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PubMedDate not supplied

Psychometric evaluation of selected pain intensity scales for use with cognitively impaired and cognitively intact older adults.

The purpose of this study was to determine the reliability and validity of selected pain intensity scales such as the Faces Pain Scale (FPS), the Verbal Descriptor Scale (VDS), the Numeric Rating Scale (NRS), and the Iowa Pain Thermometer (IPT) to assess pain in cognitively impaired older adults. A descriptive correlational design was used, and a convenience sample of 66 volunteers age 60 and older residing in assisted living facilities in the South was recruited for this study. The sample included 22 (33%) men and 44 (67%) women, with a mean age of 76. Ninety-eight percent (65) of the sample comprised Caucasian participants, with the exception of 1 African-American man. Seventy percent (47) completed high school and/or college. The mean Mini Mental State Exam (MMSE) score was 16, with a range of 1 to 29. Eighty-five percent scored 24 or lower, indicating some degree of cognitive impairment. The remaining 15% were cognitively intact. All but one participant could use each scale to rate their pain. Concurrent validity of the VDS, NRS, and IPT was supported with Spearman rank correlation coefficients ranging from .78 to .86 in the cognitively impaired group. The FPS, however, demonstrated weak correlations with other scales when used with the impaired group, ranging from .48 to .53. In the cognitively intact group, strong correlations ranging from .96 to .97 were found among all of the scales. Test-retest reliability at a 2-week interval was acceptable in the cognitively intact group (Spearman rank correlations ranged from .67 to .85) and unacceptable for most scales in the cognitively impaired group (correlations ranged from .26 to .67). When asked about scale preference, both the cognitively impaired and the intact groups preferred the IPT and the VDS. This study revealed that cognitive impairment did not inhibit participants' ability to use a variety of pain intensity scales, but the stability issue must be considered.

Aged↗
PubMed1991

Scale formation in algae.

Scale biogenesis in algae represents a unique model system to study the transport of secretory macromolecules through the Golgi apparatus (GA) and their exocytosis. The larger scales can be visualized in the light microscope, and thus the kinetics of scale assembly, transport, and secretion can be studied in vivo. In addition, scales are osmiophilic and readily visible in conventional transmission electron microscopy; thus, details of scale assembly and sorting can be studied without invoking immunolabeling techniques. The following are distinctive features of scale biogenesis in algae: 1) transport of scales through the GA-stack occurs by cisternal progression; 2) scale secretion may be very rapid (in some cases a single GA-cisterna leaves the stack every 15-20 s); 3) sorting of different scale types does not occur in the GA, but in a post-GA-compartment. Recent progress in the analysis of scale formation in the green flagellates Tetraselmis and Scherffelia is reviewed.

Animals↗
PubMed1982

The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain.

Two 10 cm visual analogue scales were compared with a 0-10 point numerical rating scale and a four-point verbal descriptive scale, in assessing pain severity in twelve patients with post-operative pain following removal of an impacted lower third molar. High correlations were shown between the pain scores from the two visual analogue scales and the numerical scale, but a lower correlation was obtained when the four-point scale was compared with the other scales. Analgesic efficacy was found to be dependent on the type of scale used. The 10 cm visual analogue scale was more sensitive than other pain scales and could discriminate between small changes in pain intensity.

Adult↗
PubMed1977

Child abuse and neglect: effect on Bayley Scale scores.

Compared to controls, children who were diagnosed as victims of Nonaccidental Trauma or Failure to Thrive had depressed Bayley Scale Mental Index scores, p less than .002 and p less than .0001, respectively. Failure-to-Thrive children also had depressed Bayley Scale Motor Index scores, p less than .0001. Nonaccidental-Trauma children had Mental and Motor Scale range scores, as determined by differences between basal and ceiling items on the Mental and Motor scales, that were a function of measured Mental and Motor Index Scores. Specifically, Nonaccidental-Trauma children with lower Mental Index scores had higher Mental Scale range scores than Nonaccidental-Trauma children with higher Mental Index scores, p less than .003. Control children had Mental Scale range scores that did not differ between the high-low Mental Index score conditions. On the Motor Scale, range scores of Nonaccidental-Trauma children in the high-low Motor Index score conditions did not differ. However, children with higher Motor Index scores had higher Motor Scale range scores than control children with lower Motor Index scores, p less than .02. In addition, the Infant Behavior Record of the Bayley Scales revealed behavior ratings of Nonaccidental-Trauma and Failure-to-Thrive children that differed from Mental and Motor Scale scores on several dimensions. These differences may reflect differential effects of the Nonaccidental-Trauma and Failure-to-Thrive conditions.

