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Does social problem solving mediate the relationship between personality traits and personality disorders?

PERSONALITY AND MENTAL HEALTH, Issue 3 2010
An exploratory study with a sample of male prisoners
Background Social problem solving therapy is one helpful approach to treating people with personality disorders (PD). Consequently, it is worthwhile to develop a greater understanding of the role of social problem solving in PD. One hypothesis is that social problem solving mediates the relationship between personality dimensions and personality disorder. This premise was explored in a sample of male prisoners, a population known to have a high prevalence of PD. Method Sixty-eight men completed the International Personality Disorder Examination (IPDE), NEO-Five Factor Inventory (NEO-FFI) and the Social Problem-Solving Inventory,Revised: Short Version (SPSI-R:S). The data were explored for direct and indirect mediational effects of social problem solving variables in the personality dimension,PD relationship, using methods appropriate for small samples and multiple mediators. Results A number of relationships between personality dimensions, social problem solving, and personality disorder traits were identified, but only for paranoid, schizotypal, borderline, narcissistic, and avoidant PDs. Discussion These findings support the hypothesis that social problem solving mediates between personality dimensions and some PDs. Further research is necessary to verify these relationships. However, these findings begin to clarify the mechanisms by which personality dimensions relate to PDs. This knowledge has potential to contribute to the development of more effective interventions for people with particular personality dimensions and specific personality disorders. Copyright © 2010 John Wiley & Sons, Ltd. [source]


Alcohol, suppressed anger and violence

ADDICTION, Issue 9 2010
Thor Norström
ABSTRACT Aims Is alcohol related causally to violence, and if so, is the effect of drinking contingent on suppressed anger such that it is strongest among individuals who are highly inclined to withhold angry feelings? We addressed these questions by analysing panel data using a method that diminishes the effects of confounding factors. Design We analysed data on heavy episodic drinking and violent behaviour from the second (1994) and third (1999) waves of the Young in Norway Longitudinal Study (n = 2697; response rate: 67%). The first difference method was applied to estimate the association between these behaviours, implying that changes in the frequency of violence were regressed on changes in the frequency of drinking. Hence, the effects of time-invariant confounders were eliminated. Analyses were conducted for the whole sample, and for groups scoring low, medium and high on a short version of the STAXI anger suppression scale. Findings Changes in drinking were related positively and significantly to changes in violent behaviour, but the alcohol effect varied with the level of suppressed anger: it was strongest in the high-anger group (elasticity estimate = 0.053, P = 0.011) and weakest (and insignificant) in the low-anger group (elasticity estimate = 0.004, P = 0.806). Conclusions Alcohol use may be related causally to violence, but the effect of drinking is confined to individuals who are inclined to suppress their angry feelings. [source]


The carboxy-terminal tail region of human Cav2.1 (P/Q-type) channel is not an essential determinant for its subcellular localization in cultured neurones

GENES TO CELLS, Issue 2 2005
Qiuping Hu
A recent report on the mechanism of synaptic targeting of Cav2.2 channel suggested that this process depends upon the presence of long C-terminal tail and that protein interactions mediated by SH3-binding and PDZ-binding motifs in the tail region are important. To examine the possibility that C-terminal tail of the Cav2.1 channel and the polyglutamine stretch therein are also involved in the mechanism for channel localization, we constructed several expression plasmids for human Cav2.1 channel tagged with enhanced green fluorescent protein (EGFP) and introduced them into mouse hippocampal neuronal culture. HC construct encodes short version of Cav2.1, and HS and HL encode Cav2.1 channel with a long C-terminal tail, which contains polyglutamine tract of 13 (normal range) and 28 (SCA6 disease range) repeat units, respectively. Surprisingly, transfection with HC, HS, and HL gave essentially the same results: EGFP signal was observed in cell soma, dendrites, and the axon as well. Furthermore, mutation of the PDZ-binding motif located at the C-terminus of the long version of Cav2.1, by adding FLAG tag, did not affect the localization patterns of HS and HL as well. Therefore, the C-terminal region is not indispensable for the subcellular localization of Cav2.1 channel, nor expansion of polyglutamine length affected the localization of the channel. Thus, it is possible that the localization mechanism of Cav2.1 channel is different from that of Cav2.2, though these channels share various structural and functional characteristics. [source]


AQS security scores: What do they represent?

