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Minor psychiatric disorder in NHS trust staff: occupational and gender differences.

BACKGROUND: It is widely suggested that many National Health Service (NHS) workers experience high levels of minor psychiatric disorder. However, inadequacies of sampling and measurement in studies to date have not allowed this suggestion to be properly evaluated. METHOD: The present study was designed to overcome these methodological weaknesses by using a sample of over 11,000 employees from 19 NHS trusts and a well-established measure of minor psychiatric disorder for which there are comparative data. RESULTS: The findings show that 26.8% of the health service workers reported significant levels of minor psychiatric disorder, compared with 17.8% of people in the general population. Psychiatric morbidity was highest among managers, doctors, nurses and professions allied to medicine, with each of these groups recording higher rates than their professional counterparts outside the health service. It was lower among those in support occupations, such as administrative and ancillary staff. A feature of the findings was that female doctors and managers showed a much higher prevalence of minor psychiatric disorder than their male colleagues. CONCLUSION: Studies are required to establish the organisational, occupational and individual determinants of minor psychiatric disorder among NHS employees.

Administrative Personnel↗

Comparative study with double-exposure digital holographic interferometry and a shack-hartmann sensor to characterize transparent materials.

We compare wave-front measurements using double-exposure digital holography and a Shack-Hartmann sensor. A voltage-driven liquid-crystal wedge modulates the optical wave front and provides a refractive-index gradient typical of interesting transparent materials. Measurement accuracy and reliability are similar for both methods. In our opinion, digital holographic interferometry has several advantages for both laboratory and field environments. When compared with Shack-Hartmann methods, these advantages include hardware simplicity and robustness, relative insensitivity to sample dynamic range, and less computational demanding and more straightforward data evaluation algorithms. We believe that digital holography provides the methodology of choice for field studies of transparent materials such as microgravity protein crystal growth experiments.

Journal Article↗

Orthogonal array design as a chemometric method for the optimization of analytical procedures. Part 5. Three-level design and its application in microwave dissolution of biological samples.

The theory and methodology of a three-level orthogonal array design as a chemometric method for the optimization of analytical procedures were developed. In the theoretical section, firstly, the matrix of a three-level orthogonal array design is described and orthogonality is proved by a quadratic regression model. Next, the assignment of experiments in a three-level orthogonal array design and the use of the triangular table associated with the corresponding orthogonal array matrix are illustrated, followed by the data analysis strategy, in which significance of the different factor effects is quantitatively evaluated by the analysis of variance (ANOVA) technique and the percentage contribution method. Then, a quadratic regression equation representing the response surface is established to estimate each factor that has a significant influence. Finally, on the basis of the quadratic regression equation established, the derivative algorithm is used to find the optimum value for each variable considered. In the application section, microwave dissolution for the determination of selenium in biological samples by hydride generation atomic absorption spectrometry is employed, as a practical example, to demonstrate the application of the proposed three-level orthogonal array design in analytical chemistry.

Chemistry Techniques, Analytical↗

Toward large-scale mass spectrometry-based omics for clinical applications.

INTRODUCTION: As healthcare advances toward personalized medicine, mass spectrometry-based research is advancing our understanding of cellular biology and disease states, and translating these findings into clinical applications. This review highlights recent advances in methodology and technology that demonstrate the capabilities of mass spectrometry-based proteomics, lipidomics, and metabolomics in clinical practice. AREAS COVERED: The ability to directly analyze functional molecules with mass spectrometry uncovers crucial clinical information. Each data modality (proteins, lipids, and metabolites) provides essential insight into healthy and disease states. As technology advances, integrating data from different modalities unlocks new possibilities for clinical research. To gain the most from this multi-omic data, unsupervised integration methods can provide detailed insights into complex biological processes. As the field applies this knowledge, healthcare could experience significant leaps in the near future. This review examines recent advancements in mass spectrometry-based proteomics, lipidomics, and metabolomics, focusing on how improvements in sample preparation, automation, and multi-omics data integration are making large-scale clinical studies more accessible. EXPERT OPINION: Recent technical and methodological advancements in mass spectrometry analysis have propelled healthcare toward a tipping point, shifting from traditional RNA- and DNA-based research to downstream analysis of protein, lipid, and metabolite effectors.

