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Profiles of adolescent stress: the development of the adolescent stress questionnaire (ASQ).

The importance of stress in the understanding of adolescent health and well-being is widely documented. The measurement of adolescent stress has however been subjected to sufficient methodological and conceptual criticism in recent times to warrant a concerted re-evaluation of the exercise. This study sought information on the nature of adolescent stressors, building on a previous instrument developed by the first author to ask adolescents themselves to inform the development of a pool of new items reflecting stressor experience and to advise on the wording of these items to comprehensively assess that experience. This pool of items was then administered as a self-reported questionnaire to a large sample of school-age adolescents (N>1000) together with a scale to assess the intensity of distress arising from stressor occurrence. Principal components analysis of the questionnaire yielded 10 internally reliable dimensions of adolescent stress, the nature of which were consistent with the available literature on adolescent stressor experience. Scales constructed from this PCA related positively to measures of anxiety and depression, and negatively to a measure of self-esteem, suggesting that they were valid measures of adolescent stress. Test-retest reliability was good for all scales. The resultant Adolescent Stress Questionnaire (ASQ) is therefore suggested to have potential for the measurement of adolescent stress in both research and clinical contexts.

Achievement↗

PCR analysis of immunoglobulin heavy chain (IgH) and TcR-gamma chain gene rearrangements in the diagnosis of lymphoproliferative disorders: results of a study of 525 cases.

This report summarizes a cumulative 4-year experience in polymerase chain reaction (PCR) analysis of immunoglobin heavy chain (IgH) and TcR-gamma chain gene rearrangements in 525 cases of lymphoproliferative disorders. Because the sensitivity of the PCR methodology was found to be tissue dependent, in the study of the presence of clonal cell population in tissues containing a small number of polyclonal lymphocytes, such as skin and gastrointestinal biopsy specimens, we used the multiple-PCR run approach. In this latter methodology, we repeat the PCR reaction from the same sample at least three times to confirm the reproducibility of the results. In the study of 273 cases of B- or T-cell lymphomas with characteristic immunomorphological and clinical features, a clonal IgH or TcR-gamma chain gene rearrangement was detected in approximately 80% of cases. A clonal rearrangement involving both IgH and TcR-gamma chain genes was found in 10% of cases of both B-cell and T-cell lymphomas. The study of 167 cases of nonneoplastic lymphoid tissue samples showed the presence of clonally rearranged cell populations for IgH or TcR-gamma genes in 3 and 9% of cases, respectively. We also applied PCR for the study of 85 cases of lymphoproliferations with no definite diagnosis (i.e., benign versus malignant) after immunomorphological analysis. In 65 cases (76%), the correlation of immunomorphological features with the presence (48 cases) or the absence (17 cases) of clonal lymphoid cell populations led to a definite diagnosis. In almost all these cases, the final diagnosis was found to be in agreement with the clinical course. In the 20 remaining cases (24%), no definite diagnosis could be made. We also assessed the value of PCR in detecting bcl-2/J(H) gene rearrangement as an additional clonal marker in the diagnosis of follicular lymphoma. Bcl-2/J(H) rearrangement and/or IgH gene rearrangement was found in approximately 85% (71/85) of follicular lymphoma cases studied.

Adolescent↗

Increasing speed and throughput when using HPLC-MS/MS systems for drug metabolism and pharmacokinetic screening.

Both combinatorial chemistry and parallel synthesis provide a valuable means for the production of large numbers of compounds with diverse molecular architectures that become available for various drug discovery experiments. In both the lead optimization and lead selection stages, one requirement that is common for many processes is the need for bioanalytical support. This review summarizes current high throughput strategies and efficient methodologies that are employed for drug metabolism and pharmacokinetic (DMPK) screens for a series of drug discovery compounds. For these types of assays, high performance liquid chromatography coupled to a tandem mass spectrometer (HPLC-MS/MS) has now become the technique of choice. The major high throughput strategies including sample reduction and cassette dosing are discussed. The methods for increasing the speed of HPLC-MS/MS-based analyses, such as fast chromatography, direct sample injection, parallel technologies and combined ionization interfaces are also presented in this review. In addition, the special challenges when performing HPLC-MS/MS bioanalysis, such as the choice of ionization sources, matrix ionization suppression and the potential for endogenous interferences, are addressed.

