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PubMed1997

Disaggregating parental depression and family stress in assessing families of children with developmental disabilities: a multisample analysis.

The psychometric properties of a 5-item subcomponent (DEP5) of Factor 1, Parent and Family Problems, of the Friedrich Questionnaire on Resources and Stress were examined to determine whether these items formed a depression subcomponent of the larger family stress factor. Data were pooled from two samples numbering more than 450 respondents. Internal analyses established that the DEP5 had adequate internal reliability and stability over 2 years. Furthermore, confirmatory factor analyses indicated that the DEP5 measured depressive reactions as distinct from other parent and family problems. These results should be useful to researchers who want to reanalyze the Questionnaire on Resources and Stress data specifically for depressive reactions. Also, the technique for disaggregating global instruments can be applied to other variables.

Activities of Daily Living↗
PubMed2006

Critical issues in psychological autopsy studies.

This paper reviews research based on the psychological autopsy (PA) method applied to the study of suicide. It evidences the presence of a number of methodological problems. Shortcomings concern sampling biases in the selection of control subjects, confounding influences of extraneous variables, and reliability of the assessment instruments. The absence of homogeneity among studies in the procedure employed, as well as the lack of defined guidelines for performing this type of inquiry are emphasized. Questions needing empirical investigation in the future are pointed out. It is concluded that the validity and reliability of findings emerging from the use of this method of investigation would benefit from a standardization of its application.

Autopsy↗
PubMed1994

Learned helplessness and its correlation to impairment, pain, anxiety and depression in rheumatoid arthritis.

A Swedish version of the self-report instrument Arthritis Helplessness Index (AHI) is presented. Validity and reliability of the translation has been analyzed. 100 consecutive patients with rheumatoid arthritis (RA) were studied, 78 of which completed 2 self-administered questionnaires with AHI, impairment, pain, anxiety and depression. Furthermore 20 of the patients were interviewed with regard to AHI. Forty-two other patients with RA were analyzed for correlation between AHI and biochemical activity and Signals of Functional Impairment (SOFI). We conclude that the Swedish version of AHI has satisfactory validity and reliability. It correlates with age, physical impairment, pain, anxiety and depression but not with sex or disease activity. Five of the original 15 items could for various reasons be omitted, leaving a 10 statement instrument. AHI is promising as a variable in future outcome studies of RA.

Adult↗
PubMed1997

Comparison of traditional and non-traditional baccalaureate nursing students on selected components of Meichenbaum and Butler's model of test anxiety.

The purpose of this study was to compare traditional and non-traditional baccalaureate student nurses on test anxiety and major contributing factors using the model proposed by Meichenbaum and Butler. Instruments used to measure the model variables were the Test Anxiety Inventory, the Effective Study Test, the Self-Concept of Academic Ability Scale, the Cognitive Interference Questionnaire and students' admission GPAs. Analysis of data revealed no significant difference between the groups on test anxiety. A significant difference was found between the two groups on knowledge of effective test-taking skills. Significant differences were found between the two groups on two correlations: 1) academic self-concept and knowledge of time management and study organization skills and 2) academic self concept and worry. Pearson correlations indicated that for both groups cognitive interference was the strongest variable associated with test anxiety.

Adult↗
PubMedDate not supplied

Reliability and validity of two instruments designed to assess the walking and bicycling suitability of sidewalks and roads.

PURPOSE: Public health professionals hypothesize that when community environments provide suitable walking and bicycling conditions, community members will be more active. Measurement indicators and assessment instruments are needed to evaluate suitability. This study determined the reliability and validity of two instruments to assess the suitability of sidewalks for walking and roads for bicycling. METHODS: Two data collectors used walking and bicycling suitability assessment instruments to collect data on 31 road segments. In addition, three transportation experts used a 7-point Likert response system to subjectively evaluate walking and bicycling conditions for the same segments. Intraclass correlations determined the reliability of each assessment instrument and the reliability of the Likert response system. Pearson correlations (research staff assessments with expert assessments) were calculated to determine the criterion-related validity of the suitability measures. RESULTS: Intercoder reliability (intraclass) correlations for the walking and bicycling assessment instruments were r = .79 and .90, respectively. Intercoder reliability of the experts' Likert response system was r = .73 for the walking form and r = .77 for the bicycling form. Criterion-related validity (Pearson) correlations for the walking and bicycling assessment instruments were r = .58 and .62, respectively. CONCLUSION: Although some variables have lower reliability and validity than is ideal, the walking and bicycling suitability assessment instruments appear promising as instruments for community members and professionals to systematically assess key aspects of the physical environment.

