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PubMed2005

Teaching breast cancer screening to African American women in the Arkansas Mississippi river delta.

PURPOSE/OBJECTIVES: To determine the effectiveness of a multifaceted, culturally sensitive breast cancer education program for African American women in the Arkansas Mississippi River Delta. DESIGN: Experimental (i.e., posttest only, control group design). SETTING: African American churches and a county Extension Homemakers Club sponsored through the Arkansas Extension Homemakers council. SAMPLE: 53 African American women. The experimental group included 30 participants who had a mean age of 56 years, and the control group consisted of 23 participants with a mean age of 51 years. METHODS: After the presentation of a multifaceted, culturally sensitive breast cancer education program, a variety of instruments were administered to participants in the experimental group that measured dependent variables. Subjects in the control group completed the same instruments in the absence of a viable intervention. Data were analyzed using t tests. MAIN RESEARCH VARIABLES: Knowledge and beliefs about breast cancer. FINDINGS: The experimental group's mean scores were significantly higher than the control group's on the Breast Cancer Knowledge Test and the susceptibility scale of the Breast Cancer Screening Belief Scales. The experimental group also scored significantly higher than the control group on the confidence scale of the Breast Cancer Screening Belief Scales. CONCLUSIONS: The multifaceted, culturally sensitive breast cancer education program appeared to be responsible for the differences in scores between the experimental and control groups. IMPLICATIONS FOR NURSING: Culturally sensitive group educational programs aimed at helping African American women in the rural South become more knowledgeable about breast cancer and early detection clearly are needed. Such efforts also must focus on increasing women's confidence in effectively performing regular breast self-examination as well as their understanding of personal risk. Healthcare professionals play a major role in the development and implementation of these programs.

Black or African American↗
PubMed1997

Comparison of screening instruments for alcohol problems between black and white emergency room patients from two regions of the country.

A number of brief screening instruments to identify alcohol dependence exist, but the validity of these instruments across ethnic groups or regions of the country is not well established. The sensitivity and specificity of a number of standard screening instruments (CAGE, brief MAST, AUDIT, TWEAK, and RAPS), as well as other measures (History of Trauma Scale, breathalyzer reading, self-reported drinking before the event, and consuming five or more drinks at a sitting at least monthly) are compared against ICD-10 and DSM-IV criteria for alcohol dependence between probability samples of Black and White emergency room patients in Santa Clara County, CA (n = 716) and in Jackson, MS (n = 1330). Variability in the sensitivity of screening instruments among current drinkers was found to be greater between samples for both Blacks and Whites, than for Blacks compared with Whites within the same sample. The AUDIT, TWEAK, and RAPS seemed to perform well by gender and injury status for both Blacks and Whites in the two samples, and no significant differences were found in the performance of these instruments across sample sites. To evaluate the influence of regional differences in alcohol dependence on differences found in the performance of screening instruments, using logistic regression with the simultaneous entry of demographic variables (age, gender, ethnicity, injury status, and site) and drinking variables (breathalyzer reading, self-reported drinking before the event, and drinking five or more drinks at a sitting at least monthly) to predict alcohol dependence in a merged sample of these patients (Jackson vs. Santa Clara) site was not found to be significant. Data suggest that, whereas region of the country may not be important in predicting alcohol dependence in emergency room populations, regional differences in the performance of screening instruments for alcohol dependence may exist, even when ethnicity is taken into account. Given distinct regional differences in drinking patterns and problems in the U.S., further research on commonly used screening instruments is needed to determine those screeners most efficient for identifying problem drinking.

Adolescent↗
PubMed1986

A rapid leaf-disc sampler for psychrometric water potential measurements.

