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Age differences in personality structure revisited: Studies in validity, stability, and change.

Construct validity and longitudinal stability evidence for three cluster dimensions of personality identified as Anxiety, Extraversion, and Openness is examined in a sample of adult males. Correlations with Allport-Vernon-Lindsay Value scales, Cornell Medical Index scores, Eysenck E and N scales, and factors from the SVIB are presented in support of the interpretation of the three clusters. Nine-year longitudinal evidence of stability is presented for Anxiety and Extraversion scores. Previous evidence for change in the structure of Openness to Experience is reconsidered in the light of eleven-year longitudinal data. While the earlier structural differences were not longitudinally replicated, a pattern of external correlates provided evidence for validity of an Openness dimension. Finally, the structural approach to personality development is illustrated by examining the differing relations between field-dependence and tendermindedness in younger and older men.

Adult↗

European views on personality disorders: a conceptual history.

A historical account is offered of the European origins of the DSM-III-R category, personality disorder, and a differentiation is made between the history of terms, patterns of behaviors, and concepts. The concept of "disorder of character (personality)" developed in the nineteenth century, and was possible after notions such as character, constitution, temperament, and self received a psychological definition, and after the insanities became transformed into "psychoses." Terms such as "type" and "trait" were in turn ushered into the nineteenth century by faculty psychology and the phrenological tradition. Until the end of that century, "personality" referred to the subjective aspects of the self, and "personality disorder" meant alteration of consciousness (e.g., hysterical dissociation); the behavioral patterns dealt with by DSM-III-R as personality disorders were then called disorders of character and explained as states of volitional failure, or loss of coherence between cognitive, emotional, and conative functions, or of "automatism," i.e., the manifestation of lower (more primitive or animal) forms of behavior escaping the control of higher (human) ones. Character types and disorders were first considered as forms of attenuated insanity, and later on were made into a separate group whose membership could be attained via the visitation of a degeneration taint, neurological disease (e.g., encephalitis), or plain ill-breeding. The relevance of the intellectual background of the nineteenth century to these diagnostic changes is also discussed.

Europe↗

Implementing performance management in the Irish Health Sector.

To realize the goals of successive health strategies, managers in the Irish Health Sector will have to proactively facilitate optimal employee performance in line with policy objectives. Along with developing employee and teams' capabilities, these managers have begun to implement performance management to achieve the latter. However, there typically are a variety of foundational organizational characteristics required for the successful implementation of performance management. These include providing top-down support for line management buy-in, providing ongoing managerial and performance management training so that trusting relationships and a culture of consensus and cooperation are developed, and appropriately managing expectations. Agreement on employee role definitions and provision of team-based conflict resolution training is also needed to facilitate performance management. There is a need for negotiated performance indicators that are of various types, specific, measurable, and aligned with strategy objectives. Associated reward systems need to be holistic and imaginative, and personal development plans need to have a broader focus than merely improving current job skills and performance. Performance review needs to be ongoing, conducted in a transparent manner, and allocated sufficient discussion time. Managers also need to be mindful of managing overperformance.

Cooperative Behavior↗

[Personality structure and child-rearing behavior of parents of children with psychologically defective development].

The personality structure and educational methods of parents exert considerable influence on the emergence of psychic defects in children. Tests have been conducted with a group where cerebro-organic damage but no psychic defects occurred, another group of children showing psychic defects and previous cerebro-organic injury, and a third group with psychic defects. In the last two groups there was a marked recurrence of traits from the personality structure of the parents, and a larger number of misguided attitudes and educational activities occurred.

Brain Damage, Chronic↗

Knowing what to weigh: women's self-care activities related to weight.

Overweight and obesity are major health problems among women. Data were collected from intensive interviews of 37 white middle-class and working-class women to explore how women interpret and use health information in the practice of self-care related to weight management. The findings indicated that all women develop personalized norms or categories of physical identity for weight and criteria for knowing if they weigh too much or too little. These norms and criteria represent creative self-care tactics devised without professional assistance in weight management and without regard for the cultural pressure to be thin. The results of this study have relevance for theory development and nursing practice related to women's health. In addition, they support the need for more community-based studies of women to understand the cultural and physical environments in which women conduct their lives and maintain their health.

Attitude to Health↗

[Clinical picture and features of the course of protracted psychogenic asthenic disorders].

