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PubMed2000

When it is more than a job: close relationships between home health aides and older clients.

OBJECTIVES: A qualitative study was conducted to investigate the types of relationships that were formed between older clients and their home health aides and to identify structural characteristics and interactive processes that facilitated various types of relationships. METHODS: Using semistructured interviews, members of 16 families and their home health aides described the relationships that developed between clients and aides and the conditions and contexts that facilitated or inhibited close relationship development. Data were coded and analyzed using a multistage process. RESULTS: Most relationships between aides and older clients were described as friendship or like one of the family, with friendship occurring most often. Several structural conditions and numerous interactive friendship processes were identified. The cognitive process of boundary setting discriminated between friendships and family-like relationships. DISCUSSION: Results show support for socioemotional selectivity theory and highlight the benefits of close relationships for older homebound adults and their home health aides.

Activities of Daily Living↗
PubMed2006

Within the web: the family-practitioner relationship in the context of chronic childhood illness.

This hermeneutic phenomenological study explores the relationship between health professionals and families who have a child with a chronic illness. Study participants included 10 family groups who had a child with a chronic illness and 12 practitioners from the disciplines of nursing, medicine, dietetics, physiotherapy and speech therapy. Data were collected by narrative audiotaped interviewing. The results of this study revealed that chronic childhood illness 'throws' families and practitioners together into a web of relationships, which must work for the sake of the child. However, children are usually excluded from the relationship. To understand and manage the child's illness, practitioners and families 'go around' and act 'in-between' relationships. While the quality of the relationship from the family perspective is not essential, relationships are more successful when practitioners recognize the uniqueness of each family web. The nature of the relationship is often simple, yet it coexists with complexity.

Adaptation, Psychological↗
PubMed2006

Inter-relationship between microsatellite instability, thymidylate synthase expression, and p53 status in colorectal cancer: implications for chemoresistance.

BACKGROUND: Studies indicate that thymidylate synthase (TS) expression, p53 and mismatch repair status have potential to influence colorectal cancer (CRC) outcome. There is, however, little data on the inter-relationship between these three markers. We sought to investigate whether relationships exist between these markers that might contribute to CRC phenotypes. METHODS: Four hundred and forty-one stage I-III CRCs were investigated. p53 status and TS expression were assessed by standard immunohistochemistry methods. Mismatch repair status was determined by assessment of microsatellite instability (MSI) using radiolabelled microsatellite genotyping. RESULTS: 244 tumours (55%) over-expressed p53, and 259 (58%) expressed high TS levels. 65 tumours (15%) had MSI. A significant relationship between p53 over-expression and high TS expression was observed (p = 0.01). This was independent of MSI status. A highly significant inverse relationship between MSI and p53 status was observed (p = 0.001). No relationship was seen between MSI status and TS expression (p = 0.59). CONCLUSION: Relationships exist between p53 status and TS expression, and MSI and p53 status. These inter-relationships may contribute to the clinical phenotype of CRCs associated with each of the molecular markers. High TS expression is unlikely to account for the clinical behaviour of CRCs with MSI.

Biomarkers, Tumor↗
PubMed1999

Influence of the teacher-student relationship on childhood conduct problems: a prospective study.

Examined the influence of the quality of the teacher-student relationship on children's subsequent levels of aggression in a sample of 61 second and third-grade children nominated and rated by their teachers as aggressive. The stability of teachers' and children's reports of relationships quality across academic years was in the low to moderate range. Teachers and children showed little agreement in their reports of relationship quality. Teachers' and children's reports of relationship quality in year 1 (Y1) predicted teacher-rated aggression the following year, controlling for Y1 ratings of aggression. Teachers' reports of relationship quality across Y1 and Y2 predicted peer-rated aggression, but not teacher-rated aggression, in Y3, controlling for Y1 aggression. Consistent with a buffering role for teacher-student relationships, a positive teacher-student relationship was of greatest benefit to children whose mothers reported rejecting parenting histories. We discuss implications for school-based prevention programs.

