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PubMed2006

Neurophysiologic assessment of neonatal sleep organization: preliminary results of a randomized, controlled trial of skin contact with preterm infants.

BACKGROUND: Sleep is important to brain organization, but few strategies to promote sleep among premature infants have been tested. Behaviorally based measures of sleep have shown increased quiet sleep (QS) and decreased active sleep (AS) during skin-to-skin contact (SSC) with the mother, but these results have not been confirmed with objective electroencephalographic/polysomnographic measures of sleep organization. Important differences exist between behavioral and electroencephalographic/polysomnographic definitions of sleep state. METHODS: Data for the first 28 relatively healthy, preterm subjects of an ongoing randomized trial of one 2- to 3-hour session of SSC or incubator care between feedings are reported here. Infants were positioned prone, inclined, and nested in an incubator during the 2- to 3-hour pretest period, were fed, and then went into the test period of SSC or incubator care. Infants were left largely undisturbed throughout testing. A mixed-model regression analysis compared the test-pretest differences in outcome measures within and between groups. RESULTS: Results showed that arousals were significantly lower in the SSC group, compared with the control group, for the entire study period and for test-pretest matched segments of QS and AS. Rapid eye movement was significantly lower for the SSC group for the study period and AS segments. Indeterminate sleep was significantly lower for the SSC group when confounding environmental variables were included in the regression analysis. When 4 subjects who experienced excessive ambient light levels during SSC were removed from analysis, QS increased during SSC. CONCLUSIONS: The patterns demonstrated by the SSC group are analogous to more-mature sleep organization. SSC may be used as an intervention to improve sleep organization in this population of preterm infants.

Electroencephalography↗
PubMed1999

Smoking influences decision making in periodontal therapy: a retrospective clinical study.

BACKGROUND: Mechanical periodontal therapy consists of a non-surgical course, followed by surgical treatment to eliminate or reduce remaining pathological pockets. Only if diligent mechanical therapy fails are additional measures considered. It has been documented that smoking interferes with the host defense mechanisms. This study addresses the question is meticulous non-surgical periodontal therapy equally successful in smokers and non-smokers? If not, is a thorough and cumbersome non-surgical approach in smokers worth undertaking? METHODS: Thirty-five smokers and 35 non-smokers were selected retrospectively from a pool of 306 patients treated in a private practice over a 17-month period. All had at least 14 teeth present with 8 presenting with gingival pockets > or =6 mm. Non-surgical treatment was performed in 6 to 10 appointments and results were evaluated 6 to 12 weeks after therapy. Bleeding on probing sites with probing depths > or =5 mm were then considered for surgical treatment. RESULTS: Before treatment smokers had statistically significantly higher mean percent of pockets 4 to 5 mm and > or =6 mm (40.36+/-10.65 and 26.51+/-11.95, respectively, compared to 30.38+/-7.57 and 20.42+/-10.03 for non-smokers) and showed significantly lower proportional reduction of these parameters with treatment (50.80+/-33.76 and 81.36+/-19.82 for pocket 4 to 5 mm and 6 mm, compared to 68.43+/-21.23 and 91.7+/-8.92 for nonsmokers). A multivariate analysis gave smoking, plaque control, and initial percent of sites > or =6 mm to be significant predictors of the percent of teeth in need of further therapy. In non-smokers, treatment was apparently successful in all tooth types with the exception of upper first and second molars (28.5% failure) and lower second molar (20% failure). In smokers, rates of further treatment needs were particularly high in the premolar-molar area in both jaws, ranging from 31.4% to 48.5% for an individual tooth type; 42.8% of smokers and 11.5% of non-smokers needed further treatment in 16% of their teeth (pretest probability). A decision analysis showed that for smokers with at least 1 of 5 sites > or =6 mm, one should initiate surgical treatment, rather than first treat non-surgically. If the point of indifference that the decision is correctly set at 95%, the pretest probability should be >12%. There is a higher risk that non-surgical therapy will fail, for instance if we lower the point of indifference to 60%, the pretest probability should be >31%. CONCLUSIONS: It is concluded that smoking impairs healing after nonsurgical periodontal therapy. The decision analysis of this study questions the need for a thorough course of non-surgical treatment in smokers with advanced periodontal disease.

