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PubMed1997

Healthiness, fatigue, and symptom experience in women with and without breast cancer.

The article reports a study designed to test hypothesized relationships among healthiness, fatigue, and symptom experience derived from a holistic world view of health in women with and without breast cancer. Women with breast cancer did not differ significantly from healthy women on healthiness or fatigue or in the relationships among healthiness, fatigue, and symptom experience. Women with breast cancer had higher symptom experience scores than the healthy women, but when women with breast cancer who had completed treatment were compared with women without breast cancer, there were no significant differences in healthiness, fatigue, or symptom experience. Implications of the findings are interpreted in the framework of a holistic world view. Recommendations for further research are made.

Adult↗
PubMed2004

Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches.

BACKGROUND: A huge range of patient classification systems/tools are used in critical care units to inform workforce planning, however, they are not always applied appropriately. Many of these systems/tools were not originally developed for the purposes of workforce planning and so their use in determining the nurse:patient ratio required in critical care settings raises a number of issues for the organisation and management of these services. AIM: The aim of this paper is to review the three main assessment systems that are commonly used in critical care settings in the UK and evaluate their effectiveness in accurately determining nurse : patient ratios. If the application of these systems/tools is to enhance care, a thorough understanding of their origins and purpose is necessary. If this is lacking, then decisions relating to workload planning, particularly when calculating nurse : patient ratios, may be flawed. CONCLUSIONS: Patient dependency/classification systems and patient dependency scoring systems for severity of illness are robust measures for predicting morbidity and mortality. However, they are not accurate if used to calculate nurse : patient ratios because they are not designed to measure nursing input. Nursing intensity measures provide a useful framework for calculating the cost of providing a nursing service in critical care and can serve as a measure of nursing input, albeit a fairly basic one. However, many components of the nursing role are not "accounted" for in these measures. IMPLICATIONS: The implications of these findings for the organization and management of critical care services are discussed. Careful consideration of these areas is vital if a cost efficient and cost-effective critical care service is to be delivered.

Activities of Daily Living↗
PubMed1998

The relationship of self-concept and self-care in children with cancer.

The purposes of this descriptive study were to examine the relationships between self-concept and (a) self-care, (b) dependent-care, and (c) basic conditioning factors for children with cancer, and to compare the self-concept of children on- and off-therapy. The theoretical framework was Orem's self-care deficit theory of nursing. The sample consisted of 74 children with cancer and their mothers. Results showed small but significant correlations between variables, providing some evidence that if children had higher self-concept scores they performed more self-care activities and received more dependent-care from their mothers. The self-concept scores of the on- and off-therapy groups were not significantly different. This study supports Orem's theory and reinforces the need to promote positive self-concept.

Adolescent↗
PubMed2003

The impact of invisible illness on identity and contextual age across the life span.

This study explored the impact invisible illness has on identity, specifically contextual age, throughout the life span. It was grounded in the assumption that an individual's identity is formed through communicative interaction. Using social identity theory (Tajfel & Turner, 1986) as a framework, individuals' identities after disclosure of invisible illness were explored. Rubin and Rubin's (1986) Contextual Age Questionnaire was used to determine self-perceived as well as other-perceived contextual age. Invisibly ill individuals reported significantly "higher" contextual age scores than did same chronologically aged, matched non-ill individuals. In addition, the friends of invisibly ill individuals reported "higher" contextual age scores for the invisibly ill individuals than the self-reported scores of the same chronologically aged non-ill individuals. Interviews further revealed that illness instilled insight and that disclosure of illness provoked comments from others that led invisibly ill individuals to identify with older individuals. Future directions and limitations of this study are also discussed.

Aging↗
PubMed1994

Paranormal belief and proneness to dissociation.

The study investigated the relationship between scores on paranormal belief and proneness to dissociation in a sample of 100 Australian students of psychology. Scores on dissociation were positively correlated with those on global paranormal belief and with belief in psi, precognition, spiritualism, and extraordinary life-forms. It is suggested that in some instances paranormal beliefs may be a component of a complex defensive framework constructed in the face of the perceived uncontrollability of life.

