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PubMedDate not supplied

Identification of nurse-family intervention sites to decrease health-related family boundary ambiguity in PICU.

The most common explanation of parental stress associated with hospitalized children is based on individual stress theory. Using a family stress and family systems approach with an emphasis on examining family integrity, this qualitative study selected families in the Pediatric Intensive Care Unit (PICU) with high boundary ambiguity in the caregiving environment and identified potential sites for nursing actions that impede or assist families in maintaining family integrity. Within three days of admission of their child to a major tertiary children's hospital PICU, 29 families were recruited and screened with a Health-Related Family Boundary Ambiguity Scale. High scoring families (n = 11) were interviewed using an open-ended method. Data were analyzed using a content analysis method, and results were interpreted within a family systems framework. The following three potential areas of intervention to encourage family integrity during acute illness of a child were identified: fostering family normalcy, respecting family rights, and strengthening the family boundary. Implications for initiating or improving family centered care in the PICU are discussed.

Adolescent↗
PubMed1995

A longitudinal study of Off-Target Verbosity.

This study reports a follow-up examination of the speech of 175 subjects, aged 65 and over, who had participated in an initial evaluation of the cognitive and psychosocial correlates of Off-Target Verbosity (OTV). OTV speech showed significant stability across the 15 months of the study. The pattern of relationships among age, cognitive function, psychosocial variables, and OTV scores was similar for the two test occasions. Subjects who had experienced more frequent and less desirable life changes and had lower verbal fluency scores were more verbose. An association between age and OTV appeared due to age-related inhibition and psychosocial functioning. The results were interpreted within a conceptual model framework illustrating causal and other links among variables.

Age Factors↗
PubMed2003

Results of a high-resolution genome screen of 437 Alzheimer's disease families.

Alzheimer's disease (AD) is a devastating neurodegenerative disorder of late life with complex inheritance. Mutations in three known genes lead to the rare early-onset autosomal dominant form of AD, while a common polymorphism (epsilon 4) in the gene encoding apolipoprotein E (APOE ) is a risk factor for more typical late-onset (>60 years) AD. A recent study concluded that there are up to four additional genes with an equal or greater contribution to the disease. We performed a 9 cM genome screen of 437 families with AD, the full National Institute of Mental Health (NIMH) sample, which has been carefully ascertained, evaluated and followed by our group over the last decade. Performing standard parametric and non-parametric linkage analyses, we observed a 'highly significant' linkage peak by Lander and Kruglyak criteria on chromosome 19q13, which probably represents APOE. Twelve additional locations-on 1q23, 3p26, 4q32, 5p14, 6p21, 6q27, 9q22, 10q24, 11q25, 14q22, 15q26 and 21q22-met criteria for 'suggestive' linkage [i.e. two-point lod score (TLS) >/=1.9 and/or multipoint lod score (MLS) >/=2.2] in at least one of our analyses. Although some of these will surely prove to be false positives, these linkage signals should provide a valuable framework for future studies aimed at identifying additional susceptibility genes for late-onset AD.

Aged↗
PubMed1996

Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness.

To measure the effects of skin disease on patients' quality of life, we developed a 61-item self-administered survey instrument called Skindex. Skindex has eight scales, each of which addresses a construct, or an abstract component, in a comprehensive conceptual framework: cognitive effects, social effects, depression, fear, embarrassment, anger, physical discomfort, and physical limitations. Item responses are standardized from 0 (no effect) to 100 (maximal effect); a scale score is the average of responses to items addressing a construct. In 201 patients seen by dermatologists, mean scale scores (+/-SD) ranged from 14 (+/-17) for physical limitations to 31 (+/-22) for physical discomfort. Scale scores were reproducible after 72 h (r = 0.68-0.90) and were internally consistent (Cronbach's alpha = 0.76-0.86). Construct validity was assessed in two ways: (i) in a comparison of patients with inflammatory dermatoses and patients with isolated lesions, patients with inflammatory dermatoses had higher scale scores, and (ii) in an exploratory factor analysis, 78% of the common variance was explained by seven factors that correlated with the scale scores of Skindex. Most of the a priori scale scores changed in the expected direction in patients who reported that their skin conditions had improved or worsened after 6 mo. Finally, physicians' judgments of disease severity did not consistently correlate with Skindex scores. These preliminary data suggest that Skindex reliably and responsively measures the effects of skin disease on patients' quality of life and may supplement clinical judgments of disease severity.

Adult↗
PubMed2003

Validity and reliability of portfolio assessment of competency in a baccalaureate dental hygiene program.