Attention↗
PubMed2004

Perception of teasing in underweight persons: a modification of the perception of teasing scale.

The psychometric properties of the Perception of Teasing Scale-Underweight, a modified version of the Perception of Teasing Scale (1), were examined. One hundred eighty-three college students (81 male; 102 female; age range 17-57 years) completed questionnaires about underweight-related and competency-related teasing experiences, eating attitudes, body image, self-esteem, and mood. Factor analysis suggested the Perception of Teasing Scale-Underweight has a two-factor structure, measuring both underweight-related and competency-related teasing experiences. Significant correlations (p<0.05) were found between the Perception of Teasing Scale-Underweight, Beck Depression Inventory, Fear of Negative Appearance Evaluation Scale, Multidimentional Body-Self Relations Questionnaire-Appearance Scales, Multiaxial Eating Disorder Scale, Social Physique Anxiety Scale, and Rosenberg Self-Esteem Scale. The pattern of correlations differed between the entire sample and those with a body mass index <21. One-way analysis of variance analyses found significant differences (p<0.05) between those with body mass index (BMI) <21 and those with BMI >21 for the weight-related event and weight-related impact scales, indicating that the measure discriminates between those individuals most likely to have been underweight as adolescents versus those most likely to have been normal weight or overweight. This measure provides a sound psychometric tool for examining underweight-related and competency-related teasing experiences. The impact of appearance and competence related teasing in underweight persons is less well understood than in overweight samples; therefore, future work should be conducted with a more underweight sample to bridge this gap in the literature.

Adult↗
PubMed2003

Estimating scale-dependency in disturbance impacts: El Niños and giant kelp forests in the northeast Pacific.

Recent discussions on scaling issues in ecology have emphasized that processes acting at a wide range of spatial and temporal scales influence ecosystems and thus there is no appropriate single scale at which ecological processes should be studied. This may be particularly true for environmental disturbances (e.g. El Niño) that occur over large geographic areas and encompass a wide range of scales relevant to ecosystem function. However, it may be possible to identify the scale(s) at which ecosystems are most strongly impacted by disturbances, and thus provide a measure by which their impacts can be most clearly described, by assessing scale-dependent changes in the patterns of variability in species abundance and distribution. This, in turn, may yield significant insight into the relative importance of the various forcing factors responsible for generating these impacts. The 1997-98 El Niño was one of the strongest El Niños ever recorded. I examined how this event impacted giant kelp populations in the northeast Pacific Ocean at 90 sites ranging from central Baja California, Mexico to central California, USA. These sites spanned the geographic range of giant kelp in the Northeast Pacific and were surveyed just before, immediately following, several months after, more than 1 year after, and nearly 2 years after the El Niño. I used a hierarchical sample design to compare these impacts at five spatial scales spanning six orders of magnitude, from a few meters to more than 1,000 km. Variance Components Analyses revealed that the El Niño shifted control over giant kelp abundance from factors acting at the scale of a few meters (local control) to factors operating over hundreds to thousands of kilometers (regional control). Moreover, El Niño resulted in the near-complete loss of all giant kelp throughout one-half of the species' range in the northeast Pacific Ocean. Giant kelp recovery following El Niño was far more complex and variable at multiple spatial scales, presumably driven by numerous factors acting at those scales. Recovery returned local control of giant kelp populations within 6 months in southern California, and within 2 years in Baja California.

California↗
PubMed2002

Scale-down studies on the hydrodynamics of two-liquid phase biocatalytic reactors.