Adult↗
PubMed1983

Pennsylvania's domiciliary care experiment: II. Cost-benefit implications.

A pilot program based on the substitution of domiciliary care for traditional institutional care was established by the Commonwealth of Pennsylvania to provide community-based care for individuals who could no longer live independently (aging, mentally retarded, mentally ill). To ascertain the cost saving potential of this program, 190 participants and a comparable pool of non-participants were followed for an average 10-month follow-up period. Within each subgroup, participants were disaggregated into two categories: those residing in a community setting at pretest, and those residing in an institutional setting. An analysis of medical care and social support service utilization profiles indicated that program savings exceeded program cost for five of the six study subsamples; the one exception was the mental retardation cohort residing in a community setting at pretest. Net savings were greatest for the three subsamples residing in an institutional setting at pretest. For all the subsamples, over 90 per cent of the program saving stemmed from a lower use of institutional placements.

Aging↗
PubMedDate not supplied

Attempts to modify cognitive tempo in elderly adults.

Three experiments were conducted in an attempt to modify the cognitive tempo of elderly adults. In all three, attempts were made to modify response latency. In the first experiment, the participants were given either instructions to take as much time as they needed, instructions to respond as quickly as they could, or no instructions regarding response speed. In the second experiment, the participants observed a model who either responded more slowly, more quickly, or at the same speed typically used by elderly adults. In the third experiment, the participants were either forced to respond very slowly, forced to respond very quickly, or allowed to respond at their own rate. Only one of the experimental manipulations affected response latencies. The participants who were forced to respond very quickly in the third experiment exhibited a decrease in response latency from pretest to posttest while the participants in the other two conditions did not. There was a corresponding effect for errors; the participants in the fast condition exhibited very little change in error rate from pretest to posttest while the participants in the other two conditions made fewer errors on the posttest than on the pretest. In the third experiment, an attempt was also made to modify the error rate by training the participants in the use of a thorough and systematic scanning strategy. The strategy training had no effect on either errors or latencies.

Aged↗
PubMed1975

Adverse reactions to intravascularly administered contrast media. A comprehensive study based on a prospective survey.

Case reports on 112,003 patients obtained through a prospective survey have been studied and submitted to computer processing. The significant findings have been reviewed and their importance discussedmthe following points are noteworthy: the value of pretesting is doubtful; and routine pretesting is not a recommended procedure. The constant readiness of a fully equipped emergency tray offers far greater security and assurance of patient safety than the unpredictable and unreliable results of pretesting. The over-all incidence of nonfatal reactions is lower than has been prviously indicated: 5.65 per cent for intravenous urography; and 2.33 per cent for intravascular studies. The incidence of fatal reaction (1 in 10,000) is higher than that reported on the basis of retrospective studies. This figure may or may not be duplicated in the next 100,000 examinations. The cause of death in some patients may be related to a combination of factors-primary disease, diagnostic procedure, and contrast medium. The over-all incidence of adverse reactions in patients with allergy is about twice that in the general population. The incidence of adverse reactions is highest in the third and fourth decades, and lowest at either end of the age spectrum. Incidence of reactions is equal in both sexes. History of reaction to previous examinations is not a contraindication to re-examination. The incidence is approximately 3 times that of the general population. Rapid injection rate, in intravenous urography, is accompanied by fewer reactions than a slow injection rate. A slow injection rate in intravenous cholangiography is accompanied by fewer ractions than a rapid injection rate. It is anticipated that this program will continue, so that additional meaningful data and significant information will be accumulated. The members of our Committee are of the firm belief that this program will become the foundation of a permanent national and international adverse reaction reporting system, thus meeting a great need. We invite the collaboration and support of all those interested and involved in the many phases of contrast medium work.

Adolescent↗
PubMed1989

[Clinical study of the anti-calculus effect of a dentifrice containing sodium polyphosphate].