This study examined the validity and reliability of portfolio assessment using Messick's unified framework of construct validity. Theoretical and empirical evidence was sought for six aspects of construct validity. Seven faculty raters evaluated twenty student portfolios using a primary trait analysis scoring rubric. A significant relationship (r = .81-.95; p < .01) between the seven subscales in the scoring rubric demonstrates measurement of a common construct. There was a significant relationship between portfolios and GPA (r = .70; p < .01) and the NBDHE (r = .60; p < .01). The relationship between portfolios and the Central Regional Dental Testing Service (CRDTS) examination was both weak and nonsignificant (r = .19; p > .05). A fully crossed, two-facet generalizability (G) study design was used to examine reliability. ANOVA demonstrated that the greatest source of variance was the scoring rubric itself, accounting for 78 percent of the total variance. The smallest source of variance was the interaction between portfolio and rubric (1.15 percent). Faculty rater variance accounted for only 1.28 percent of total variance. A phi coefficient of .86, analogous to a reliability coefficient in classical test theory, was obtained in the decision study by increasing the subscales to fourteen and decreasing faculty raters to three. In conclusion, the pattern of findings from this study suggests that portfolios can serve as a valid and reliable measure for assessing student competency.

Adult↗
PubMed2005

A novel drill set for the enhancement and assessment of robotic surgical performance.

BACKGROUND: There currently exist several training modules to improve performance during video-assisted surgery. The unique characteristics of robotic surgery make these platforms an inadequate environment for the development and assessment of robotic surgical performance. METHODS: Expert surgeons (n=4) (>50 clinical robotic procedures and >2 years of clinical robotic experience) were compared to novice surgeons (n=17) (<5 clinical cases and limited laboratory experience) using the da Vinci Surgical System. Seven drills were designed to simulate clinical robotic surgical tasks. Performance score was calculated by the equation Time to Completion + (minor error) x 5 + (major error) x 10. The Robotic Learning Curve (RLC) was expressed as a trend line of the performance scores corresponding to each repeated drill. RESULTS: Performance scores for experts were better than novices in all 7 drills (p<0.05). The RLC for novices reflected an improvement in scores (p<0.05). In contrast, experts demonstrated a flat RLC for 6 drills and an improvement in one drill (p=0.027). CONCLUSION: This new drill set provides a framework for performance assessment during robotic surgery. The inclusion of particular drills and their role in training robotic surgeons of the future awaits larger validation studies.

Clinical Competence↗
PubMed2006

Research validation of misguided entitlement.

This writer theorized that psychiatric patients that exhibited high levels of "misguided entitlement" (ME) would share certain personality traits, including narcissism, aggression, sociopathy, paranoia, and depression. The Millon Multiaxial Clinical Inventory (MMCI-II) was the instrument chosen to measure these traits in a sample of 100 psychiatric hospital/day hospital patients (Millon, 1987). An Entitlement Scale (ES) was devised so that staff nurses could rate entitled behaviors observed in these same 100 patients during the daily course of providing care. Scores from both instruments then were tested for statistical significance. High ME (low scores) was found to be significantly correlated with high scores on Millon's aggression, sociopathy and paranoia scales, but were not with narcissistic or depressive personality patterns. These findings validated certain propositions put forth in the conceptual framework, and invalidated others (Kerr, 1985). Validity and reliability studies indicated that the ES was a valid and reliable instrument for measuring the behavioral manifestations of misguided entitlement.

Adult↗
PubMed2006

Improving medical student intensive care unit communication skills: a novel educational initiative using standardized family members.

OBJECTIVE: To determine whether intensive care unit (ICU) communication skills of fourth-year medical students could be improved by an educational intervention using a standardized family member. DESIGN: Prospective study conducted from August 2003 to May 2004. SETTING: Tertiary care university teaching hospital. PARTICIPANTS: All fourth-year students were eligible to participate during their mandatory four-week critical care medicine clerkship. INTERVENTIONS: The educational intervention focused on the initial meeting with the family member of an ICU patient and included formal teaching of a communication framework followed by a practice session with an actor playing the role of a standardized family member of a fictional patient. At the beginning of the critical care medicine rotation, the intervention group received the educational session, whereas students in the control group did not. MEASUREMENTS AND MAIN RESULTS: At the end of each critical care medicine rotation, all students interacted with a different standardized family member portraying a different fictional scenario. Sessions were videotaped and were scored by an investigator blinded to treatment assignment using a standardized grading tool across four domains: a) introduction; b) gathering information; c) imparting information; and d) setting goals and expectations. A total of 106 (97% of eligible) medical students agreed to participate in the study. The total mean score as well as the scores for the gathering information, imparting information, setting goals, and expectations domains for the intervention group were significantly higher than for the control group (p < .01). CONCLUSIONS: The communication skills of fourth-year medical students can be improved by teaching and then practicing a framework for an initial ICU communication episode with a standardized family member.

