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PubMed2006

Pain, demographics, and clinical characteristics in persons who received hospice care in the United States.

Pain in persons who receive hospice care is not fully understood. The purpose of this study was to describe the demographics, clinical characteristics, and pain intensity of persons who received hospice care in the United States from 2000-2004. Data for this study were obtained from a provider of hospice pharmacy services and included information about the hospice organization, demographics and clinical characteristics, pain intensity, and opioid analgesic prescribing. Worst pain intensity during the previous 24 hours was assessed using a 0-10 numeric rating scale (0=none, 10=worst) periodically during hospice care. During the study period, 347,555 persons received hospice services; 55.2% of these persons were female, 87.4% were Caucasian, and mean age was 75.3 years. At least one pain score was available for 156,887 (45.1%) individuals. Among persons with at least one pain score, pain was reported a mean of 2.9 times per person. Overall, mean pain intensity was mild, but severe pain was reported at least once by 20.3% of persons. Of individuals who reported severe pain at least once, mean age was 68.9 years, 53.7% were female, 78.0% were Caucasian, 7.4% were cared for in long-term care hospices, and 73.9% had a primary diagnosis of cancer. Severe pain was reported at least once by a substantial percentage of persons in this study. These data provide insight into pain reported by persons who received hospice care, and may be useful as process indicators of the quality of care.

Adolescent↗
PubMed1995

Self-managed versus agency-provided personal assistance care for individuals with high level tetraplegia.

OBJECTIVE: To determine whether a finite population, with severe physical disability, had better perceived quality of life, health status, and lower cost depending on whether they used agencies for their caregivers or hired, trained, and reimbursed their caregivers, independently. DESIGN AND SETTING: A survey, including demographics and portions of the Rand-36, LSI-A, PASI, PIP and CHART. The interviews were completed by telephone, by the leading author. PARTICIPANTS: Seventy-one persons who had sustained spinal cord lesions between C1 and C4. All were at least 1 year postinjury and had received rehabilitation at a local hospital in Englewood, Colorado. Ten additional persons came from the leading author's case management caseload or from a Boston rehabilitation center. They were interviewed in person for pretesting. MAIN OUTCOME MEASURES: Chi square, t tests, and multiple regression analysis, which controlled for potentially confounding group differences. Individuals were placed in two cohorts. Twenty-nine persons received primarily agency provided care and 42 individuals used personal care attendants. RESULTS: The self-managed group showed significantly better health outcomes, with fewer rehospitalizations and diminished preventable complications. They also experienced greater life satisfaction and significantly lower costs. Those in the self-managed care group had significantly higher composite scores on Rand-36, indicating higher perception of recent health status. Significant differences in mean PIP scores indicated that members of the self-managed care cohort perceived greater control over day-to-day lives. PASI scores showed that persons in this cohort had greater satisfaction with their caregivers and costs. Cost benefit analysis showed appreciable lowering of costs in the self-managed care group. CONCLUSIONS: The self-managed care group had many more hours of paid attendant care, whereas the agency provider group had almost equal amounts of care from paid and unpaid providers. Persons using self-managed care reported having fewer medical problems, fewer hospitalizations and better perception of health. Participants declared greater satisfaction in having a choice of caregivers. Persons who were self-managing their care spent less money and used more hours of paid care. The financial burden borne both by the individual and society and the emotional burden borne by families and friends were diminished by the persons managing their care individually.

Adult↗
PubMed2003

Nature of personal semantic memory: evidence from Alzheimer's disease.

Personal semantic memory is factual knowledge about a person's own past. Although personal semantic memory is assumed to have features of both semantic memory and episodic memory, the relationship to episodic memory and to semantic memory have not been well documented. In patients with Alzheimer's disease, episodic memory, semantic memory, and personal semantic memory are all defective. In this study, the hypothesis that defective personal semantic memory is related to both semantic and episodic memory dysfunction was tested in patients with Alzheimer's disease. Functions of episodic, semantic, and personal semantic memory were examined by using the Wechsler Memory Scale-Revised (WMS-R), subtests of the WAIS-R (Information, Vocabulary, Comprehension and Similarities), and the Family Line Test (FLT) in 62 patients who met the NINCDS/ADRDA criteria for probable Alzheimer's disease. Specific effects of episodic and semantic memory on personal semantic memory were examined by using multiple linear regression analysis with the total score of the FLT as the dependent variable and the WMS-R Delayed Recall weighted sum score and the WAIS-R Semantic Memory score (a composite of standardized scores of the four subtests) as the independent variables. Personal semantic memory function was significantly correlated with both the episodic and semantic memory functions, after controlling age, sex, educational attainment, and severity of dementia. This result supports the hypotheses that personal semantic memory has features of both episodic and semantic memory, and that semantic memory is transformed from episodic memory.