INFANT MENTAL HEALTH JOURNAL, Issue 3 2004
A study in construct validation
In a sample of 129 Dutch 15-month-old infants, attachment security was assessed both with the Attachment Q-Set (AQS; Waters, 1995) and with a short version of Ainsworth, Blehar, Waters, and Wall's (1978) Strange Situation (SSS). Infants classified as secure using the SSS had significantly higher AQS scores than insecure and disorganized infants in particular. At the AQS item level, disorganized infants were described as significantly more noncompliant, fussy, and angry relative to secure infants. When security as assessed using the SSS was controlled, the observed quality of parental interactive behavior, parental ego-resilience, high levels of infant task orientation and pleasure, and low levels of infant anger proneness were found to explain significant and unique portions of the variance in the AQS security scores. The apparently unfavorable set of characteristics associated with low AQS security scores suggests such scores to predict later developmental problems. ©2004 Michigan Association for Infant Mental Health. [source]


Older people's expectations regarding ageing, health-promoting behaviour and health status

JOURNAL OF ADVANCED NURSING, Issue 1 2009
Su Hyun Kim
Abstract Title.,Older people's expectations regarding ageing, health-promoting behaviour and health status. Aim., This paper is a study to explore the influence of expectations regarding ageing on physical and mental health status, and to examine the mediating effects of health-promoting behaviour on the relationship between these expectations and physical and mental health. Background., To achieve healthy ageing, it is necessary for older people to play an active role in maintaining good health. Without any expectations for healthy ageing among older people themselves, encouraging them to participate in health-promoting behaviour and thereby to maintain good health would be unsuccessful. Method., A convenience sample of 99 community-residing Korean older people was surveyed in 2007 via questionnaire using a short version of the Expectations Regarding Aging questionnaire, Health Promoting Lifestyle Profile II, and Medical Outcomes Study 12-item short form. Findings., Having a higher expectation about ageing was associated with better physical and mental health, after adjusting for age, gender and education. Expectations about ageing were partially mediated through the health-promoting behaviour that influenced physical and mental health. Conclusion., It may be necessary for nurses to make an effort to improve older people's expectations about ageing to help them achieve good health. Nursing interventions to improve these expectations need to be used in conjunction with an emphasis on older people's active involvement in health-promoting behaviour. [source]


Effect of Fish Oil Supplementation on Quality of Life in a General Population of Older Dutch Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009
Ondine Van De Rest MSc
OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Independently living individuals from the general older Dutch population. PARTICIPANTS: Three hundred two individuals aged 65 and older without depression or dementia. INTERVENTION: 1,800 mg/d EPA-DHA (n=96), 400 mg/d EPA-DHA (n=100), or placebo capsules (n=106) for 26 weeks. MEASUREMENTS: QOL was assessed using the short version of the World Health Organization QOL questionnaire (WHOQOL-BREF). The WHOQOL-BREF covers four domains: physical health, psychological health, social relationships, and satisfaction with environment. The total score range is 26 to 130, with higher scores indicating a more favorable condition. RESULTS: Mean age of the participants was 70, and 55% were male. Plasma concentrations of EPA-DHA increased 238% in the high-dose and 51% in the low-dose EPA-DHA group, reflecting excellent adherence. Median baseline total WHOQOL scores ranged from 107 to 110 in the three groups and were not significantly different from each other. After 26 weeks, the mean difference from placebo was ,1.42 (95% confidence interval (CI)=,3.40,0.57) for the high-dose and 0.02 (95% CI=,1.95,1.99) for the low-dose fish oil group. Treatment with 1,800 mg or 400 mg EPA-DHA did not affect total QOL or any of the separate domains after 13 or 26 weeks of intervention. CONCLUSION: Supplementation with high or low doses of fish oil for 26 weeks did not influence the QOL of healthy older individuals. [source]


Advanced home care: patients' opinions on quality compared with those of family members