An instrument was designed which facilitates faster and more accurate sampling of leaf discs for psychrometric water potential measurements. The instrument consists of an aluminum housing, a spring-loaded plunger, and a modified brass-plated cork borer. The leaf-disc sampler was compared with the conventional method of sampling discs for measurement of leaf water potential with thermocouple psychrometers on a range of plant material including Gossypium hirsutum L., Zea mays L., and Begonia rex-cultorum L. The new sampler permitted a leaf disc to be excised and inserted into the psychrometer sample chamber in less than 7 seconds, which was more than twice as fast as the conventional method. This resulted in more accurate determinations of leaf water potential due to reduced evaporative water losses. The leaf-disc sampler also significantly reduced sample variability between individual measurements. This instrument can be used for many other laboratory and field measurements that necessitate leaf disc sampling.

Journal Article↗
PubMed1996

Surface roughness of dentin after tooth preparation with different rotary instrumentation.

Although surface finish can be a critical variable in clinical performance, there is a dearth of information regarding surface characteristics of teeth prepared for artificial crowns. This study characterized teeth prepared for complete cast restorations using three representative types of rotary instruments. One hundred and five standardized tooth preparations for complete crowns were performed using a modified milling machine on extracted human teeth with diamond, tungsten carbide, and tungsten carbide finishing burs of similar shape (n = 35). The prepared dentin was analyzed with a surface profilometer and a scanning electron microscope (SEM). Differences between rotary instrument groups were determined with parametric ANOVA and Tukey's Studentized Range (HSD). Statistically significant differences in the surface topography of prepared teeth were open. Mean surface roughnesses (Ra) were 8.6 and 6.8 mum for teeth prepared with diamond and tungsten carbide burs. Teeth completed with finishing burs appeared to result in a smoother surface (1.2 mum).

Analysis of Variance↗
PubMed1996

Predictors of family functioning and change 3 years after traumatic brain injury in children.

OBJECTIVES: To examine changes in family functioning from injury to 3 years after pediatric traumatic brain injury; to determine factors most predictive of family outcomes at 3 years and variables that promote positive outcomes and changes over time. DESIGN: Prospective cohort study. SETTING: Two regional tertiary care centers: cases followed for 3 years into community. PARTICIPANTS: Families of 81 children, ages 6 to 15 years, who sustained closed head injury and loss of consciousness (mild = 43, moderate = 20, severe = 18), consecutively enrolled over 15 months. MAIN OUTCOME MEASURES: Family Environment Scale, Family Assessment Device, Family Inventory of Life Events, Health Insurance Survey-General Well-Being, NYU Problem Checklist for Significant Others, Family Interview Rating Scale, Family Global Assessment Scale. All were obtained initially and at 3 months, 1 year, and 3 years postinjury. Predictor variables were selected from the instruments above, as well as from the parent and teacher versions of the Child Behavior Checklist, socioeconomic status, and injury severity. RESULTS: Preinjury functioning was the best predictor of 3-year outcomes. Fewer changes in family functioning were reported over 3 years in the mild or moderate groups, whereas more deterioration occurred in the severe group. At 3 years, one third to one half of parents in either the moderate or severe groups reported medium to high strain in 19 of 34 problem areas. Low levels of family control and high levels of expressiveness correlated with better outcomes for severe group. Positive change for the severe group was marked by better preinjury levels of communication, expressiveness, problem solving, use of resources, role flexibility, greater activity orientation, and less conflict, control, and stress. Preinjury variables and severity explained from 26% to 69% of the variation in 3-year outcomes. CONCLUSIONS: Families at risk for poorer outcomes can be prospectively identified and should be supported and encouraged in their efforts to develop new coping resources.

Adaptation, Psychological↗
PubMed1995

Body composition by DXA: tried and true?

Dual-energy x-ray absorptiometry (DXA) is unquestionably the method of choice for the assessment of bone mass. Recent generations of DXA instruments also have the capability of assessing soft tissue mass, thereby providing a three-compartment model of body composition, i.e., bone mineral, fat, and bone-free lean masses. Although hydrodensitometry has long been considered the reference method of assessing body composition, assumptions regarding the constancy of the constituents of fat-free mass may compromise its validity in some populations. Because DXA appears to be less dependent on assumptions regarding biological consistency, it is possible that it has the potential to provide a more accurate assessment of body composition across populations than does hydrodensitometry, and that it should be considered the reference method. DXA has been shown to provide precise measures of body composition, but it remains questionable as to whether those measures are accurate. Contributing to the uncertainty regarding validity is the variability among manufacturers of DXA instruments in the methods of calibration, data acquisition, and data analysis. Although DXA holds great promise in becoming the criterion method of assessing body composition, and has been promoted as such by some investigators, available data indicate that this endorsement is premature.

