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At least 1,117 records · Page 62Linked to original sources
PubMed2003

What is the risk of developing pigmentary glaucoma from pigment dispersion syndrome?

PURPOSE: To determine the probability of converting from pigment dispersion syndrome to pigmentary glaucoma. DESIGN: Retrospective community-based study of all newly diagnosed cases of pigment dispersion syndrome or pigmentary glaucoma. METHOD: Subjects were patients newly diagnosed with pigment dispersion syndrome or pigmentary glaucoma from 1976 to 1999 in Olmsted County, Minnesota. Criteria for pigment dispersion syndrome were two of three signs: midperipheral, radial iris transillumination defects; Krukenberg spindle; heavy trabecular meshwork pigmentation. Criteria for pigmentary glaucoma were pigment dispersion syndrome and two of three findings: intraocular pressure (IOP) greater than 21 mm, optic nerve damage, or visual field loss. Kaplan-Meier survival curves were used to determine the probability of conversion to pigmentary glaucoma. RESULTS: A total of 113 patients were newly diagnosed with pigment dispersion syndrome over the 24-year period. Of these, 9 persons developed pigmentary glaucoma or elevated IOP requiring therapy. The probability of converting to pigmentary glaucoma was 10% at 5 years and 15% at 15 years. An additional 23 patients were found to have pigmentary glaucoma at their initial examination. The mean age at diagnosis of pigmentary glaucoma was 42 +/- 12 years; 78% of patients were male, whereas 58% of patients with pigmentary dispersion syndrome glaucoma were male. The most significant risk factor for conversion to pigmentary glaucoma was an IOP greater than 21 mm Hg at initial examination, whereas age, refractive error, and family history of glaucoma were not correlated with conversion. CONCLUSIONS: The risk of developing pigmentary glaucoma from pigment dispersion syndrome was 10% at 5 years and 15% at 15 years. Young, myopic men were most likely to have pigmentary glaucoma. An IOP greater than 21 mm Hg at initial examination was associated with an increased risk of conversion.

Adolescent↗
PubMed1999

The United Medical and Dental School of Guy's and St Thomas' Hospitals' MSc in general practice: graduates' perspectives.

AIM: Higher degrees have been proposed as one means whereby general practitioners can continue their professional development and avoid a slow decline into professional isolation and burnout. The United Medical and Dental School of Guy's and St Thomas' Hospitals' MSc in general practice has been available to experienced general practitioners for over a decade. This study reports some of the outcomes of participation for the 76 graduates of the first nine cohorts. METHOD: As part of an ongoing programme of evaluation the graduates were sent a questionnaire which, in addition to seeking information about attainment of intended outcomes, gave respondents the opportunity to write freely about the contribution made by the course to their own professional and personal development. Seventy-one graduates completed the questionnaire, a response rate of 93%. RESULTS AND CONCLUSIONS: An increased confidence that arises not only from a broadened knowledge base and increased skills but also from a sense of having been enabled to explore more deeply into their discipline, is the most frequently and highly valued outcome of participation. Graduates appreciated having additional protected time and demonstrated an ability to use it productively. A further significant outcome was the ability of the course to confront those habitual assumptions of doctors which inform their practice in a manner that was both challenging and supportive. Tendencies to professional isolation and burnout appear to have been reversed with a greater sense of connectedness to their discipline. Doctors seeking to diversify their general practice careers beyond the task of providing medical services have found the MSc an important route for change.

Attitude of Health Personnel↗
PubMed2005

Philosophy, self-knowledge, and personality in Iranian teachers and students of philosophy.

Like psychology, philosophy apparently operates from a commitment to the belief that self-knowledge should be a goal of disciplinary and personal development. Iranian teachers and students of philosophy responded to a Philosophical Orientations Scale created for this study that assessed the possible content of a high school philosophy course, along with instruments measuring self-knowledge, need for cognition, the five-factor model, anxiety, depression, and perceived stress. As the authors hypothesized, self-knowledge predicted higher levels of a philosophical orientation, even after controlling for the variance explained by need for cognition and openness to experience. Philosophical orientations and self-knowledge were also correlated with psychological adjustment, and teachers scored higher than students on these two sets of constructs. These data supported the hypothesis that personal and disciplinary interests in an adaptive self-knowledge converge in philosophy.