Aggression↗
PubMed1999

Prediction of dissolution-absorption relationships from a continuous dissolution/Caco-2 system.

The objectives were 1) to design a continuous dissolution/Caco-2 system to predict the dissolution-absorption relationships for fast and slow dissolving formulations of piroxicam, metoprolol tartrate, and ranitidine HCl, and compare the predicted relationships with observed relationships from clinical studies; 2) to estimate the effect of croscarmellose sodium on ranitidine dissolution-absorption relationships; and 3) to estimate the effect of solubilizing agents on piroxicam dissolution-absorption relationships. A continuous dissolution/Caco-2 system was constructed from a dissolution apparatus and a diffusion cell, such that drug dissolution and permeation across a Caco-2 monolayer would occur sequentially and simultaneously. The continuous system generally matched observed dissolution-absorption relationships from clinical studies. For example, the system successfully predicted the slow metoprolol and slow ranitidiine formulations to be permeation-rate-limited. The system predicted the slow piroxicam formulation to be dissolution-rate-limited, and the fast piroxicam formulation to be permeation-rate-limited, in spite of piroxicam's high permeability and low solubility. Additionally, the system indicated croscarmellose sodium enhanced ranitidine permeability and predicted solubilizing agents to not modulate permeability. These results suggest a dissolution/Caco-2 system to be an experimentally based tool that may predict dissolution-absorption relationships from oral solid dosage forms, and hence the relative contributions of dissolution and permeation to oral drug absorption kinetics.

Absorption↗
PubMed2006

Three-dimensional computed tomographic analysis of the relationship between the arcuate eminence and the superior semicircular canal.

OBJECTIVE: The location of the superior semicircular canal (SSC) is often determined intraoperatively based on its topographic association with the arcuate eminence (AE). This determination is not always possible because of the potential variability in the relationship between these two structures. The goal of this study was to describe the three-dimensional (3-D) relationship between the AE and SSC using 3-D computed tomography (CT) and to evaluate the utility of 3-D CT for preoperative planning for surgical approaches to the middle cranial fossa. METHODS: We studied 11 patients (22 sides) radiographically using 0.8- to 1-mm thick reconstructed CT images. A standard set of structural relationships was measured between the AE, SSC, and other regional landmarks. RESULTS: 3-D CT clearly demonstrated the relationships between traditional landmarks along the petrous ridge and middle cranial fossa. The relationship between the arcuate eminence and SSC was found to be highly variable. The average distance between the tips of the two structures was found to be 5.7 mm (range, 2.7-10.4 mm). CONCLUSIONS: There is significant variability in the relationship between the AE and the SSC. The AE is not a consistent or reliable landmark for identifying the precise position of the SSC. Detailed preoperative information regarding the relationship between the AE, SSC, and other bony landmarks can be easily and quickly assessed using 3-D CT.

Adolescent↗
PubMed1990

[Life style and the right to clean air in public places (RCA). Part 1. The relationship between life style and legal consciousness on smoking regulations].

The right to clean air in public places (RCA) could be a good indicator of health consciousness. We surveyed the consciousness of RCA among residents (20 years of age or older; n = 1500) in city D, a satellite town of Osaka, and examined the relationship between life style and the knowledge aspect of RCA, one of the three aspects of the consciousness concerning RCA. Knowledge of laws concerning the smoking regulations in public places are divided into two categories. One is knowledge of laws concerning general matters, and the other is knowledge of laws concerning concrete matters. Therefore, we get two kinds of relationships. These are the relationship between life style and knowledge of laws concerning general matters, and the relationship between life style and knowledge of laws concerning concrete matters. We examined these two relationships by using Student's t test, and tried to determine the individual life style closely related to the scores for knowledge of laws with the chi-square test. We got following results. (1) The relationship between life style and knowledge of laws concerning general matters Knowledge scores got higher as the life style scores (HPI) became higher. This trend could be detected in all four subgroups. The scores of male subgroups were generally higher than those of female subgroups. This could be construed as follows: those who take care of their physical health have a lot of knowledge of laws concerning smoking regulations. (2) The relationship between life style and knowledge of laws concerning concrete matters Knowledge scores got lower as the life style scores became higher. This trend was almost the same in all four subgroups. The scores of male groups were generally higher than those of female subgroups. This trend could be construed as follows: men and women whose HPI is lower get more opportunities to be in the public places where smoking is totally allowed (e. g., bars) irrespective of their smoking status.