Adolescent↗
PubMed2005

Longevity, big five personality factors, and health behaviors: presidents from Washington to Nixon.

In this study, the positive correlation between conscientiousness and death age discovered by H. S. Friedman et al. (1993, 1995) was replicated for 32 American presidents. Conscientiousness scores, using the Big Five variables produced by S. J. Rubenzer, T. R. Faschingbauer, and D. S. Ones (1996, 2000), were correlated with death age, r(30) = .41, p < .01, and the relationship was maintained with controls in a multiple regression framework. Smoking, drinking, and exercise, as assessed by J. R. Bumgarner (1994), were also correlated in the expected fashion with death age. Conscientiousness was correlated negatively with smoking and drinking, but openness to experience was correlated negatively with smoking and drinking to a higher degree and also was positively correlated with exercise. Openness, extraversion, neuroticism, and agreeableness were not correlated with death age, and extraversion, neuroticism, and agreeableness were not correlated with smoking, drinking or exercise.

Factor Analysis, Statistical↗
PubMed2003

Validation of nursing-sensitive outcomes in persons with spinal cord impairment.

Identification of nursing-sensitive patient outcomes in individuals with spinal cord impairment (SCI) is the first step in documenting the importance of nursing practice for this population. The aims of this descriptive study were to identify a comprehensive list of nursing-sensitive patient outcomes that SCI nurse's judge to be relevant to individuals with SCI and establish a framework for clinical validation of these outcomes in the future. Members of the American Association of Spinal Cord Injury Nurses (AASCIN) completed the Nursing Outcomes Classification (NOC) Relevance of Outcome Rating Questionnaire. Twelve outcome categories had a diagnostic content validity (DCV) score above 0.8, sixteen were between 0.6 and 0.79, and one was below 0.6. Of the 260 individual outcome items, 139 had a DCV score above 0.8 (12 were 0.9 or higher), 76 had a DCV score between 0.6 and 0.79, and 45 had a DCV score below 0.6.

Adult↗
PubMed2002

GAZE: a generic framework for the integration of gene-prediction data by dynamic programming.

We describe a method (implemented in a program, GAZE) for assembling arbitrary evidence for individual gene components (features) into predictions of complete gene structures. Our system is generic in that both the features themselves, and the model of gene structure against which potential assemblies are validated and scored, are external to the system and supplied by the user. GAZE uses a dynamic programming algorithm to obtain the highest scoring gene structure according to the model and posterior probabilities that each input feature is part of a gene. A novel pruning strategy ensures that the algorithm has a run-time effectively linear in sequence length. To demonstrate the flexibility of our system in the incorporation of additional evidence into the gene prediction process, we show how it can be used to both represent nonstandard gene structures (in the form of trans-spliced genes in Caenorhabditis elegans), and make use of similarity information (in the form of Expressed Sequence Tag alignments), while requiring no change to the underlying software. GAZE is available at http://www.sanger.ac.uk/Software/analysis/GAZE.

Algorithms↗
PubMed2005

Characteristics of schizophrenia residents and staff rejection in community mental health hostels.

