive accuracy of 1983 antisocial behaviour for 1987 outcome is generally modest and differs by gender (better for boys for externalizing disorder [PPV = 41%, sensitivity = 57%]; better for girls for internalizing disorder [PPV = 13%, sensitivity = 80%]; better for boys for conduct problems [PPV = 54%, sensitivity = 21%]¿. Using either gender-specific thresholds or gender-neutral thresholds does not alter predictive accuracy in a consistent way, nor does the use of a single contextual variable. Use of a cumulative risk index increases PPV but decreases sensitivity. CONCLUSION: The predictive accuracy of antisocial behaviour in 4-and 5-years-old children over 4 years in a nonclinical community population is limited. The clinical, research, and policy implications of this work are discussed.

Attention Deficit and Disruptive Behavior Disorder↗
PubMed1998

Confirmatory factor analysis of the revised Personal Style Inventory.

The revised Personal Style Inventory (PSI) was developed to measure the sociotropy and autonomy personality dimensions; both of these dimensions are thought to confer specific vulnerabilities to the onset, maintenance, and reoccurrence of depression. Confirmatory factor analysis was used to test the theoretical structure that informed the construction of the PSI. Using a large sample of nonclinical participants (n = 869) and a sample of outpatients with major depression (n = 101), both the items and the subscales of the PSI decomposed into factor structures that were, overall, fair to good representations of the theoretical model. Modifications were needed at the subscale level to achieve an adequate fit for the nonclinical and clinical samples, which provide implications for both the measurement and theory of the PSI and the sociotropy and autonomy domains.

Adult↗
PubMed2001

Validation of an instrument to measure dental students' use of, knowledge about, and attitudes towards computers.

Currently, no validated survey instrument exists to measure dental students' use of, knowledge about, and attitudes towards computers. Several studies have surveyed students about their knowledge and opinions regarding computers, but none of them has established the reliability and validity of the instrument(s) used. A measurement study to validate a preliminary survey for dental students was conducted. The preliminary instrument contained five scales: computer use, information resource use, computer knowledge, capabilities of computer systems, and effects of computers on dental practice. Selected variables were summarized descriptively, and a factor analysis for each scale was performed. In addition, construct validity was assessed through correlational analyses among several variables. Three hundred seventy surveys distributed to students at nine dental schools generated 156 responses (42 percent response rate). Sixty-four percent of respondents were male, 36 percent female. Respondents used computers an average approximately four hours per week, and most had begun using computers in 1991. All survey scales except computer use were unidimensional. Computer use required a two-factor solution that distinguished between clinical and nonclinical uses of computers. The instrument can be used for a demonstration study, but should be continuously refined and validated.

Analysis of Variance↗
PubMed1986

Developmental classification of reading-disabled children.

The present study developed and used longitudinal cluster analysis, a multivariate classification technique, to classify a sample of 200 nonclinical normal and reading-disabled males based on their performances on a neuropsychological battery at kindergarten, second, and fifth grades. The resulting classification was examined against various internal and external validation criteria. Using a validation framework, five developmental subtypes of children, two normal and three deficit reader groups, were found. Three of these groups could best be described as partitions of a multivariate normal distribution; the other two, both containing deficit readers, showed different covariance structures, suggesting differing developmental patterns. These groups were shown to differ with respect to the domains of academic achievement, parental achievement, neurological status, birth histories, school behaviors, and neuropsychological-cognitive development. The results suggest that developmental classifications can be formed by using multivariate classification methods and the subtypes support findings from cross-sectional classification research on similar populations.

Child↗
PubMed1998

Estimation of confidence intervals for area under the curve from destructively obtained pharmacokinetic data.