A double-blind clinical study was conducted to evaluate the effect of a tartar-control dentifrice containing 1% sodium polyphosphate as tartar control agent compared with dentifrice A containing 5% sodium pyrophosphate and a placebo dentifrice. One hundred forty-eights who continued to have a degree of calculus formation after using a regular dentifrice containing no tartar control agent for 1 month in the pretest, were stratified randomly on the basis of pretest, calculus score, age and sex into 3 homogeneous groups. All subjects who received initial prophylaxis were provided the assigned dentifrice and toothbrush. No instructions regarding frequency or method of toothbrushing were allowed. Assessment of supragingival calculus was made at 4 and 12 weeks using the calculus scoring procedure proposed by Volpe et al. Side effects such as oral irritation, ablation of oral mucosa and discoloration of teeth caused by dentifrices were also diagnosed after 12 weeks of use. The following results were obtained in this study. 1. The test dentifrice had reduced (P less than 0.01) supra-gingival calculus significantly more than dentifrice A and the placebo at 12 weeks. 2. A significant reduction (P less than 0.01) was observed when dentifrice A was compared with the placebo dentifrice. 30.1% reduction was obtained using the test dentifrice and 9.0% reduction using dentifrice A when assessed in subjects who had a pretest VMI score of more than 6.0. 3. No side effects caused by the dentifrice which contained sodium polyphosphate were observed.

Dental Calculus↗
PubMed2005

Assessment of the dark-adaptation time required for recovery of electroretinographic responses in dogs after fundus photography and indirect ophthalmoscopy.

OBJECTIVE: To investigate the duration of dark-adaptation time required for recovery of electroretinographic responses after fundus photography or indirect ophthalmoscopy in dogs. ANIMALS: 6 dogs. PROCEDURE: Initially, scotopic-intensity series of electroretinograms (ERGs) were recorded after 20 minutes of dark adaptation. The fundus of the left eye of each dog was photographed (n = 10) or examined via indirect ophthalmoscopy for 5 minutes with moderate- (117 candela [cd]/m2) or bright-intensity (1,693 cd/m2) light; ERGs were repeated after a further 20 or 60 minutes of dark adaptation (6 procedures/dog). RESULTS: Following 20 minutes of dark adaptation after fundus photography, the b- and a-wave amplitudes were reduced in response to brighter stimuli, compared with pretest ERGs; after 60 minutes of dark adaptation, ERG amplitudes had recovered. Following 20 minutes of dark adaptation after indirect ophthalmoscopy (moderate-intensity light), significantly lower b-wave amplitudes were recorded in response to 2 of the brighter flash stimuli, compared with pretest ERGs; after 60 minutes of dark adaptation, ERG amplitudes had recovered. Following 20 minutes of dark adaptation after indirect ophthalmoscopy (bright-intensity light), all ERG amplitudes were significantly decreased and implicit times were significantly decreased at several flash intensities, compared with pretest ERGs; after 60 minutes of dark adaptation, ERG amplitudes and implicit times had returned to initial values, except for b-wave amplitudes recorded in response to dimmer stimuli. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that at least 60 minutes of dark adaptation should be allowed before ERGs are performed in dogs after fundus photography or indirect ophthalmoscopy.

Adaptation, Ocular↗
PubMed1978

Sex differences in familial correlations for visual and kinesthetic aftereffects.

72 subjects from 16 families performed a visual and kinesthetic aftereffect task where data were also obtained on the pretest variability and on the adjustment times. Considerable sex differences were found, such that for mothers pretest variability correlated positively with magnitude of kinesthetic and negatively with magnitude of visual aftereffect. Daughters showed more pretest variability on both tasks and much larger individual differences on the visual task than sons. These sex differences complicate any attempt at genetic analysis. However, there was some indication of X-linked inheritance in males for magnitude aftereffect and of autosomal inheritance of visual adjustment time in females.

Adult↗
PubMed1984

Comparative study of static, dynamic, and proprioceptive neuromuscular facilitation stretching techniques on flexibility.

63 college women served as subjects in this 7-wk. study examining the effects of static, dynamic, and proprioceptive neuromuscular facilitating stretching techniques on the flexibility of the hamstring-gastrocnemius muscles. Subjects were assigned to one of the 3 treatment groups and received treatment 3 days a week. A pretest, a midtest (after 11 treatment days), and a posttest (after 21 treatment days) were administered. Analysis of group and test effects was accomplished by using a 3 X 3 factorial design with the group factor nested and the test factor crossed. Post hoc analysis indicated that all scores significantly improved from pretest to posttest. The findings indicated all 3 methods of flexibility training produced significant improvements when pretest and posttest mean scores were compared.