Humans↗

[The benefits of auditing clinical histories. Our experience over 5 years].

OBJECTIVE: To evaluate how our clinical records (CR) are filled in and to observe the impact of measures taken to correct faults found over a five-year follow-up period. DESIGN: Three descriptive studies (auditing methodologies) on representative samples of CR selected at random. Four quality indicators were fixed: internal communication (i.e. legibility and comprehensibility), external communication, manageability and the quality of the activity at attendances measured by the SOAP. The optimum standards (OS) were agreed by the team (technique of nominal group). SETTING: "Florida" Health Centre, Alicante. PATIENTS AND OTHERS PARTICIPANTS: Periodic team meetings to analyse results and agree activities. In 1986, N of CR = 367; in 1988, 370; and in 1990, 372. MAIN MEASUREMENTS AND RESULTS: During the follow-up period, the filling-in of all the variables, except the address, the test carried out and blood pressure, improved. But the following did not reach the OS: code, affiliation, origin, instruction, habits, allergies, working activity, socio-economic data, age and gender, family/personal background, test carried out, blood pressure and analytical data. The following all reached the OS: legibility, which went up from 88% to 96.5%, comprehensibility from 62 to 75.3%, external communication from 81 to 88.9%, manageability from 53 to 79.6% and SOAP from 62 to 82.5%. CONCLUSIONS: Auditing allows the level of the filling-in of the CR to be measured. Deficiencies which appear to be due to the design of the record itself can be detected. The efficacy of corrective measures to improve records can also be assessed.

Communication↗

Assessment of psychosocial experiences in childhood: methodological issues and some illustrative findings.

The development of a new standardised investigator-based interview, PACE (Psychosocial Assessment of Childhood Experiences), for the assessment of acute life events and long-term psychosocial experiences is described. An application of PACE to a sample of 84 children referred to psychiatric clinics and 22 general population controls, is presented. Reliability was assessed using a separate clinic sample of 15 child-parent pairs. The findings showed that PACE has satisfactory reliability and discriminant validity.

Adaptation, Psychological↗

Using discrete choice experiments to estimate a preference-based measure of outcome--an application to social care for older people.

This paper reports the results of a study that used discrete choice experiment (DCE) methodology to estimate quality weights for a of social care outcome measure. To reflect different states of need, a five-dimensional profile measure was developed. Experimental design techniques were used to derive a sample of states for which preferences were elicited. The DCE approach was employed to elicit values and regression techniques used to estimate a model that could predict index scores for all 243 possible outcomes. The utility model, estimated on the basis of 297 responses, had good test-retest reliability and converged with preferences elicited from a rating exercise.

Aged↗

Current trends in differential expression proteomics: isotopically coded tags.

Isotopically coded tag methodology holds significant promise for differential expression proteomic experiments. This methodology has the potential for high sensitivity, high coverage, and high throughput. Although significant technical advances have been made in the past year, this approach must be viewed as an emerging technique. Advances in sample fractionation, both at the protein and peptide level, and improved data acquisition schemes, will all be required before the full potential of the method is realized.

Affinity Labels↗

Continuous blood withdrawal as a rapid screening method for determining clearance of oral bioavailability in rats.

PURPOSE: To develop a methodology for continuous blood withdrawal in rats suitable for drug discovery screening purposes and perform limited validation studies with a series of test compounds. METHODS: A reliable methodology for continuous blood withdrawal in rats was developed. The method is dependent on continuous heparin infusion during withdrawal and the minimization of constrictive, thrombogenic sites. Plasma drug concentrations from either intermittent sampling or continuous withdrawal experiments were determined with HPLC analysis. RESULTS: The continuous withdrawal method was successfully adapted to rats such that blood samples could be reliably collected over a 6-hr experiment. The clearance and oral bioavailability values for theophylline, atenolol, propranolol, warfarin, BMS-182874 and BMS-A were determined from continuous withdrawal or intermittent sampling experiments. The results from the two methods were comparable, with each compound reliably placed in the same low, medium or high category based on clearance or oral bioavailability characteristics. CONCLUSIONS: The continuous withdrawal method proved to be a viable alternative to the classic intermittent sampling technique. The method should prove useful in drug discovery screening, where the evaluation of large numbers of compounds for systemic clearance or oral bioavailability is often necessary.