Aged↗
PubMed2003

Cognitive anxiety as a function of speaker role for fluent speakers and persons who stutter.

UNLABELLED: Fransella [Personal change and reconstruction. London: Academic Press] suggested that persons who stutter experience a lack of meaningfulness of their fluent speaker role and demonstrated that a Personal Construct Psychology approach to therapy with persons who stutter may be useful. Few studies, however, have investigated her claims. This study investigated the "meaningfulness" with which fluent and disfluent persons were able to construe themselves in stuttering and non-stuttering speaker roles. Results indicated that persons who stuttered displayed greater cognitive anxiety (difficulty integrating their experience meaningfully) in a fluent speaking role than in a stuttering role, whereas the reverse was found for fluent speakers. These results suggest the relevance of assessing and addressing the meaningfulness of the "dominant" disfluent speaker role in treating persons who stutter, insofar as a tendency to maintain the predictability of this familiar role may contribute to stuttering maintenance and relapse. The refined guidelines developed for applying the Cognitive Anxiety Scale to the content analysis of self-descriptions of persons who stutter can make a practical contribution to this effort. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) describe the potential influence of speaker roles in the maintenance of stuttering; (2) define cognitive anxiety and how it relates to meaningful interpretations of experience; (3) detect potential signs that a person who stutters may be engaged in "defending" a stutterer role; and (4) describe the clinical implications of this view of stuttering maintenance.

Adult↗
PubMed2026

Robust inference and correlates from genetic associations with personality.

Personality traits describe stable differences in how people think, feel and behave, and how they interact with and experience their social and physical environments1,2. Many questions remain unanswered about associations between DNA and personality traits, such as their robustness, their generalizability and the biological and social pathways through which they act. Here we meta-analyse data across 46 cohorts comprising 611,037 to 1.14 million participants with European-like and African-like genomes for genome-wide association studies (GWAS) of the Big Five personality traits (extraversion, agreeableness, conscientiousness, neuroticism and openness to experience), and data from up to 50,725 participants for within-family GWAS. We identify 1,260 lead genetic variants associated with personality, including 824 novel variants3. Common genetic variants explain a moderate 4.8-9.3% of the variance in measures of each trait, and 9.3-13.3% among instruments with typical measurement reliability. Genetic associations with personality are highly consistent but not identical across geography, reporter (self versus close other), age group and measurement instrument, and we find minimal spousal assortment for personality in recent history. In contrast to many other social and behavioural traits4,5, within-family GWAS and polygenic index analyses indicate that genetic associations with personality are minimally confounded by the shared family environment. Polygenic prediction, genetic correlation and Mendelian randomization analyses indicate that personality traits have widespread, potentially causal associations with consequential behaviours and life outcomes. Overall, we find that the genetic architecture of personality is robustly generalizable, minimally confounded and widely relevant to human experience.

Journal Article↗
PubMedDate not supplied

The relationships between personal PM exposures for elderly populations and indoor and outdoor concentrations for three retirement center scenarios.