The area under the curve (AUC) of the concentration-time curve for a drug or metabolite, and the variation associated with the AUC, are primary results of most pharmacokinetic (PK) studies. In nonclinical PK studies, it is often the case that experimental units contribute data for only a single time point. In such cases, it is straightforward to apply noncompartmental methods to determine an estimate of the AUC. In this report, we investigate noncompartmental estimation of the AUC using the long-trapezoidal rule during the elimination phase of the concentration-time profile, and we account for the underlying distribution of data at each sampling time. For data that follow a normal distribution, the log-trapezoidal rule is applied to arithmetic means at each time point of the elimination phase of the concentration-time profile. For data that follow a lognormal distribution, as is common with PK data, the log-trapezoidal rule is applied to geometric means at each time point during elimination. Since the log-trapezoidal rule incorporates nonlinear combinations of mean concentrations at each sampling time, obtaining an estimate of the corresponding variation about the AUC is not straightforward. Estimation of this variance is further complicated by the occurrence of lognormal data. First-order approximations to the variance of AUC estimates are derived under the assumptions of normality, and lognormality, of concentrations at each sampling time. AUC estimates and variance approximations are utilized to form confidence intervals. Accuracies of confidence intervals are tested using simulation studies.

Algorithms↗
PubMed1998

Restorative treatment need assessment by dentally and nondentally trained subjects.

A study was carried out which compared how two groups of people, one with clinical dental experience and one without, assessed restorative dental treatment need. Using a visual analogue scale, a group of final year dental students (n = 50) and nonclinical university students (n = 50) assessed the extent to which they considered common dental imperfections, viz. spacing of the upper anterior teeth and discolouration of upper anterior teeth, warranted restorative correction. The group of dental students judged the necessity for treatment of discolouration to be more urgent than correction of spacing. The nondental group did not differentiate between the degrees of need. Data were non-normal in distribution but the use of appropriate statistical tests showed the differences in mean assessments to be significant.

Adolescent↗
PubMed2005

Factorial structure of the hallucinatory experience: continuity of experience in psychotic and normal individuals.

Examination of the distribution of the hallucinatory experience may aide in the determination of their continuity and the psychological mechanisms that mediate their occurrence. Past investigators have found that hallucinatory experiences are not limited to disordered individuals and can be induced in the laboratory and occur naturally in the general population. Few reports to date, however, have directly investigated the continuity of the experience by comparing hallucinatory behavior of psychotic patients with a nonclinical sample. In the present study, we examined the architecture of the hallucinatory experience by comparing the factorial structure of the Launay-Slade Hallucination Scale using psychotic patients with active hallucinations, psychotic inpatients without hallucinations, and a group of university students. In support of the continuum model of psychosis, a very similar factor-analytic solution was obtained for all three groups. Discriminant function analysis, however, revealed that all groups achieved a high classified rate by their item responses. These results are consistent with the notion that expression of hallucinatory behavior exists along a continuum, but at a certain level of symptom severity beyond a critical threshold, the behavior becomes discontinuous and dysfunctional.

Adult↗
PubMed2006

Error-related electrocortical responses are enhanced in children with obsessive-compulsive behaviors.

The error-related negativity (ERN or Ne) and positivity (Pe) are event-related potential components elicited during simple discrimination tasks after an error response. The ERN and Pe have a fronto-central scalp distribution and may be an indirect measure of anterior cingulate (AC) activity as it relates to performance monitoring. Brain imaging studies suggest that obsessive-compulsive disorder (OCD) is associated with exaggerated activity of the AC while electrophysiological studies have found an association between OCD and pronounced ERNs in adults. The present study explored the relation between obsessive-compulsive behaviors, the ERN, and the Pe in a sample of nonclinical 10-year-old children. It was found that more parent-reported obsessive-compulsive behaviors were associated with larger ERN and Pe components in the children. Results suggest unique contributions of the ERN and Pe in predicting obsessive-compulsive behaviors.

Anxiety↗
PubMed1986

Jungian personality typology and the recall of everyday and archetypal dreams.