Administration, Oral↗

Impact of parental health problems on children: concepts, methods, and unanswered questions.

Described conceptual and methodological issues that arise in the design and analysis of data from studies of the impact of parental health problems on children. Researchers should consider how the functional effects, duration, and type of exposure of parental health problems affect children's psychological experience. Multiple pathways (e.g., parental modeling, family socialization practices, and genetic factors) that affect the transmission of psychological and/or health risk to children need to be considered. Important methodological issues in this area of research include sample selection and bias, confounding factors, and limited assessment of family influences. Future work should identify factors that enhance child and family resilience to the effects of parental health problems. Studies are also needed to develop and test interventions to reduce the psychological morbidity associated with parental health problems.

Adaptation, Psychological↗

[The role of social support in the relationship between job stress and job satisfaction/organizational commitment].

PURPOSE: The purpose of this study is to investigate the role of social support in the experience of job stress among hospital nurses. METHOD: This study was carefully designed to overcome methodological shortcomings found in past research, and examined two organizational effectiveness variables(job satisfaction and organizational commitment) as outcome variables. The sample used in this study consisted of 602 nurses from 5 general hospitals. Data were collected with self-administered questionnaires and analyzed using hierarchical regression and LISREL technique. RESULT: It was found that: (a) three job stress variables(workload, role conflict and conflict with other medical staff) have negative effects on job satisfaction and organizational commitment; (b) social support have positive main effects on the two output variables; (c) the negative effects of job stress variables on job satisfaction and organizational commitment are not buffered by social support, and (d) social support mediates the effects of job stress on job satisfaction and organizational commitment, and the size of the mediating effects is small. CONCLUSION: Further research needs to be done to further refine this study.

English Abstract↗

Benner and the critics: promoting scholarly dialogue.

The research and theorizing of Patricia Benner and colleagues have been very influential in nursing around the world. In recent years, however, her work has been challenged on both methodological and philosophical grounds, primarily from critical-hermeneutic and postmodernist perspectives. Critics have identified concerns about Benner's work, including sample limitations, decontextualized exemplars, the exclusion of social and political concerns, the problematic issues of experience and interpretation, and the unacknowledged position of the researcher. This article attempts to synthesize those critiques, and offers a comprehensive framework for constructive dialogue. Disciplinary maturity and scholarly integrity require critical reevaluation of influential texts and research programs.

Education, Nursing↗

Methodological errors in radioisotope flux measurements.

We examined several sources of error in isotopic flux measurements in a commonly used experimental model: the study of 22Na and 36Cl fluxes across rat ileal tissue mounted in the Ussing flux chamber. The experiment revealed three important sources of error: the absolute counts per minute, the difference in counts per minute between serial samples, and averaging of serial samples. By computer manipulation, we then applied hypothetical changes in the experimental protocol to generalize these findings and assess the effect and interaction of the absolute counts per minute, the sampling interval, and the counting time on the magnitude of the error. We found that the error of a flux measurement will vary inversely with the counting time and the difference between the consecutive sample counts per minute used in the flux calculations and will vary directly with the absolute counts per minute of each sample. Alteration of the "hot" side specific activity, the surface area of the tissue across which flux is measured and the sample volume have a smaller impact on measurement error. Experimental protocols should be designed with these methodological considerations in mind to minimize the error inherent in measuring isotope flux.

Animals↗

Are social-psychological smoking prevention programs effective? The Waterloo study.

Recent evaluations of smoking prevention programs have suggested considerable promise for curricula emphasizing resistance of social influences. The present study extends these evaluations by addressing key methodological limitations in previous work. Twenty-two matched schools were randomized to experimental and control conditions. Grade 6 students received a 6-week core curriculum, plus additional sessions through Grades 7 and 8. Questionnaires, and saliva samples to validate self-reported smoking behavior, were collected at five times over the 2-year study period. Cross-sectional and longitudinal analyses examined program impact for five levels of initial smoking experience, ranging from "never smoker" through regular, weekly smoker. Significant program effects were documented, most clearly for those having some experience with smoking before the program began and for those with smoking peer and family models. This study provides the methodologically most rigorous test to date of social influence programs for smoking prevention and documents for the first time significant effects for those at high risk for smoking.

Adolescent↗

Types of social support in African Americans with cancer.