Absorptiometry, Photon↗
PubMedDate not supplied

Design and testing of the use of a complementary and alternative therapies survey in women with breast cancer.

PURPOSE/OBJECTIVES: To design and test a reliable and valid instrument to determine the frequency of use of complementary and alternative medicine (CAM) therapies among women diagnosed with breast cancer. DESIGN: A descriptive cross-sectional survey. SETTING: Women were recruited from the southeastern area and a rural midwestern area of the United States. SAMPLE: 105 predominantly Caucasian women (mean= 59 years of age) with a diagnosis of breast cancer. METHODS: The Use of Complementary and Alternative Therapies Survey was designed with a content validity index, and reliability was determined with the coefficient alpha. Exploratory factor analysis using a principal components analysis identified primary components (factors) embedded within the survey. Frequency of CAM therapy use was calculated for 33 individual therapies listed on the survey and among three survey-defined subscales of CAM therapies (i.e., diet and nutritional supplements, stress-reducing techniques, and traditional and ethnic medicines). MAIN RESEARCH VARIABLES: Psychometric properties of an instrument to assess frequency of use of CAM among women with breast cancer. FINDINGS: The reported prevalence of use of the individual CAM therapies varied considerably. The coefficient alpha estimate for the total survey was 0.86. Estimates for the individual hypothesized subscales were 0.67 for diet and nutritional supplements, 0.79 for stress-reducing techniques, and 0.80 for traditional and ethnic medicines. The principal components analysis resulted in a two-factor solution with nine items that loaded heavily and uniquely on a factor conceptualized as stress and anxiety reduction and six items that loaded heavily and uniquely on a factor conceptualized as dietary and physical manipulation. The remaining five items (vitamins and minerals, prayer and spiritual healing, massage, reflexology, and aromatherapy) indicated moderate loadings on factors one and two and, thus, were interpreted as equivocal items. CONCLUSIONS: Preliminary data indicated that the instrument is reliable and valid. Additional work is needed to improve the range of items and to test the instrument with other populations. IMPLICATIONS FOR NURSING: Use of CAM by women with breast cancer is believed to be increasing. However, limited data exist on the frequency and predictors of its use in this patient population; therefore, reliable and valid instruments are needed to determine use. If nurses can determine which CAM therapies women are employing, nurses can educate patients with breast cancer on the safe use of these therapies.

Breast Neoplasms↗
PubMed1993

Regional and cardiac haemodynamic effects of NG, NG,dimethyl-L-arginine and their reversibility by vasodilators in conscious rats.