BACKGROUND: In the era of deinstitutionalization, increasing numbers of schizophrenia patients reside and receive rehabilitational treatment within the framework of community hostels. The quality of staff-patient relationships is a crucial determinant of the rehabilitational process outcome. METHOD: This study examined the characteristics of 56 schizophrenia hostel residents, measured the degree of staff criticism and rejection expressed towards these patients and assessed the contribution of residents and staff characteristics to the induction of staff rejection. Measures included assessments of patients' symptoms using the Positive and Negative Syndrome Scale (PANSS), staff attitudes using the Patient Rejection Scale (PRS), and patients' living skills using the Independent Living Skills Survey (ILSS). RESULTS: Young, relatively inexperienced instructors represented 60% of the hostels staff. Residents' symptoms and staff rejection levels were overall low. However, significantly increased rejection was expressed towards patients who were more symptomatic, as measured by PANSS total and positive symptoms scores and had diminished job-related and health care living skills. Staff older age and longer professional experience were correlated with higher rejection scores. LIMITATIONS: Relatively small sample size and catchment area. CONCLUSIONS: These findings highlight the need for a better definition and understanding of schizophrenia residents selection criteria and treatment goals in community hostels. Moreover, they suggest that improvements in this area should be coupled with the provision of specialized staff training aiming at the achievement of more flexible staff attitudes. Within this framework, the PRS may serve as a practical, cost-effective tool for monitoring crucial aspects of staff-patients relationships.

Adult↗
PubMed2002

A review of approaches to quality assurance of veterinary systems for health-status certification.

Regarding national and international trade of animals and animal products, certificates are required to document specific health levels. The credibility of such certificates depends on the quality of the data used to establish the status. Credibility also depends on the quality of the design and protocols used in the data-gathering process (i.e. on the quality of the surveillance-and-monitoring systems (SMS) and on the quality of the veterinary administrative systems (VAdminS)). The major requirements for the assessment of the SMS and VAdminS are: objectivity, accuracy, transparency, practicality, quantitative in nature. To assess the quality of SMS and VAdminS, systems analysis might provide a suitable framework. Systems analysis requires the identification and description of all components of the system-how they interact with each other and with other systems. Graphical methods (e.g. fault trees) are available to support this procedure. To assess the quality of SMS, scoring systems have been suggested. Their main weakness is the inherent subjectiveness. Alternatively, performance indicators (PI) could be used. For the assessment of VAdminS, questionnaires have been developed and applied. Their main limitations are that they focus on the input rather than on the output and that they are purely descriptive in nature. Thus, comparisons between countries are almost impossible. Semi-quantitative questionnaires using scores now are being developed and tested, although their limitations will be similar to those mentioned above. Another approach is the use of risk assessment including standardised data files assembled by countries volunteering to be assessed. This was applied successfully by the European Union (EU) in the geographic risk assessment for bovine spongiform encephalopathy (BSE). In general, the publication and documentation of veterinary systems needs to be encouraged to make them accessible to peer review.

Animal Diseases↗
PubMed1998

Evolution of indirect reciprocity by image scoring.

Darwinian evolution has to provide an explanation for cooperative behaviour. Theories of cooperation are based on kin selection (dependent on genetic relatedness), group selection and reciprocal altruism. The idea of reciprocal altruism usually involves direct reciprocity: repeated encounters between the same individuals allow for the return of an altruistic act by the recipient. Here we present a new theoretical framework, which is based on indirect reciprocity and does not require the same two individuals ever to meet again. Individual selection can nevertheless favour cooperative strategies directed towards recipients that have helped others in the past. Cooperation pays because it confers the image of a valuable community member to the cooperating individual. We present computer simulations and analytic models that specify the conditions required for evolutionary stability of indirect reciprocity. We show that the probability of knowing the 'image' of the recipient must exceed the cost-to-benefit ratio of the altruistic act. We propose that the emergence of indirect reciprocity was a decisive step for the evolution of human societies.

Altruism↗
PubMed2005

Evaluation of a developmental care training programme for neonatal nurses.

Although the impact of developmental care on premature infants has been investigated at length, often the issue of professional development and training related to this type of care has not been examined. The aim of the present study was to evaluate the impact of a developmental care training programme on nurses' behaviours and cognitive attributes with regard to the prevention of overstimulation of premature infants. The Theory of Reasoned Action (TRA) was the framework underlying the study. This programme evaluation used a quasi-experimental one group pre-test/post-test design. Participants were nurses working in a neonatal intensive care unit. Data were collected by self-administered questionnaires. Significantly higher post-test scores were observed for knowledge and for a variety of theoretical constructs. The results of this study showed the potential of such training programmes to help nurses implement developmental care.