Female↗
PubMed1986

Effect of playing a video game on a measure of spatial visualization.

70 undergraduate students, without any prior experience of video games playing, were given a pretest and a posttest on the Space Relations Test of the DAT, Forms A and B being, respectively, administered on the two occasions. The experimental group of 38 had eight sessions of playing the Zaxxon video game, each session including five plays. The control group of 32 received no such treatment. A 2 (sex) by 2 (group) analysis of covariance, using pretest scores as the covariate, yielded a significant effect for group which supports the hypothesis that spatial visualization test scores can be improved by video game playing. Moreover, the sex-related difference in visual-spatial skills frequently reported does not appear on the pretest. Finally, no effect for sex and no interaction of group X sex were found, indicating that both male and female subjects gained equally from playing Zaxxon.

Adult↗
PubMed1993

A study with a follow-up of the effects of music education on holistic development of empathy.

Half of the 32 children, aged 6 yr. old, took part in the 12-hr. holistic empathy education program with music exercises over three months. Others were controls. Children were tested at a pretest, 3 months later at the posttet after the training, and follow-up test, 9 months after posttest. The Feshbach and Roe Empathy Slide Test, the Weir and Duveen Prosociability Rating Scale, and the Kalliopuska Prosociability Rating Scale for Teachers were used. Empathy and prosociability increased significantly from pretest to posttest after empathy education. As hypothesized, comparison of pretest and follow-up test results showed a significant increase in empathy for the test group and a nonsignificant increase among controls.

Child↗
PubMedDate not supplied

Competence-building in adolescents, Part I: A self-help nursing intervention.

The purpose of this study was to test the effects of a self-help nursing intervention on adolescent psychosocial competence. A community sample of 139 adolescents was assigned to three conditions (intervention, delayed intervention, and control) within a pretest-posttest design. The self-help nursing intervention was a 9-page, 14-step self-help workbook for use by adolescents in dealing with upsetting situations in day-to-day living. After a self-assessment of coping, subsequent workbook steps aided adolescents in developing alternate coping responses and generating other ways to deal with the upsetting situation. Adolescents in the three conditions did not differ on pretest measures of psychosocial competence: problem-solving appraisal, adolescent self-perception, and general self-efficacy. After statistically controlling for pretest scores, gender, and age, the intervention group showed more favorable self-perceptions in scholastic competence, social acceptance, and conduct/morality compared with the control group. However, expected differences in the delayed intervention group failed to appear. Thus, anticipated benefits in psychosocial competence were found inconsistently. Although not predicted, significant reductions in the prevalence of negative affect occurred among adolescents in both intervention groups. Overall, the self-help format for delivering psychosocial competence training lacked the power needed to bring about consistent benefits for adolescents. Testing the self-help workbook in a group context is recommended in future nursing intervention research.

Adaptation, Psychological↗
PubMedDate not supplied

Effects of a couple communication program on marital adjustment.

BACKGROUND: Couples are usually advised to improve their communication skills to increase harmony and avoid conflicts. However, studies aimed at increasing marital adjustment in primary care are limited. METHODS: A Couple Communication Program was announced at the Ondokuz Mayis University Permanent Education Center, and the Dyadic Adjustment Scale was administered to 67 couples who volunteered. Twenty-eight persons (14 couples) with the lowest test scores were randomized into study and control groups. At the end of the program (post-test), the scale was again administered to the study group. Afterward, the pretest and post-test scores of the study and control groups were compared. The study group's pretest, post-test, and follow-up test scores were also examined. RESULTS: No difference in marital adjustment was found between the study and control groups before the start of the program (P > .05). The post-test scores of the couples attending the Couple Communication Program proved to be higher in total than the scores of those who did not attend (P < .001). The post-test and follow-up scores of the study group were significantly higher than their pretest scores (P < .001). There was no significant difference between the post-test and follow-up scores of the study group (P = 1.0). CONCLUSION: This program may have a positive effect on marital adjustment levels by improving communication skills and may lead to long-term behavioral modifications in couples.