On the basis of a clinico-dynamical and paraclinical (mathematico-statistical, electrophysiological, experimental-psychological) study of 122 patients with the asthenical form of neurosis 2 main groups were distinguished: protracted asthenical neurosis and neurotical personality development. Different clinical varieties, common symptoms, typical for each form and the therapeutical-preventive measures are determined.

Adolescent↗

Psychometric characteristics of the child occupational self-assessment (COSA), part two: refining the psychometric properties.

Self-assessment is an appropriate way to support client-centered practice and promote personal development in young occupational therapy clients. This study, the second study in a series of two, sought to refine the psychometric properties based on previous analysis of the Child Occupational Self-Assessment (COSA), a self-report tool based on the Model of Human Occupation. The COSA comprises 24 statements, which the child rates in terms of personal competence and importance. The Rasch Rating Scale Model was used to evaluate the measurement properties of the Competence and Values scales that result from these self-ratings. The original three-point rating scale was expanded to four response categories in this study, which resulted in improved reliability and sensitivity. In this second study, the items once again coalesced to form measures of competence and values, and the order of items from less to more competence and value was similar to that in the first study, supporting the internal validity of the COSA scales. The results provide evidence that the COSA can be used as meaningful and reliable client-directed assessment tool as well as an outcome measure.

Activities of Daily Living↗

Pathogenesis of Helicobacter pylori infection.

Helicobacter pylori induces persistent inflammation in the human stomach, yet only a minority of colonized persons develop peptic ulcer disease or gastric malignancy. Numerous studies published in the last year have demonstrated that H. pylori isolates possess substantial phenotypic and genotypic diversity, which may engender differential host inflammatory responses that influence clinical outcome. Results from these recent investigations have more precisely delineated the mechanisms of H. pylori pathogenesis, which will ultimately help to define colonized persons bearing the highest risk for disease, and enable physicians to appropriately focus diagnostic testing and eradication therapy.

Animals↗

The sustainability of telemedicine projects.

Although there are instances where the provision of health care is successfully driven by the profit motive, in most countries it is considered a public service. The provision of telemedicine services assuredly meets an important social need to extend health care to remote and rural areas in developing countries. While there are potential advantages and benefits from telemedicine, the evidence of its cost-effectiveness and sustainability is meagre. Telemedicine undoubtedly yields cost savings in certain circumstances, but few service providers have found a way to recover their costs (and make a profit) from those to whom they provide their service. With their low expenditures per person, developing countries face a daunting challenge in making such public services sustainable. Pilot projects should be a first step in demonstrating the cost-effectiveness and benefits of telemedicine, but such projects should also be sustainable. Sponsors of such pilot projects must have a clear plan from the start about how the project can continue after the sponsorship comes to an end. This paper examines ways in which telemedicine services can be made sustainable.

Capital Financing↗

[Stroke of cardioembolic origin in Chagas disease].

INTRODUCTION: American trypanosomiasis, Chagas disease is caused by Trypanosoma cruzi. Between 10% and 30% of infected persons develop the chronic form, with predominance of the cardiac and gastrointestinal forms. Chagas myocardiopathy leads to congestive heart failure, dysrhythmias and thromboembolic phenomena, and may cause strokes. PATIENTS AND METHODS: We report two patients, a 57 year old woman and a 52 year old man, carriers of the chronic cardiac form of Chagas disease, with cardioembolic strokes. In both persons, serology was positive for Chagas disease (indirect hemagglutination and indirect immunofluorescence). The causes of atherothrombotic stroke were ruled out on carotid and transcranial Doppler studies. RESULTS: The woman had previously had an infarct of the left middle cerebral artery. She was admitted with a stroke involving the vertebrobasilar territory. On Holter studies there was second degree atrioventricular block and the electrocardiogram showed severe dilated myocardiopathy. On magnetic resonance studies there was an old left temporoparietal infarct and recent ischaemia of the pons and cerebral peduncle. She was anticoagulated and a pacemaker implanted. The man had a right middle cerebral artery infarct. His electrocardiogram showed atrial fibrillation and left anterosuperior block. The echocardiogram showed left ventricular dysfunction and concentric ventricular hypertrophy. CONCLUSIONS: The chronic cardiac form of Chagas disease should be included in the differential diagnosis of stroke of cardioembolic origin both in endemic areas and in countries to which persons exposed to infection during the early years of life emigrate.