Bicycling↗
PubMed1993

Physician satisfaction with rural hospitals.

This study examines factors leading to physician satisfaction with small rural hospitals. Interviews were conducted with 122 rural physicians using a standardized survey instrument. The relationship between the independent variables and the dependent variable, hospital satisfaction, are described and tested using chi-square and discriminant analysis. The findings of this study revealed that no demographic variables appeared in the chi-square, and only age appeared in the discriminant analysis. Practice factors impacting hospital satisfaction included practice satisfaction (both in the chi-square and discriminant analysis) and years at current location (only in the chi-square). Hospital-related factors affecting hospital satisfaction included administrative responsiveness (strongest association); administration accessibility, communication with administration, and nursing skill and knowledge in the chi-square; and administrative responsiveness, nursing skill and knowledge, and technology in the discriminant analysis.

Adult↗
PubMed1999

[Occupational status of Saxony social psychiatry service clients as a result of the reunification of Germany].

PURPOSE: Evaluating the establishment of social psychiatry services (SPS) in Saxony was part of a public health research project. METHOD: One of the variables in a specifically designed assessment instrument--used in 8 SPS during the period 08/95-01/97--was the retrospective statement concerning changes in the client's vocational situation caused by the social upheavals in 1989. RESULTS: 40.6% (n = 335) answered in the affirmative. Men are significantly overrepresented in the group with vocational changes; compared to the population without vocational changes the proportion of currently unemployed persons (56%) is five times higher; only 16% are still employed. Neurotic/personality disorders as well as brief mental disturbances and dependency disorders are more frequent than in the whole SPS-clientele.--The most important constellation (19%) identified by a configuration-frequency analysis is that of patients with prolonged psychotic disorders (started < 1990, not associated with dependency disorder) who were employed at sheltered workplaces during the GDR-period despite of their mental disorder. CONCLUSION: Following the political German reunification possibilities of vocational rehabilitation have deteriorated and up to now the number of newly established alternatives in regional mental health services is insufficient.

Adult↗
PubMed1993

Transesophageal echocardiographic evaluation of baboons during microgravity induced by parabolic flight.

The central cardiovascular responses to transient microgravity are not well understood. Theoretically, entrance into microgravity results in the loss of the hydrostatic pressure head and an increase in central venous pressure (CVP) as a consequence of augmented venous return. However, controversy exists regarding the time course and magnitude of cephalad blood volume shifts and its relationship to central atrial filling pressures. On the June 1991 STS 40 shuttle mission, pre-launch echocardiograms suggested changes in cardiac dimensions occurred while the astronauts were in the supine, feet-up position. Furthermore, a CVP line in an astronaut (n=1) demonstrated an unexpected abrupt decrease in CVP during orbital insertion. In April 1991, our laboratory performed Doppler echocardiography in 6 normal human volunteers during parabolic flight. Increases in right ventricular velocities reflecting a central shift of blood volume was demonstrated in subjects examined in the sitting position. However, test subjects examined in the horizontal positions had no significant rise in Doppler velocities. In addition, Latham et al noted variable central cardiovascular responses in chronically instrumented baboons during early microgravity. Transthoracic echocardiography (TTE) is a feasible method to noninvasively examine cardiac anatomy during parabolic flight. However, transducer placement on the chest wall is very difficult to maintain during transition to microgravity. In addition, TTE requires the use of low frequency transducers (2.5 MHz) which limits resolution. Transesophageal echocardiography (TEE) is an established imaging technique which obtains echocardiographic information from the esophagus. It is a safe procedure and provides higher quality images of cardiac structures than obtained with TTE. Since there are no interposed structures between the esophagus and the heart, higher frequency transducers can be used and resolution is enhanced. With TEE, a flexible transducer tip permits contact with the esophageal mucosa, allowing for consistent imaging. This study was designed to determine whether TEE was feasible to perform during parabolic flight and to determine whether acute central volume responses occur in acute transition to zero gravity (0G) by direct visualization of the cardiac chambers.

Animals↗
PubMedDate not supplied

[Migration policies and population distribution in Mexico: regional implementation and impact].

