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PubMed1999

Developmental task achievement and learned resourcefulness in healthy older adults.

Although resourcefulness has been found to promote healthy functioning and is believed to be learned throughout life, studies have not examined relationships between developmental variables and resourcefulness. This study examined Erikson's eight developmental tasks as predictors of learned resourcefulness in 60 healthy elders. Hierarchical regression based on Erikson's theory revealed that 37% of the variance in learned resourcefulness was explained by trust, autonomy, initiative, industry, and identity whereas intimacy, generativity, and integrity were not significant. The results suggest that mastery of developmental tasks through adolescence play a key role in determining how resourceful healthy elders are in their daily activities.

Adaptation, Psychological↗
PubMed2001

Capecitabine (Xeloda) improves medical resource use compared with 5-fluorouracil plus leucovorin in a phase III trial conducted in patients with advanced colorectal carcinoma.

Standard therapy for advanced or metastatic colorectal cancer consists of 5-fluorouracil plus leucovorin (5-FU/LV) administered intravenously (i.v.). Capecitabine (Xeloda), an oral fluoropyrimidine carbamate which is preferentially activated by thymidine phosphorylase in tumour cells, mimics continuous 5-FU and is a recently developed alternative to i.v. 5-FU/LV. The choice of oral rather than intravenous treatment may affect medical resource use because the two regimens do not require the same intensity of medical intervention for drug administration, and have different toxicity profiles. Here we examine medical resource use in the first-line treatment of colorectal cancer patients with capecitabine compared with those receiving the Mayo Clinic regimen of 5-FU/LV. In a prospective, randomised phase III clinical trial, 602 patients with advanced or metastatic colorectal cancer recruited from 59 centres worldwide were randomised to treatment with either capecitabine or the Mayo regimen of 5-FU/LV. In addition to clinical efficacy and safety endpoints, data were collected on hospital visits required for drug administration, hospital admissions, and drugs and unscheduled consultations with physicians required for the treatment of adverse events. Capecitabine treatment in comparison to 5-FU/LV in advanced colorectal carcinoma resulted in superior response rates (26.6% versus 17.9%, P=0.013) and improved safety including less stomatitis and myelosuppression. Capecitabine patients required substantially fewer hospital visits for drug administration than 5-FU/LV patients. Medical resource use analysis showed that patients treated with capecitabine spent fewer days in hospital for the management of treatment related adverse events than did patients treated with 5-FU/LV. In addition, capecitabine reduced the requirement for expensive drugs, in particular antimicrobials fluconazole and 5-HT3-antagonists to manage adverse events. As anticipated with an oral home-based therapy patients receiving capecitabine needed more frequent unscheduled home, day care, office and telephone consultations with physicians. In the light of clinical results from the phase III trial demonstrating increased efficacy in terms of response rate, equivalent time to progression (TTP) and survival (OS), and a superior safety profile, the results from this medical resource assessment indicate that capecitabine treatment of colorectal cancer patients results in a substantial resource use saving relative to the Mayo Clinic regimen of 5-FU/LV. This benefit is derived principally from the avoidance of hospital visits for i.v. drug administration, less expensive drug therapy for the treatment of toxic side-effects, and fewer treatment-related hospitalisations required during the course of therapy for adverse drug reactions in comparison to patients treated with 5-FU/LV.

Adult↗
PubMed2003

Assessment of basic human performance resources predicts operative performance of laparoscopic surgery.