Animals↗

Prevalence of sexualized violence among women. A population-based study in a primary healthcare district.

In order to estimate the prevalence of sexual and physical abuse, postal questionnaires were sent to a random sample of 251 adult women in a primary care district. Three yes/no-questions were asked on these topics, and a fourth inquired into effects on health. Space was left for open-ended answers in which yes-responders were invited to write about their experiences. A total of 175 women (70%) answered, and 25 (14%) of these reported abuse. Nine (5%) had experienced women battering. Thirteen (7.5%) reported sexual abuse as an adult, and 12 (7%) as a child. Many told their stories. Methodological shortcomings in this study might explain why the rates are somewhat lower than in other investigations. However, our figures verified that abuse of women is a common social phenomenon. They also confirmed abuse as a major health problem for women. One-third of respondents explicitly reported effects on health. Others, though negating such effects, described them in written narratives. In order to study this contradiction, in-depth interviews with abused women are recommended.

Adolescent↗

Diffusion-sink sampling for minimally invasive measurement of tissue available hormones.

The interpretation of hormone concentrations measured in blood plasma is made difficult by some features of hormone physiology that are common to many endocrine systems: 1) secretion occurs in episodes; and 2) specific binding proteins profoundly influence the availability of hormone to tissue. Frequently repeated sampling and specific measurement of the freely diffusing hormone concentration are thus desirable. Traditional methods to this end are invasive, laborious, and frequently impractical. Diffusion-sink (DS) devices that are able to continuously sample the freely-diffusing concentration of a hormone in a biological fluid over a period of time have been built; these devices can be used for minimally invasive sampling. For some steroid hormones, DS devices can be worn orally to estimate tissue-available hormone in saliva; direct installation of DS devices in interstitial fluid is also possible. Experience to date in using these devices to measure corticosteroids and progesterone suggests several practical advantages, including: 1) similar time-averaging capability as with invasive area-under-the-curve methods; 2) specificity for the freely-diffusing concentration even in the presence of varying concentrations of protein-bound forms; and 3) ability to sample under conditions where traditional methods are prohibitively invasive, such as normal work and sleep. The diffusion-sink sampling approach can probably be combined with appropriate immunoassay methodologies to yield measurements that are simple and quick enough for routine clinical use.

Adrenal Cortex Hormones↗

Does breastfeeding empower women? Insights from a select group of educated, low-income, minority women.

A grounded theory study examined the breastfeeding experiences of a small group of educated, low-income, minority women. In-depth interviews were used to collect data. The five themes that emerged as primary descriptors of the experience were against all odds, personal motivation, support, attachment, and telling the world. These themes help to identify the factors that enhanced successful breastfeeding among this select sample of women, and demonstrate that the perception of successful breastfeeding can have an empowering effect on women.

Adult↗

Effect of olive mill wastewaters on the oxygen consumption by activated sludge microorganisms: an acute toxicity test method.

The test for inhibition of oxygen consumption by activated sludge (ISO 8192-1986 (E)) was evaluated as a tool for assessing, the acute toxicity of olive mill wastewaters (OMW). According to the ISO test, information generated by this method may be helpful in estimating the effect of a test material on bacterial communities in the aquatic environment, especially in aerobic biological treatment systems. However, the lack of standardized bioassay methodology for effluents imposed that the test conditions were modified and adapted. The experiments were conducted in the presence or absence of an easily biodegradable carbon source (glucose) with different contact times (20 min and 24 h). The results obtained showed a remarkable stimulatory effect of this effluent to the activated sludge microorganisms. In fact, the oxygen uptake rate values increase with increasing effluent concentrations and contact times up to 0.98 microl O(2) h(-1) mg(-1) dry weight for a 100% OMW sample, 24 h contact time, with blanks exhibiting an oxygen uptake rate of ca. 1/10 of this value (0.07-0.10). It seems that the application of the ISO test as an acute toxicity test for effluents should be reconsidered, with convenient adaptation for its utilization as a method of estimating the effect on bacterial communities present in aerobic biological treatment systems.