The maintenance of constant interfacial area per unit volume is a key parameter for the successful scale-up of two-liquid phase bioconversion processes. To date, however, there is little published information on the hydrodynamics of such systems and a suitable basis for scale-up has yet to be defined and verified. Here we report power input and hydrodynamic data for a whole-cell bioconversion process using resting cells of Rhodococcus R312 to catalyse the hydration of a poorly water-soluble substrate 1,3-dicyanobenzene (1,3-DCB). Experiments were performed in geometrically similar 3-L and 75-L reactors, each fitted with a three-stage Rushton turbine impeller system. The two-phase system used comprised of 20% v/v toluene dispersed in 0.1 M aqueous phosphate buffer containing up to 10 g(ww) x L(-1) of resuspended biocatalyst and 20 g x L(-1) 1,3-DCB. The power input to the 3-L reactor was first determined using an air-bearing technique for both single-phase and two-phase mixing. In both cases, the power number attained a constant value of 11 at Re>10,000, while the measured power inputs were in the range 0.15-3.25 kW x m(-3). Drop size distributions and Sauter mean drop diameters (d(32)) were subsequently measured on-line in both reactors, using an in-situ light-backscattering technique, for scale-up on the basis of either constant power input per unit volume or constant tip speed. At both scales d(32) decreased with increasing agitation rate, while the drop size distributions obtained were log-normal. All the measured d(32) values were in the range of 30-50 microm, with the lowest values being obtained in systems with biocatalyst present. In all cases, constant power input per unit volume was found to be the most suitable basis for scale-up. This gave virtually identical d(32) values and drop size distributions at both scales. A number of correlations were also identified that would allow reasonable prediction of d(32) values for various agitation rates at each scale. While the results obtained are for a particular phase system, the scale-down methodology presented here would allow the rapid evaluation of other bioconversion processes in the 3-L reactor with a 25-fold reduction in scale. In this way, potential problems that might be encountered at the larger scale, such as the carryover of antifoam from the fermentation stage, could be quickly and efficiently identified.

Journal Article↗
PubMed2002

The Youth Self-Report (YSR) and the Depression Self-Rating Scale (DSRS) as measures of depression and suicidality among adolescents.

Two hundred and thirty-seven adolescents from a junior high school in a small community outside Göteborg, Sweden, completed the Youth Self Report (YSR) and the Depression Self Rating Scale (DSRS). Self-reported suicidality and biographical data were also recorded. The school doctor and nurse assessed the adolescents' somatic, psychological and behavioural problems using school health-records. The convergent validity of the YSR total problems scale and syndrome scales were tested against the DSRS. Discriminant validity was assessed by the two measures' ability to predict suicidality and school health problems. The Internalising (r = 0.65**) and Anxious/Depressed (r= 0.61**) syndrome scales of the YSR had the highest correlations with the DSRS. However, all YSR syndrome scales were significantly, though more modestly, correlated with the DSRS. Using stepwise logistic regression analysis, four YSR sub-scales [Social Withdrawal, Anxious/Depressed, Attention problems and Delinquency] predicted mild-severe self-reported depression (DSRS scores 12 and above). The YSR syndrome scales Anxious/Depressed and Delinquency predicted suicide ideation whereas the Self-destructive/Identity problem and Social Withdrawal (low scores) scales predicted Suicide attempts. The YSR Anxious/Depressed sub-scale and the DSRS total score seem to measure a similar dimension. However, the Anxious/Depressed and Selfdestructive/Identity problem scales were superior in predicting suicidality.

Adolescent↗
PubMed2006

A stoma quality of life scale.

