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Reducing fear of falling and avoidance of activity in elderly persons: the development of a Dutch version of an American intervention.

OBJECTIVE: The present study reports on the development of a Dutch version of an American intervention for community-residing older persons in The Netherlands. Adaptation of this cognitive behavioural group intervention, to reduce fear of falling and avoidance of activity in older persons, was required before evaluation in a different setting. METHODS: The process of adaptation consisted of defining the target population, translating the original intervention manual literally, consulting Dutch experts and a developer of the original intervention, selecting qualified facilitators and conducting a pilot study of the adapted manual. RESULTS: Adaptations were incorporated to improve the content, feasibility and didactic materials. The main adaptations were scheduling more time for some activities, changing session frequency from twice to once a week, adding a booster session after 6 months and adding more transparencies. CONCLUSION: A critical assessment of the appropriateness and feasibility of the original intervention provided important information to facilitate replication in the Dutch setting. Applying a systematic approach is recommended in the process of adapting an original intervention for use in a different setting. PRACTICE IMPLICATIONS: To facilitate replication, in general, more detailed information should be provided about interventions.

Accidental Falls↗

As time goes by: change and stability in personality over fifty years.

Dimensions of personality, based on Q-sorted descriptions at seven points in time over a 50-year period and derived from a three-way component analysis, are described for a core sample of 118 subjects and two additional childhood samples of 99 and 108 subjects that partially overlap with the core sample. Stability and change in personality are described between adjacent periods and across a substantial segment of the life span from early childhood to late adulthood. These descriptions do not seem consistent with various explanations that personality develops either by stages or by steady gradual accumulation, or that it results from early effects. Instead, some aspects of personality shifted in level and correlational stability at particular intervals in time and according to sex of participants; other aspects were comparatively stable, irrespective of time interval and sex of participants. We suggest that the development of personality and achievement-based variables is not alike. Instead, personality development appears to be considerably more innovative and responsive-that is, more adaptive.

Child↗

[Constancy or change in personality in the elderly? Findings and discussion of a controversy].

Research on personality development in the second half of life is reviewed, making a distinction between studies following a trait-oriented and studies using a process-oriented approach. A methodological and theoretical discussion of results not only explains differences in results, it also allows to conclude that the two approaches describe and explain complementary facets of the field. A synthesis between approaches is proposed in order to understand part of the controversy on constancy and change of personality development.

Adult↗

Temperament and personality: origins and outcomes.

This article reviews how a temperament approach emphasizing biological and developmental processes can integrate constructs from subdisciplines of psychology to further the study of personality. Basic measurement strategies and findings in the investigation of temperament in infancy and childhood are reviewed. These include linkage of temperament dimensions with basic affective-motivational and attentional systems, including positive affect/approach, fear, frustration/anger, and effortful control. Contributions of biological models that may support these processes are then reviewed. Research indicating how a temperament approach can lead researchers of social and personality development to investigate important person-environment interactions is also discussed. Lastly, adult research suggesting links between temperament dispositions and the Big Five personality factors is described.

Adult↗

The problem of self-assessment in nurse education.

Nurse education is expected to fulfil two functions: the facilitation of individual personal development and professional selection. The need to produce competent nurses compromises the facilitation of personal development. This is reflected in the minor role assigned to self-assessment in preregistration nurse education. The problematic nature of self-assessment in nurse education is illustrated through a discussion of three issues: self-assessment and power, self-assessment and stereotyping and self-assessment and context.

Clinical Competence↗

[Aspects of children with combined defects].

Eleven children with slight cerebral dysfunction (SCD) were recorded in the process of admission to the social care home (SCH). The children came from the families of older parents with genetic disorder either in the parents themselves or in their families. Due to educational faults combined with uncritical use of excessively protective means symptomatology of disharmonic personality development began to develop in children in which gradual decrease of mental capacity occurred. Symptomatology of disharmonic personality development slowly prevailed over that of SCD. Although the mental capacity was at the lower level of debility, these children were not able to finish their school education. Similarly it may happen in combination of sense organs defects, serious somatic and speech defects. Such children find their place in society with great difficulties.

Adolescent↗

Sympathy and personal distress: development, gender differences, and interrelations of indexes.