Hypotheses concerning the relations among personality types, neuroticism, and the recall of archetypal dreams were derived from Jungian theory. Dream records were obtained from a nonclinical population in two stages: first, recall of the most recent, most vivid, and earliest remembered dreams (N = 146), and then dream recall on awakening, over an average of 23 nights, from 30 of the first-sample subjects. A total of 697 dreams was recorded. Subjects also completed the Eysenck Personality Inventory (EPI) the Myers-Briggs Personality Inventory, and a Dreaming Questionnaire. Dream archetypality was rated in accordance with procedures of H. Y. Kluger. The distribution of archetypal dreams across earliest (n = 106), most vivid (n = 105), and most recent (n = 102) dream types matched Kluger's earlier results. The dream diary recall data showed that Jungian intuitives, as measured via Myers-Briggs continuous scores, recalled more archetypal dreams; introverts, as measured via Myers-Briggs continuous scores, recalled more everyday dreams; high EPI neuroticism scorers recalled fewer archetypal dreams. The results support several propositions of Jungian personality theory.

Adolescent↗
PubMedDate not supplied

[Symptoms of DSM IV borderline personality disorder in a nonclinical population of adolescents: study of a series of 35 patients].

1,363 high school students were solicited to complete a personality disorder questionnaire and were encouraged to continue in the study by signing up for interviews with Master's level psychology students. 107 students (7.8%, 34 males, 73 females, mean age = 16.7 +/- 1.8) manifested themselves for the interview and were assessed by using structured diagnostic interviews for borderline personality disorder and major depressive disorder (DIB-R, Revised Diagnostic Interview for Borderlines; MINI, Mini International Neuropsychiatric Interview). The interviews were audiotaped. Interrater reliability was determined by independent ratings of 12 borderline subjects and 12 non-borderline subjects (kappa: 0.795). The distribution of the 107 subjects based on the number of DSM IV borderline personality disorder criteria indicated a gradual dispersion suggesting a continuum from normality to borderline personality disorder: 8% of the subjects met none of the criteria; 16% met one criterion; 17% met two; 12.5%, three; 13.7%, four; 8.4%, five; 5.6%, six; 9.3%, seven; 4.6%, eight; 4.6%, nine. Thirty-five of these 107 subjects (32.7%, 6 males, 29 females, mean age = 16.7 +/- 1.7) received a diagnosis of borderline personality disorder according to DSM IV criteria. The most frequent symptoms were paranoid ideation or dissociative symptoms (97.1%), affective instability (88.6%), inappropriate, intense anger (85.6%), suicidal gestures or automutilation (82.9%), followed by frantic efforts to avoid abandonment (77%), impulsivity (65.7%), unstable and intense relationships (62.9%), identity disturbance (60%), and emptiness (57.1%). The comparison between borderline and non-borderline subjects showed that all borderline personality disorder criteria discriminated significantly between the two groups. The high incidence of paranoid ideation (97.1%) and dissociative experiences (65.7%) in the borderline group suggests the pertinence of criterion 9 in the diagnosis of borderline personality disorder in adolescents. Two criteria of schizotypal personality disorder were also frequent in this group: 68.6% of the borderline group reported odd beliefs or magical thinking, in particular beliefs in clairvoyance or telepathy and 88.6% reported unusual perceptual experiences, in particular sensing the presence of a force or person and bodily illusions. Moreover, 31.4% of the borderline group reported transient "quasi" psychotic experiences, mainly "quasi" visual hallucinations. Auditory hallucinations or delusional ideas were not observed. This symptomatology suggests a "quasi" psychotic dimension of adolescent borderline personality disorder. Affective instability was the next most frequent symptom which was usually marked by a cyclothymic appearance. Comorbidity with major depressive disorder was high: 85.7% of the borderline subjects had a concurrent diagnosis of major depression versus 45.8% of the non-borderline subjects. Thus, major depression is more frequent than most of the borderline personality disorder criteria, with the exception of the already noted paranoid ideation and affective instability. Hypomanic symptoms were frequent in the borderline group (65.7%) as well as in the non-borderline group (38.8%). This symptomatology suggests that adolescent borderline personality disorder is linked to an attenuated bipolar spectrum characterised by major depressive episodes and soft signs of bipolarity. However, hypomanic symptoms, which were quite frequent in non-borderline subjects, might also be due to a mechanism of defence, i.e. the denial of depression. Comorbidity with anxiety disorders appeared also to be high: anxiety symptoms were found in 91.4% of the borderline subjects who reported symptoms of generalised anxiety disorder, panic disorder, and somatoform disorders. The overall clinical appearance of these borderline adolescents not referred for treatment seemed to be quite similar to that of borderline adolescents in clinical samples. This study shows that adolescent borderline personality disorder in non-clinical population is a serious disorder characterised by the importance of mental suffering and behavioural disturbances the disorganising power of which may fix the developmental process in a pathological pathway. Adolescent borderline personality disorder appears in this study to be strongly associated with major depressive disorder and at-risk behaviours linked to impulsivity, affective instability, and suicidal ideation. However, this study found an absence of precise cut-off between borderline and non-borderline subjects. Two factors might have contributed to the appearance of a continuum. First, some degree of impulsivity and instability in affectivity, self-images and interpersonal relationships is part of normal adolescence. (ABSTRACT TRUNCATED)