Adolescent↗
PubMed1996

[Humanistic care--a vital dialog with myself as a nurse].

The author documents the use of "humanistic care" as described by Paterson & Zderad (1988) and presents two case studies. Humanistic care is a transactional process, the carer entering into a relationship with the person for whom he/she cares. At the same time the carer embarks on a conscious dialogue with him/her self. To be "present" means being conscious of ones own thoughts, feelings, impressions and reactions. During a course of graduate study in Canada, the author enrolled in a "self-directed learning programme". She set herself the task of self-analysis. She conducted interviews with two patients suffering from cancer and with their relatives. She hoped that she would be able to reexamine, in this new situation, feelings and emotions which she had repressed earlier in her hospital nursing experience. The goal of the learning experience was to develop personal "authenticity" by becoming aware of existential experiences (her own and others').

Education, Nursing, Continuing↗
PubMed1971

Studies of immunity in typhoid fever. Protection induced by killed oral antigens or by primary infection.

Adult male volunteers were orally vaccinated with two "killed" antityphoid preparations. The recommended doses of both vaccines resulted in serum antibody development in only a few of the subjects. When the dose of the monovalent preparation (Taboral) was doubled, serological responses occurred more frequently, with a rise in O agglutinins in nearly one-fifth of the subjects, in H agglutinins in approximately one-fourth, and in Vi antibodies in nearly half.When vaccinated volunteers were fed virulent typhoid organisms, disease occurred less frequently among those men vaccinated with Taboral at twice the recommended dose (38%) than among those not vaccinated (54%). This preparation did not confer protection at the recommended dose.Volunteers who had previously recovered from an induced typhoid infection received a further challenge with virulent organisms. These persons developed typhoid fever less frequently (23%) than individuals without prior typhoid exposure (30%).

Administration, Oral↗
PubMed2007

Meaning and action in employed mothers' health work.

The purpose of this critical feminist study was to examine employed mothers' meanings of family and personal health as they frame the context of daily experience in caring for their families' and their own health. Twenty mothers employed in support staff positions with a large institution in Western Canada participated in repeat interviews over 2 years. Women considered individual family members and the family group as they emphasized everyday function and satisfaction, and the presence or absence of various attributes of health as a multifaceted and dynamic experience. Women's health work included keeping track, constructing routines, facing challenges, setting priorities, being there for each other, finding joy and fulfillment, and fostering personal development. A preliminary typology of four orientations to family health work is suggested. Common themes between women's and family health and congruence between women's health meanings and actions provide guidance to nurses in family health promotion practice.

Adaptation, Psychological↗
PubMed1989

[Raising physically and psychologically disabled children and non-disabled children within the family].

The formation of close fraternal relations is of great importance for the personality development of the children as well as of their parents and for the relations arising between brothers and sisters with advancing age. With regard to these relations the parents can be partly relieved from the care, troubling them possibly all their life for their disabled child. This has to be considered more thoroughly in the educational advice for the parents of physically-mentally disabled children.

Child↗
PubMed1991

Psychosocial assessment and intervention at initial diagnosis.

Advances in the long-term survival and possible cure of the child with cancer have challenged pediatric professionals to no longer view this child as terminally ill, but rather as a developing person with a future. The time of initial diagnosis presents the family with coping tasks which, once mastered, lay the ground work for future adjustment and, hopefully, the child's eventual return to good health. A multidimensional psychosocial assessment can be used to identify strengths and difficulties. A range of psychosocial interventions helps children and families with the coping tasks of this difficult but challenging experience.

Adaptation, Psychological↗
PubMed1975

Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients.