Animals↗

Associated handicaps in children with hearing loss.

In the differential diagnosis as well as in the rehabilitation of hearing impaired children other disorders affecting language aquisition and speech development need to be taken into account. The rehabilitation programme is highly dependent on the early diagnosis of these additional disorders such as dysphasia, mental retardation of various degrees, cognitive disorders such as dyslexia and dysgraphia, dyspractic and dysarthric disorders of speech production, cleft palate and other anomalies of articulatory organs, autism and other abnormal features of psychic and personality development. In addition children with multiple disorders like malformations, visual disorders, epilepsy, CP and other diseases and handicaps, even though they may not influence language and speech development directly, may still be deprived of possibilities to aquire adequate verbal stimulation. The paper presents a material of 200 children whose hearing loss was diagnosed at the preschool age. Major associated handicaps were found in 35.5% of cases and in 26% they were complicating rehabilitation and development of the child. The frequency of associated disorders and their effect on language and speech development, learning ability and social development is being more closely analysed and discussed.

Adolescent↗

Personality and personality disorders predict development and relapses of major depression.

The aim of this study was to investigate the role of personality deviations in the development and relapses of major depression. The study is based on an investigation of an initial sample of 298 psychiatric out-patients, who were re-evaluated after 6 years when the sample included 253 patients. SCID-R was used for assessment of possible relapses and new cases, and a logistic regression analysis was used to determine the best prediction of the recurrence of depression. Borderline personality disorders and dependency predicted relapses. In addition, borderline personality disorders, together with avoidant personality disorders, predicted the development of new cases. Comorbid clinical syndromes appear to be of no importance. These findings suggest that the comorbidity with personality deviations accounts for the chronicity and poor prognosis in major depression.

Bipolar Disorder↗

Fostering students' personal and professional development in medicine: a new framework for PPD.

CONTEXT: Altruism, accountability, duty, integrity, respect for others and lifelong learning are qualities that have been identified as central to medical professionalism. However, we do not have a systematically developed understanding of what is needed to optimise medical students' personal and professional development (PPD). We need some level of agreement on how to teach and assess PPD, but traditional educational methods may not be strong determinants of students' or graduates' actual behaviour in clinical settings. AIMS: This paper considers the factors that demonstrably influence doctors' behaviour as a contribution to the development of a model for considering PPD within the broader context of medical practice. The model presented acknowledges that behaviour change comes about through a number of influences including education, feedback, rewards, penalties and participation. These elements can be plotted against the cognitive, affective and metacognitive processes that are intrinsic to learning. IMPLICATIONS: A framework that promotes the consideration of all of these factors in PPD can provide guidance for schools undergoing curriculum reform and inform further research into one of the most important and challenging aspects of medical education.

Clinical Competence↗

Identity and adherence in a diabetes patient: transformations in psychotherapy.

The authors present the case study of a 26-year-old woman who developed diabetes in early adolescence and who attended seven CAT sessions. They used phenomenology to analyze therapy transcripts, case notes, and a reflexive journal and extract the major themes. The client's identity had been overshadowed by the development of a "diabetic identity" that the client rejected. Poor adherence was linked to the rejection. Motivation to manage her diabetes changed during the CAT sessions once her identity was confirmed as being separate from her diabetes. The client was then able to integrate diabetes into her life. Psychological and psychosocial factors are linked in complex ways, in both the personal development of adolescents with diabetes and their transition to adulthood. Understanding the impact of diabetes on identity can enhance the effectiveness of therapeutic interventions with nonadhering clients.

Adaptation, Psychological↗

Personal exposure to airborne dust and microorganisms in agricultural environments.