Adult↗
PubMed1995

Patient-hospital relationship and quality of life in elderly patients with hypertension.

To investigate the influence of the patient-hospital relationship on the quality of life (QOL) and on medication compliance in elderly patients with hypertension, we developed a comprehensive scale for assessing the patient-hospital relationship. In the first phase, an original questionnaire consisting of 40 items was designed under five fields for global assessment of the concept. We administered this questionnaire to 715 patients with cardiovascular diseases. Variations in the scores were evaluated by factor analysis. Three factors that comprised the majority of variance were derived by principal components analysis and varimax transformation. These orthogonal factors were considered to reflect "convenience of outpatient clinic", "satisfaction with clinical staff", and "communication with physician". We adopted three items under each of the three domains. Using this instrument, we assessed the patient-hospital relationship in 402 elderly outpatients with hypertension at 8 clinical centers. QOL and medication compliance were simultaneously assessed. A linear regression analysis revealed a significant positive correlation between patient-hospital relationship and QOL scores (r = 0.403, p < 0.0001), which means that patient-hospital relationship explained up to 16% of the total variability in scores on the Overall Quality of Life scale. The medication compliance was also better in patients with higher scores on the Patient-Hospital Relationship scale. These results indicate that the patient-hospital relationship is one of the substantial factors determining QOL and medication compliance in elderly patients with hypertension.

Aged↗
PubMed2003

Pressure-flow relationship and longitudinal distribution of pulmonary vascular resistance in heartworm-infected dogs.

The pressure-flow relationships and the longitudinal distributions of pulmonary vascular resistance in normal and heartworm-infected (HWI) dogs were compared in an isolated, blood perfused preparation. The pulmonary circulation was partitioned into pulmonary arterial, middle, and venous segment based on the concept of a five element lumped model. The pulmonary arterial pressure-flow relationships were found to be non-linear and convex to the pressure axis in both normal and HWI lungs. The pressure-flow relationships of the pulmonary arterial and venous segment were linear and these slopes in the HWI lungs were significantly higher than the normal lungs. The pressure gradient of the middle segment was increased as flow increased at lower flow range, however, it was not increased during higher perfusion range in both lungs. At higher flow, the pressure gradient of the middle segment in the HWI lungs was significantly higher than the normal lungs. These results suggest that the ohmic resistance was almost equal to the sum of the two slopes of the pressure-flow relationships of the pulmonary arterial and venous segment because the pressure gradient of the middle segment was not altered as flow increased during higher perfusion rate. Because the slopes of the pressure-flow relationships of the pulmonary arterial and venous segment were increased with heartworm infection, the ohmic resistance of HWI lungs would be higher than normal lungs. The intercept pressure on the pressure axis of the linear portion of the pulmonary arterial pressure-flow relationship, a critical closing pressure, was regarded as pressure gradient of the middle segment during higher perfusing rate because the intercept pressures of pressure-flow relationships of pulmonary arterial and venous segment were almost equal to zero. Therefore, the critical closing pressure of HWI lungs would be higher than normal lungs. The pulmonary hypertension of filariasis appears to be due to an increase in ohmic resistance and elevated critical closing pressure.

Animals↗
PubMed2003

Queering relationships: toward a paradigmatic shift.