Clinical Clerkship↗
PubMed2000

Erosion Control at Construction Sites: The Science-Policy Gap.

/ To test the effectiveness of Michigan's soil erosion control law, 30 construction sites were evaluated in the east-central part of the state. The analytical framework lumped nine best management practices (BMPs) most closely related to the law into three categories: slope stabilization, soil stabilization, and water management. All sites were in the land clearing or foundation/framing stage of construction and were evaluated within 2 days after a rainfall event. Only four of the sites performed above the mean of the scoring scale, with the categorical scoring of BMPs indicating the worst performance for slope stabilization measures. The poor results suggest a failure to integrate scientific knowledge of erosion control with policy. A fundamental problem is the lack of basic site data on soil, topography, and hydrology, resulting in the incorrect application of BMPs, such as staging, filter fences, and berms. The current institutional framework for soil erosion control also provides disincentives to mitigate local erosion problems.

Journal Article↗
PubMed2001

Cumulative logit models for ordinal data: a case study involving allergic rhinitis severity scores.

Ordered categorical data arise in numerous settings, a common example being pain scores in analgesic trials. The modelling of such data is intrinsically more difficult than the modelling of continuous data due to the constraints on the underlying probabilities and the reduced amount of information that discrete outcomes contain. In this paper we discuss the class of cumulative logit models, which provide a natural framework for ordinal data analysis. We show how viewing the categorical outcome as the discretization of an underlying continuous response allows a natural interpretation of model parameters. We also show how covariates are incorporated into the model and how various types of correlation among repeated measures on the same individual may be accounted for. The models are illustrated using longitudinal allergy data consisting of sneezing scores measured on a four-point scale. Our approach throughout is Bayesian and we present a range of simple diagnostics to aid model building.

Antibodies, Monoclonal↗
PubMed2026

Nuclear single-copy orthologous genes as phylogenomic markers for resolving the closely related firefly genera Pteroptyx, Medeopteryx, and Trisinuata (Coleoptera: Lampyridae: Luciolinae).

Fireflies (Lampyridae) are bioluminescent beetles with broad ecological roles across temperate and tropical ecosystems, occupying diverse habitats including forests, wetlands, grasslands, mangroves, and riverine systems. The subfamily Luciolinae is primarily distributed across Asia and the Indo-Pacific. Phylogenetic relationships among three closely related Luciolinae genera - Medeopteryx, Pteroptyx, and Trisinuata - remain unresolved using mitochondrial genome data alone. This study used nuclear genome data to resolve relationships among these genera and identify a lighter-weight nuclear marker panel for expanding taxon sampling. Draft genomes were reconstructed for fifteen firefly species, eight from the focal genera, and analyzed with five published firefly genomes. Using BUSCO and OrthoFinder, 1,011 nuclear single-copy orthologs (SCOs) were identified for phylogenomic inference. Discordance between concatenation- and coalescence-based phylogenies indicated incomplete lineage sorting (ILS). The coalescence-based phylogeny recoveredPteroptyxas monophyletic and sister to a (Medeopteryx,Trisinuata) clade, with Trisinuata nested within a non-monophyletic Medeopteryx; however, quartet support at the base of Pteroptyx, particularly at Pt. valida, was low.Filtering for compositional homogeneity, clock-likeness, and species-tree concordance yielded 103 SCOs with a significantly higher proportion of parsimony-informative sites than non-selected loci, retaining the backbone topology with higher gene concordance support at scored clades, while ILS-driven discordance at Pt. valida persists - confirming that the reduced panel retains phylogenetic resolving power for future taxon sampling. These findings demonstrate a practical framework for using nuclear SCOs to resolve close phylogenetic relationships within Luciolinae. Future work should expand taxon sampling - especially forTrisinuata - alongside long-read assemblies, for a more robust phylogenomic framework.

Fireflies↗
PubMed2026

Early-childhood temperament trajectories map onto transdiagnostic psychiatric risk.

