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Factors related to integrating persons with chronic mental illness into a peer social milieu.

Client characteristics and their perceptions of the milieu in a psychosocial rehabilitation program were used to predict the clients' level of involvement in the peer-based social network. 81 clients in a psychosocial rehabilitation program participated in the study. The results indicated that client perceptions of higher support and clarity in the staff-client milieu, and being female, were strongly related to higher peer social involvement. Milieu factors were generally more important than client characteristics in predicting client social functioning. The implications of these findings for psychosocial intervention and for research on the social functioning of this population are discussed.

Adult↗

Muscle activation and force production in Parkinson's patients during sit to stand transfers.

OBJECTIVE: The purpose of this study was to compare the kinematics, muscle activation, and force production between Parkinson's patients and healthy, age-matched participants during sit-to-stand transfers. DESIGN: This cross-sectional study employed a 2x2x3 multivariate analysis of variance to test for significant differences between and within groups. BACKGROUND: The underlying mechanisms that predispose an individual to lose strength during the clinical progression of Parkinson's disease have proved to be elusive, especially during performance of functional tasks such as the sit to stand transfer. METHODS: Twenty-four men (mean age: 71.5 years) categorized as Parkinson's patients (n = 13) and healthy adults (n = 11) participated in this study. Two force platforms measured antero-posterior and vertical force components as well as peak torque. Muscle activation was measured by a six channel, bilateral electromyography system. A lower-body kinematic assessment was conducted utilizing a high-speed motion analysis system. RESULTS: No statistically significant differences were found between groups for the outcome variables measured. However, Parkinson's patients did exhibit significant within-group bilateral differences for the variables of knee angle at seat-off, peak vertical force and peak torque. CONCLUSION: Data from this study reveal that persons with mild to moderate Parkinson's disease exhibit moderately altered bilateral mechanics when performing a sit to stand transfer compared to their healthy peers. RELEVANCE: The inability to produce constant equilateral force when performing functional tasks could be an indicator for the increased propensity of falls or other instabilities in this population.

Aged↗

Escalated substance use: a longitudinal grouping analysis from early to middle adolescence.

The authors surveyed a cohort of 1,184 adolescents in the 7th, 8th, and 9th grades. Measures of tobacco, alcohol, and marijuana use and of constructs from 3 theoretical models of substance use were obtained at each point. Clustering analysis for 3-wave substance use data indicated subgroups of nonusers, minimal experimenters, late starters, and escalators. Discriminant function analyses tested whether study variables differentiated the subgroups. One discriminant function accounted for the majority of between-group association; it had loadings for (high) life stress, nonadaptive coping, deviance-prone attitudes, and parental and peer substance use, and (low) parental support, academic competence, and behavioral control. Escalators were high on this function; late starters and experimenters had intermediate values; and nonusers were low on the function. Implications for theories of vulnerability to substance abuse are discussed.

Adolescent↗

Chronoecological health watch of arterial stiffness and neuro-cardio-pulmonary function in elderly community at high altitude (3524 m), compared with Japanese town.