This article exposes, and is critical of, the blatant and insidious ways in which a specific brand of heterosexual relationship has been promoted as the ultimate relational form at the expense of others who neither believe in nor practice such idealized relationships. To uncover this multilayered and deeply imbedded ideology, this piece turns to a description and analysis of how various institutions (e.g., organized religion, medicine, education, law, politics, and the family) perpetuate heteronormative practices in general. Next, specific traits considered to constitute the best and most respectable relationship style are identified. Then, notions of how heteronormativity is marketed and reproduced to create a sexual relationship hierarchy--with a certain form of heterosexuality elevated to the top, as the most revered and cherished relational form--are described and analyzed. Turning to the results of such a well-established and entrenched "marketing campaign," the author offers some notes regarding attitudes about sexual relationships gleaned from teaching a course, "Sex and Relationships," for over a decade. Finally, the author explores the merits and potential drawbacks of a paradigmatic shift toward queering relationships and possible directions for theoretical interventions.

Female↗
PubMed2002

The quality of the caregiving relationship in informal care for older adults with dementia and chronic psychiatric patients.

The present study focuses on the dyadic relationship between a family carer and a patient. Besides clarifying the quality of the caregiving relationship in two populations of chronically ill patients, this investigation examines whether patient characteristics, carer characteristics and network characteristics are predictive of relationship quality in dementia caregiving. Partners, children or children-in-law caring for a relative suffering from dementia (N = 144) and partners or parents of persons suffering from chronic mental illness (N = 77) were interviewed with a semi-structured questionnaire. The measurement of relationship quality is based on the literature of Expressed Emotion and covers two dimensions: the level of criticism and the level of warmth. In general, the relationship between a carer and his or her chronically ill relative was marked by a low level of conflict or criticism and a high degree of warmth. The main predictors of a poorer relationship quality were disturbances in the patient's behaviour and the carer's perception of these disturbances. Our results suggest that, rather than limiting investigations to the burden experienced by the family carer, future research and interventions on chronically ill patients should focus on the quality of the carer-patient relationship and its determinants.

Adult↗
PubMed1991

The oxygen uptake-oxygen delivery relationship during ICU interventions.

There is much interest in the relationship between oxygen delivery and oxygen consumption in the critically ill patient. This interest is occasioned by the observation that patients with sepsis and the adult respiratory distress syndrome have a linear or "supply-dependent" relationship instead of the normally observed biphasic or "supply-independent" relationship. These relationships are only valid when subjects are at rest, since during exercise, as VO2 increases, so do DO2 and the oxygen extraction ratio (ER, VO2/DO2). We examined the VO2-DO2 relationship in a group of 16 mechanically-ventilated surgical ICU patients while they were at rest and during activities that increase VO2. At low levels of activity, where mean VO2 increased from 207 +/- 38 (SD) ml/min at rest to 241 +/- 44 ml/min, there were significant increases in mean DO2 but not mean ER. With the greater (greater than 50 percent) increases in VO2 seen with chest physical therapy, there were increases in both DO2 and ER. When the VO2-DO2 relationship during low levels of exercise and rest are plotted, a linear pattern emerges that could be misinterpreted as a "supply dependent" pattern. Therefore, it is important to pay close attention to the activity state of a patient when examining the VO2-DO2 relationship.

Aged↗
PubMed2003

On the countertransference of the patient: Transformations of the psychoanalyst's 'theoretical self' and their possible articulations with the vicissitudes of the analytic relationship.

In this paper the author examines one of the many levels of the analyst/analysand relationship: the possible interaction between the analyst's mental routes in relation to theories (also meant, but not only, as internal objects) and the vicissitudes of the psychoanalytic relationships with his patients. The author assumes that an important variable affecting the transformation of certain therapeutic relationships is the change that takes place in the relationship between the analyst and that part of his internal world where his theories find their place. He names this part of his internal world 'theoretical self', and 'precipitates of the analyst's theoretical self' those complex formations, akin to more or less cohesive conglomerates, that are formed by his relationship to theories and to psychoanalytic institutions, and by the various, 'personal' internalised objects. The psychoanalyst will relate to these precipitates in a variety of ways, and he will make use of them mostly at an unconscious level in his analytical work; and his patient is likely to 'react' to them, almost chemically. The author also offers some working indications: the psychoanalyst, despite his knowledge of some aspects of his own countertransference, is in fact lacking in knowledge, unless he constantly does some extra work focusing on how his mental position (i.e. the relationship with the precipitates of his theoretical self) may intervene in any of the therapeutic relationships that he establishes--not necessarily in the same way in each of them. The author also illustrates his reflections and conceptualisations by reporting dreams and excerpts from sessions taken from three psychoanalytic treatments in the course of several years.