In summary, in our multimethod research concerning vicariously induced emotion, we have obtained several patterns of importance. First, we have obtained modest differences in facial and self-report indexes of emotion, nearly all indicating greater responsivity by females. Moreover, some of the data suggest that this gender difference increases with age. Second, we have found that facial indexes of negative emotion are stronger for younger than older persons and that older children's self-reports of emotion are somewhat more consistent with the context than are those of young children. Finally, although we have not obtained strong or consistent relations among our physiological, self-report, and facial indexes of emotion, those that have been obtained suggest a positive relation among indexes, one that appears to be stronger for younger than older persons (especially girls). Further research confirming these patterns of findings is needed; nonetheless, the preliminary data can be viewed as indicating that a multimethod approach to studying empathy is useful for increasing our understanding of empathy, sympathy, and personal distress reactions and their development.

Age Factors↗

A framework for portfolio development in postgraduate nursing practice.

AIMS AND OBJECTIVES: The aim of this study is to explore the introduction of portfolios into the first year of an MSc in Nursing Programme. BACKGROUND: This paper outlines a framework for portfolio development in postgraduate nursing practice. The framework is being piloted, within the Irish context, with students in the first year of a Masters in Nursing programme and has the potential to be developed for other nursing programmes at postgraduate level. DESIGN AND METHOD: An action research approach has been chosen to study the implementation of the portfolio and the development of a framework to guide this initiative. To date the development of the framework is being piloted as part of the 'taking action' phase of a first action research cycle. RESULTS: In its current stage of development the framework is constructed to embrace the core concepts of specialist nursing practice and the nursing management competencies, from current Irish health care documents. In addition the portfolio is anchored around personal development planning and is supported by the use of action learning tutorials and academic and practice facilitators. The first evaluating phase will take place later this year and will involve the collection of data from students, facilitators and lecturers. CONCLUSION: The introduction of the portfolio at postgraduate level has highlighted, to date, issues of confidentiality in committing experiences to paper, issues around its assessment, and issues around sharing this document with other students. RELEVANCE TO CLINICAL PRACTICE: Portfolio development at postgraduate level emphasizes linking theory and practice and stresses the importance of reflection on practice. The portfolio can also be used by nurses to develop their clinical career pathways and encourage personal development planning.

Attitude of Health Personnel↗

The Spanish-Language Version of the Diagnostic Interview for DSM-IV personality disorders: development and initial psychometric evaluation of diagnoses and criteria.

We describe the development of the Spanish-Language Version of the Diagnostic Interview for DSM-IV Personality Disorders (S-DIPD-IV). Initial descriptive (frequency and gender distribution of personality disorders [PDs]) and psychometric findings (inter-rater reliability of diagnoses, internal consistency, and criteria inter-relatedness) are reported based on administration of the S-DIPD-IV to 95 adult monolingual Hispanic patients. The S-DIPD-IV had adequate inter-rater reliability for most PD (mean kappa =.83). Except for the significantly greater proportion of males diagnosed with antisocial PD, no significant gender differences in the distribution of PD were observed. Within-category inter-relatedness of PD criteria was evaluated by coefficient alpha and mean intercriterion correlations (MIC). Between-category criteria overlap was evaluated by intercategory mean intercriterion correlations between all pairs of PD (ICMIC). For PD criteria, alpha ranged .36 to .99 (mean =.75, median =.81), MIC ranged .07 to .95 (mean = .36), and ICMIC ranged.09 to.45 (mean = .24). Six PD (borderline, antisocial, narcissistic, avoidant, obsessive-compulsive, and depressive) had no instances in which their criteria sets correlated higher with those of other PD than their own. Two PD (histrionic and dependent PD) had some instances of overlap, and four PD (paranoid, schizotypal, schizoid, and passive-aggressive) had pervasive overlap with other PD criteria sets. These findings suggest the utility of the S-DIPD-IV for assessing PD in Spanish-speaking Hispanic outpatients. Our initial findings for this patient group suggest that, except for antisocial PD in males, specific PD diagnoses are not differentially distributed by gender. Moreover, except for cluster A PD, the criteria for specific PD tend to be more highly correlated within than across PD. The S-DIPD-IV appears to have utility to facilitate PD research with Hispanic groups.

Adult↗

[Personality disorders: old and new problems].