Effects of high altitude on arterial stiffness and neuro-cardio-pulmonary function were studied. Blood pressure (BP) and heart rate (HR) were measured in a sitting position on resting Ladakhis, living at an altitude of 3250-4647 m (Phey village, 3250 m: 17 men and 55 women; Chumathang village, 4193 m: 29 men and 47 women; Sumdo village, 4540 m: 38 men and 57 women; and Korzok village, 4647 m: 84 men and 70 women). The neuro-cardio-pulmonary function, including the Kohs block design test, the Up and Go, the Functional Reach and the Button tests, was examined in 40 elderly subjects (19 men and 21 women, mean age: 74.7 +/- 3.3 years) in Leh, Ladakh (altitude: 3524 m), for comparison with 324 elderly citizens (97 men and 227 women, mean age: 80.7 +/- 4.7 years) of Tosa, Japan (altitude: 250 m). Cardio-Ankle Vascular Index (CAVI) was measured as the heart-ankle pulse wave velocity (PWV) in these subjects using a VaSera CAVI instrument (Fukuda Denshi, Tokyo). SpO(2) decreased while Hb and diastolic BP increased with increasing altitude. At higher altitude, residents were younger and leaner. Women in Leh vs. Tosa had a poorer cognitive function, estimated by the Kohs block design test (3.7 +/- 3.6 vs. 16.4 +/- 9.6 points, P < 0.0001) and poorer ADL functions (Functional Reach: 13.7 +/- 7.0 cm vs. 25.3 +/- 8.7 cm, P < 0.0001; Button test: 22.5 +/- 4.8 vs. 14.8 +/- 5.7 s, P < 0.0001). Time estimation was shorter at high altitude (60-s estimation with counting: 41.1% shorter in men and 23.0% shorter in women). A higher voltage of the QRS complex was observed in the ECG of Leh residents, but two times measurement of CAVI showed no statistically significant differences between Leh and Tosa (two times of CAVI measures; 9.49 vs. 10.01 m/s and 9.41 vs. 10.05 m/s, respectively), suggesting that most residents succeed to adapt sufficiently to the high-altitude environment. However, correlation of CAVI with age shows several cases who show an extreme increase in CAVI. Thus, for the prevention of stroke and other adverse cardiovascular outcomes, including dementia, CAVI may be very useful, especially at high altitude. In conclusion, elderly people living at high altitude have a higher risk of cardiovascular disease than low-latitude peers. To determine how these indices are associated with maintained cognitive function deserves further study by the longitudinal follow-up of these communities in terms of longevity and aging in relation to their neuro-cardio-pulmonary function.

Adolescent↗

An ecological assessment inventory to facilitate community recreation participation by severely disabled individuals.

Severely disabled individuals have long been systematically excluded from actively participating in normalized recreation/leisure activities in integrated community settings. Severely disabled individuals should be taught functional and age appropriate skills, based upon the performance characteristics of nonhandicapped peers. In order to present this position, typical assumptions of leisure skill instruction for severely disabled individuals are discussed and opposing points of view are presented. Finally, the article presents a concrete strategy, or inventory, that is divided into three interrelated areas including: skill selection and skill/facility description, component skills and adaptations for full/partial participation, and supportive skills. The inventory can be used by therapeutic recreation specialists and other educators to develop functional, age appropriate leisure skill instructional content. It is expected that this approach, coupled with longitudinal planning, will facilitate the provision of opportunities for severely disabled individuals to actively participate in normalized recreation/leisure skills in integrated community settings.

Community Health Services↗

The adjustment to diabetes of school-age children with psychological adjustment problems.

OBJECTIVE: To determine whether diabetic children with psychological adjustment problems have greater difficulties in specific areas of disease adaptation than their well-adjusted diabetic peers by comparing their diabetes-related adjustments in the family, school and peer environments. METHOD: Mothers of 47 school-age preadolescent children with diabetes completed a standardized assessment of general psychological functioning. Children with psychological adjustment problems were then compared with children who did not exhibit problems along the following dimensions: their demographic and medical profiles, maternal diabetes knowledge, associations between general psychological functioning and diabetes control, and the quality of their diabetes adjustment. RESULTS: No differences were found between children with psychological adjustment problems and their better-adjusted peers along any of the demographic or health status variables tested or in maternal diabetes knowledge. However, children with adjustment problems were more likely to receive visits from the hospital's home-care team and to be absent from school. Also, for children with psychological difficulty, indices of diabetes control and general psychological functioning were related, and the nature of this relation differed across the school and family environments. In addition, poorer psychological adjustment was associated with diabetes-specific problems in both mother and child. These included individual adjustment problems such as feeling different, relationship difficulties with family and peers, and difficulties with the treatment protocol, in particular, with the dietary regime. CONCLUSION: These findings are considered in relation to (1). the importance of multi-method techniques in research which concerns adjustment to diabetes, in particular the need to use both psychological and disease-specific instruments, and (2). clinical evaluations and interventions for children with diabetes and their families.