JOURNAL OF CLINICAL NURSING, Issue 2 2004
Bodil Wilde Larsson PhD
Background., Advanced medical care in the patient's home setting is becoming more common. Many of the patients who receive this kind of care have severe illnesses and are unable to respond to questions about the quality of care. The research question was: are the patients' opinions congruent with those of family members? Aim., To explore and compare the relationship between patients' perception of the quality of care and close family members' perception of this care as well as their perception of the patients' perception. Methods., Sixty-seven patients receiving advanced home care, 82 family members (54 matched patient + family member pairs) participated. Data were collected using a short version of the quality from the patient's perspective questionnaire modified to advanced home care. Results., A high degree of perceptual congruence was found between patients and their family members. The similarity was also high between family members' own opinion and their appraisal of how the patient perceived the care. A subgroup of family members who met the patient once a week or less often deviated from this pattern. Conclusion., Patients' views on the quality of care are congruent with the opinions of family members if they meet every day (live together) and share the same everyday and care-related experiences. The results can be understood in the light of empathic accuracy theory. Relevance to clinical practice., The findings of this study have important implications for clinical nursing practice. Family members' perception of the quality of care may be a valuable data source for nurses in the case of advanced home care if the patient and family member share the same everyday, care-related experiences, otherwise family members' perception tend to be more critical than those of the patients themselves. [source]


Life satisfaction of people with intellectual disability living in community residences: perceptions of the residents, their parents and staff members

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2003
C. Schwartz
Abstract Background Within the literature on quality of life (QoL), life satisfaction (LS) has emerged as a key variable by which to measure perceived well-being, which is referred to as subjective QoL. The LS self-reports of 93 residents with intellectual disability (ID) living in community-based residences were compared with reports about their LS completed by their staff and parents. Method The residents were interviewed on their LS by social workers who did not belong to the staff of the interviewee's residence. The instrument used was the Life Satisfaction Scale (LSS). Staff and parents completed the short version of the LSS. Results Residents and staff's LS reports were positively correlated. However, significant differences were found between these two groups of informants when the residents were characterized as high functioning, had a low score in challenging behaviour, worked in an integrative employment setting and lived in an apartment. As opposed to staff/resident discrepancies, no differences were found between parents' and residents' LS reports. Conclusions If residents cannot to be interviewed about their LS, then the parent is the preferred person to respond on behalf of the resident. The current study highlights the importance of including both objective measures (e.g. functional assessment characteristics) and subjective measures (e.g. LS) in order to get a better understanding of the QoL of people with ID. [source]


The Alcohol Use Disorders Identification Test: An Update of Research Findings

ALCOHOLISM, Issue 2 2007
Duane F. Reinert
Background: The Alcohol Use Disorders Identification Test (AUDIT) has been extensively researched to determine its capability to accurately and practically screen for alcohol problems. Methods: During the 5 years since our previous review of the literature, a large number of additional studies have been published on the AUDIT, abbreviated versions of it, its psychometric properties, and the applicability of the AUDIT for a diverse array of populations. The current article summarizes new findings and integrates them with results of previous research. It also suggests some issues that we believe are particularly in need of further study. Results: A growing body of research evidence supports the criterion validity of English version of the AUDIT as a screen for alcohol dependence as well as for less severe alcohol problems. Nevertheless, the cut-points for effective detection of hazardous drinking as well as identification of alcohol dependence or harmful use in women need to be lowered from the originally recommended value of 8 points. The AUDIT-C, the most popular short version of the AUDIT consisting solely of its 3 consumption items, is approximately equal in accuracy to the full AUDIT. Psychometric properties of the AUDIT, such as test,retest reliability and internal consistency, are quite favorable. Continued research is urged to establish the psychometric properties of non-English versions of the AUDIT, use of the AUDIT with adolescents and with older adults, and selective inclusion of alcohol biomarkers with the AUDIT in some instances. Conclusions: Research continues to support use of the AUDIT as a means of screening for the spectrum of alcohol use disorders in various settings and with diverse populations. [source]


Psychopathology is associated with dyspeptic symptom severity in primary care patients with a new episode of dyspepsia

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2009
S. MUJAKOVIC
Summary Background, Personality and psychiatric disorders are reported to be more common in dyspeptic patients with severe complaints, but it remains unclear whether this association exists for patients with mild and moderate dyspepsia. Aim, To study the association between dyspeptic symptom severity and psychopathology, major life events and coping ability in patients with a new episode of dyspepsia. Methods, Dyspeptic symptom severity was measured using the validated eight symptom Veldhuyzen van Zanten questionnaire. Psychopathology was measured using the Symptom Check List-90 (SCL 90). Major life events were measured with a modified version of the Social Readjustment Rating Scale (SRRS). Coping styles were measured by a short version of the Utrecht Coping Questionnaire, distinguishing six coping styles. Linear regression was used to assess the relationship between dyspepsia symptom severity and psychological factors. Results, In all, 664 patients with a new episode of uninvestigated dyspepsia, aged >18 years were included. Dyspeptic symptom severity was positively correlated with the presence of depression (P < 0.01), somatization symptoms (P < 0.01), use of an active coping style (P < 0.01) and negatively correlated with age (P < 0.01). Conclusions, Primary care patients consulting with dyspepsia have higher levels of depression and somatization especially at younger age. An active coping style is associated with dyspepsia symptom severity. [source]