1. A series of experiments was carried out on 3 separate groups of male Long Evans rats, chronically instrumented for the measurement of regional haemodynamics, to compare the effects of NG,NG, dimethyl-L-arginine (ADMA) and NG-monomethyl-L-arginine (L-NMMA), and their reversibility by the nitric oxide donors, S-nitroso-N-acetyl-penicillamine (SNAP), S-nitroso-glutathione (SNOG), sodium nitroprusside (SNP), and the vasodilator, hydralazine. 2. As previously reported for L-NMMA, ADMA (1-100 mg kg-1) caused dose-dependent pressor and bradycardic effects, accompanied by renal, mesenteric and hindquarters vasoconstrictions. The magnitude and duration of these effects were similar for ADMA and L-NMMA, consistent with their being equipotent inhibitors of nitric oxide synthase. 3. Infusion of SNAP or SNOG (300 micrograms kg-1 h-1) after injection of ADMA or L-NMMA (100 mg kg-1) reversed the pressor but did not abolish the vasoconstrictor, effects of ADMA or L-NMMA. However, a higher dose of SNAP (3 mg kg-1 h-1) caused complete reversal of the pressor and mesenteric haemodynamic effects of ADMA (100 mg kg-1), although its renal and hindquarters vasoconstrictor effects were not abolished. 4. Infusion of SNP (300 micrograms kg-1 h-1) after administration of L-NMMA (100 mg kg-1), caused complete reversal of its pressor and mesenteric and hindquarters haemodynamic effects, and reduced substantially its renal vasoconstrictor action; hydralazine (7.5 mg kg-1 h-1) was almost as effective as SNP in reversing all these variables. 5. In animals chronically instrumented for the measurement of cardiac haemodynamics, ADMA(100 mg kg-1) caused a pressor effect accompanied by a rise in central venous pressure, and reductions in heart rate, cardiac index, stroke index, peak aortic flow, maximum rate of rise of aortic flow and total peripheral conductance. The reversal of the pressor effect of ADMA by SNAP (300 microg kg-1 h-1) was accompanied by a reduction of central venous pressure below resting levels and a further diminution of stroke index; all other variables showed an increase, but they still remained below resting levels (with the exception of heart rate).6. Thus, following inhibition of NO synthesis, pharmacological intervention with NO donors, or other vasodilators, may cause normalisation of the mean arterial pressure without necessarily returning all associated cardiovascular variables to normal.

Animals↗
PubMed1996

Hostility and doctor-patient interaction in chronic pelvic pain.

BACKGROUND: Interaction in medical consultations is of interest for many reasons and has long been thought an important variable in determining outcomes. Relatively few methods or instruments exist that attempt to access this phenomenon. The design, validation and possible application of a simple instrument to assess doctor-patient interaction are reported. Rapport and hostility may be related and we hypothesised that interaction between doctor and patient would be related in part to hostility. METHODS: A simple instrument to assess doctor-patient interaction was designed based on 4 areas related to interaction and perception of 'the other'. These were the areas of communication, rapport, trust and sense of ease. The instrument was compared with an external previously validated measure of hostility. Data were obtained from 74 women attending initial and follow-up consultations for chronic pelvic pain during the course of a larger study. RESULTS: The instrument had acceptable reliability and a single-factor structure. Patients' assessment of the initial consultation as unsatisfactory correlated with inwardly directed hostility (Spearman correlation coefficient, r = 0.30, p = 0.011). Patients' tendency to rate the consultation worse than the doctor was correlated with inwardly directed hostility (r = 0.42, p < 0.001). Pain outcomes were not directly related to the variables studied. CONCLUSIONS: This instrument offers a simple method of assessing some interactional aspects of a medical consultation.

Chronic Disease↗
PubMed2004

Variability of wavefront aberration measurements in small pupil sizes using a clinical Shack-Hartmann aberrometer.

BACKGROUND: Recently, instruments for the measurement of wavefront aberration in the living human eye have been widely available for clinical applications. Despite the extensive background experience on wavefront sensing for research purposes, the information derived from such instrumentation in a clinical setting should not be considered a priori precise. We report on the variability of such an instrument at two different pupil sizes. METHODS: A clinical aberrometer (COAS Wavefront Scienses, Ltd) based on the Shack-Hartmann principle was employed in this study. Fifty consecutive measurements were performed on each right eye of four subjects. We compared the variance of individual Zernike expansion coefficients as determined by the aberrometer with the variance of coefficients calculated using a mathematical method for scaling the expansion coefficients to reconstruct wavefront aberration for a reduced-size pupil. RESULTS: Wavefront aberration exhibits a marked variance of the order of 0.45 microns near the edge of the pupil whereas the central part appears to be measured more consistently. Dispersion of Zernike expansion coefficients was lower when calculated by the scaling method for a pupil diameter of 3 mm as compared to the one introduced when only the central 3 mm of the Shack - Hartmann image was evaluated. Signal-to-noise ratio was lower for higher order aberrations than for low order coefficients corresponding to the sphero-cylindrical error. For each subject a number of Zernike expansion coefficients was below noise level and should not be considered trustworthy. CONCLUSION: Wavefront aberration data used in clinical care should not be extracted from a single measurement, which represents only a static snapshot of a dynamically changing aberration pattern. This observation must be taken into account in order to prevent ambiguous conclusions in clinical practice and especially in refractive surgery.