Adaptation, Psychological↗

Adolescent individuation and alcohol use.

OBJECTIVE: This study evaluates a developmental psychosocial model of adolescent drinking. Specifically, the role of two aspects of adolescent individuation-separation and intergenerational individuation-is examined within the context of family dynamics, stress and peer associations. These measures parallel an ongoing debate regarding the nature of individuation. The separation measure captures aspects of individuation related to detachment or rebelliousness. Intergenerational individuation measures increasing self-reliance and control with maintenance of supportive family bonds. METHOD: A structural equation model describing adolescent alcohol use as a function of two measures of individuation, family conflict, communication with mother, stress and peer use of alcohol was tested in two independent samples. The first included 6th- through 12th-grade adolescents and the second was composed of 6th- through 8th-grade students. RESULTS: In both studies, significant direct and indirect paths were found from individuation measures and family, peer use and stress constructs to adolescent alcohol use. Separation had a stronger relationship to alcohol use than did intergenerational individuation and was associated with higher levels of stress and alcohol use by peers. CONCLUSIONS: The findings support the role of individuation as a contributing factor in adolescent alcohol use. They indicate the importance of family and parent-adolescent relationships in adolescent alcohol use and suggest directions for both family-based and school-based preventive interventions.

Adolescent↗

Professional self-regulation: peer review.

Dentistry, in fulfilling its responsibility for self-regulation, has established a highly specific and formalized method of peer review. Its primary purpose is to mediate problems between patients, dentists, and third parties relative to the quality of treatment and appropriateness of care. It is a confidential service provided to the public and profession at no cost and accomplished with the voluntary cooperation of all parties involved. Decisions of peer review committees are advisory in nature but offer an alternative to legal resolution of misunderstandings and problems in patient care. The profession, by continually refining peer review and by educating its members and the public to its function, is providing a unique and valuable service to patients, dentists, and third parties. The objective and consistent application of this self-monitoring process is but one mechanism by which dentistry seeks to serve the public and perpetuate its high standard of care.

Dentists↗

Whole-cell K+ currents in type II pneumocytes freshly isolated from rat lung: pharmacological evidence for two subpopulations of cells.

The patch clamp technique was used to record whole cell K+ currents in type II pneumocytes freshly isolated from adult rats. Depolarizing voltage steps evoked outward K+ currents which were distinguished into low and high threshold types, only one type being apparent in any one cell. Low-threshold (LT) currents were activated at test potentials of -40 mV to -20 mV and were reduced in amplitude by 20 mM tetraethylammonium (TEA). High-threshold (HT) currents were activated only at test potentials positive to -20 mV and current noise was always greater than for LT currents. HT currents were also significantly more sensitive than were LT currents to block by TEA. Quinine (1 mM) blocked LT currents reversibly at all activating test potentials. HT currents were also reversibly blocked by 1 mM quinine, but in a voltage-dependent manner, the degree of block increasing with increasing test potential. 4-Aminopyridine (2 mM) further distinguished the two current types: it was virtually without effect on HT currents but caused large reductions in LT current amplitudes, apparently by acting on the open channels underlying this current. These data clearly distinguish type II pneumocytes into two subpopulations and suggest that they may play separate roles in the functioning of the intact alveolar epithelium.

4-Aminopyridine↗

Peer and teacher bullying/victimization of South Australian secondary school students: prevalence and psychosocial profiles.

This study examined the nature and prevalence of bullying/victimization by peers and teachers reported by 1,284 students (mean age = 15.2 years) drawn from a representative sample of 25 South Australian government and private schools. Students completed a self-report survey containing questions relating to teacher and peer-related bullying, measures of psychosocial adjustment, and personality. The results showed that students could be clearly differentiated according to the type of victimization they had experienced. Students reporting peer victimization typically showed high levels of social alienation, poorer psychological functioning, and poorer self-esteem and self-image. By contrast, victims of teacher victimization were more likely to be rated as less able academically, had less intention to complete school and were more likely to be engaged in high-risk behaviours such as gambling, drug use and under-age drinking. Most bullying was found to occur at school rather than outside school and involved verbal aggression rather than physical harm. Boys were significantly more likely to be bullied than girls, with the highest rates being observed amongst boys attending single-sex government schools. Girls were more likely to be subject to bullying if they attended coeducational private schools. The implications of this work for enhancing school-retention rates and addressing psychological distress amongst adolescent students are discussed.