International validation of ReQuest in patients with endoscopy-negative gastro-oesophageal reflux disease

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2004
K. D. Bardhan
Summary Background :,Reflux Questionnaire (ReQuest), a newly developed gastro-oesophageal reflux disease-sensitive scale, can be used to reliably evaluate the effect of treatment on gastro-oesophageal reflux disease symptoms. Aim :,International validation of this scale, in patients suffering from endoscopy-negative gastro-oesophageal reflux disease. Methods :,In this open, multicentre and multinational clinical trial 840 endoscopy-negative gastro-oesophageal reflux disease patients received pantoprazole 20 mg daily for 28 days. The long and short versions of ReQuest were completed both in the pre-treatment and treatment phases. For scale development an item reduction analysis was performed. Internal consistency, test,retest reliability and responsiveness were calculated for psychometric analysis. Construct validity was evaluated by comparison with the Gastrointestinal Symptom Rating Scale and the Psychological General Well-being questionnaire by means of correlation coefficients. Results :,Factor analyses confirmed the content validity of both long and short version of ReQuest. Psychometric calculations proved high internal consistency (Cronbach's alpha: 0.9), test,retest reliability [Intraclass Correlation Coefficient: 0.9 (long vs. long) and 0.8 (short vs. short)], and responsiveness (Responsiveness Index 320.3) of the scale, for which also good construct validity was achieved (correlation coefficient: Gastrointestinal Symptom Rating Scale ,0.6; Psychological General Well-being ,0.4). Conclusion :,ReQuest proved valid, reliable, and responsive in this multinational clinical trial to evaluate treatment response in endoscopy-negative gastro-oesophageal reflux disease patients. [source]


Assessing fear of falling: Can a short version of the Activities-specific Balance Confidence scale be useful?

MOVEMENT DISORDERS, Issue 12 2006
Chava Peretz PhD
Abstract We present the process of further validation of the 16-item Activities-specific Balance Confidence scale (ABC-16) and a short version (ABC-6) derived by us, to assess balance confidence and fear of falling (FOF). The ABC-16 was administrated to three groups who were anticipated to have a range of balance confidence: 70 patients with higher level gait disorders (HLGDs), 68 healthy controls, and 19 patients with Parkinson's disease (PD). Item reduction was based on identifying items with the lowest scores (high FOF) among the patients. Internal consistency and discriminative validity were assessed using Cronbach's alpha and logistic regression, respectively. The intraclass correlation (ICC) between the short and long versions was assessed using a mixed model approach, accounting for the difference between the scores of the two versions. Six items were found to reflect the most frightening conditions, especially in the patient groups, and to form the short version (ABC-6). Internal consistency of the ABC-16 and ABC-6 were high in the three groups: Cronbach's alpha was between 0.83 and 0.91 and 0.81 and 0.90, respectively. Compared to the control group, the sensitivity of the ABC-16 was 96% for identification of patients with HLGDs (greatest FOF) and 58% for identification of PDs (moderate FOF), based only on the ABC scores. Similar values were obtained for the short version, i.e., 91% for HLGDs and 53% for PDs. ICCs between the short and the long versions was 0.88 (HLGDs), 0.83 (PDs), and 0.78 (Controls). To conclude, the short version of the ABC has properties analogous to the parent questionnaire and is apparently useful in assessing FOF. © 2006 Movement Disorder Society [source]