Early-childhood temperament is associated with later mental health. Temperament continues to develop throughout the first years of life, and a single assessment cannot capture its trajectory. Whether departures from an individual's developmental trajectory carry psychiatric risk remains unknown. Using data from more than 50,000 children in the Norwegian Mother, Father and Child Cohort Study, we modeled longitudinal temperament at 1.5, 3, and 5 years of age with the FEMA-Long mixed-effects framework. We then quantified each child's departures from their predicted trajectories. Multivariate analysis revealed two transdiagnostic dimensions linking trajectory departures to psychiatric diagnoses across childhood and adolescence. Higher scores on the first dimension were associated with an increased hazard of subsequent ADHD diagnosis (hazard ratio&#x2009;=&#x2009;1.54), and higher scores on the second with an increased hazard of Asperger syndrome (hazard ratio&#x2009;=&#x2009;1.64). To examine the genetic basis of these associations, we performed longitudinal GWAS of temperament and conjunctional FDR analysis to detect loci shared with the associated diagnoses. The effects of these loci changed across early childhood, with some strengthening and others attenuating with age. These findings show that departures from predicted temperament trajectories reflect transdiagnostic psychiatric risk with a shared genetic basis. Longitudinal, trajectory-based monitoring could help identify children at elevated psychiatric risk.

Journal Article↗
PubMed1998

Candidate gene analysis of GH1 for effects on growth and carcass composition of cattle.

We present an approach to evaluate the support for candidate genes as quantitative trait loci (QTLs) within the context of genome-wide map-based cloning strategies. To establish candidacy, a bacterial artificial chromosome (BAC) clone containing a putative candidate gene is physically assigned to an anchored linkage map to localise the gene relative to an identified QTL effect. Microsatellite loci derived from BAC clones containing an established candidate gene are integrated into the linkage map facilitating the evaluation by interval analysis of the statistical support for QTL identity. Permutation analysis is employed to determine experiment-wise statistical support. The approach is illustrated for the growth hormone 1 (GH1) gene and growth and carcass phenotypes in cattle. Polymerase chain reaction (PCR) primers which amplify a 441 bp fragment of GH1 were used to systematically screen a bovine BAC library comprising 60,000 clones and with a 95% probability of containing a single copy sequence. The presence of GH1 in BAC-110R2C3 was confirmed by sequence analysis of the PCR product from this clone and by the physical assignment of BAC110R2C3 to bovine chromosome 19 (BTA19) band 22 by fluorescence in situ hybridisation (FISH). Microsatellite KHGH1 was isolated from BAC110R2C3 and scored in 529 reciprocal backcross and F2 fullsib progeny from 41 resource families derived from Angus (Bos taurus) and Brahman (Bos indicus). The microsatellite KHGH1 was incorporated into a framework genetic map of BTA19 comprising 12 microsatellite loci, the erythrocyte antigen T and a GH1-TaqI restriction fragment length polymorphism (RFLP). Interval analysis localised effects of taurus vs. indicus alleles on subcutaneous fat and the percentage of either extractable fat from the Iongissimus dorsi muscle to the region of BTA19 harbouring GH1.

Animals↗
PubMed1997

Construction of composite scales for risk assessment in epidemiology: an application to ectopic pregnancy.

Composite scoring systems that combine information contained in a number of risk factors are being used increasingly in clinical practice, planning, and health risk appraisal. The authors propose a methodological framework for the construction and validation of a composite measurement scale to assess the risk, considered as a continuous phenomenon, of developing a particular disease or outcome. This framework integrates several statistical methods, especially those concerning model fitting, coefficient rounding, and validation strategy. It also uses psychometric methods, addressing important measurement properties such as measurement level, content and construct validity, and reliability of the constructed scale. The proposed framework is illustrated by application to the construction of a composite scale for measurement of the risk of ectopic pregnancy.

Adolescent↗
PubMed2026

RCoxNet: A Deep Learning Framework Integrating Random Walk with Restart, Mutation, and Clinical Data for Cancer Survival Prediction.

Accurate survival prediction in cancer remains challenging due to the sparsity of somatic mutation profiles and the failure of existing models to capture higher-order gene-gene dependencies. Network diffusion methods such as Random Walk with Restart (RWR) can propagate mutation signals across protein-protein interaction (PPI) networks to address sparsity, yet their integration within a deep learning Cox survival framework has not been comprehensively benchmarked across multiple cancer cohorts. We present RCoxNet, a deep learning framework that maps somatic mutation profiles onto a ConsensusPathDB-derived PPI network via RWR, selects prognostic genes by log-rank filtering, and processes network-informed mutation scores through three fully connected hidden layers feeding into a Cox proportional hazards output. RCoxNet was evaluated on The Cancer Genome Atlas (TCGA) cohorts for four cancer types (breast invasive carcinoma [BRCA], lung adenocarcinoma [LUNG], glioblastoma multiforme [GBM], and ovarian serous cystadenocarcinoma [OV]) using 20 independent random splits. The model achieved mean C-index values of 0.807 &#xb1; 0.044 (BRCA), 0.750 &#xb1; 0.039 (LUNG), 0.704 &#xb1; 0.041 (GBM), and 0.668 &#xb1; 0.036 (OV), consistently outperforming DeepSurv, Cox-nnet, SurvivalNet, Cox Elastic-Net (Cox-EN), and DeepHit, with statistically significant gains over Cox-EN, Cox-nnet, SurvivalNet, and DeepHit across the majority of cohorts. RCoxNet demonstrates that embedding sparse mutation profiles into a PPI network context substantially improves cancer survival prediction and yields biologically interpretable prognostic features relevant to precision oncology.