Countertransference↗
PubMed2004

Relationships between God and people in the Bible, part III: When the other is an outsider.

This study considers intergroup attitudes in the Bible and compares relationships between God or Jesus and (a) Torah non-Israelites; (b) New Testament people who were not followers of Jesus; and (c) New Testament people who were not Jewish. Torah non-Israelites belonged to an out-group with respect to the Hebrew Torah, New Testament people who were not followers of Jesus belonged to an out-group with respect to the Christian New Testament, and New Testament people who were not Jewish were an in-group with respect to Christians. Results were that God or Jesus' relationships were very negative with people in the Torah who were non-Israelites and with people in the New Testament who were not followers, while relationships were positive with people in the New Testament who were not Jewish. Thus, in conclusion, results indicate that both the New Testament and the Torah portray negative relationships between God or Jesus and members of out-groups. Relationships portrayed in New Testament narratives about God and people who were not followers were sometimes more negative than observed for other groups in the New Testament and the Torah; for people who were viewed as outsiders, the New Testament could sometimes be more negative than the Torah. An aim of this study was to identify patterns of relationships between God or Jesus and different types of people in narratives of the Torah and in the New Testament. One of the characteristics of different types of people, including people described in biblical narratives, is whether they are members of in-groups or out-groups. Our focus in this report is on biblical narratives about people who are members of out-groups. The results contribute a clinical-quantitative assessment of out-groups in the Torah and New Testament that is focused on relationship with God, a central issue in the psychology of religion and the Bible.

Bible↗
PubMed1990

[Life style and right to clean air in public places (RCA) (Part 2). The relationship between life style and the aspect of knowledge level of the consciousness towards smoking regulations among employees].

The right to clean air in public places (RCA) is a useful indicator of health consciousness. We surveyed the life style and consciousness towards RCA among employees working at the head office of a major company in Osaka, and examined the relationship between life style and knowledge aspect of RCA, one of the three aspects of consciousness towards RCA. Knowledge on laws concerning smoking regulations in public places was classified into two categories. One was knowledge on laws concerning general matters and the other was knowledge on laws concerning concrete and specific matters. Therefore, there are two kinds of relationship; the relationship between life style and knowledge on laws concerning general matters and the relationship between life style and knowledge on laws concerning concrete matters. These two relationships were examined with statistical procedures. Mean scores of knowledge on laws of subgroups divided by HPI score (POOR, MODERATE and GOOD) within groups divided by age and sex ("M. smoker," "M. nonsmoker" and "F. nonsmoker") were compared by t-test. Life style related to knowledge score was checked by correlation coefficient. The following results were obtained. (1) Relationship between life style and knowledge on laws concerning general matters Knowledge scores and their age-adjusted scores of MODERATE groups were the lowest among the 3 groups ("M. smoker," "M. nonsmoker," "F. nonsmoker"). This set of questions was designed to measure the knowledge level on laws concerning general matters. One would have abundant knowledge if one is health-conscious. In other words, those who do many things beneficial to physical health and have a high HPI have a wealth of knowledge on laws concerning smoking regulations on general matters. In the case of the employees, MODERATE groups were less health-oriented than others ("POOR," "GOOD") within the 3 groups ("M. smoker," "M. nonsmoker," "F. nonsmoker"). (2) Relationship between life style and knowledge on laws concerning concrete matters This set of questions was designed to measure the knowledge on laws concerning concrete and specific matters. To attain high scores, it is necessary to have more smoking experiences in various types of indoor places. POOR group of "M. smoker" and MODERATE groups of "M. nonsmoker" and "F. nonsmoker" had high knowledge scores. They were considered to have greater opportunities to visit public places where smoking is permitted (for example, bars) irrespective of their smoking status.