Adult↗
PubMed2005

Quality of structured abstracts of original research articles in the British Medical Journal, the Canadian Medical Association Journal and the Journal of the American Medical Association: a 10-year follow-up study.

BACKGROUND: We compared the quality of structured abstracts of original research articles from the British Medical Journal (BMJ), Canadian Medical Association Journal (CMAJ), and the Journal of the American Medical Association (JAMA) from 1991 to 1992 and 2001 to 2002 between journals. METHODS: A random, stratified sample of 54 abstracts from 2001 to 2002 in BMJ, CMAJ, and JAMA was compiled and coded. Two blinded raters reviewed 27 abstracts each against 33 objective criteria, separated into eight categories (purpose, research design, setting, subjects, intervention, measurement of variables, results, and conclusion). The quality score was the proportion of criteria present (range = 0-1). RESULTS: The overall mean quality score (0.74) for 2001-2002 was significantly higher than the 1988-1989 unstructured abstracts (mean = 0.57; p<0.001) but not different from the 1991-1992 structured abstracts (mean = 0.74; p>0.05). In 2001-2002, abstracts of CMAJ and JAMA (both means = 0.76) improved significantly over 1991-1992 (p<0.05) and scored significantly higher than BMJ (mean = 0.71; d.f. = 16, p<0.05). Some individual criteria scores (intervention, statistical information) improved but information was found consistently under-represented in areas that imply shortcomings of the studies. INTERPRETATION: We found a consistency in abstract quality regardless of the precise format used by different journals. This indicates that the framework for research articles already in place should be maintained and further modification of the framework may not necessarily improve the abstract quality.

Abstracting and Indexing↗
PubMed2025

Synaptic protein CSF levels relate to memory scores in individuals without dementia.

BACKGROUND: We investigated how cerebrospinal fluid levels of synaptic proteins associate with memory function in normal cognition (CN) and mild cognitive impairment (MCI), and investigated the effect of amyloid positivity on these associations. METHODS: We included 242 CN (105(43%) abnormal amyloid), and 278 MCI individuals (183(66%) abnormal amyloid) from the European Medical Information Framework for Alzheimer's Disease Multimodal Biomarker Discovery (EMIF-AD MBD) and the Alzheimer's Disease Neuroimaging Initiative (ADNI). For 181 (EMIF-AD MBD) and 36 (ADNI) proteins with a synaptic annotation in SynGO, associations with word learning recall were analysed with linear models. RESULTS: Subsets of synaptic proteins showed lower levels with worse recall in preclinical AD (EMIF-AD MBD: 7, ADNI: 5 proteins, none overlapping), prodromal AD (EMIF-AD MBD only, 27 proteins) and non-AD MCI (EMIF-AD MBD: 1, ADNI: 7 proteins). The majority of these associations were specific to these clinical groups. CONCLUSIONS: Synaptic disturbance-related memory impairment occurred very early in AD, indicating it may be relevant to develop therapies targeting the synapse early in the disease.

Humans↗
PubMed2002

Mood and sex of participant in perception of happy faces.

The influences of mood-state and sex of subject were examined for ratings of the emotional intensity of videotaped facial expressions of happiness. 102 subjects who were classified by sex and their scores on the Beck Depression Inventory provided ratings of the faces. A significant sex by mood-state interaction indicated that ratings of intensity by men and women were influenced differently by mood-state, and these findings are interpreted within the framework of the Affect Infusion Model. The results support our hypothesis that men and women tend to rely preferentially on low and high affect infusion strategies, respectively. The findings further suggest that the cognitive effect of affect infusion on the magnitude of perceived intensity of facial affect could be influenced by mood-state via differences in cognitive effort subjects employ when in a dysphoric or nondysphoric mood.

Adult↗
PubMed1993

Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL).