Bacteria, Aerobic↗

Functionalized nanoparticles for liquid atmospheric pressure matrix-assisted laser desorption/ionization peptide analysis.

Nanoparticles for the extraction of peptides and subsequent analysis using atmospheric pressure matrix-assisted laser desorption/ionization (APMALDI) have been evaluated. The atmospheric pressure source allows for particles to be directly introduced in the liquid matrix, minimizing sample loss and analysis time. Described in this work are two sample preparation procedures for liquid APMALDI analysis: a C18 functionalized silica nanoparticle for hydrophobic extractions, and an aptamer functionalized magnetite core nanoparticle for rapid, affinity extractions. The C18 particles provide a non-selective support for rapid profiling applications, while the aptamer particles are directed towards reducing the complexity in biological samples. The aptamer functionalized particles provide a more selective analyte-nanoparticle interaction whereby the tertiary structure of the analyte becomes more critical to the extraction. In both cases, the liquid APMALDI matrix provides a support for ionization, and acts as the releasing agent for the analyte-particle interaction. Additionally, analyte enrichment was possible due to the large surface-to-volume ratio of the particles. The experiments conducted with functionalized nanoparticles, in an atmospheric pressure liquid matrix, present a basis for further methodologies and utilities of silica nanoparticles to be developed.

Adsorption↗

Microanalysis of indoor aerosols and the impact of a compact high-efficiency particulate air (HEPA) filter system.

Aerosol particles in municipal atmospheres are of increasing public health concern; however, since most of our time is spent indoors, indoor aerosols must be researched in counterpart. Compact High-Efficiency Particulate Air (HEPA) filter systems are commonly employed in residences to alleviate airborne dust concentrations. In this study, a detailed and original methodology was used to determine concentrations and types of submicrometer aerosols, as well as of large (> 4 microns) dust particles. Scanning electron microscopy was used to quantify and characterize ambient aerosols collected from filtered and non-filtered rooms. Particle concentrations were significantly lower in samples collected in the presence of the filter system (mean 23 to 8 coarse particles liter-1, 63% reduction; 13 to 3 inorganic submicron particles cm-3, 76% reduction; 85 to 33 total submicron particles cm-3, 62% reduction; all P < 0.05). This study provides a new methodology for analysis of indoor aerosols and new data on their physico-chemical characteristics. Since the filter systems are effective at reducing submicron aerosol concentrations, they may improve the health of individuals such as asthmatics, who experience health problems caused by anthropogenic fine particles.

Aerosols↗

Machine learning and word sense disambiguation in the biomedical domain: design and evaluation issues.

BACKGROUND: Word sense disambiguation (WSD) is critical in the biomedical domain for improving the precision of natural language processing (NLP), text mining, and information retrieval systems because ambiguous words negatively impact accurate access to literature containing biomolecular entities, such as genes, proteins, cells, diseases, and other important entities. Automated techniques have been developed that address the WSD problem for a number of text processing situations, but the problem is still a challenging one. Supervised WSD machine learning (ML) methods have been applied in the biomedical domain and have shown promising results, but the results typically incorporate a number of confounding factors, and it is problematic to truly understand the effectiveness and generalizability of the methods because these factors interact with each other and affect the final results. Thus, there is a need to explicitly address the factors and to systematically quantify their effects on performance. RESULTS: Experiments were designed to measure the effect of "sample size" (i.e. size of the datasets), "sense distribution" (i.e. the distribution of the different meanings of the ambiguous word) and "degree of difficulty" (i.e. the measure of the distances between the meanings of the senses of an ambiguous word) on the performance of WSD classifiers. Support Vector Machine (SVM) classifiers were applied to an automatically generated data set containing four ambiguous biomedical abbreviations: BPD, BSA, PCA, and RSV, which were chosen because of varying degrees of differences in their respective senses. Results showed that: 1) increasing the sample size generally reduced the error rate, but this was limited mainly to well-separated senses (i.e. cases where the distances between the senses were large); in difficult cases an unusually large increase in sample size was needed to increase performance slightly, which was impractical, 2) the sense distribution did not have an effect on performance when the senses were separable, 3) when there was a majority sense of over 90%, the WSD classifier was not better than use of the simple majority sense, 4) error rates were proportional to the similarity of senses, and 5) there was no statistical difference between results when using a 5-fold or 10-fold cross-validation method. Other issues that impact performance are also enumerated. CONCLUSION: Several different independent aspects affect performance when using ML techniques for WSD. We found that combining them into one single result obscures understanding of the underlying methods. Although we studied only four abbreviations, we utilized a well-established statistical method that guarantees the results are likely to be generalizable for abbreviations with similar characteristics. The results of our experiments show that in order to understand the performance of these ML methods it is critical that papers report on the baseline performance, the distribution and sample size of the senses in the datasets, and the standard deviation or confidence intervals. In addition, papers should also characterize the difficulty of the WSD task, the WSD situations addressed and not addressed, as well as the ML methods and features used. This should lead to an improved understanding of the generalizablility and the limitations of the methodology.