Adult↗
PubMed2004

Within- and between-laboratory precision in the measurement of body volume using air displacement plethysmography and its effect on body composition assessment.

OBJECTIVE: To determine and compare the extent of within- and between-laboratory precision in body volume (BV) measurements using air displacement plethysmography (ADP), the BOD POD body composition system, and to interpret any such variability in terms of body composition estimates. DESIGN: Repeated test procedures of BV assessment using the BOD POD ADP were reproduced at two laboratories for the estimation of precision, both within and between laboratories. SUBJECTS: In total, 30 healthy adult volunteers, 14 men (age, 19-48 y; body mass index (BMI), 19.7-30.3 kg/m2) and 16 women (age, 19-40 y; BMI, 16.3-35.7 kg/m2), were each subjected to two test procedures at both laboratories. Two additional volunteers were independently subjected to 10 repeated test procedures at both laboratories. MEASUREMENTS: Repeated measurements of BV, uncorrected for the effects of isothermal air in the lungs and the surface area artifact, were obtained using the BOD POD ADP, with the identical protocol being faithfully applied at both laboratories. Uncorrected BV measurements were adjusted to give estimates of actual BV that were used to calculate body density (body weight (BWt)/actual BV) from which estimates of body composition were derived. The differences between repeated BV measurements or body composition estimates were used to assess within-laboratory precision (repeatability), as standard deviation (SD) and coefficient of variation; the differences between measurements reproduced at each laboratory were used to determine between-laboratory precision (reproducibility), as bias and 95% limits of agreement (from SD of the differences between laboratories). RESULTS: The extent of within-laboratory methodological precision for BV (uncorrected and actual) was variable according to subject, sample group and laboratory conditions (range of SD, 0.04-0.13 l), and was mostly due to within-individual biological variability (typically 78-99%) rather than to technical imprecision. There was a significant (P<0.05) bias between laboratories for the 10 repeats on the two independent subjects (up to 0.29 l). Although no significant bias (P=0.077) was evident for the sample group of 30 volunteers (-0.05 l), the 95% limits of agreement were considerable (-0.68 to 0.58 l). The effects of this variability in BV on body composition were relatively greater: for example, within-laboratory precision (SD) for body fat as % BWt was between 0.56 and 1.34% depending on the subject and laboratory; the bias (-0.59%) was not significant between laboratories, but there were large 95% limits of agreement (-3.67 to 2.50%). CONCLUSION: Within-laboratory precision for each BOD POD instrument was reasonably good, but was variable according to the prevailing conditions. Although the bias between the two instruments was not significant for the BV measurements, implying that they can be used interchangeably for groups of similar subjects, the relatively large 95% limits of agreement indicate that greater consideration may be needed for assessing individuals with different ADP instruments. Therefore, use of a single ADP instrument is apparently preferable when assessing individuals on a longitudinal basis.

Adult↗
PubMed2001

Does social support buffer functional decline in elderly patients with unipolar depression?

OBJECTIVE: This study tested whether social support protects against functional decline, either generally or selectively, in the most severely depressed elderly patients undergoing treatment for major depressive disorder. METHOD: In a prospective cohort study design, 113 patients with incident and prevalent unipolar depression were followed for 12 months while they were undergoing naturalistic treatment. Outcome measures included performance on basic and instrumental activities of daily living; predictor variables included Hamilton Depression Rating Scale scores and four domains of informal social support. The analysis employed multivariable ordinary least squares regression models. RESULTS: Improved scores on instrumental activities of daily living and stable scores on basic activities of daily living characterized the subjects. In adjusted analyses, instrumental social support provided marginal protection against worsening performance on instrumental activities of daily living, which were primarily a function of baseline depression severity. Large social networks, more frequent social interaction, and the perceived adequacy of social support played a modest buffering role against declines in performance on basic activities of daily living among the most depressed elderly patients. CONCLUSIONS: Instrumental support was generally protective against worsening performance on instrumental abilities of daily living among elderly patients with recurrent unipolar depression. Subjective and structural dimensions of social support protected the most severely depressed elderly patients against the loss of basic maintenance abilities.