Burden and coping strategies in mothers of patients with schizophrenia in Japan

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2008
Setsuko Hanzawa phd
Aim:, The present study was conducted to identify factors contributing to burden of care in 57 mothers caring for patients with schizophrenia. Methods:, Members of the Federation of Families of People with Mental Illness in Nagasaki Prefecture were evaluated using well-validated scales to evaluate burden of care (eight-item short version of the Japanese version of the Zarit Caregiver Burden Interview), general health status (General Health Questionnaire 12-item version), difficulty in life, coping strategies, emotional support, and understanding of mental illness and disorders. Results:, Burden of care was significantly associated with general health status and difficulty in life. Conclusion:, On multiple regression it was found that ,social interests' and ,resignation', both of which are the subscales of coping strategies, exerted significant and independent effects with respect to burden of care. [source]


Genetic and attachment influences on adolescents' regulation of autonomy and aggressiveness

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2009
Peter Zimmermann
Background:, Adolescence is a time when intense emotions are elicited within the parent,adolescent relationship, often when autonomy subjectively is endangered. As emotion dysregulation is one of the risk processes for the development of psychopathology, adolescence may be perceived as a highly sensitive period for maladjustment. Inter-individual differences in emotionality and emotion regulation have been shown to be influenced or moderated by molecular genetic differences in the serotonin transporter gene (5-HTT) and by attachment patterns. We investigated whether both the 5-HTT and attachment are associated with emotionality and emotion regulation in an observed adolescent,mother interaction and the personality traits aggressiveness and anxiety in adolescence. Methods:, Ninety-one adolescents at age 12 were observed in interaction with their mothers during a standardized emotion-eliciting social task to assess emotionality and emotion regulation in relation to autonomy. Adolescents' aggressiveness and anxiety were assessed by mother report. Concurrent attachment quality was determined by an attachment interview. DNA samples were collected in order to assess the 5-HTTLPR, a repeat polymorphism in the promoter region of the serotonin transporter gene. Results:, While the short allele of the serotonin transporter gene was associated with a higher overall rate of autonomy behaviors, attachment security was related to more agreeable and less hostile autonomy. A significant interaction revealed a moderating effect of attachment security. Carriers of the short version of the 5-HTTLPR showed more agreeable autonomy when they had a secure attachment behavior strategy but showed more hostile autonomy when they were insecurely attached. Carriers of the short version of the 5-HTTLPR and insecurely attached adolescents were rated as more aggressive. Conclusions:, The study suggests a gene,attachment interaction in adolescents where the adolescent's attachment status moderates a genetically based higher negative reactivity in response to threats to autonomy in social interactions. [source]


Family stigma and care burden of schizophrenia patients: Comparison between Japan and Korea

ASIA-PACIFIC PSYCHIATRY, Issue 3 2009
Setsuko Hanzawa PhD
Abstract Introduction: In the present study, we compared the care burden and stigma experienced by families of patients with schizophrenia in Japan (Niigata) and Korea (Seoul and Daegu) to elucidate similarities and differences in the sociocultural factors that affect the care experience of families in East Asia. Methods: Factors such as care burden (evaluated using the eight-item short version of the Zarit Caregiver Burden Interview [ZBI-8]), stigma, and social distance were evaluated in members of support groups for families of mentally ill individuals in Japan (n=47) and Korea (n=92) using an interview questionnaire. Interviewees reported their personal attitudes (personal stigma and social distance) and perceptions of the attitudes of others in the community (perceived stigma) with respect to a case vignette. These vignettes described a person with chronic schizophrenia. Results: The data analysis revealed the following: (i) feelings of care burden (according to ZBI-8), perceived stigma, and social distance were significantly stronger in Japan compared to Korea, and (ii) feelings of personal stigma were significantly stronger in Korea than in Japan. Discussion: The care burden and stigma experienced by families of patients with schizophrenia differed between Japan and Korea. The present findings suggest that to provide effective support for reducing family stigma and care burden, the necessity of such support must be emphasized in both countries. [source]