Airborne dust and microorganisms are associated with respiratory diseases and increased mortality and morbidity. Farmers are at high risk of exposure to both of these hazards. Very limited information, however, is available on the combined exposures to both hazards on different types of farms. Moreover, most of the previous studies have measured the mass concentration of particles ignoring the particle size. In this study, farmers' exposure to airborne dust and microorganisms was studied using our newly developed personal sampling system. Particle number concentration and size distribution were measured with an optical particle counter. Simultaneously, particles were collected on a filter and analyzed for microorganisms. The field measurements were conducted in animal confinements (swine, poultry, and dairy) and during grain harvesting (corn and soybean). The results show the following average concentrations on the workers' breathing zone: 1.7 x 10(6) to 2.9 x 10(7) particles/m(3) for total dust, 0.9 x 10(3) to 3.9 x 10(4) spores/m(3) for total fungal spores, 0.3 x 10(3) to 3.6 x 10(4)CFU/m(3) for culturable fungal spores, 0.3 x 10(4) to 3.3 x 10(8) CFU/m(3) for culturable bacteria, and limit of detection (LOD) to 2.8 x 10(3) CFU/m(3) for culturable actinomycetes in animal confinements. The respective concentrations were 4.4 x 10(6) to 5.8 x 10(7) particles/m(3), 3.4 x 10(4) to 6.1 x 10(6) spores/m(3), 8.2 x 10(4) to 7.4 x 10(6) CFU/m(3), 0.4 x 10(5) to 1.4 x 10(6) CFU/m(3), and LOD to 2.6 x 10(4) CFU/m(3) during grain harvesting. The highest contribution of large particles (3-10 microm) in total particles was found during grain harvesting, whereas the size distribution was dominated by smaller particles (< 3 microm) in animal confinements. High fraction (up to 37%) of particles between 2-10 microm was found to be fungal spores. The results indicate that an increase in the concentration of large dust particles (2-10 microm) during grain harvesting was partially attributed to the increase in the concentration of the fungal spores. Overall, the combined exposure to airborne dust and microorganisms was found to be more severe during harvesting than in animal confinements.

Aerosols↗

Psychological and emotional development, intellectual capabilities, and body image in short normal children.

It is well established that children with short stature frequently have problems in cognitive development, personality, self-esteem and social relations. This is partly due to the fact that many parents view them as more vulnerable than other children of normal stature and do not allow them to face the normal experiences that correspond to their actual age. The aim of the present study was to assess, through the administration of appropriate psychological tools, a series of psychological and cognitive characteristics [i.e. anxiety, depression, good adjustment, social functioning, feeling of guilt, interpersonal relationship, intelligence quotient (IQ)], as well as variables linked to development of body image, in a group of children suffering from normal growth variants [familial short stature (FSS), no. 10, 4 males/6 females; with constitutional growth delay (CGD), no. 4,4 males; height standard deviation score (HSDS) ranging between -2.4 and -1.9] and in a control group children of normal stature (HSDS between -0.1 and +0.1). Children with short stature significantly differed from normal statured controls as far as Colored Progressive Matrices (CPMs, centiles), IQ (IQ, obtained using the Goodenough test), "Good Adjustment" (Draw-a-Person index, DAP), "Feelings of Guilt" (DAP index), "Height" (as emerges from drawings of the body) are concerned. Significant relationships were found between the height of the subjects (in centiles) and cognitive skills, measured both using CPMs (r=0.408; p=0.017) and Draw-a-Man (DAM) (r=0.359; p=0.037) and between height and feelings of guilt (r=0.325; p=0.027), measured using DAP. CPM scores correlated positively with the "Good Adjustment" index of DAP (r=0.354; p=0.05) and negatively with Children's Depression Inventory (CDI) (r=-0.609; p=0.01), "School Anxiety" index (r=-0.427; p=0.05) and "Total Anxiety" index (r=-0.436; p=0.05) of the Anxiety Scale Questionnaire for the Age of Development, and with 2 indices of DAP, namely, "Feelings of Guilt" (r=-0.461; p=0.01) and "Interpersonal Relationships (Difficulty in Establishing)" (r=-0.455; p=0.01). A significant positive correlation was found between the height of the subject and both the measurement of the "Body of Drawing 3" (r=0.450, p=0.01) and the measurement of the "Body of Drawing 4" (r=0.461, p=0.01), as well as the with the "Total Height of Drawing 4" (r=0.464, p=0.01). Higher indices for anxiety, depression, feelings of guilt and difficulty in establishing interpersonal relationships and lower indices for good adjustment were found in children with CGD as compared to subjects with FSS or normal statured children. Although further additional studies on larger samples are needed to confirm these preliminary observations, the present study underlines the importance of psychological support also during the growth and development in short normal children.

Adaptation, Psychological↗