Activities of Daily Living↗
PubMed2001

Construction of a single global scale for multi-item assessments of the same variable.

Complex health-related concepts are commonly measured by means of multi-item scales or questionnaires. As the item scales of an instrument cover different aspects of the same variable, a single global response value is required of the concept to be measured. In this paper, different approaches that take into account the non-metric properties of ordered categorical data when aggregating multi-item scales into global scaling were suggested. A single score of equally important items is easily defined by the median. When the multi-items are constructed to identify the most serious sign of a particular state, the maximum categorical level of the items could be an appropriate single score of the variable. By means of the joint response scheme over two aspects of the same variable, a global scale with an optional number of ordered categories could be defined. Some of the multi-item scales of the Short-Form Health Survey (SF-36) and Euro-QoL were used for illustrations to the proposed approaches.

Health Surveys↗
PubMed1993

Instrumental straight-leg raising: results in healthy subjects.

The instrumental performance of Lasègue's test (instrumental straight-leg raising) provides information about the extensibility, elasticity, and electrical activity of hamstrings and back muscles and about pelvic rotation. Because relevant data on these variables are not known in literature, instrumental straight-leg raising was performed in healthy subjects. Using the toe-touch test, three groups of eight subjects were selected: a flexible group, able to touch the ground with their hands flat, a medium group, able to touch the ground with their finger tips, and a stiff group, not able to touch the ground at all. Measurements showed a considerable difference in the extensibility of the hamstrings between the groups with only a slight difference in the extensibility of the back muscles. They also showed clear differences in elasticity of the hamstrings and the back muscles in the subjects within the groups. Between the groups, however, muscle elasticity was not systematically different. Electromyogram activity was most often present in the subjects of the stiff group, predominantly in the hamstrings. It began only after the leg had been raised to a considerable extent, showed a gradual increase with leg raise, and never reached a high level.

Back↗
PubMed2005

Older people specific health status and quality of life: a structured review of self-assessed instruments.

OBJECTIVES: To review evidence relating to the measurement properties of older people specific self-assessed, multi-dimensional measures of health status. DESIGN: Systematic literature searches to identify instruments. Pre-defined criteria relating to reliability, validity, responsiveness, precision and acceptability. RESULTS: A total of 46 articles relating to 18 instruments met the inclusion criteria. Most evidence was found for the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), CARE, Functional Assessment Inventory (FAI) and Quality of Life Profile--Seniors Version (QOLPSV). Most instruments have been evaluated in single studies. Four instruments have evidence of internal consistency and test-retest reliability--LEIPAD, Philadelphia Geriatrics Centre Multilevel Assessment Inventory, Perceived Well-being Scale, Wellness Index (WI). Two instruments lack evidence of reliability--Brief Screening Questionnaire, Geriatric Quality of Life Questionnaire (GQLQ). Older people contributed to the content of the GQLQ, QOLPSV and WI. Most instruments were assessed for validity through comparisons with other instruments, global judgements of health, or clinical and socio-demographic variables. Limited evidence of responsiveness was found for five instruments--GQLQ, OMFAQ, PGCMAI, QOLPSV, Self-Evaluation of Life Scale (SELF). CONCLUSION: Although most evidence was found for the OMFAQ this was largely for the ADL domain; evidence for reliability and responsiveness is limited. Limited evidence of reliability, validity and responsiveness was found for the PGCMAI, QOLPSV and SELF. The lack of evidence for measurement properties restricts instrument recommendation. Instrument content should be assessed for relevance before application and the concurrent evaluation of specific and widely used generic instruments is recommended. Several instruments, including the BSQ and EASY-Care, were developed recently and further evidence of instrument performance is required.

Aged↗
PubMed2005

Cognitive status, depressive symptoms, and health status as predictors of functional disability among elderly persons with low-to-moderate education: The Faenza Community Aging Study.