Personal exposures, indoor and outdoor concentrations, and questionnaire data were collected in three retirement center settings, supporting broader particulate matter (PM)--health studies of elderly populations. The studies varied geographically and temporally, with populations studied in Baltimore, MD in the summer of 1998, and Fresno, CA in the winter and spring of 1999. The sequential nature of the studies and the relatively rapid review of the mass concentration data after each segment provided the opportunity to modify the experimental designs, including the information collected from activity diary and baseline questionnaires and influencing factors (e.g., heating, ventilation, and air-conditioning (HVAC) system operation, door and window openings, air exchange rate) measurements. This paper highlights both PM2.5 and PM10 personal exposure data and interrelationships across the three retirement center settings, and identifies the most probable influencing factors. The current limited availability of questionnaire results, and chemical speciation data beyond mass concentration for these studies, provided only limited capability to estimate personal exposures from models and apportion the personal exposure collections to their sources. The mean personal PM2.5 exposures for the elderly in three retirement centers were found to be consistently higher than the paired apartment concentrations by 50% to 68%, even though different facility types and geographic locations were represented. Mean personal-to-outdoor ratios were found to 0.70, 0.82, and 1.10, and appeared to be influenced by the time doors and windows were open and aggressive particle removal by the HVAC systems. Essentially identical computed mean PM2.5 personal clouds of 3 micrograms/m3 were determined for two of the studies. The proposed significant contributing factors to these personal clouds were resuspended particles from carpeting, collection of body dander and clothing fibers, personal proximity to open doors and windows, and elevated PM levels in nonapartment indoor microenvironments.

Aerosols↗
PubMed2004

Ambient, indoor and personal exposure relationships of volatile organic compounds in Mexico City Metropolitan Area.

Air pollution standards and control strategies are based on ambient measurements. For many outdoor air pollutants, individuals are closer to their sources (especially traffic) and there are important indoor sources influencing the relationship between ambient and personal exposures. This paper examines the relationship between volatile organic compounds (VOCs) measured at central site monitoring stations and personal exposures in the Mexico City Metropolitan Area. Over a 1-year period, personal exposures to 34 VOCs were measured for 90 volunteers from 30 families living close to one of five central monitoring stations. Simultaneous 24-h indoor, outdoor and central site measurements were also taken. Dual packed thermal desorption tubes and C(18) DNPH-coated cartridges were used for sampling VOCs and these were analyzed by GC/MS and HPLC, respectively. A factor analysis of the personal exposure data aided in grouping compounds by the most likely source type: vehicular (BTEX, styrene and 1,3-butadiene), secondary formed or photochemical (most aldehydes), building materials and consumer products (formaldehyde and benzaldehyde), cleaning solvents (tetrachloroethene and 1,1,1-trichloroethane), volatilization from water (chloroform and trichloroethene) and deodorizers (1,4-dichlorobenzene). Mean ambient, indoor and personal concentrations were 7/7/14 microg/m(3) for benzene, 1/3/3 for 1,3-butadiene, 6/20/20 for formaldehyde and 3/9/50 for 1,4-dichlorobenzene. Geometric mean (GM) ambient concentrations of trichloroethene and carbon tetrachloride were similar to GM personal exposures. While outdoor and indoor home GM concentrations for most vehicular related compounds (benzene, MTBE, xylenes and styrene) were comparable, the GM personal exposures were twice as high. Indoor concentrations of 1,3-butadiene, 1,1,1-trichloroethane, tetrachloroethane, chloroform, formaldehyde, valeraldehyde, propionaldehyde and n-butyraldehyde were comparable to personal exposures. For certain compounds, such as chloroform, aldehydes, toluene, 1,3-butadiene and 1,4-dichlorobenzene, GM personal exposures were more than two times greater than GM ambient measurements.

Adolescent↗
PubMed2005

Personal exposure to PM2.5, black smoke and NO2 in Copenhagen: relationship to bedroom and outdoor concentrations covering seasonal variation.