The author begins by analyzing the legal framework of migration and population redistribution policies in Mexico since 1973, when the General Law on Population was passed. In that framework, she points out several institutional deficiencies and contradictions. In the second section, she discusses demographic planning in this field, and conducts a follow-up on implementation based on reports from the institutions involved and official documents. To conclude, she examines practical applications of policy instruments, comparing the behavior of governmental variables that had a bearing on the phenomenon before and after the implementation of said policy (1970 to 1990). One of her findings is that the basic elements making population policies on migration operational did not move in the desired direction, i.e., to modify migratory and population distribution so as to achieve expected goals. Despite the continuity of population policies on migration, the implementation of such policies still poses diverse obstacles.

Americas↗
PubMed2002

Clinical research trials: a comparison of African Americans who have and have not participated.

The purpose of this is study was to gain an understanding of the knowledge and perceptions African Americans have that influence decisions to participate or not participate in clinical research trials. A survey instrument designed to measure the key variables; knowledge and perceptions of clinical research processes, and selected demographic characteristics were utilized in this study. The major finding suggests that African Americans who have been participants in a clinical trial are more likely to participate in future clinical trials if details are provided in advance concerning the requirements and criteria for their participation.

Adult↗
PubMed1990

Normal physiological values for conscious pigs used in biomedical research.

Although the domestic pig is rapidly becoming an animal of choice in certain areas of biomedical research requiring a large animal model, effective utilization of the species is often encumbered by a lack of reference values for common functional variables. To address this problem, normal data for over 100 physiologic or related variables were collected from conscious chronically instrumented animals that were maintained under near basal conditions. Included were measurements of body composition, fluid volumes, blood physical and biochemical characteristics, blood gas and acid-base status, plasma hormone levels, energy metabolism, renal function, hemodynamics and pulmonary function. Most porcine values were similar to those collected under comparable conditions from humans. Compared to adult man, however, pigs had higher values for extracellular space, plasma volume, arterial pH, plasma bicarbonate, cardiac output, arterial pressure, expired ventilation, heat production, and core temperature, and lower values for red cell volume, hemoglobin level, plasma osmotic and oncotic pressure, arterial O2 content, renal blood flow and glomerular filtration rate. Many of these deviations were due to immaturity. Nevertheless, we have found pigs to be an excellent large animal model for a variety of functional studies.

Acid-Base Equilibrium↗
PubMed1985

Oxygen in the treatment of spinal cord decompression sickness.

Twenty-five anesthetized dogs were used to find the optimum Po2 for the delayed treatment of spinal cord decompression sickness (DCS). They were instrumented for the measurement of physiological variables and somatosensory spinal evoked potentials (SEP) given an air dive of 15 min at 10 bar (300 ft) and decompressed in under 6 min. At the surface SEP were observed for signs of DCS. Fifteen minutes after cord DCS was observed in the SEP, the dogs were compressed to 5.0 bar breathing one of 5 gas mixtures giving a Po2 of 1.0, 1.5, 2.0, 2.5, or 3.0 bar. At the start of therapy all groups were in a similar physiological state with a similar loss of SEP. Between 40 and 120 min, recovery was significantly different (P less than 0.05) between the groups, most SEP recovery having occurred within 15 min. The treatments ended with 22, 32, 70, 66, and 42% recovery, respectively. It would appear that the optimum Po2 is around 2.0 bar.

Animals↗
PubMedDate not supplied

Recognition of maternal identity in preterm and fullterm mothers.

The purpose of this exploratory and descriptive study was to investigate the maternal role attainment process of the preterm mother by comparing the endpoint of the process--maternal identity--in preterm and fullterm mothers. Forty-two first-time mothers, 21 preterm mothers and 21 fullterm mothers, were interviewed once at approximately one year post-birth. Qualitative and quantitative phenomena were examined. Qualitative data were collected via semi-structured interviews. Quantitative data were collected with instruments that measured maternal role attainment variables. Content analysis of the maternal identity recognition event revealed eight commonly discussed themes. Analysis of the quantitative data revealed no statistically significant relationships between length of gestation and any of the maternal role attainment variables. Also, no difference was found between preterm and fullterm mothers in the mean timing of the recognition of maternal identity. However, a 10-week difference in the median timing of maternal identity recognition was found. Sixty-two percent of the fullterm mothers recognized a maternal identity by two weeks after delivery, whereas only 24% of the preterm mothers experienced maternal identity recognition within this time frame. A statistically significant relationship was found between the timing of maternal identity recognition and maternal affective perception of the infant. The more positive the maternal affective perception of the infant, the earlier was the timing of maternal identity recognition. The study concluded that preterm mothers experienced a maternal role attainment process similar to fullterm mothers except that identity recognition was relatively delayed. The themes described by the preterm mothers tended to be qualitatively different and focused on denied maternal role experiences, especially denied contact with the infants and denied rights in relation to the infants.