Adolescent↗
PubMed1994

Interactions with lectins and agglutination profiles of clinical, food, and environmental isolates of Listeria.

On the basis of preliminary trials with 14 collection strains of Listeria, five lectins (Canavalia ensiformis, concanavalin A; Griffonia simplicifolia lectin I; Helix pomatia agglutinin; Ricinus communis agglutinin; and Triticum vulgaris wheat germ agglutinin) were selected to set up a microtiter agglutination assay. The lectin agglutination profiles of 174 clinical, food, and environmental strains of Listeria monocytogenes, Listeria innocua, and Listeria seeligeri were investigated. Data on the standard determination of the antigenic structure were available for clinical strains; nonclinical isolates were assigned to serogroup 1 or 4 with commercial antisera. The listeria-lectin interaction was related to serological type rather than species; in particular, the strains assigned to serogroup 1 or belonging to serovars 1/2a, 1/2b, 1/2c, 3a, 3b, and 7 were never agglutinated by G. simplicifolia lectin I. The five-lectin set proved to be capable of detecting differences between serologically identical isolates of L. monocytogenes. Of the 150 isolates of this species, 144 were distributed over 15 different lectin agglutination profiles and 6 autoagglutinated, the overall typeability being 96%. However, the profiles encountered among L. monocytogenes isolates were not randomly distributed. With strains assigned to serogroup 1 or belonging to serovars 1/2a, 1/2b, 1/2c, and 3b, the clinical isolates fell into only two of the eight patterns recorded overall; with strains of serogroup 4 and serovar 4b, food and environmental isolates were distributed over eight of the nine patterns found in total, while clinical isolates were distributed over five patterns. In a comparative study of 15 epidemiologically relevant isolates of L. monocytogenes from five distinct outbreaks, strains with identical phage types and/or DNA fingerprints displayed identical lectin profiles. The heterogeneity of agglutination profiles may form the basis of a new approach to L. monocytogenes typing.

Agglutination↗
PubMed1997

Use and abuse of the Children's Depression Inventory.

This study investigated current uses of the Children's Depression Inventory (CDI), a frequently cited self-report measure for children's depressive symptomatology. Recently published studies of "childhood depression" were reviewed: Half of them used the CDI. Of these studies, 68% did not use a clinical or structured interview to determine diagnostic status. When the CDI was used alone to assess depressive symptoms, 44% of studies referred to high CDI scorers as "depressed" without providing a clear cautionary statement (i.e., either stating that the CDI cannot be used to diagnose depression or clarifying limitations regarding generalization of findings from a nonclinical to a clinical sample). These results are similar to those previously published regarding the Beck Depression Inventory, and they suggest a need for caution in the administration and interpretation of results from self-report inventories for children's depressive symptoms.

Chi-Square Distribution↗