Epidemiological studies have found negative associations between human health and particulate matter in urban air. In most studies outdoor monitoring of urban background has been used to assess exposure. In a field study, personal exposure as well as bedroom, front door and background concentrations of PM(2.5), black smoke (BS), and nitrogen dioxide (NO(2)) were measured during 2-day periods in 30 subjects (20-33 years old) living and studying in central parts of Copenhagen. The measurements were repeated in the four seasons. Information on indoor exposure sources such as environmental tobacco smoke (ETS) and burning of candles was collected by questionnaires. The personal exposure, the bedroom concentration and the front door concentration was set as outcome variable in separate models and analysed by mixed effect model regression methodology, regarding subject levels as a random factor. Seasons were defined as a dichotomised grouping of outdoor temperature (above and below 8 degrees C). For NO(2) there was a significant association between personal exposure and both the bedroom, the front door and the background concentrations, whereas for PM(2.5) and BS only the bedroom and the front door concentrations, and not the background concentration, were significantly associated to the personal exposure. The bedroom concentration was the strongest predictor of all three pollution measurements. The association between the bedroom and front door concentrations was significant for all three measurements, and the association between the front door and the background concentrations was significant for PM(2.5) and NO(2), but not for BS, indicating greater spatial variation for BS than for PM(2.5) and NO(2). For NO(2), the relationship between the personal exposure and the front door concentration was dependent upon the "season", with a stronger association in the warm season compared with the cold season, and for PM(2.5) and BS the same tendency was seen. Time exposed to burning of candles was a significant predictor of personal PM(2.5), BS and NO(2) exposure, and time exposed to ETS only associated with personal PM(2.5) exposure. These findings imply that the personal exposure to PM(2.5), BS and NO(2) depends on many factors besides the outdoor levels, and that information on, for example, time of season or outdoor temperature and residence exposure, could improve the accuracy of the personal exposure estimation.

Adult↗
PubMed2005

Burden of support for partners of persons with spinal cord injuries.

STUDY DESIGN: Cross-sectional survey. OBJECTIVES: (1) To describe the support given to persons with spinal cord injuries (SCI) by their partners, (2) to describe the perceived burden of support by partners and (3) to examine predictors of perceived burden of support. SETTING: The Netherlands. METHODS: All members of the Dutch patients organisation DON (N = 1004) and their caregivers, if applicable, were invited. Physical disability of the person with SCI was measured using the Barthel Index (BI). A number of secondary conditions, other practical problems and psychosocial problems were recorded. Partner support was described using a list of ADL-support, other practical support and emotional support. Burden of support was measured by a six-item measure (Cronbach's alpha 0.92), Nonparametric descriptive statistics and correlations were used. Linear regression was used to identify predictors of caregiver burden. RESULTS: Responses were obtained from 461 persons with SCI. Of 265 couples, patient as well as partner data were available. Mean age of the partners was 49.4 years (SD 12.2) and 69.8% were women. Mean BI of the persons with SCI was 12.3 (SD 4.7) on a 0-20 scale and 60.4% were seriously disabled (BI < 15). Most partners provided various kinds of support. ADL-support and other practical support were given much more often by partners of persons with serious disability, but less difference was seen regarding emotional support. Professional (paid) support was obtained by 45.3% of all couples. Perceived burden of support was high in 24.8% of partners of persons with serious disabilities against 3.9% of partners of persons with minor disabilities. Significant predictors of caregiver burden were (in order of importance) the amount of ADL support given, psychological problems of the patient, partner age, partner gender, BI score and time after injury (total explained variance 47%). CONCLUSION: A substantial proportion of partners of persons with SCI suffer from serious burden of support. Prevention of caregiver burnout should be part of the lifelong care for persons with SCI.

Activities of Daily Living↗
PubMed2003

Quality of care for older persons at the dawn of the third millennium.

During the past quarter century, researchers, providers, insurers, and governmental agencies have devoted considerable effort to improving and standardizing the quality of health care provided to older persons. Because older persons differ from younger persons as a result of their life expectancy, disease prevalence and comorbidity, social resources, goals of treatment, and preferences for care, defining and measuring quality of care has been more difficult for this age group. Nevertheless, several decades of research have led to reliable, although imperfect, methods of measuring quality, including those for geriatric conditions. Using these measurement approaches, a variety of studies using different patient populations and sampling strategies have consistently identified deficiencies in quality of care provided to older persons. Moreover, efforts to improve quality of care for older persons have been difficult to design, implement, and sustain. Some have been successful, including having effects on outcome measures, but have not made the transition from research to clinical settings. Others have used quality improvement methods to improve the care of diseases (e.g., diabetes mellitus, congestive heart failure) that commonly affect older persons. However, the lack of alignment of incentives between providers and insurers for most older persons is a major barrier to this approach. In addition, there is no concerted effort among providers, regulatory agencies, and insurers to move the quality-of-care agenda for most Medicare recipients. Despite substantial progress in defining and measuring high-quality care for older persons, the goal of ensuring that older persons receiving such care remains a distant hope.