Correlations were found between the structure of personality disorders (PD) (neurotic--borderline personality organization) and the regularities of PD dynamics. Taking into consideration the regularities of interaction of psychopathologic manifestations with positive symptomatology, three types of PD dynamics were psychopathologically identified, which show information on polar (compensation--decompensation) processes: 1) that in form of personality development; 2) that in form of PD-associated quasipsychoses; associated with DP; 3) that in form of transformation of characterological disorders into psychopathologic ones. The first two types of dynamics, which appear as as actualization of pathocharacterological formations in the pattern of mental disorders, reflect decompensation processes. In neurotic personality (emotionally labile, anxious, dependent, sensitive schizoids, etc) there is a deep (in terms of personality development) reorganization of characterological abnormalies. In borderline personality (paranoid, expansive schizoids, anancasts, borderline, etc.), aggravation and chronic pattern of mental disorders occurs with dynamics of PD-associated quasipsychoses. The third type of dynamics is not accompanied by aggravation of pathocharacterological manifestations and reflects compensation process. Separation of the isolated symptom complexes, PD derivatives (steady-state catathymically charged pathocharacterological formations are symptom-forming) is possible in any type of personality organization, but more frequently is observed at complex forms with a high proportion of facultative complexes and accentuations.

Humans↗

[Biological and social correlates of favorable and unfavorable neurosis course].

Four hundred ninety seven patients with neurosis of Astana (Kazakhstan) community, 116 men and 381 women, have been studied. The patients were traced in 5-year follow up study. Favorable and unfavorable types of the disorder were established, the latter being characterized by transforming into neurotic personality development. The influence of endogenous and environmental factors on neurosis prognosis was examined. To elaborate adequate measures for preventing neurotic personality development, criteria for favorable and unfavorable prognosis of neurotic disorders were suggested.

Adult↗

Three-year follow up of women with and without borderline personality disorder: development of Cloninger's character in adolescence.

The purpose of the present study was to examine the developmental patterns of Cloninger's biogenetic character traits in subjects with borderline personality disorder (BPD). Study subjects met Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised; DSM-III-R) criteria for BPD without comorbid axis I or II disorders, as determined by the Diagnostic Interview for Borderlines-Revised, Structured Clinical Interview for the DSM-III-R, and Diagnostic Interview for Personality Disorders. The BPD subjects and age- and sex-matched healthy comparison subjects were initially interviewed for Cloninger's biogenetic characters and re-interviewed at an interval of 1 year for the following 3 years. There were significant differences in the developmental patterns of self-directedness, cooperativeness, and self-transcendence between BPD and healthy comparison subjects (significant group by time interaction: repeated measures manova, F = 17.3, d.f. = 3,240, P < 0.001; F = 28.5, d.f. = 3,240, P < 0.001; F = 4.7, d.f. = 3,240, P < 0.01, respectively). The BPD subjects had less changes in character-related maturity with increasing age than did healthy comparison subjects. Post-hoc tests with Duncan's statistics revealed that subjects with BPD had significantly lower scores on self-directedness at all assessment time periods (P < 0.01) and lower scores on cooperativeness at the second-year and third-year follow-up assessments as compared to healthy comparison subjects (P < 0.01). The BPD subjects had a distinctively different developmental pattern of Cloninger's character compared to healthy comparison subjects. The character development of BPD patients was more fixed and immature than those of healthy comparison subjects.

Adolescent↗

[Transmission of tuberculosis (III)].

Tuberculosis outbreak is defined as group infection more than 20 persons had been infected with tubercle bacilli in Japan, provided one person developed disease is counted as 6 persons had been infected. Outbreak is to be reported compulsory to the Ministry of Health, Welfare and Labor. A total of 365 outbreaks of tuberculosis have been reported in these 10 years during 1994 and 2004. Out of them, large scale outbreak more than 10 persons have developed disease were 41 (11.2%). Results of contact surveys has reported that 0.36% of newly registered smear positive cases had caused tuberculosis outbreak, 1.1% had resulted small scale group infection (5 to 19 persons had been infected), although majority of the bacteriology positive cases didn't infected even one person. To make clear the mode of airborne infection with tubercle bacilli more clearly, the author has discussed the results of quantitative model on droplet nucle infection by Riley RL and others, nosocomial infection of smallpox virus in Germany in 1970, the results of analysis of airflow at the sites of outbreaks at business office and middle school in Japan, and so on. Finally, the author has reviewed the development of research on annual risk of tuberculosis infection in Japan and discussed about the present problems of risk of tuberculosis infection in Japan.

Disease Outbreaks↗