Adaptation, Psychological↗

Brief report: group social-multimodal intervention for HFASD.

Current study is the second part of a 2-year cognitive-behavioral-ecological (CB-E) intervention for high-functioning (HF) children with autism spectrum disorder (ASD). We examined the utility of a group-centered intervention on children's ability to interact cooperatively with peers during structured and non-structured social situations. Direct (e.g., social problem solving) and indirect (theory of mind; executive function) treatment effects on social cognitive capabilities were also examined. Participants were 26 preadolescent HF children with ASD. Study results demonstrated direct and indirect treatment effects on social cognition and mixed results regarding children's social interaction capabilities. Although children's cooperative capabilities within the intervention group improved, dyadic, and group social interactions during school recess did not. Discussion focused on the utility of such group-intervention in increasing social functioning.

Asperger Syndrome↗

Physical fitness, functional ability and quality of life in children with severe haemophilia: a pilot study.

In the Netherlands comparable levels of sports-participation between persons with haemophilia and healthy controls have been reported. This raises the question if children with haemophilia under the currently available prophylaxis do reach comparable levels of physical fitness and health-related quality of life (HRQoL) as their healthy peers. The aim of this study was to investigate the level of physical fitness, functional ability and quality of life and to determine the feasibility to safely test the exercise capacity of boys with severe haemophilia A. Thirteen subjects participated in this study. Physical fitness was determined using the measurement of maximal oxygen uptake (VO2peak) attained during a graded maximal exercise test to volitional exhaustion. Joint health, physical activity levels and health-related quality of life (Haemo-Qol) were also measured. Mean VO2peak was 1.86+/-0.77 L min-1 (Z-score: -0.39+/-1.61) which was not significantly different from reference values. Relative VO2peak was 47.42+/-8.29 mL min-1 kg-1 (Z-score: -0.52+/-1.43), which did not differ significantly from reference values either. One boy suffered a joint bleeding one day after the test. Haemo-Qol scores in parents and children ranged from 3.2% to 36.7% (100% reflects poor outcome). Relationship between the child or parent reports of Haemo-QoL and both absolute and relative VO2peak ranged from R=0.00 and R=0.4. Exercise testing in children with severe haemophilia A was a safe procedure. Patients with severe haemophilia A with good joint health and no limitations of activities have comparable physical fitness and physical active lifestyle with healthy peers and good HRQoL.

Adolescent↗

Comparative vs global self-rated health: associations with age and functional ability.

BACKGROUND AND AIMS: This study examined the relationship of age and functional ability with comparative (age-referential) and global self-rated health (SRH), and the possible effect of selection bias. The focus is on differences between these questions and on the consequences which these differences have in research. METHODS: The data came from the second wave of the Tampere Longitudinal Study on Ageing (TamELSA), consisting of 830 persons aged 60-99 years. The associations of both self-rated health measures with age and functional ability were examined using multinomial regression analyses. RESULTS: People with increasing age, particularly over 80-year-old, are inclined to rate their health better than that of their age peers. The association of older age with better comparative SRH became even stronger after adjustment for functional ability, chronic diseases and sociodemographic factors. The relation of older age with global SRH was weaker than that with age-referential SRH. By contrast, functional ability was more strongly associated with global than with comparative SRH. CONCLUSIONS: Our results suggest that comparative and global self-rated health cannot be used interchangeably. The comparative measure is more strongly "calibrated" by age. Therefore, when SRH is used as a measure in survey studies or in clinical settings, the global question should be preferred.