This is a prognostic study on 41 patients with anorexia nervosa (including three males) who satisfied defined diagnostic criteria. The patients had all been admitted to a metabolic unit where the mainstay of treatment was nursing care aimed at rapid restoration of body weight. A follow-up was conducted after a minimum lapse of four years after each patient's discharge from hospital. The outcome of the patient's illness was expressed in terms of an 'average outcome score' and a 'general outcome'. The series included a relatively high proportion of patients with a long illness who had received previous psychiatric treatment. Their families tended to come from higher social classes; a disturbed relationship with the patient was frequent. Premorbid disturbances in personality development were also common. The immediate response to treatment was excellent, with the majority of the patients returning to a normal weight, but relapses after discharge were common and readmissions were necessary in half the patients. At follow-up, the patients fell into the following defined categories: 'good' (39%), 'intermediate' (27%), 'poor' (29%), died (5%). Most of the patients who failed to recover continued to display the clinical features characteristic of anorexia nervosa. Among predictors of an unfavourable outcome were found a relatively late age of onset, a longer duration of illness, previous admissions to psychiatric hospitals, a disturbed relationship between the patient and other members of the family, and premorbid personality difficulties. It is suggested according to the severity of their illness, rather than on the method of treatment itself. The illness may last several years before eventual improvement or recovery, and a follow-up study must be extended over at least four years to be meaningful. An accurate prediction of eventual outcome is almost impossible, but late recoveries justify an optimistic outlook and continued therapeutic endeavour.

Adolescent↗
PubMed2006

Reasons for post registration learning: impact of the learning experience.

This exploratory study is the second stage of a multi-method approach to explore some of the reasons why registered nurses take part in formal and informal learning and higher education. Also under exploration is the extent to which their various learning experiences met their expectations. The sample consists of 25 registered nurses, randomly selected from a population (N=162) of 1st and 2nd Level nurses employed in public and private clinical settings, who have taken part in continuing education to obtain a Diploma or a Degree in Nursing. The data gathering was achieved by three focus group interviews. Formal learning included mandatory and non-mandatory in house teaching. Mandatory input was regarded as a self-protection measure by the employer, not related to personal development and with no perceived benefit on client care. Regarding the achievement of additional clinical competences, the overwhelming reason is to improve client care, although the motives of the employer and medical staff are viewed with some suspicion as a measure to saving doctors' time. Higher education pursuits appears to be triggered by a perceived need to increase the participants' level of existing knowledge in line with that of current students on placement, but adjustment to adult life transition period also appear to be an influencing factor. In terms of learning experiences, the relevance and quality of mandatory sessions came under criticism, whilst a measure of surprise was expressed at the unexpected benefits, at a personal and a professional level, gained by taking part in academic learning.

Adult↗
PubMed1998

Benefit of aggressive lipid-lowering therapy: insights from the post coronary artery bypass graft study and other trials.

The importance of treating patients to lower cholesterol levels to lessen the risk of developing atherosclerosis is well accepted. However, the benefits of aggressive treatment for lowering low-density lipoprotein (LDL) cholesterol and a defined threshold at which lowering cholesterol is of little use are still questionable. Although definitive answers are still not available, interesting data come from follow-ups and reviews of epidemiologic and clinical trials completed decades ago. In the Seven Countries Study, a 25-year follow-up shows that while absolute levels of coronary artery disease mortality differed by geographic area, the relative increase in mortality due to a given increase in cholesterol was similar in all cultures except Japan. A new look at the Framingham Study reveals that mean serum cholesterol of persons developing coronary disease has been decreasing progressively for the last 3 decades. Most recently, average levels of total serum cholesterol and LDL cholesterol for men are below the levels now recommended for treatment according to the National Cholesterol Education Program guidelines. Clinical and angiographic intervention trials have now ascertained that lowering LDL cholesterol is effective in prevention and in secondary treatment of coronary atherosclerosis. Recent reviews of the Scandinavian Simvastatin Survival Study (4S), the Cholesterol and Recurrent Events (CARE) study, Holme's meta-analysis of 42 randomized cholesterol-lowering trials, Roussouw's meta-analysis of 14 angiographic trials, and the Harvard Atherosclerosis Reversibility Project retrospectively validate the effectiveness of treatment and point to those patient populations in which treatment is most effective. The Post Coronary Artery Bypass Graft (Post CABG) trial evaluated aggressive LDL cholesterol-lowering therapy versus moderate treatment goals, and definitively demonstrated that in patients with a moderate increase in serum cholesterol, aggressive lipid lowering compares very positively with a moderate strategy. The benefits of decreasing cholesterol to very low levels are not yet certain, although epidemiologic reviews strongly correlate lower cholesterol levels with lowered coronary artery disease mortality. Meta-analyses confirm that LDL cholesterol lowering is at least as effective in low-risk patients as in those at high risk. Review of the Post CABG trial comes closest to providing practitioners with clinical guidelines.