Adult↗
PubMed2000

Relationship between the pixel value in digital subtraction angiography and iodine concentration: study in high iodine concentration with original phantom.

Quantitative digital subtraction angiography (DSA) image analysis based on densitometry is widely accepted and used. For the densitometoric DSA image analysis, it is required that there is a linear relationships between the pixel values on DSA images (DSA values) and contrast medium iodine concentration or the thickness of the vessels or the chambers filled with contrast material. We studied on relationship between the DSA value and iodine concentration especially in high iodine concentration. As for the relationship between DSA values and iodine concentration on the DSA images at low concentration, DSA phantom had a good linear relationship. However, the relationship at the high iodine concentration, DSA phantom sometimes lost this linear relationship. Our results suggested that it was necessary to identify relationship between DSA values and iodine concentration in each DSA system, especially in high iodine concentration setting, for densitometoric DSA image analysis.

Angiography↗
PubMed2006

Changing relationship of blood pressure with mortality over time among hemodialysis patients.

High BP is a major risk factor for atherosclerotic cardiovascular disease mortality in the general population. Surprising, studies that have been conducted among hemodialysis (HD) patients have yielded conflicting data on the relationship between BP and mortality. This study explores two hypotheses among HD patients: (1) The relationship between BP and mortality changes over time, and (2) mild to moderate hypertension is well tolerated. Incident HD patients who were treated at Dialysis Clinic Inc. facilities between 1993 and 2003 were studied. Primary end points were atherosclerotic cardiovascular disease and all-cause mortality. The relationship between BP and mortality was analyzed in two sets of Cox proportional hazards models. Model-B explored the relationship between baseline BP and mortality in sequential time periods. Model-TV assessed the relationship between BP, treated as time-varying, and mortality. The study sample (n = 16,959) was similar in characteristics to the United States Renal Data Systems population, although black patients were slightly overrepresented. Model-B demonstrated that the relationship between baseline BP and mortality changes over time. Low systolic BP (<120 mmHg) was associated with increased mortality in years 1 and 2. High systolic BP (> or =150 mmHg) was associated with increased mortality among patients who survived > or =3 yr. Low pulse pressure was associated with increased mortality. Model-TV demonstrated that mild to moderate systolic hypertension may be relatively well tolerated. In conclusion, the relationship between baseline BP and mortality changes over time. Mild to moderate systolic hypertension was associated with only modest increases in mortality.

Adult↗
PubMed2006

Longitudinal evaluation of the intermaxillary relationship in Class III malocclusions.

OBJECTIVE: To analyze the sagittal, vertical, and transverse relationship of the maxilla and mandible in Japanese girls with Class III malocclusions. MATERIALS AND METHODS: This longitudinal study utilized biannual posteroanterior and lateral cephalograms of 44 untreated subjects from age 8 to 14 years (Class I, 23 girls; Class III, 21 girls). Sagittal and vertical growths were analyzed on the basis of lateral cephalograms, and transverse growth was analyzed on the basis of posteroanterior cephalograms. RESULTS: There was no significant difference in sagittal intermaxillary relationships in Class III malocclusion from age 8 to 14 years, whereas significant difference in vertical and transverse intermaxillary relationships appeared with ages during this period. When comparing Class III to Class I malocclusions at the same age point, there were significant differences in sagittal and transverse intermaxillary relationships, whereas significant difference in vertical intermaxillary relationship appeared after 12 years of age. CONCLUSION: The results suggest that the sagittal intermaxillary relationships in Class III malocclusions were established before 8 years of age and remained through puberty and that the vertical and transverse intermaxillary relationships in Class III malocclusions changed with ages from 8 to 14 years.

Adolescent↗