BACKGROUND: Interest in laparoscopic surgery has prompted development of educational programs designed to teach and assess laparoscopic skills. Although these programs are beneficial, because of the inherent demands imposed by laparoscopy some aspects of operative performance might not improve with practice. This suggests that innate ability could predict level of operative skill. Assessment of operative and technical potential to date has relied largely on subjective rather than objective criteria. In this study, the relationships between objective measures of human basic performance resources (BPRs) and laparoscopic performance were evaluated using Nonlinear Causal Resource Analysis (NCRA), a novel predictive and explanatory modeling approach based on General Systems Performance Theory. STUDY DESIGN: Twenty urology residents were voluntary enrolled. Thirteen validated BPRs were measured and analyzed relative to operative laparoscopic performance (assessed by two experts) of two porcine laparoscopic nephrectomies (LN). The laparoscopic procedure, representing a High Level Task (HLT), was evaluated using a modified Global Rating of Operative Performance Scale. NCRA models were devised to predict performance of the HLT laparoscopic nephrectomies based on BPRs and to determine the limiting performance resource. RESULTS: NCRA models predicted excellent agreement with actual operative performance, suggesting that measures of innate ability (or BPRs) predicted performance of laparoscopic nephrectomy. In 65%, the prediction by NCRA was near identical to the expert rating on the HLT. In 25% of cases, NCRA overpredicted performance; in 10%, NCRA underpredicted performance of the HLT compared to the subjective ratings. Neuromotor channel capacity was the most common performance-limiting resource. CONCLUSIONS: Preliminary findings suggest objective prediction of laparoscopic performance with limiting resource diagnostics for an individual surgeon is possible and practical using appropriate new measurement and modeling methods. Selection of surgical candidates, training, and educational curriculum could be positively affected.

Adult↗
PubMed1997

The DERWeb project--dental education resources on the Internet.

The delivery of dental education, in common with other forms of higher education, has altered considerably over the last decade. The introduction of the World Wide Web enabled resources for dental education to be delivered in a new and innovative manner. DERWeb was funded by HEFC-JISC. The primary resource consists of a library of 1600 clinical dental images each with keywords and a description. Selected images were used to create teaching materials to demonstrate to dental educators world wide how the image library could be used by individual institutions. Hands-on courses were held to demonstrate the new resource and to evaluate computer skills in the dental community. Since the commencement of the project in September 1994 DERWeb has become one of the leading resources for dental education world wide. The site has been accessed by 79 countries with approximately 107000 accesses in October 1996. DERWeb also designs and maintains the British Dental Association pages together with other professional organisations. Its resources also include dental contact addresses and links to quality dental sites world wide. Further funding has enabled DERWeb to expand further and explore new technologies to develop interactivity on the Web.

Computer Communication Networks↗
PubMed1998

Development and validation of an evaluation tool for multimedia resources in health education.

The last decade saw a rapid increase in the use of multimedia in health education. Easy availability, accessibility, low cost of technological resources and the expanding body of research on the role of multimedia in student learning, among others, have all contributed to this increase in usage. Since one of the roles of educators is to assess and select learning resources based on curriculum goals and student needs, the development of standardized methods for multimedia evaluation becomes vital. To the learner, it is important for reviews of the quality of the resource to be readily available. An evaluation too was developed based on the recognition of this need. The validity of the tool was tested using experts in technology and education. Reliability was determined using faculty and students who reviewed the same software, using the tool. In addition, graduate students reviewed two versions of a nursing program, of varying quality. The results indicate that the tool is reliable and valid. It is envisaged that this tool can be utilized by health educators for evaluating multimedia resources and setting up a much needed clearinghouse for health education resources.

CD-ROM↗
PubMed1997

Chronic medical conditions and mental health in older people: disability and psychosocial resources mediate specific mental health effects.

BACKGROUND: This study describes the differences in psychological distress, disability and psychosocial resources between types of major medical conditions and sensory impairments (collectively denoted as CMCs); and tests whether disability and psychosocial resources mediate CMC-specific mental health effects. METHODS: Data were obtained from a population-based, cross-sectional survey of 5078 non-institutionalized, late middle-aged and older Dutch persons. The predictors were 16 types of CMCs, including all major chronic medical diseases as well as impairment of hearing, vision, and cognition. The outcomes were assessed in terms of psychological distress as measured by the Hospital Anxiety and Depression Scale. Two aspects of disability were measured (namely, physical and role functioning) and also three psychosocial resources (namely, mastery, self-efficacy and social support). RESULTS: Level of psychological distress varied across type of CMC. Hearing impairment, neurological disease, vision impairment, and lung and heart disease had particularly strong associations with distress. The level of distress in patients with hearing impairment was 0.45 standard deviation higher than in those without hearing impairment (adjusted for demographics and all other CMCs). Roughly similar patterns of association were found between type of CMC and disability, and also, but to a lesser extent, mastery and self-efficacy. Stepwise multiple regression revealed that type of CMC accounted for 9% of the variance in distress initially, but this fell to 1% after the variance due to disability, mastery and self-efficacy was taken out. Social support was not a mediator. Disability and psychosocial resources accounted for 13% and 14% of the variance in distress, respectively. CONCLUSION: These results support the conventional wisdom that it is not the nature of the condition that determines psychological distress, but instead the severity of the disability and loss of psychological resources associated with the condition on the one hand and the psychological characteristics of the patient on the other.