Algorithms↗

Describing suicidality: an investigation of qualitative SSF responses.

Given the incidence and seriousness of suicidality in clinical practice, the need for new and better ways to assess suicide risk is clear. While there are many published assessment instruments in the literature, survey data suggest that these measure are not widely used. One possible explanation is that current quantitatively developed assessment instruments may fail to capture something essential about the suicidal patient's experience. The current exploratory study examined a range of open ended qualitative written responses made by suicidal outpatients to five assessment prompts from the Suicide Status Form (SSF)--psychological pain, press, perturbation, hopelessness, and self-hate. Two different samples of suicidal outpatients seeking treatment, including suicidal college students (n = 119) and active duty U.S. Air Force personnel (n = 33), provided a wide range of written responses to the five SSF prompts. A qualitative coding manual was developed through a step-by-step methodology; two naive coders were trained to use the coding system and were able to sort all the patients' written responses into the content categories with very high interrater reliability (Kappa > .80). Certain written qualitative responses of the patients were more frequent than others, both within and across the five SSF constructs. Among a range of specific exploratory findings, one general finding was that two thirds of the 636 obtained written responses could be reliably categorized under four major content headings: relational (22%), role responsibilities (20%), self (15%), and unpleasant internal states (10%). Theoretical, research, and clinical implications of the methodology and data are discussed.

Adult↗

The use of brain electrical potentials (BEP) to study localization of human brain function.

Various techniques such as neuropsychological diagnosis of individuals with focal lesions, stimulation of neurosurgery patients, and regional cerebral blood flow have been used to elucidate the major anatomical and functional divisions of the human cerebral cortex. Because of insufficient spatial sampling and other limitations, only minor support for these divisions comes from brain electrical potential (BEP) experimentation. The use of EEG to localize different neuropathologies and to screen and track the evolution of seizure disorders is fairly reliable and still widely practiced. Its use, however, in localizing higher cognitive functions is much more complicated and has not stood the test of scientific scrutiny because of methodological problems. More specifically, the failure to control for the stimulus, response and performance related properties of tasks in experiments has rendered ambiguous the results of most EEG studies of higher cognitive functions. Those studies which actually controlled for these properties did not find and differences between tasks.

Brain↗

Patients' and healthcare providers' opinions regarding advance directives.

PURPOSE/OBJECTIVES: To gain a better understanding of patients' and healthcare providers' preferences regarding when, how, and by whom advance directive information should be given and to explore the nursing role in advance directives. DESIGN: A qualitative study using focus group methodology. SETTING: A National Cancer Institute-designated comprehensive cancer center located within a large, university-affiliated, tertiary care hospital in the northeastern United States. SAMPLE: Two samples participated in the study: eight adult ambulatory patients with cancer and 15 healthcare providers (4 physicians, 10 nurses, and 1 social worker). METHODS: Separate patient and provider focus groups were conducted in private rooms by experienced facilitators using an interview guide with questions based on the literature, the hospital's advance directive materials, and the investigators' experience; sessions were audio-taped, transcribed, and analyzed using qualitative data analysis techniques. FINDINGS: Patients and healthcare providers discussed focus group questions and commented that advance directive discussions should be provided early in the treatment or illness, presented in a short and simple format with reading materials at a level appropriate for the patient, and continued throughout the illness with those who desire follow-up. Nurses, doctors, social workers, or a designated/trained advance directive person were individuals that the patients identified as people with whom they could have advance directive discussions. CONCLUSIONS: Results suggested that advance directive information should be given prior to hospital admission, be provided in a variety of formats, and that nurses, social workers, doctors, or designated staff representatives could all be part of the advance directive process. NURSING IMPLICATIONS: Nursing roles should include early assessment of patients to determine needs for discussion, advocacy on behalf of patients, and provision of information. Future research should examine use of specific personnel for facilitating advance directives and compare different formats for presenting advance directive information to patients.