PURPOSE: Few studies have evaluated the impact of a stoma on patient quality of life because of a lack of specific validated measures. This study documents the development and initial application of a Stoma Quality of Life Scale. METHODS: Content experts generated initial questions. Patient focus groups were conducted to ensure that the questions addressed all stoma-related issues considered important by patients. Responses from pilot groups allowed refinement to produce the final measure, the Stoma Quality of Life Scale, a 21-item questionnaire. Three scales are featured: Work/Social Function (6 items), Sexuality/Body Image (5 items), and Stoma Function (6 items). In addition, one item (scored separately) measures financial impact, one measures skin irritation, and two measure overall satisfaction. This questionnaire was administered to 100 consecutive ostomy patients, and readministered three weeks later. Reliability was assessed by using coefficient alpha for internal consistency and intraclass correlation coefficient for test-retest reproducibility. To test validity in extreme groups, scores were compared for patients with improved quality of life vs. those whose stoma worsened their quality of life. To evaluate convergent validity, we analyzed correlation of instrument scales with the SF12. RESULTS: The Stoma Quality of Life scales demonstrated adequate test-retest reproducibility (intraclass correlation coefficient>0.8) and acceptable internal consistency (coefficient alpha approximately 0.8). The scales were capable of discriminating between patients with better and worse quality of life after stoma formation (P<0.02 for all scales). The Stoma Quality of Life scales significantly correlated (range, 0.12-0.75) with the Physical and Mental Health Composite Scale Scores of the SF-12. CONCLUSIONS: The Stoma Quality of Life Scale demonstrates reasonable psychometric properties for measuring quality of life in patients with stomas. Further studies are needed to refine the instrument.

Adult↗
PubMed1985

Differentiation of embryonic chick feather-forming and scale-forming tissues in transfilter cultures.

The dermal-epidermal tissue interaction in the chick embryo, leading to the formation of feathers and scales, provides a good experimental system to study the transfer between tissues of signals which specify cell type. At certain times in development, the dermis controls whether the epidermis forms feathers or scales, each of which are characterized by the synthesis of specific beta-keratins. In our culture system, a dermal effect on epidermal differentiation can still be observed, even when the tissues are separated by a Nuclepore filter, although development is abnormal. Epidermal morphological and histological differentiation in transfilter cultures are distinct and recognizable, more closely resembling feather or scale development, depending on the regional origin of the dermis. Differentiation is more advanced when epidermis is cultured transfilter from scale dermis than from feather dermis, as assessed by morphology and histology, as well as the expression of the tissue-specific gene products, the beta-keratins. Two-dimensional polyacrylamide gel analysis of the beta-keratins reveals that scale dermis cultured transfilter from either presumptive scale or feather epidermis induces the production of 7 of the 9 scale-specific beta-keratins that we have identified. Feather dermis, although less effective in activating the feather gene program when cultured transfilter from either presumptive feather or scale epidermis, is able to turn on the synthesis of 3 to 6 of the 18 feather-specific beta-keratins that we have identified. However, scale epidermis in transfilter recombinants with feather dermis also continues to synthesize many of the scale-specific beta-keratins. Using transmission and scanning electron microscopy, we detect no cell contact between tissues separated by a 0.2-micron pore diameter Nuclepore filter, while 0.4-micron filters readily permit cell processes to traverse the filter. We find that epidermal differentiation is the same with either pore size filter. Furthermore, we do not detect a basement membrane in transfilter cultures, implying that neither direct cell contact between dermis and epidermis, nor a basement membrane between the tissues is required for the extent of epidermal differentiation that we observe.

Animals↗
PubMed1995

Development of a numeric Health Care Worker Risk-Assessment Scale to evaluate potential for blood-borne pathogen exposures.