Aged↗
PubMed1996

College students' judgements and perceptions of persons with AIDS from different risk groups.

In this analog study, 104 female and 75 male undergraduate students in the United States read 1 of 8 vignettes that described a person who had just received positive HIV antigen results. The vignettes were identical except for the sex of the person described and his or her risk-group membership (gay, heterosexual, injection-drug user, or hemophiliac). After reading the vignette, the participants completed questionnaires assessing (a) responsibility, blame, and personality characteristics of the person described in the vignette; and (b) their own homophobia and knowledge about AIDS. Results revealed that homophobia was a significant covariate that affected participants' perceptions of the person in the vignette. With homophobia as a covariate, the hemophiliac was judged the least harshly, followed by the heterosexual person, the gay person, and the injection-drug user. No gender differences were revealed. The injection-drug user was evaluated the most negatively on the personality characteristics; the other 3 groups were rated similarly. Analyses without homophobia as a covariate revealed significant gender differences, suggesting that prior research findings of gender differences on perceptions of persons with AIDS may be attributable more to differential levels of homophobia than to gender of the rater.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Persons with screening-detected haemochromatosis: as healthy as the general population?

BACKGROUND: Hereditary haemochromatosis (HH) is a common genetic disease leading to iron deposition in the liver and other organs. Early treatment will prevent clinical disease and population-based screening for HH has been advocated. However, the benefit of screening depends on the morbidity of HH. We have compared the morbidity in HH persons detected by screening with the morbidity in the rest of the population. METHODS: All inhabitants 20 years or older in a Norwegian county (94,191 persons) were invited to participate in a health survey programme. Of 65,717 participating persons, a blood specimen for transferrin saturation was obtained from 65,238. After repeated laboratory testing and clinical examination, 269 persons were found to have phenotypic HH, while 297 had genotypic HH (the C282/C282Y mutation). Using self-reported data, clinical examinations and analysis of non-fasting blood samples, the morbidity in phenotypic and genotypic HH persons was compared with the morbidity in the rest of the population. All data were collected before subjects were diagnosed with HH, and all comparisons were corrected for age and gender. RESULTS: Compared to control persons, phenotypic and genotypic HH men and women had a higher score on 1 of 17 questions dealing with joint complaints. Phenotypic and genotypic HH women below 50 years of age had a higher prevalence of hypothyroidism (15.2% and 12.5%, respectively, compared to 3.0% in the control population). Phenotypic HH women below 50 years of age had higher diastolic blood pressure than control women. Phenotypic HH men above 50 years of age and genotypic HH men scored lower than control men on a compound myocardial infarction risk score variable, in part due to lower serum cholesterol concentration. Fewer phenotypic HH men above 50 years of age reported having angina pectoris. Otherwise, the health of phenotypic and genotypic HH persons was not different from the health of control persons. CONCLUSION: When corrected for age and gender, the morbidity in persons with screening-detected HH was not very different from the morbidity in the control group, indicating that population-based screening may not be as beneficial as anticipated.

Adult↗
PubMed2004

Accuracy of world-wide-web death searches for persons with traumatic brain injury.

PRIMARY OBJECTIVE: Determine (1) the sensitivity of world-wide-web searches for deaths among persons with traumatic brain injuries and (2) factors associated with the likelihood of identifying deceased persons with traumatic brain injuries. RESEARCH DESIGN: Stratified case series. METHODS AND PROCEDURES: Sequential submission of 371 deceased persons with traumatic brain injuries to a world-wide-web site to determine inclusion in the Social Security Death Index (SSDI). MAIN OUTCOMES AND RESULTS: Almost 87% of deceased persons ages 50+ were found, 69.8% of persons ages 30-49 and 34.6% of persons younger than age 30. Other factors influencing the likelihood of finding deceased persons in the SSDI were male gender, white race, being married, knowing the Social Security number and survival of 1+ years post-injury. CONCLUSIONS: The SSDI provides useful information for mortality studies among persons with traumatic brain injuries, but does a poor job of identifying deaths among younger persons. Sole reliance on the SSDI may result in under-ascertainment of mortality.