Activities of Daily Living↗

Smokeless tobacco and cigarettes: differential attitudes and behavioral intentions of young adolescents toward a hypothetical new peer.

Examined adolescents' perceptions of cigarette smokers and smokeless tobacco users. Participants were 562 middle school students in rural Florida who viewed 1 of 6 videotapes of a hypothetical peer (i.e., actor) who would soon be attending their school. The videotapes differed only as a function of sex (boy or girl) and tobacco condition (no tobacco, cigarette, smokeless tobacco). After viewing the videotape, participants completed 2 measures designed to assess attitudes and behavioral intentions toward the peer. Results indicated that (a) the actor in the no-tobacco condition was rated more favorably than actors in the other two conditions, although the actor in the smokeless-tobacco condition was rated more favorably than the actor in the cigarette condition; (b) girls viewed the actor in smokeless-tobacco condition more favorably than did boys; (c) compared to nonsmokers, adolescents with a cigarette use history provided more favorable ratings for the actor in the cigarette condition. Taken together, results suggest that different types of tobacco use may have a different impact on social image within the young adolescent population.

Adolescent↗

Aging, inhibition, and social inappropriateness.

This study explores the hypothesis that age-related declines in inhibitory ability are associated with increases in socially inappropriate behavior. Consistent with this hypothesis, older participants were less likely than younger participants to differentiate between public and private settings when inquiring about potentially embarrassing issues, according to their peers. Additionally, this indiscriminate public inquiry was associated with decreased closeness with participants' peers, particularly for older adults. Finally, this age-related increase in social inappropriateness was mediated by inhibitory deficits associated with aging. These results suggest that age-related deficits in inhibitory ability may cause people to become socially inappropriate against their will.

Adolescent↗

Treatment adherence of youth and young adults with and without a chronic illness.

The present study was undertaken to explore the psychosocial functioning of young people with chronic illness, their beliefs about treatment adherence, difficulties with adherence and concerns about living with their illness. A small correlational study was undertaken to compare the psychosocial functioning of young people, with and without chronic illness, aged between 12 and 24 years. Subjects were recruited from a metropolitan teaching hospital. Group 1 included 44 young people with chronic illness; Group 2 included 41 young people without chronic illness. Both groups were divided on the basis of age: younger (12-18 years, n = 24); older (19-24 years, n = 61) and sex (female = 43; male = 42). Subjects completed the Achenbach self-report questionnaire as a measure of psychosocial functioning, and a second questionnaire constructed for this study to explore treatment adherence. Psychosocial functioning scores were found to be similar on the majority of subscales. Young women with chronic illness were, however, found to have significantly higher internalizing scores than young women without chronic illness. A significant negative relationship was found for the chronic illness group between internalizing scores and treatment adherence. The findings highlight potential areas of difficulty in psychosocial functioning of some young people with chronic illness. They also suggest the existence of a subgroup of young people with chronic illness who experience more problems than their peers. More research is needed to generate evidence about this possible subgroup to determine predictors of psychosocial functioning and test the timing and efficacy of psychosocial interventions.

Acute Disease↗

Peer-directed communicative interactions of augmented language learners with mental retardation.

Naturally occurring peer-directed communicative interactions of 13 youth with mental retardation and little or no functional speech who used the System for Augmenting Language (SAL) as their primary means of communication were described. Findings suggest that this system was an integral component of both successful and effective conversations and may be one important means of enhancing social interactions with peer communicative partners who have and do not have mental retardation.

Adolescent↗

Manuscript peer review at the AJR: facts, figures, and quality assessment.

Concern by the government, funding institutions, and the public for quality assurance in all aspects of medical endeavors mandates critical examination of various professional activities. Although peer review is generally regarded as the best system for selecting and improving scientific papers for publication, the efficacy of this process has never been proved. Moreover, the administrative functions of the editorial staff are often poorly understood. The purpose of this article is to make peer review a the AJR less esoteric and more understandable by quantifying some of its activities. This information is then assessed as it relates to the quality of this important step in scientific publication.

Peer Review, Research↗