The World Health Organization (WHO) has undertaken a project to develop an instrument (the WHOQOL) for measuring quality of life. Quality of life is defined as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, and their relationship to salient features of their environment. The instrument will be developed in the framework of a collaborative project involving numerous centres in different cultural settings. In addition, it will have proven psychometric properties of validity, responsiveness and reliability and will be sensitive to the cultural setting in which it is applied, whilst maintaining comparability of scores across different cultural settings. This paper outlines the characteristics of the planned instrument and the study protocol governing work on its development. To date steps 1 through 5 have been completed and work is progressing on step 6. It is anticipated that the instrument will be available for piloting in July 1993 and a final version available for use in June 1994.

Focus Groups↗
PubMed1997

Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections.

OBJECTIVE: To identify the predictors of mortality due to acute lower respiratory tract infection (ALRI). DESIGN: Prospective cohort study. SETTING: Urban tertiary care teaching hospital. METHODS: 201 cases with ALRI between 2 weeks to 5 years of age were prospectively enrolled and followed up to determine outcome. Detailed history and clinical evaluation were recorded on a pretested proforma. Significant independent predictors of mortality were determined by comparison of dead subjects (n = 21) with surviving children (n = 180) in a multiple logistic analytic framework. RESULTS: The case fatality rate (CFR) was 10.45%. Significant independent predictors of mortality were (OR, 95% CI) age less than 1 year (23.1, 2.7-197.5), inability to feed (6.2, 1.3-30.7), associated loose stools (5.1,1.2-27.3), weight for age Z score < -3 (3.9,1.01-9.7), short duration of fever (1.2,1.0-1.5) and bandemia (1.1,1.05-1.2). The WHO guidelines identified 91% of children diagnosed as ALRI by clinical and investigative criteria. The CFR was related to severity of WHO classification ("pneumonia"-0%, "severe pneumonia"-8.7% and "very severe pneumonia"-47.0%). However, 2 of the 18 subjects with a diagnosis of "no pneumonia" expired (CFR 11.1% and 10% of total mortality). CONCLUSION: Even in settings of high case fatality, predictors of mortality can be identified in under five children suffering from ALRI. In this context, age below 1 year, inability to feed, presence of loose stools and severe malnutrition merit attention for interventional purposes.

Age Distribution↗
PubMed2006

How can immunochemical methods contribute to the implementation of the Water Framework Directive?

Immunochemical methods (in particular immunoassays) have been applied to spring and surface water samples, respectively, which were set-up as reference materials (RM) within two proficiency testing campaigns. For the first set of proficiency tests (PTs) described here (which were actually the second round of PTs organized, spring 2005), three ELISAs (enzyme-linked immunosorbent assays) were employed in the enzyme tracer format for isoproturon, diuron, and atrazine, respectively. Results were evaluated in comparison with conventional reference methods (LC, GC). Based on their Z-score laboratory performances, the results for isoproturon and diuron were satisfactory, both for fortified spring water and for the blind solution. The results for atrazine were strongly influenced by other triazines present and needed detailed interpretation. For the second set of PTs described here (which were actually the third round of PTs organized, spring 2006), two ELISAs in the coating antigen format were used for isoproturon and diuron, and the result was included with the results obtained by conventional methods during the PTs. The results (the Z-scores) for isoproturon were again classified as satisfactory, in both fortified surface water and blind solution. The results for diuron in ELISA showed an influence of the water matrix, while the analysis of the blind solution was satisfactory. In addition, an ELISA in the enzyme tracer format was applied to analyze isoproturon, diuron, and atrazine in surface water samples, which had been set-up and spiked during a field trial (tank experiment) at the Maas River at Eijsden, The Netherlands. The immunoassay results were compared with those from an in-house on-line SPE LC/MS-MS used as reference. Although the immunochemical results were sometimes higher than those determined in the reference analysis, the general concentration trends in the samples were similar. The contribution of immunochemical methods to the implementation of the European Water Framework Directive is also discussed.

Environmental Monitoring↗