Adolescent↗
PubMed2000

Hourly personal exposures to fine particles and gaseous pollutants--results from Baltimore, Maryland.

A study to characterize 1-hr multi-pollutant exposures was performed in Baltimore, MD, during the summer of 1998 and the winter of 1999, and was conducted over a 15-day period in each of the two seasons. Personal exposures were measured by a trained field technician, who wore a newly developed Roll-Around System (RAS) to measure 1-hr PM2.5 and gaseous (CO, O3, NO2, SO2, volatile organic compounds [VOCs]) exposures. One-hour O3, NO2, and SO2 personal exposures were measured using samplers developed in our laboratory, while short-term PM2.5, CO, and VOCs exposures were measured using currently available monitors. All 1-hr multi-pollutant exposures were measured while the technician performed pre-determined activities, beginning at 7:00 a.m. and ending at 7:00 p.m. of the same day. Activities were scripted to simulate activities performed by older adults (65+ years of age). Corresponding 1-hr ambient pollutant concentrations were obtained from federal or state monitoring networks. In this paper, we discuss the results from our study and present our descriptive analysis of the 1-hr personal particulate and gaseous exposure data. Personal PM2.5, O3, CO, and VOCs exposures showed substantial variability over the 12-hr sampling periods. Multiple pairwise comparison tests showed that 1-hr personal O3 exposures were significantly lower in indoor microenvironments as compared with outdoor microenvironments. One-hour personal CO exposures measured in vehicles were significantly higher than those measured in other microenvironments. The associations between 1-hr personal exposures and corresponding ambient concentrations differed by pollutant and by microenvironment. For example, the correlation between personal PM2.5 exposures and ambient concentrations was lowest (rs = 0.36, p < 0.05) in the winter for indoor non-residential microenvironments, and was highest (rs = 0.90, p < 0.05) in the winter for in-vehicle microenvironments. For O3, the correlation between personal exposures and ambient levels was weakest in the winter for residential microenvironments (rs = 0.05, p > 0.05), and was strongest in the summer for outdoor near-roadway microenvironments (rs = 0.91, p < 0.05).

Activities of Daily Living↗
PubMed2000

Assessing the relationship between personal particulate and gaseous exposures of senior citizens living in Baltimore, MD.

We conducted a multi-pollutant exposure study in Baltimore, MD, in which 15 non-smoking older adult subjects (> 64 years old) wore a multi-pollutant sampler for 12 days during the summer of 1998 and the winter of 1999. The sampler measured simultaneous 24-hr integrated personal exposures to PM2.5, PM10, SO4(2-), O3, NO2, SO2, and exhaust-related VOCs. Results of this study showed that longitudinal associations between ambient PM2.5 concentrations and corresponding personal exposures tended to be high in the summer (median Spearman's r = 0.74) and low in the winter (median Spearman's r = 0.25). Indoor ventilation was an important determinant of personal PM2.5 exposures and resulting personal-ambient associations. Associations between personal PM2.5 exposures and corresponding ambient concentrations were strongest for well-ventilated indoor environments and decreased with ventilation. This decrease was attributed to the increasing influence of indoor PM2.5 sources. Evidence for this was provided by SO4(2-) measurements, which can be thought of as a tracer for ambient PM2.5. For SO4(2-), personal-ambient associations were strong even in poorly ventilated indoor environments, suggesting that personal exposures to PM2.5 of ambient origin are strongly associated with corresponding ambient concentrations. The results also indicated that the contribution of indoor PM2.5 sources to personal PM2.5 exposures was lowest when individuals spent the majority of their time in well-ventilated indoor environments. Results also indicate that the potential for confounding by PM2.5 co-pollutants is limited, despite significant correlations among ambient pollutant concentrations. In contrast to ambient concentrations, PM2.5 exposures were not significantly correlated with personal exposures to PM2.5-10, PM2.5 of non-ambient origin, O3, NO2, and SO2. Since a confounder must be associated with the exposure of interest, these results provide evidence that the effects observed in the PM2.5 epidemiologic studies are unlikely to be due to confounding by the PM2.5 co-pollutants measured in this study.

Aged↗
PubMed2001

Personal exposure levels and microenvironmental concentrations of formaldehyde and acetaldehyde in the Helsinki metropolitan area, Finland.