Age Factors↗
PubMed2005

Family interaction and the development of borderline personality disorder: a transactional model.

Although no prospective epidemiological studies have evaluated the relationship between family interactions and the development of borderline personality disorder (BPD), there is considerable evidence for the central role of family interactions in the development of BPD. This paper describes the role of family interactions or processes, especially those that might be regarded as invalidating or conflictual, negative or critical, and the absence of more validating, positive, supportive, empathic interactions, in the development of BPD. Perhaps more importantly, the proposed model considers how these parental and family behaviors transact with the child's own behaviors and emotional vulnerabilities, resulting in a developmental model of BPD that is neither blaming of the family member with BPD nor of her or his parents and caregivers, and has important and specific implications for both prevention and intervention.

Adolescent↗
PubMed2004

A new instrument for assessing quality of life in atopic dermatitis: international development of the Quality of Life Index for Atopic Dermatitis (QoLIAD).

BACKGROUND: Atopic dermatitis (AD) is a chronic or chronically relapsing inflammatory skin condition that can have a considerable impact on those affected. There are a number of instruments available to measure outcome in dermatological conditions but none have been developed specifically for AD. In addition, most measure symptoms and/or daily functioning, which are potential influences on quality of life (QoL) rather than assessments of the construct itself. OBJECTIVES: The aim of the current study was to develop a new instrument specifically designed to measure QoL in adults with AD-the Quality of Life Index for Atopic Dermatitis (QoLIAD). METHODS: The instrument was developed based on the needs-based model of QoL and was produced in several different countries simultaneously. Its content was derived from 65 in-depth interviews with relevant patients in the U.K., Italy and the Netherlands. The initial version of the measure was produced in U.K. English and translations were produced for the Netherlands, Italy, Germany, France and the U.S.A. using a dual translation panel methodology. A Spanish version was developed using the same adaptation process after the instrument was finalized. Field-test interviews were conducted with approximately 20 patients in each country to assess face and content validity. The instrument [in addition to the Dermatology Life Quality Index (DLQI) and the Psychological General Well-Being Schedule (PGWB)] was then administered to up to 300 AD patients in each country at two time points to finalize the instrument and test its psychometric properties. RESULTS: The initial version of the QoLIAD had 56 items that reflected the areas of need fulfillment identified in the qualitative interviews as having been affected by AD: mental and emotional stimulation, physical and emotional stability, security, sharing and belonging, self-esteem, personal development and fulfillment. Comments from patients in field-test interviews resulted in the removal of 14 items, to leave a 42-item instrument that was considered relevant and acceptable. The number of patients participating in the survey were 286 in the U.K., 46 in the Netherlands, 213 in France, 187 in Germany, 178 in the U.S.A. and 83 in Spain. Application of the Rasch model to these data identified the final 25-item QoLIAD. Unidimensionality was confirmed, with deviation of the total scale from the Rasch model evident at a single time point in one country only (the U.K.). All language versions, with the exception of the Dutch measure, had test-retest reliability coefficients in excess of 0.85. The test-retest in the Netherlands was 0.80. However, this country had the smallest sample size and the corresponding reliability for the DLQI was only 0.40. The QoLIAD had adequate internal consistency and the initial indications of construct validity were good. The levels of association with the DLQI indicated that the two instruments measure related but distinct constructs. CONCLUSIONS: The QoLIAD is a practical, reliable, valid and culturally applicable instrument for measuring the impact of AD and its treatment on QoL in clinical trials or in routine clinical practice.