BACKGROUND: An attempt to develop a Health Care Worker Risk Assessment Scale to evaluate potential for exposure to blood-borne pathogens was made in late 1989 through 1990. The research questions were as follows: (1) Can a scale be developed to assign weights to variables that influence health care workers' risk of exposure to blood-borne pathogens? (2) If so, what variables would be included? METHODS: A five-round Delphi technique was used with 26 panel members from 15 U.S. states and the United Kingdom who were recognized experts in strategies to reduce health care workers' risk of exposure to blood-borne pathogens. The scale included four elements, each scored up to 40 points. Elements were as follows: (1) potential route of exposure, (2) experience of health care worker and cooperation of patient, (3) prevalence of blood-borne pathogens, and (4) difficulty in managing the situation. A minimum score of 20 indicated an extremely low-risk situation; a maximum score of 160 indicated an extremely high-risk situation. RESULTS: Consensus was achieved among the panel members in identifying the elements that contributed to risk for exposure to blood-borne pathogens and in applying the scale to carefully worded vignettes. This required several modifications of both the scale and the vignettes to ensure consistent interpretation of the terms used. In all vignette situations, the risk-abatement strategy was specific to the situation depicted in the vignette and not to the task itself; the value of a numeric scale is thus questionable. CONCLUSIONS: Even with the participation of 26 expert panelists, we were unable to develop a numeric scale to objectively quantify risk in such a way that risk-reduction strategies could be based on the scale rather than on the specific risk elements in a situation. Instead of attempting to use a scale such as this to quantify risk objectively, educators or clinicians may be better advised to teach health care workers the four scale elements so that health care workers can subjectively use these elements to evaluate and modify their own risk situations.

Blood-Borne Pathogens↗
PubMed1983

A clinical comparison of two pain scales: correlation, remembering chronic pain, and a measure of compliance.

Fifteen chronic pain patients rated their pain intensity on both a visual analogue scale and a verbal scale so that comparisons between the scales could be made for each subject. Compliance to fill in the rating blanks and the remembering of pain intensity were also studied. Subjects first made a pre-baseline estimate of their pain and then they rated their pain throughout a baseline and treatment period averaging 5 weeks. Four to 9 weeks after baseline, subjects were asked to remember how much pain they had had at baseline and to confidentially provide ratings concerning their compliance. Results indicated that two-thirds of the individual subjects had significant correlations between the scales with a mean of 0.68. The one-third of the subjects who did not have significant correlations also had significantly less variability in their ratings than did subjects with significant correlations. This low level of variability may account for the lack of a significant correlation between the scales for these subjects. Discrepancies between actual baseline and remembered pain ratings were observed on both rating scales, but the visual analogue scale produced significantly greater discrepancies than the verbal scale. This was mainly because subjects tended to overestimate their baseline pain on the visual analogue scale, while discrepancies on the verbal scale were in both directions (overestimations, underestimations) when taken as a group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Appearance scales to measure cosmetic outcomes of healed lacerations.

To develop an appearance scale that will allow the objective and scientific comparison of the cosmetic results of healed lacerations, 33 photographs of healed lacerations and incisions with variable cosmetic results were shown to four plastic surgeons. These plastic surgeons were asked to independently rate the photographs on two separate occasions using two scales, a Visual Analogue Scale and a Categorical Scale. Interobserver and intraobserver agreement were determined for each scale. Comparison of the scales with each other was done to assess consistency. The Visual Analogue Scale showed good interobserver agreement with an Intraclass Correlation Coefficient of 0.75. Intraobserver agreement was also high across the four observers with Pearson correlation coefficients ranging from 0.73 to 0.87. The agreement of the categorical scale was also good with a kappa coefficient for interobserver agreement of 0.53. The kappa coefficient for intraobserver agreement ranged from 0.48 to 0.72. Because the visual analogue scale and categorical scale showed good interobserver and intraobserver agreement, both may be considered good measurement tools in the comparison of alternate methods of laceration care.

Adult↗
PubMed2007

Quasi-continuous and discrete confidence rating scales for observer performance studies: Effects on ROC analysis.