Activities of Daily Living↗
PubMedDate not supplied

Predictors of emotional adjustment following traumatic injury: personal, social, and material resources.

INTRODUCTION: The identification of factors influencing emotional adjustment after injury may elucidate the design of assessment and treatment procedures in emergency medicine settings and suggest targets for early intervention to prevent the later development of psychological impairment. Personal, social, and material resources may be influential factors and require further evaluation. HYPOTHESES: Greater experiential avoidance, social constraints on discussing the trauma experience, and loss of material resources would be associated with more of the symptoms of post-traumatic stress and depression following traumatic injury. METHODS: Participants (n = 47) at a mean of 7.4 months post-injury, completed a telephone interview assessment, including evaluation of sociodemographic characteristics, conservation of resources, social constraints, acceptance and commitment, and symptoms of post-traumatic stress disorder (PTSD) and depression. Hypotheses were tested using multivariate regression analyses. RESULTS: Only greater social constraints were uniquely predictive of greater PTSD symptomatology. Higher levels of experiential avoidance, social constraints, and loss of material resources all were associated with greater levels of depression. CONCLUSION: Assessment of personal coping style, receptivity of social network, and loss of potential material resources following traumatic injury may facilitate identification of individuals at-risk for poorer post-injury adaptation. Psychosocial interventions targeting such individuals may be promising.

Adult↗
PubMed2001

Resource absorption in a health service system.

This paper considers the use of treatment resources in a health service system. The particular aspect of system use which is identified is resource absorption - excessive use by a small subset of users and unmet need by others. A dynamic stochastic model for health status with treatment interventions is formulated and the distribution of accumulated treatment time (service) is developed. The characterization of heavy tails in the distribution, the essential feature of resource absorption, is based on the Lorenz curve and an Index of Resource Absorption is defined for any feasible Lorenz curve. The index is applied to the use of psychiatric hospital resources in a Province of Canada.

Age Factors↗
PubMed1997

Depression in the caregiving mothers of adult schizophrenics: a test of the resource deterioration model.

The predictive validity of the resource deterioration model was tested with a sample of 100 Black, elderly, low-income, unmarried, caregiving mothers of adult schizophrenic sons and/or daughters. Stressors consisted of three social variables (burden of care, economic strain, undesirable life events) and one physical variable (poor physical health). Stress mediators consisted of coping and social support resources; the outcome variable was defined as depression. The results indicated support for the resource deterioration model with regard to a physical stressor and coping resources, but not for social stressors and social support resources.

Adaptation, Psychological↗
PubMed2004

The Resource Mothers Study of Maternal Phenylketonuria: preliminary findings.

Women with phenylketonuria (PKU) must follow a strict low-phenylalanine diet during pregnancy in order to protect the fetus from the deleterious effects of high maternal blood phenylalanine. The Resource Mothers Study of Maternal PKU was undertaken to determine whether a home visitation programme was effective in helping women with PKU attain blood phenylalanine control earlier during pregnancy. Resource Mothers were trained to provide social support and practical assistance to women with PKU during pregnancy. Eight metabolic clinics in the United States participated in the study. Women with PKU who were planning pregnancy or already pregnant were enrolled in the study and were treated with a low-phenylalanine diet aimed at controlling blood phenylalanine to 120-360 micromol/L. They were randomly assigned to receive the services of a Resource Mother (RM group) or to a control group. Fifty women were enrolled, and accounted for 44 pregnancies which resulted in 28 live births, and 6 spontaneous abortions. Ten women are currently pregnant and another 6 have not become pregnant. Fifty-six percent of enrolled women began the diet prior to becoming pregnant. Fifty-three percent of women in the Resource Mother group were in metabolic control by 10 weeks gestation as compared to 39% in the control group. In addition, women who began diet after pregnancy and had a Resource Mother attained metabolic control earlier (mean gestational age of 22.4 weeks in the RM group vs 29.8 weeks in the control group). There was no difference in birth measurement z -scores of offspring born to women in the RM group compared to controls. All but 4 women rated themselves as feeling worse about the diet at the end of pregnancy than at the beginning, and few women in either group remained on diet after delivery.