Adult↗
PubMedDate not supplied

Reliability and validity of spirometry measurements in a paperless home monitoring diary program for lung transplantation.

OBJECTIVE: To demonstrate that home spirometry measurements are reliable and valid and can be used as part of a home measurement monitoring system by lung transplant recipients. DESIGN: Longitudinal, observational. SETTING: University medical center. SUBJECTS: Eighteen patients who have undergone lung transplantation; age range was 24 to 63 years (mean of 49.5 years). OUTCOME MEASURES: Reliability and validity of forced expiratory volume at 1 second (FEV1) and forced vital capacity (FVC). INTERVENTION: Recording of spirometry, vital signs, and symptom measures at home each day by use of a paperless electronic diary/spirometer instrument. RESULTS: Day-to-day variability as measured by the standard deviation ranged from 0.013 L to 0.202 L for FVC and 0.015 L to 0.117 L for FEV1. The correlation between the two best forced expiratory maneuvers on any given day was 0.98 for both FVC and FEV1, with percent differences between the measurements of 2% for FVC and 3% for FEV1. The correlation between measurements performed in the pulmonary function laboratory and measurements done by the patient at home on the same day was 0.94 for FVC and 0.99 for FEV1. CONCLUSIONS: This evaluation demonstrated that home measurements are both reliable (i.e., repeatable) and valid when compared with the "gold standard" of the pulmonary function laboratory. The home monitoring program has been well accepted by patients, is easy to use, and provides data comparable to that collected during clinic visits.

Adult↗
PubMed1993

Acculturation and compliance with medical therapy.

Lack of compliance with medical therapy is a major clinical problem. We undertook a study to determine whether degree of acculturation to mainland U.S. culture was predictive of compliance in Puerto Rican families having a child with asthma. A questionnaire was administered to parents of Puerto Rican asthmatic children attending an asthma clinic and taking oral theophylline as part of their medical management. The questionnaire included items concerning medical, socioeconomic, and cultural variables, as well as a standardized instrument devised to measure degree of acculturation. Compliance was measured by a serum theophylline level obtained at the time of the visit. Families were divided into compliant (n = 15) and noncompliant (n = 13) groups based on their child's serum theophylline determination. There was a significant difference in mean acculturation scores between compliant and noncompliant groups (p = .008). Those in the complaint group had scores indicative of a style of acculturation that integrated aspects of both "Anglo" and Puerto Rican lifestyles. Those in the noncompliant group had scores indicative of a less acculturated lifestyle. The findings of this study show that degree of acculturation is a predictor of compliance with medical therapy in mainland Puerto Ricans. Additional studies with other cultural groups are needed, as well as other studies incorporating acculturation into a multivariate model of compliance.

Acculturation↗
PubMed1996

Comparative cardiopulmonary effects of intramuscularly administered etorphine and carfentanil in goats.

OBJECTIVE: To determine comparative cardiopulmonary effects of IM administered etorphine and carfentanil in goats. ANIMALS: Seven clinically normal adult female goats. DESIGN: Each goat received at least 9 drug treatments (etorphine HCl, 5 [twice], 10, 20, and 40 and carfentanil citrate, 5, 10, 20 and 40 micrograms/kg of body weight), with a minimal 2-day interval between trials. Although drug dosages were randomized, etorphine and carfentanil treatments were alternated. To assess for drug tolerance, the first and last treatments always were etorphine (5 micrograms/kg). PROCEDURE: All goats were instrumented for long-term cardiopulmonary variable data collection. RESULTS: Both drugs induced rapid catatonic immobilization, characterized by limb and neck hyperextension, with occasional vocalization and bruxation. Etorphine elicited transient violent struggling and vocalization immediately. Time to immobilization appeared dose-dependent, and was more rapid with carfentanil (< or = 5 minutes) than etorphine (5 to 10 minutes) at all dosages. Recovery to standing occurred earlier for etorphine (1 to 2 hours) than carfentanil (> 2 hours) at all dosages. Both drugs at all dosages significantly (P < or = 0.05) increased systemic and left ventricular (LV) end-diastolic pressures, LV peak negative dP/dt, total peripheral resistance (TPR), hemoglobin concentration, and left atrial (LA) and pulmonary O2 contents. They also significantly decreased heart and respiration rates, and TPR. A significant increase was observed at some dosages for LV stroke volume and index, LV peak positive dP/dt, mean pulmonary artery pressure, PaO2, pulmonary artery oxygen partial pressure, PaCO2, pulmonary mixed venous carbon dioxide partial pressure, LA hemoglobin saturation, LA transport index, and body temperature. Pulmonary and systemic mixed venous carbon dioxide and oxygen contents were significantly decreased at some dosages. CONCLUSIONS: Intramuscularly administered etorphine and carfentanil induce hypertension, bradycardia, and bradypnea in goats. The hypertension appears attributable to an increase in TPR. CLINICAL RELEVANCE: Although the cardiopulmonary effects of carfentanil occurred more rapidly, these effects were similar in magnitude for etorphine and carfentanil over the evaluated dosage range.