PURPOSE/OBJECTIVES: To determine the types of social support that African Americans use to cope with the experience of cancer. RESEARCH APPROACH: Qualitative study using a grounded theory approach. SETTING: Participants' homes in the southeastern United States. PARTICIPANTS: A purposeful sample of 13 African American men (aged 61-79 years) treated for prostate cancer and 15 African American women (aged 42-87 years) treated for breast cancer. Participants were selected according to key variables known to influence social support: age, gender, marital status, education, geographic region, and proximity to family. METHODOLOGIC APPROACH: Open-ended and semistructured interviews were conducted with each participant (N = 28). Participants were interviewed until informational redundancy was achieved. Constant comparison techniques were used to identify variations of social support within and across cases. MAIN RESEARCH VARIABLES: The experience of social support during diagnosis or treatment for cancer as well as post-treatment. FINDINGS: Participants used types of social support not currently emphasized in the literature. The emotional support of "presence" was reported most frequently. Instrumental support included not only current conceptualizations but also offers of prayers, assistance to continue religious practices, and assistance to maintain social roles. Informational support included what to expect and how to manage symptoms, interpret information, and validate information received. CONCLUSIONS: Findings suggest the need to reconceptualize social support for African Americans with cancer and to refine instruments to include these different manifestations of social support. IMPLICATIONS FOR NURSING: Researchers can use these findings in the design of culturally relevant questionnaires and interventions for this population. Clinicians can use knowledge of the types of social support valued among African American patients with cancer to develop more appropriate strategies to promote healthy outcomes for this population.

Adult↗

[Study of dissociative disorders and depersonalization in a sample of young adult French population].

UNLABELLED: Questioned by several researches about dissociative disorders, the authors study differences established on the nosographic register, through a quantitative study and a psychodynamic argumentation in a sample of french population. From the utilisation of the Dissociative Experiences Scale (DES) created by Bernstein E and Putnam FW (1986), which is an excellent screening tool for dissociative disorders and constructed on DSM II diagnostic criterions, the authors will show the interest of a psychodynamic analysis of dissociative disorders, in the face of the diagnostic difficulty in relation to several approaches of this concept. This difficulty is studied giving the background to dissociative disorders and depersonalization. Ionescu (1999) shows that between 1890 and 1910 dissociation represents one of major themes of psychology, psychopathology and psychiatry. Then, this interest about dissociation decreases and will be almost non-existent in the middle of the twentieth century. The interest for dissociative disorder will grow in the eighties with north-american studies about multiple personality disorders. Until 1980, dissociative disorders exist in DSM II as a list of symptoms included into hysterical neurosis, among the conversive disorders. In 1980, the publication of DSM III replaces the notion of hysteria with the notion of dissociative disorder. In this way, we can see on the one hand somatoform disorders quarterly corresponding to the ancient version of conversive hysteria, and on the other hand dissociative disorders characterized by a perturbation of consciousness, memory, identity or perception of environment. In 1994, The DSM IV delete the notion of hysteria and neurosis and keeps only the notion of dissociative disorders. They include now the five following categories: dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative identity disorder, dissociative disorder not otherwise specified (including derealization). Depersonalization disorders consist of "persistent or recurrent episodes of depersonalization characterized by a feeling of detachment or estrangement from one's self. The individual may feel like an automation or like he or she is living in a dream or movie" (DSM IV). Depersonalization disorder cannot be diagnosed if it is part of schizophrenia, panic disorder, acute stress disorder or dissociative identity disorder. Various depressive disorders, hypocondriasis or obsessive-compulsive disorders can accompany depersonalization disorder. The first purpose of this study will search the frequency of dissociative disorders and depersonalization in a sample of normal population. Further, the inclusion of depersonalization amongst dissociative disorders seems not so evident: depersonalization belongs to self-consciousness disorder in french psychiatry. This fact seems more logical insofar as dissociative disorders have all together a memory and consciousness perturbation, and this perturbation is missing from depersonalization's feeling. The second purpose will be to clarify and specify the particularity of depersonalization among dissociative diorders, from the psychopathological point of view. METHODOLOGY: The sample (n = 248) is made up of french young adults aged 17 to 30 (mean age = 20, SD = 15 and 24% is male population). Subjects were streamming from universities. The screening tool which was used is the Dissociative Experiences Scale, a 28-item patient questionnaire regarding various dissociative symptoms. The subject is asked to indicate the percentage of time, to the nearest 5%, that particular symptom is experienced. The score is made by adding the various percentages and finding a mean that is expressed in numbers from 0 to 100. Normal scores are in the range of 5 to 15 in american adults. RESULTS: The utilization of principal component analysis (PCA) with varimax rotation is justified by the will to compare this study with American's studies. The mean score obtained is 17.44%, and 13.3% of the scores exceed a psychiatric threshold at 30%. The descriptive analysis shows that the component 1 (PCA without varimax rotation) represents 33.02% of total explained variance. This result demonstrates that the structure of the DES is based on one concept, the same as the american population, it is the concept of dissociation. The Principal Component Analysis with varimax rotation of the DES ratings yielded a tree-factor solution: imaginative absorption (F1), depersonalization-derealization (F2) and dissociative amnesia (F3). Mean score for each factor is respectively: F1 = 21.56%, F2 = 13.95%, F3 = 11.04%. DES reliability was studied through computation of Cronbach's coefficient (0.92). The PCA with varimax rotation brings to the fore a full dissociative disorder without any trouble of memory and consciousness. This fact questions again once more the link between hysteria and dissociative disorders. There is here a clinical distinction between depersonalization-derealization and other dissociative disorders. Indeed, the absence of significant alteration of memory and conscience is specific of depersonalization and derealization in this study. CONCLUSION: Finally, this study concurs with DSM IV dissociative criterions. At last, one factor of PCA is composed by the association of depersonalization and derealization, in contradiction with DSM IV definition. This result shows that, into the french population, we cannot divide the two concepts.