Adolescent↗
PubMed1989

Assessment of children's object-representations with the Rorschach.

The recent emphasis on object relations theory as an explanatory model for personality development has been paralleled in the psychological test literature by measures that assess the quality of object-representations. The author reviews one such measure--the Mutuality of Autonomy (MOA) scale--in its research applications with adults and children. He then extends the scale to the psychotherapy of children and suggests that Rorschach object-representation scores can be of heuristic value in understanding the treatment process.

Adolescent↗
PubMed2005

[Individualized health behavior? Social structures, peer influences and life style as modifying factors of nutritional behavior of adolescents].

OBJECTIVE: Health behaviours are often explained as being determined by health knowledge, occupation, education and income. Yet, in increasingly individualized societies individuals are brought to develop personal strategies of orientation and behaviours, the later being detached from traditional status or class membership. The present study (secondary analysis) explores to what extent health behaviours are more or less individualized or still linked to social living conditions. METHODS: Eating behaviours and social status are based on a 2001 questionnaire survey among 393 randomly selected adolescents from the city of Leipzig, Germany. RESULTS: The findings show a distinct social patterning of eating behaviours. Those patterns can be explained as part of adolescents' lifestyles. Findings also indicate that the patterns of eating behaviours are strongly linked to the social background of those adolescents. CONCLUSIONS: It is concluded that for adolescents raised in deprived social conditions it is more difficult to develop health preferences conducive for health promoting behaviours.

Adolescent↗
PubMed1978

[Relationship between the dynamics of mental disorders in patients with primary hypogonadism and surgical intervention (testicular transplantation)].

Clinico-catamnestical, experimental-psychological and EEG studies were made of 60 patients with primary hypogonadism. Variants of protracted pathological reactions to the disease and pathological personality development are described. The studies indicate an intercorrelation of the dynamics of mental disorders and the character of the main disease. Recommendations as to the prophylaxis and treatment of mental disorders in different stages of surgical treatment are given. Some deontological problems of transplantation are discussed as well.

Adolescent↗
PubMed1963

Inheritance of behavior in infants.

Mental and motor abilities and personality development were studied in 20 pairs of infant twins of the same sex on a monthly basis in their first year, that is, before mutual imitation becomes a factor. Blood group determinations, made after the study was completed, revealed an N(1) of 11 fraternal and N(2) of 9 identical pairs. Within-pair differences were significantly greater within fraternal pairs on all tests and rating scales.

Female↗
PubMed2001

Dramatic-erratic personality disorder symptoms: II. Developmental pathways from early adolescence to adulthood.

This study examined the relationship over time between Cluster B personality disorder symptoms (borderline, histrionic, and narcissistic symptoms) and comorbid internalizing and externalizing symptoms in a community sample of 407 adolescents. Cross-lagged longitudinal models tested (a) the hypothesis that Cluster B symptoms reflect primary disturbances that give rise to co-occurring internalizing and externalizing symptoms; and (b) the alternative hypothesis that these Axis I symptom clusters reflect primary problems that interfere with normal personality development. Internalizing and externalizing symptoms each predicted subsequent Cluster B symptoms in girls, although these effects occurred only at specific developmental stages. Cluster B symptoms in boys and girls at ages 10 to 14 years predicted externalizing symptoms two years later. Instead of clearly supporting one hypothesis over the other, longitudinal models suggested gender-specific developmental effects that were partially consistent with both hypotheses.

Adolescent↗