Adaptation, Psychological↗
PubMedDate not supplied

Nonpharmacologic interventions to manage children's pain: immediate and short-term effects of a continuing education program.

A two-group pretest, posttest design was used to test the effects of a two-hour educational program about using five nonpharmacologic pain management techniques with children on nurses' knowledge of, comfort with, attitude toward, and use of the discussed techniques. Five pediatric patient care units were randomly assigned to a treatment or control group. Pretest responses from 54 nurses indicated that attitude was the only significant determinant of their intention to guide children's imagery. A subset of 35 nurses actually attended the program and completed posttest responses. On posttest, the treatment group reported significantly greater knowledge of and comfort with using the techniques. Comparison of pretest with posttest responses across both groups indicated a significant increase in knowledge of and comfort with using nonpharmacologic techniques. Two months after the program, 24 nurses from both groups reported increased use of the techniques in practice compared with prior to the program.

Adult↗
PubMedDate not supplied

Increasing nurses' knowledge and skills for enhanced response to intimate partner violence.

BACKGROUND: A theoretically based intimate partner violence in-service program was developed, implemented, and evaluated among public health nurses. METHODS: A two-phase, mixed-methods design was used. Phase 1 used qualitative methods for content development of the in-service program. Phase 2 used a one-group pretest-posttest design to evaluate the effectiveness of the program. RESULTS: In Phase 1, nurses perceived a need for knowledge about community intimate partner violence prevention resources and enhancement of interviewing skills. In Phase 2, no significant difference was noted in level of intimate partner violence knowledge between pretest and posttest (p < .107). However, a significant difference in skill level was noted between pretest and posttest (p < .003). CONCLUSIONS: Results support the use of an in-service program as an effective method of enhancing the intimate partner violence clinical skills of nurses.

Attitude of Health Personnel↗
PubMed1997

Evaluation of an inservice training program on dementia and wandering.

This study assessed the impact of an inservice training program in four nursing homes on nursing staff's knowledge of dementia, pacing/wandering behavior and management strategies, staff satisfaction, and their perceptions of work difficulty and quality of care. Additionally, unit-level behavioral observations of agitated behavior and the nature of resident interactions with staff members and other residents were also performed to assess whether changes in nursing staff's knowledge impacted the residents or interactions with the residents. Analyses revealed that quiz scores were significantly improved immediately following the inservice program as compared to pretest but returned to near pretest levels at the 1-month follow-up. Additionally, nursing staff reported that residents were allowed to pace/wander to a greater extent at follow-up compared to pretest. Methods for improving the effectiveness of inservice training are discussed.

Aged↗
PubMed1989

The effects of overhead transparency design on retention, recall, and application of data analysis content.

This experimental study tested the effects of overhead transparency design in conjunction with live lecture on retention, recall, and application of data analysis content over three occasions using a Solomon Four-Group, pretest-posttest design. Pretested subjects showed significant (p less than .001) gains in test scores from pre to posttest. No significant differences were found in pretest scores between control and experimental treatment groups or among the posttest scores of either the experimental or control groups.

Audiovisual Aids↗
PubMed2002

Graduate nursing students' precourse and postcourse perceptions and preferences concerning completely web-based courses.

Web-based nursing courses have proliferated rapidly in recent years, but few data are available about course outcomes. A pretest/posttest survey design of student perceptions and preferences was used to evaluate two graduate-level on-line nursing courses (required research and elective aging issues courses; N = 31 and N = 29, respectively) on the basis of Billings' outcomes evaluation framework for nursing Web-based courses. Students in both courses were favorable or at least neutral in their perceptions of outcomes at both pretest and posttest, but favorable shifts in perceptions also occurred from pretest to posttest. Most students remained stable in their preferences for format of instruction (on-line or classroom), and most favored an on-line format. Almost all students indicated they would take the course they took if they had the decision to make over again. Students who took the elective aging issues course had somewhat more favorable perceptions overall at posttest, compared to the required research course, but some differences were accounted for by pretest score differences between the groups. While outcomes were positive for both courses, the results also highlight specific needs for adequate socialization and support of students, particularly for first-year graduate students who are taking Web-based courses.

Clinical Competence↗