Personal 48-hr exposures to formaldehyde and acetaldehyde of 15 randomly selected participants were measured during the summer/autumn of 1997 using Sep-Pak DNPH-Silica cartridges as a part of the EXPOLIS study in Helsinki, Finland. In addition to personal exposures, simultaneous measurements of microenvironmental concentrations were conducted at each participant's residence (indoor and outdoor) and workplace. Mean personal exposure levels were 21.4 ppb for formaldehyde and 7.9 ppb for acetaldehyde. Personal exposures were systematically lower than indoor residential concentrations for both compounds, and ambient air concentrations were lower than both indoor residential concentrations and personal exposure levels. Mean workplace concentrations of both compounds were lower than mean indoor residential concentrations. Correlation between personal exposures and indoor residential concentrations was statistically significant for both compounds. This indicated that indoor residential concentrations of formaldehyde and acetaldehyde are a better estimate of personal exposures than are concentrations in ambient air. In addition, a time-weighted exposure model did not improve the estimation of personal exposures above that obtained using indoor residential concentrations as a surrogate for personal exposures. Correlation between formaldehyde and acetaldehyde was statistically significant in outdoor microenvironments, suggesting that both compounds have similar sources and sinks in ambient urban air.

Acetaldehyde↗
PubMed2003

Line bisection performance in patients with personality disorders.

INTRODUCTION: Normal line bisection deviation to the left of the true centre has been interpreted as resulting from relative right hemisphere activation. Right hemisphere involvement has also been associated with the problems in dependency and attachment from infancy to adulthood. This hemispheric association predicts that patients diagnosed with dependent personality disorder will deviate significantly to the left on the line bisection task. METHODS: This hypothesis was tested by comparing the results of the line bisection task obtained respectively from 30 right-handed healthy volunteers and 14, 16, 18, and 26 outpatients with schizotypal, antisocial, borderline, and dependent personality disorders. Subjects completed eight horizontal line bisection tasks and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ), a self-report measure of 18 traits delineating personality disorder. RESULTS: Patients with dependent personality disorder bisected significantly leftward compared to healthy controls. Dependent personality disorder patients scored significantly higher on DAPP-BQ Insecure Attachment, and lower on DAPP Stimulus Seeking, Callousness, Intimacy Problems, and Conduct Problems compared to the healthy controls and all other patient groups. CONCLUSIONS: Line bisection differentiates dependent personality disorder from other personality disorder diagnoses and healthy controls. This study thus suggests that line bisection can be used to enhance diagnostic specificity of dependent personality disorder and localises the brain areas implicated in the disorder.

Journal Article↗
PubMed1995

Preventing bacterial respiratory tract infections among persons infected with human immunodeficiency virus.

Bacterial respiratory tract infections occur frequently in persons infected with human immunodeficiency virus (HIV) and may be caused by a wide variety of pathogens. Pneumonia is the most commonly diagnosed respiratory infection in HIV-infected persons and is more common in those persons than in non-HIV-infected ones. HIV-infected persons have a much higher risk of pneumococcal disease than do noninfected controls, and disease may occur relatively early in the course of HIV infection. While mortality associated with the disease does not seem to be high among HIV-infected persons, there is a higher rate of recurrence of the disease in that population. Risk factors for pneumococcal disease in HIV-infected persons are not well characterized. Though efficacy data are limited, the 23-valent polysaccharide pneumococcal vaccine is recommended for use early in the course of HIV infection. There are no data suggesting that HIV-infected persons should be revaccinated routinely. Antiretroviral agents may enhance the immunologic response to the polysaccharide vaccine. Prophylactic antibiotics may have a role in preventing recurrences of severe bacterial respiratory infections, and intravenous immunoglobulin may be useful in preventing serious bacterial infections in HIV-infected children. HIV-infected persons are also at greater risk for serious infections with Haemophilus influenzae than are non-HIV-infected persons. Vaccination against H. influenzae type b (Hib) is recommended for HIV-infected children but not for adults. Antimicrobial drug-resistant strains of Streptococcus pneumoniae and H. influenzae have become more prevalent recently and consequently have impacted on strategies for prevention and treatment of those infections.

Adult↗