RATIONALE AND OBJECTIVES: To examine the effects of the number of categories in the rating scale used in an observer experiment on the results of ROC analysis by a simulation study. MATERIALS AND METHODS: We have previously evaluated the effects of computer-aided diagnosis on radiologists' characterization of malignant and benign breast masses in serial mammograms. The evaluation of the likelihood of malignancy was performed on a quasi-continuous (0-100 points) confidence rating scale. In this study, we simulated the use of discrete confidence rating scales with fewer number of categories and analyzed the results with receiver operating characteristic (ROC) methodology. The observers' estimates of the likelihood of malignancy were also mapped to BI-RADS assessments with five and seven categories and ROC analysis was performed. The area under the ROC curve and the partial area index obtained from ROC analysis of the different confidence rating scales were compared. RESULTS: The fitted ROC curves and the performance indices do not change significantly when the confidence rating scales were varied from 6 to 101 points if the estimated operating points obtained directly from the data are distributed relatively evenly over the entire range of true-positive fraction (TPF) and false-positive fraction (FPF). The mapping of the likelihood of malignancy observer data to the seven-category BI-RADS assessment scale allowed reliable ROC analysis, whereas mapping to the five-category BI-RADS scale could cause erratic ROC curve fitting because of the lack of operating points in the mid-range or failure in ROC curve fitting because of data degeneration for some observers. CONCLUSION: ROC analysis of discrete confidence rating scales with few but relatively evenly distributed data points over the entire FPF and TPF range is comparable to that of a quasi-continuous rating scale. However, ROC analysis of discrete confidence rating scales with few and unevenly distributed data points may cause unreliable estimations.

Breast Neoplasms↗
PubMed2006

A quality rating scale for aesthetic surgical procedures.

BACKGROUND: Cosmetic dermatologic procedures offer the promise of visible aesthetic enhancement with minimal risk. While in recent years the number of available procedures has proliferated, there are few objective methods for evaluating the relative quality of these procedures for particular indications or specific patients. OBJECTIVE: (A) To develop a simple, easy-to-use numerical rating scale to assess the quality of cosmetic surgical procedures on a range of parameters pertaining to clinical efficacy and patient satisfaction; (B) to statistically validate the discriminative value of this rating scale. METHODS: (A) Patient and physician interviews were performed to elicit a list of factors that may collectively characterize the clinical efficacy and patient tolerability of cosmetic dermatologic procedures. A 0-100 point rating scale was developed based on these factors, with the face-validity of this scale checked by a group of patients and physicians; (B) Statistical analysis of the questionnaire was performed by asking 15 expert cosmetic dermatologic surgeons to use it to rate 23 common cosmetic dermatologic procedures, and analyzing the results. RESULTS: (A) An easy-to-use scale was constructed to assess the quality of cosmetic dermatologic procedures by rating the associated cost, risk, time (procedure and recovery), discomfort, results, and longevity of benefit. A "physician adjustment factor" was used to further increase the relevance of this 0-100 point scale for specific patients; (B) Repeated-measures analysis of variations (ANOVAs) performed on the data from the survey of experts demonstrated that this scale can be used to discriminate between common dermatologic procedures. The differences in mean subscores and total scores among procedures grouped by anatomic site and target lesion-type were significant at the level of P < .05. LIMITATIONS: Patient preferences exogenous to the rating scale may increase or decrease the suitability of specific procedures. CONCLUSIONS: Common cosmetic dermatologic procedures are of uniformly high quality, as per expert ratings on a systematic measure. This quality rating scale appears statistically valid and robust, given that expert raters assigned similar ratings to the same procedures but mean ratings were different across procedures. In the future, this quality rating scale can be used to assess novel interventions, and to help dermatologic surgeons faced with patient concern to optimally select among alternative procedures for a given indication.

Botulinum Toxins, Type A↗
PubMed2006

Visual analog scale questionnaire to assess quality of life specific to each symptom of the International Prostate Symptom Score.

PURPOSE: We assessed patient quality of life specific to each of the 7 items on the International Prostate Symptom Score, as evaluated with a novel visual analog scale questionnaire. MATERIALS AND METHODS: A total of 246 male patients with a chief complaint of lower urinary tract symptom were asked to complete the International Prostate Symptom Score and visual analog scale questionnaires to assess bother or satisfaction regarding patient quality of life specific to each of the 7 items on the International Prostate Symptom Score. RESULTS: An item with the maximum visual analog scale measure matched the chief complaint in 169 patients (69%). In contrast, the chief complaint failed to match to an item with the most severe International Prostate Symptom Score in 104 patients (42%) (p = 0.012). Multiple regression analysis to define the best predictor of International Prostate Symptom Score quality of life score of the 14 items, including International Prostate Symptom Score and visual analog scale, revealed that the best predictor was the visual analog scale measure for nocturia (p = 0.0003), followed by visual analog scale measures for frequency (p = 0.0004) and incomplete emptying (p = 0.01). After alpha-blocker treatment improvement in the visual analog scale measure for the chief complaint correlated better with improvement in the International Prostate Symptom Score quality of life score than the change in International Prostate Symptom Score. The overall test-retest correlation for the visual analog scale questionnaire in 55 healthy elderly men and 44 patients with lower urinary tract symptoms was 0.772 and 0.742, respectively (p <0.00001). CONCLUSIONS: The novel visual analog scale measure of quality of life specific to each of the 7 items on the International Prostate Symptom Score has a significant impact on identifying the patient chief complaint as well as on patient specific quality of life. Our study supports the concomitant use of the International Prostate Symptom Score and visual analog scale questionnaires.