Female↗
PubMed2004

Perceived stress, internal resources, and social support as determinants of mental health among young adults.

BACKGROUND: Mental health is a central determinant of quality of life. While psychiatric morbidity of populations has been studied extensively, the role of perceived stress, social support, and internal resources as determinant of health is still poorly understood. METHODS: We surveyed 2000 randomly selected university students. Perceived stress was measured by the Brief Encounter Psychosocial Instrument, social support by the Duke-UNC Functional Social Support Questionnaire, internal resources (mastery and self-esteem) by a brief version of the Pearlin coping questionnaire. Linear regression models were used to explore the relationships between these variables and mental health, based on the SF-12 health survey. RESULTS: After two reminders, 1257 students answered the questionnaire. In bivariate analysis, mental health was negatively associated with stress and positively associated with internal resources and social support (all p-values < 0.001). In multiple regression analysis, internal resources were positively associated with mental health, and buffered the negative impact of stress on mental health. Internal resources and stress mediated the positive impact of social support on mental health. CONCLUSIONS: Our data confirm that perceived stress is an important risk factor for low mental health and suggest that mastery and self-esteem are important protective factors of mental health among young adults.

Adaptation, Psychological↗
PubMed1989

Conservation of resources. A new attempt at conceptualizing stress.

Major perspectives concerning stress are presented with the goal of clarifying the nature of what has proved to be a heuristic but vague construct. Current conceptualizations of stress are challenged as being too phenomenological and ambiguous, and consequently, not given to direct empirical testing. Indeed, it is argued that researchers have tended to avoid the problem of defining stress, choosing to study stress without reference to a clear framework. A new stress model called the model of conservation of resources is presented as an alternative. This resource-oriented model is based on the supposition that people strive to retain, project, and build resources and that what is threatening to them is the potential or actual loss of these valued resources. Implications of the model of conservation of resources for new research directions are discussed.

Humans↗
PubMed1982

Dividing attention within and between hemispheres: testing a multiple resources approach to limited-capacity information processing.

Two experiments tested the limiting case of a multiple resources approach to resource allocation in information processing. In this framework, the left and right hemispheres are assumed to have separate, limited-capacity pools of undifferentiated resources that are not mutually accessible, so that tasks can overlap in their demand for these resources either completely, partially, or not at all. We tested all three degrees of overlap in demand for left hemisphere supplies, using dual-task methodology in which subjects were induced to pay different amounts of attention to each task. Experiment 1 compared complete and partial overlap by combining a verbal memory load with a task in which subjects named nonsense syllables briefly presented to either the left or right visual field (LVF and RVF, respectively). Experiment 2 compared complete versus no overlap by using the same verbal memory load combined with a laterally presented same-different judgment task that did not require a spoken response. Decrements from single-task performance were always more severe when the visual field task stimulus was presented to the RVF. Further, subjects in Experiment 1 were able to trade performance between tasks on both LVF and RVF trials because there was always at least some overlap in left hemisphere demand. In Experiment 2, performance trade-offs were observed on RVF (complete overlap) trials, but not on LVF trials, where no overlap in demand existed. These results contradict a single-capacity model, but they support the idea that the hemispheres' resource supplies are independent and have implications for both cerebral specialization and divided attention issues.

Attention↗
PubMed1999

Psychological adaptation and birth outcomes: the role of personal resources, stress, and sociocultural context in pregnancy.