Adult↗

The generalizability of capsaicin sensitization and desensitization.

Studies using capsaicin-saturated filter papers have shown that the intensity of oral irritation tends to grow over successive samples, a phenomenon known as sensitization. If a hiatus of 5-15 min is then introduced, the intensity of irritation produced by a subsequent capsaicin stimulus is much reduced, and desensitization is said to have occurred. The use of other methodologies such as whole-mouth rinses, either with capsaicin or the irritants menthol or zingerone, have not consistently shown this response pattern, casting doubt on the extent to which sensitization and desensitization are general phenomena. Experiment 1 addressed this issue by comparing responses to whole-mouth rinses of 0.6 and 3 ppm capsaicin with those to 3 ppm capsaicin filter papers. Over an initial series of 10 samples, sensitization was evident but only for the 3 ppm capsaicin stimuli. Following a 10-min hiatus, desensitization was observed for all stimulus types. An examination of the data of individual subjects revealed considerable variability in response patterns over the initial 10 samples between subjects and, within subjects, between the filter paper and rinse stimuli, and between the test replications. Desensitization to the posthiatus stimuli was more consistent. A second experiment examined whether the capsaicin sensitization and desensitization shown by stimulation with filter papers or solutions also occurred in the context of the consumption of foods containing capsaicin. Two foods--soup and chili con carne--were consumed under conditions in which the rate of consumption was timed, as in Experiment 1, or was self-paced. In neither of the two conditions or foods was there strong evidence of sensitization, although, again, desensitization following a hiatus was evident. Substantial individual variability in response patterns was again apparent. There is thus no evidence for sensitization occurring during normal food consumption.

Adult↗

AIDS survey methodology with black Americans.

Unique substantive and methodological issues are involved in conducting survey research on sexual and HIV risk related behaviors among Americans of African descent. Problem conceptualization, sampling, design of instruments, mode of data collection, interviewer/respondent characteristics, community resistance, and data analysis and interpretation are discussed. The lack of survey research on sensitive health issues is noted. Possible methods for addressing these issues are drawn from the experiences of the authors in conducting national research on the general and at risk Black community populations. It is concluded that attention to these issues can substantially improve the quality of research on AIDS related behaviors on Black communities. Finally, it is suggested that behavioral theories and sophisticated methodological and analytic approaches, sensitive to the special cultural dimensions of racial/ethnic life in the United States, would contribute substantially to the scientific armamentarium needed to successfully meet the challenge of the AIDS epidemic.

Acquired Immunodeficiency Syndrome↗