cancer survival prediction↗
PubMed1999

Mammography adherence and beliefs in a sample of low-income African American women.

The purpose of this article is to describe the relation of perceptions of perceived breast cancer risks and perceived benefits and barriers to mammography and stage of mammography adherence in a convenience sample of low-income African American women. The theoretical framework of the Health Belief Model and the Transtheoretical Model were used to identify concepts and stage of mammography adherence. Data were obtained in waiting rooms of multipurpose centers. Scores for susceptibility and benefits were lowest for those who were in (a) precontemplation (had not thought about having a mammogram); as compared to (b) contemplation (had thought about having a mammogram, but not yet acted); (c) action (had a mammogram as recommended by the American Cancer Society); and (d) relapse (had a mammogram in the past, but overdue). Barriers scores were highest for those who had not had a mammogram (precontemplators and contemplators). In addition, individual barriers were significantly lower for women in action. Results have implications for interventions to increase screening in low-income African American women.

Journal Article↗
PubMed2004

Web content accessibility of consumer health information web sites for people with disabilities: a cross sectional evaluation.

BACKGROUND: The World Wide Web (WWW) has become an increasingly essential resource for health information consumers. The ability to obtain accurate medical information online quickly, conveniently and privately provides health consumers with the opportunity to make informed decisions and participate actively in their personal care. Little is known, however, about whether the content of this online health information is equally accessible to people with disabilities who must rely on special devices or technologies to process online information due to their visual, hearing, mobility, or cognitive limitations. OBJECTIVE: To construct a framework for an automated Web accessibility evaluation; to evaluate the state of accessibility of consumer health information Web sites; and to investigate the possible relationships between accessibility and other features of the Web sites, including function, popularity and importance. METHODS: We carried out a cross-sectional study of the state of accessibility of health information Web sites to people with disabilities. We selected 108 consumer health information Web sites from the directory service of a Web search engine. A measurement framework was constructed to automatically measure the level of Web Accessibility Barriers (WAB) of Web sites following Web accessibility specifications. We investigated whether there was a difference between WAB scores across various functional categories of the Web sites, and also evaluated the correlation between the WAB and Alexa traffic rank and Google Page Rank of the Web sites. RESULTS: We found that none of the Web sites we looked at are completely accessible to people with disabilities, i.e., there were no sites that had no violation of Web accessibility rules. However, governmental and educational health information Web sites do exhibit better Web accessibility than the other categories of Web sites (P < 0.001). We also found that the correlation between the WAB score and the popularity of a Web site is statistically significant (r = 0.28, P < 0.05), although there is no correlation between the WAB score and the importance of the Web sites (r = 0.15, P = 0.111). CONCLUSIONS: Evaluation of health information Web sites shows that no Web site scrupulously abides by Web accessibility specifications, even for entities mandated under relevant laws and regulations. Government and education Web sites show better performance than Web sites among other categories. Accessibility of a Web site may have a positive impact on its popularity in general. However, the Web accessibility of a Web site may not have a significant relationship with its importance on the Web.

Cross-Sectional Studies↗
PubMed2002

Assessing secure base behavior in adulthood: development of a measure, links to adult attachment representations, and relations to couples' communication and reports of relationships.

A focus on the secure base phenomenon creates a framework for exploring the function of the attachment system in adulthood. Engaged couples (N = 157) were videotaped in a problem-solving interaction and assessed using the Secure Base Scoring System (SBSS), a system based on Ainsworth's analyses of infant-parent secure base use and support. Study 1 showed behavior was significantly related to representations assessed with the Adult Attachment Interview (M. Main & R. Goldwyn, 1994). In Study 2, the interactions were independently scored with the Rapid Marital Interaction Coding System (RMICS; R. E. Heyman & D. Vivian, 1993), a communication-based system. The SBSS predicted relationship variables beyond the RMICS, especially for women. Results indicate that the secure base phenomenon provides a cogent perspective on adult attachment behavior.

Adult↗