Aged↗
PubMed2006

A haptophyte bearing siliceous scales: ultrastructure and phylogenetic position of Hyalolithus neolepis gen. et sp. nov. (Prymnesiophyceae, Haptophyta).

A haptophyte alga bearing hyaline but conspicuous scales was discovered in surface water samples of Shiribeshi Seamount, Japan. X-ray elemental analysis confirmed that silica was the major element in these scales. These scales were hat-shaped, ellipsoidal in top view, 4-6mum wide and 5-7mum long, perforated by several small pores, and were deposited on cells in several layers. Beneath the siliceous scale layers, organic scales were present, which are typical of haptophytes. The cells were non-motile despite having two short flagella hidden in the scale case. The haptonema, extended over the scale case, and one and a half times the cell length. The intracellular features were typical of haptophytes, including the peripheral endoplasmic reticulum (PER), Golgi cisternae with peculiar dilations, and the flagellar apparatus. The siliceous scales were produced in vesicles in the posterior region of the cell. Motile cells lacking silica scales were observed occasionally when cultures were maintained at lower temperatures and under oligotrophic conditions. This alga was described as Hyalolithus neolepis gen. et sp. nov. Phylogenetic analysis using the SSU rDNA and rbcL gene sequences indicated that Hyalolithus is a member of the Prymnesiales and falls in a clade including Prymnesium, Platychrysis, and Chrysochromulina polylepis. Based on these results, the evolutionary implications of the presence of silicified scales in haptophytes is discussed.

Animals↗
PubMed1996

Caregiver's burden of patients 3 years after stroke assessed by a novel caregiver burden scale.

OBJECTIVE: To assess burden of caregivers to stroke patients three year after primary stroke and to test validity and reliability of a novel caregiver burden scale (CB scale). DESIGN: A longitudinal community-based 3-year follow-up study of 35 consecutive primary stoke patients initially admitted to an Acute Medical Unit (mean age 82 yr). The validity of the CB scale was studied in 150 patients (mean age 77 yr): 83 demented outpatients with stroke from a general geriatric day-care unit. Reliability was studied in another 23 outpatients (mean age 72 yr) with stroke from the same unit. METHODS: A 22-item CB scale for different types of caregiver burden and scales for neuroticism and extroversion (Eysenck Personality Inventory) and quality of life (11-item scale). Activities of daily life were assessed by a 6-item, scale, initially and 3 years later. OUTCOME MEASURE: Reliability and validity of the CB scale. Improvements of activities of daily life of stroke patients. RESULTS: Factor analyses of the CB scale gave five indices--general strain, isolation, disappointment, emotional involvement, and environment--having good kappa values, .89 to 1.00 and Cronbach's alpha, .70 to .87, except for environment. A higher burden was related to a closer relationship but not to the living situation. The highest caregiver burden was found among patients showing the greatest improvements of ADL, when divided into tertiles. The patient's degree of extroversion and quality of life were negatively correlated to caregiver burden, -.46(p < .05) and .59(p < .01). CONCLUSIONS: The CB scale proved to be a valid and reliable instrument to assess caregiver burden. To improve the caregiver situation, individual patient personality characteristics, like extroversion, feeling of quality of life, and progression of the disease, must be considered.

Activities of Daily Living↗