Prenatal psychosocial predictors of infant birth weight and length of gestation were investigated in a prospective study of 120 Hispanic and 110 White pregnant women. Hypotheses specifying that personal resources (mastery, self-esteem, optimism), prenatal stress (state and pregnancy anxiety), and sociocultural factors (income, education, ethnicity) would have different effects on birth outcomes were tested using structural equation modeling. Results confirmed that women with stronger resources had higher birth weight babies (beta = .21), whereas those reporting more stress had shorter gestations (beta = -.20). Resources were also associated with lower stress (beta = -.67), being married, being White, having higher income and education, and giving birth for the first time. There was no evidence that resources buffered the effects of stress. The importance of personal resources in pregnancy is highlighted along with implications for understanding the etiology of adverse birth outcomes.

Adaptation, Psychological↗
PubMed1996

Age differences in retrieval: further support for the resource-reduction hypothesis.

Age differences in processing resources seem salient to age-related declines in secondary (or "recent") memory. Community-dwelling adults (N = 90, ages 30-80) completed 4 memory tests: Wechsler Memory Scale-Revised (WMS-R) Logical Memory (LM), Cowboy Story (CS), WMS-R Visual Reproductions (VR), and Extended Complex Figure Test (ECFT; Fastenau, in press). Two space-capacity measures (WMS-R Digit Span and Visual Memory Span) and 4 processing speed measures (cancellation and mental-tracking tasks) assessed processing resources. A statistical control procedure was used to isolate retrieval efficiency and measures contributions of age and processing resources to retrieval. A negative relationship between age and retrieval efficiency emerged on all measures (p < .05). The age effect was reduced 60% on LM and CS when processing resources were controlled, eliminated for VR, and unchanged on ECFT. It is possible that visual-spatial retrieval requires fewer processing resources than does verbal retrieval.

Adult↗
PubMed1996

Adaptation to community relocation: the interactive influence of psychological resources and contextual factors.

This longitudinal study examined the interactive influences of psychological resources and contextual factors on short-term adaptation to community relocation in a sample of older women (N = 102, mean age = 71.6). The effects of three psychological resources (environmental mastery, autonomy, and personal growth) and three contextual factors (pressure to move, difficulty of the move, and unexpected gains experienced) on emotional reactions to relocation were examined. The pattern of findings suggests that women with greater psychological resources were more resilient in the face of negative circumstances but that the emotional "boost" of unexpected gains was greatest for women with lower premove resources. These results underscore the importance of considering event-relevant psychological resources and contextual factors and including both negative and positive aspects of the adaptational process.

Adaptation, Psychological↗
PubMed1993

Aging and prose memory: tests of the resource-deficit hypothesis.

Two experiments tested predictions that age differences in processing resources underlie age differences in prose recall. Topic familiarity, text length, and speed of text presentation were manipulated and reduced the amount recalled in a manner consistent with the hypothesis that these variables would tax processing resources. The amount of information recalled was systematically lower in older adults, but age differences were not increased by the experimental manipulations as expected. However, measures of the putative processing resources did account for some of the age-related variance in prose recall, and relative memorability functions suggested that the experimental manipulations interfered with the quality of recall in older adults more than in younger adults. The outcome did not support the resource-deficit hypothesis as originally proposed and may best be understood in terms of factors other than age-related deficits in the measured amounts of processing resources.

Adolescent↗
PubMed2006

The role of task demands and processing resources in the use of base-rate and individuating information.

This article addresses the process that governs the use of base-rate and individuating information. Five experiments demonstrated that, for both, informational length and order of presentation (determining processing difficulty) interact with the recipients' processing resources to determine use. In cases in which the base-rate or the individuating information is brief and/or is presented early, the tendency to use it is greater under limited cognitive resources (cognitive load) than under ample cognitive resources. In contrast, in cases in which the base-rate or the individuating information is lengthy and/or is presented late in the informational sequence, the tendency to use it is greater under ample versus limited resources. These results suggest the appropriateness of conceptually decoupling informational contents (having to do with base rates or individuating descriptions) from the task demands (processing ease or difficulty) that a given judgmental problem presents and that may require different amounts of processing resources.

Cognition↗