OBJECTIVE: The authors examined the impact of very early dementia and symptoms of depression on functional disability in a community-based group of 216 elderly people with low-to-moderate education level. METHODS: The combined effect of very early dementia and symptoms of depression on functional disability was assessed with a logistic-regression model in which functional disability was the dependent variable. The same model was repeated with each item on the Instrumental Activities of Daily Living scale as the dependent variable. RESULTS: Very early dementia alone was strongly associated with functional disability, and this association tripled in subjects with both very early dementia and symptoms of depression. In fact, whereas subjects with very early dementia had an 11-fold higher risk than normal persons for disability, subjects with both very early dementia and symptoms of depression showed a 37-fold higher risk for functional dependence. CONCLUSIONS: Elderly people who suffer from very early dementia and who also have symptoms of depression are at very high risk for functional disability and have a great need for accurate diagnostic assessment. If confirmed, the results are relevant for prevention because people who suffer from very early dementia and have symptoms of depression may be a suitable target group for intervention before the development of severe disability.

Activities of Daily Living↗
PubMed2006

Impact of osteoarthritis on rehabilitation for persons with hip fracture.

OBJECTIVE: To determine the impact of osteoarthritis (OA) on length of rehabilitation stay, Functional Independence Measure (FIM Instrument) ratings at discharge and followup, functional gain, and percentage of patients discharged home. METHODS: We conducted a retrospective cohort analysis using a national registry of US medical rehabilitation inpatients. We obtained standardized data for all patients admitted after a hip fracture between 1994 and 2001. Our primary analytical method was multiple regression analysis. Outcome variables were length of stay, FIM Instrument ratings at discharge and followup, functional gain, and percentage of patients discharged home. The predictor variable was the presence of OA. Covariates were age, sex, race/ethnicity, other comorbidity, admission FIM ratings, total hip replacement, and time to followup. RESULTS: We studied 1,953 patients with OA and 11,441 patients without OA admitted to inpatient rehabilitation facilities after hip fracture. Mean +/- SD length of stay for patients with OA was 18.1 +/- 10.0 days versus 16.5 +/- 8.9 days for those without OA (P < 0.01). After adjusting for age, sex, race/ethnicity, comorbidity, admission FIM ratings, and total hip replacement, OA was associated with a longer rehabilitation stay (1.4 days; P < 0.01) and slightly higher discharge FIM ratings; however, OA was not associated with lower weekly rehabilitation gain, followup FIM ratings, and percentage discharged home. CONCLUSION: Persons with hip fracture and OA had longer inpatient rehabilitation length of stay than persons without OA, but there were similarities in weekly rehabilitation gain and percentage discharged home.

Aged↗
PubMed1986

The relationship of developmental variables to maternal behavior.

Developmental differences in self-concept, personality integration, flexibility, empathy, and temperament, and the relationship of these variables to maternal behavior, were investigated using three age groups of first-time mothers. The age groups also were tested for change in self-concept and personality integration from 1 to 3 days postpartum to 8 months postbirth. The longitudinal study included 60 mothers aged 15-19 years, 138 aged 20-29 years, and 90 aged 30-42 years. Self-completed instruments were used to measure the personality variables, and an interviewer-rated instrument measured maternal behavior. Personality integration and flexibility increased significantly and correlated significantly with age indicating that both are developmental constructs. Empathy and temperament traits did not increase with age, although teenage scores were significantly lower in empathy, self-concept, several temperament traits, and maternal behavior. The two older groups' self-concept decreased significantly the first eight months of motherhood. In the teenage group personality integration, empathy, activity level, intensity and threshold to stimulus were significantly correlated with maternal behavior. In the 20-29 year-old group, self-concept, personality integration, flexibility, rhythmicity, adaptability, intensity and mood quality correlated significantly with maternal behavior. In the older group, self-concept, flexibility, approach/withdrawal, adaptability, intensity, and mood quality correlated significantly with maternal behavior.

Adaptation, Psychological↗