Advance Directives↗

Illicit drug users in Northern Ireland: perceptions and experiences of health and social care professionals.

Over the 30 years of conflict, Northern Ireland escaped the worst excesses of illegal drug trafficking and usage. This was in large part due to the 'policing' of local community crime by paramilitaries. However, since the first 'cease-fire' in 1994 the province has witnessed a dramatic and unprecedented rise in the availability of illicit drugs. This increased availability reflects rising consumption of these drugs in the province. The aim of this study was to explore the perceptions that a sample of health and social care professionals' hold of illicit drug users in Northern Ireland. A survey methodology was used. Community settings across Northern Ireland were accessed. Focus groups and face-to-face interviews were used as data collection methods. Thirty-five health and social care professionals took part in this study. Thirty-two took part in six focus groups; three respondents underwent one-to-one interview. The participating professionals reported to have little or no education or training in the care and treatment of illicit drug users. Some stated that they would reject the offer of education and training in this area to prevent contact with illicit drug users. Many displayed strongly negative views of this client group, often expressing a preference not to care for or treat these people, preferring all their care to be given by specialists in illicit drug treatment. These findings indicate that most of the health and social care professionals who took part in this study appear unprepared and unwilling to meet the challenge of caring for illicit drug users. The findings will be of interest to service providers within and outside the UK.

Attitude of Health Personnel↗

An examination of physical activity behaviors in a sample of adolescent cancer survivors.

With a growing consensus of the importance of physical activity across a number of health outcomes, the current study investigated the impact of a cancer diagnosis on adolescent physical activity behavior. Participants (n=97) completed a mailed, self-administered questionnaire in which they recalled their physical activity behaviors across the cancer experience. Examination of the data revealed that adolescents treated for cancer experience significant declines in physical activity that are not recovered following treatment completion. It is not clear if the sustained reduction in posttreatment physical activity is attributable to the lingering effects of cancer treatment, but the long-term implications of a reduction in physical activity may be far-reaching.

Adaptation, Psychological↗

Alpha- and beta-forms of gutta-percha in products for root canal filling.

AIM: This study was undertaken to evaluate which materials were in the alpha-form of gutta-percha as claimed, and which were in the more conventional beta-form, and to explore the effect of heating on the materials. METHODOLOGY: Samples of gutta-percha without chemical additives, and dental gutta-percha formulations which included (i) two products previously studied; (ii) 12 newer products; and (iii) one newer product that had been stored at high temperature, were analysed by simultaneous differential thermal analysis and thermogravimetry. RESULTS: It was found that only four of the newer materials contained the alpha-form; all the rest comprised beta-gutta-percha. No weight loss was found for any material under the conditions of the present experiments. A typical heating cycle up to 130 degrees C caused changes in material behaviour - that is, on reheating fewer endothermic peaks were present. Storage of gutta-percha samples for 10 years under ambient temperature and storage in a heater at 80 degrees C appeared to have no effect on properties. CONCLUSIONS: It was concluded that heating dental gutta-percha to 130 degrees C causes physical changes; this was not seen with chemically pure gutta-percha. The presence of additives in the dental samples altered material behaviour.

Differential Thermal Analysis↗

A pilot study of users' experiences of urinary catheter drainage bags.

Despite the wealth of literature focused on the management of people living in the community with long-term indwelling urinary catheters, little attention has been paid to their impact on daily life. In a pilot study, a purposive sample of people with long-term indwelling urinary catheters were sent a questionnaire asking about their indwelling urinary catheter, method of drainage and impact of the catheter drainage bag on their daily life. Nearly one-quarter of respondents stated that wearing a drainage bag had a major impact on their normal daily living. The study also highlighted a number of methodological issues that need to be addressed in future research.

Activities of Daily Living↗