Analgesics↗
PubMedDate not supplied

An investigation of dental hygiene treatment fear.

PURPOSE: The purpose of this study was to develop and test the psychometric properties of a dental hygiene fear survey in a convenience sample population from a Midwestern metropolitan area. METHODS: A convenience sample of 300 subjects from two sites, a suburban general dental practice and a dental school intramural faculty practice located in a metropolitan area, was utilized. A 16-item instrument was developed that incorporated the University of Washington Fears Clinic four subtypes of dental fear: fear of specific stimuli, generalized anxiety, distrust, and catastrophe. The survey was administered prior to dental hygiene treatment. Scores were summed and patients were classified as experiencing dental hygiene fear if their scores were greater than one standard deviation above the mean. Reliability was estimated by Cronbach's alpha. Validity was examined by correlating the revised instrument with measures of conceptually related variables. RESULTS: Cronbach's alpha coefficient was .85 for specific dental hygiene stimuli, .79 for generalized anxiety, .75 for distrust, and .68 for fear of catastrophe while receiving dental hygiene treatment. Overall reliability of all 16 items was estimated at .92. A significantly positive correlation (.58) was found between dental hygiene patients who reported high fear and avoidance (> 2 years) of dental hygiene treatment (p < .05). Dental hygiene fear correlated negatively (-.12) with age (p < .05). Females reported dental hygiene fear more frequently than males. CONCLUSIONS: Further revisions of the Dental Hygiene Fear Survey are needed; however, this survey shows promise in evaluating dental hygiene fear.

Adolescent↗
PubMed1997

[Nosocomial infection at an intensive care unit: multivariate analysis of risk factors].

BACKGROUND: Nosocomial infections, especially in the intensive care unit, are a very important problem due to their frequency and important consequences (morbility and mortality). On the other hand there are some risk factors and some preventive measures which are involved in the appearance of the nosocomial infections. The purpose of this work was to recognize these risk factors and to identify the preventive measures which are effective, and also to quantify the participation of each risk factors/preventive measures in the development of the nosocomial infections. PATIENTS AND METHODS: Follow-up of a cohort of patients admitted to the intensive care unit of the General Hospital of La Paz (Madrid, Spain) during a year and with a stay of at least 48 hours. RESULTS: We have found a cummulative incidence of patients with nosocomial infection of 32.8%. More than 80% of the patients received antibiotic treatment during their stay in the intensive care unit. The stay of the patients no infected was 4 days while the stay of infected patients was 20 days. We have found a mortality of 29.5%, which was greater in the patients who were infected (42%). In the multivariate analysis we have developed an equation to predict the development of the nosocomial infection. The following variables were identified: six or more instrumentations (OR, 4.75; 95% CI, 2.75-8.19), more of ten days of hospitalization previous to the appearance of the first nosocomial infection (OR, 4.17; 95% CI, 2.60-6.70), administration of muscle relaxing drugs (OR, 2.25; 95% CI, 1.43-3.55), nasogastric tube (OR, 2.19; 95% CI, 1.25-3.84), and altered consciousness (OR, 2.19; 95% CI, 1.25-3.84). Therefore, those patients who present some of these characteristics should be monitored in a special way due to their high risk of development of a nosocomial infection. CONCLUSIONS: Several factors play an important role in the development of a nosocomial infection in the intensive care unit; these are not only intrinsec (especially the altered consciousness) but also extrinsec (instrumentations and drugs), as well as the stay at the hospital previous to the appearance of the first nosocomial infection.

Adult↗