Validation of the WHOQOL-BREF among women following childbirth

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010
Joan WEBSTER
Background:, There is increasing interest in measuring quality of life (QOL) in clinical settings and in clinical trials. None of the commonly used QOL instruments has been validated for use postnatally. Aim:, To assess the psychometric properties of the 26-item WHOQOL-BREF (short version of the World Health Organization Quality of Life assessment) among women following childbirth. Methods:, Using a prospective cohort design, we recruited 320 women within the first few days of childbirth. At six weeks postpartum, participants were asked to complete the WHOQOL-BREF, the Edinburgh Postnatal Depression Index and the Australian Unity Wellbeing Index. Validation of the WHOQOL-BREF included an analysis of internal consistency, discriminate validity, convergent validity and an examination of the domain structure. Results:, In all, 221 (69.1%) women returned their six-week questionnaire. All domains of the WHOQOL-BREF met reliability standards (alpha coefficient exceeding 0.70). The questionnaire discriminated well between known groups (depressed women and non-depressed women. P , 0.000) and demonstrated satisfactory correlations with the Australian Unity Wellbeing index (r , 0.45). The domain structure of the WHOQOL-BREF was also valid in this population of new mothers, with moderate-to-high correlation between individual items and the domain structure to which the items were originally assigned. Conclusion:, The WHOQOL-BRF is a well-accepted and valid instrument in this population and may be used in postnatal clinical settings or for assessing intervention effects in research studies. [source]


A randomised trial of two methods of issuing prenatal test results: the ARIA (Amniocentesis Results: Investigation of Anxiety) trial

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2007
J Hewison
Background, Many pregnant women experience anxiety while waiting for the results of diagnostic tests. Policies and practices intended to reduce this anxiety require evaluation. Objectives, To test the following two hypotheses: ,,That giving amniocentesis results out on a fixed date alters maternal anxiety during the waiting period, compared with a policy of telling parents that the result will be issued ,when available' (i.e. variable date). ,,That issuing early results from a rapid molecular test alters maternal anxiety during the waiting period, compared with not receiving any results prior to the karyotype. The effects of the two interventions on anxiety 1 month after receiving karyotype results were also examined. Design, A multicentre, randomised, controlled, open fixed sample, 2 × 2 factorial design trial, with equal randomisation. Setting, The prenatal diagnosis clinics in 12 hospitals in England offering amniocentesis as a diagnostic test for Down's syndrome. Sample, Two hundred and twenty-six women who had had an amniocentesis were randomised between June 2002 and July 2004. Eight women with abnormal results or test failure were excluded postrandomisation. Interventions, Issuing karyotype results on a prespecified fixed date, rather than issuing them as soon as they became available. Issuing karyotype results alone, or subsequent to issuing results from a rapid molecular test for the most common chromosomal abnormalities. Main outcome measures, Average anxiety during the waiting period, calculated using daily scores from the short version of the Spielberger State-Trait Anxiety Inventory (STAI). Anxiety 1 month after receiving karyotype results, measured using the short form STAI. Results, Issuing early results from a partial but rapid test reduced maternal anxiety by a clinically significant amount during the waiting period (mean daily score 12.5 versus 14.8; scale score difference ,2.36, 95% CI ,1.2, ,3.6), compared with receiving only the full karyotype results. There was no evidence that giving out karyotype results on a fixed or on a variable date altered maternal anxiety during the waiting period (mean daily score 13.2 versus 14.2; scale score difference ,1.02, 95% CI ,2.2, 0.2). One month after receiving normal karyotype results, anxiety was low in all groups, but women who had been given rapid test results tended to be more anxious than those who had not (mean single day score 9.2 versus 8.3; mean scale score difference 0.95, 95% CI ,0.03, 1.9). This small to moderate effect did not reach conventional levels of statistical significance. Conclusions, Rapid testing was a beneficial addition to karyotyping, at least in the short term. This does not necessarily imply that early results would be preferred to comprehensive ones if women had to choose between them. Because there are no clear advantages in anxiety terms of issuing karyotype results as soon as they become available, or on a fixed date, women could be given a choice between them. [source]


Multicenter Study of Limited Health Literacy in Emergency Department Patients

ACADEMIC EMERGENCY MEDICINE, Issue 6 2008
Adit A. Ginde MD
Abstract Objectives:, The objective was to evaluate the prevalence of limited health literacy and its association with sociodemographic variables in emergency department (ED) patients. Methods:, This was a cross-sectional survey in three Boston EDs. The authors enrolled consecutive adult patients during two 24-hour periods at each site. They measured health literacy by the short version of the Test of Functional Health Literacy in Adults (S-TOFHLA). Using multivariate logistic regression, the authors evaluated associations between sociodemographic variables and limited health literacy, as classified by S-TOFHLA scores. Results:, The authors enrolled 300 patients (77% of eligible). Overall, 75 (25%; 95% confidence interval [CI] = 20% to 30%) of participants had limited health literacy. Limited health literacy was independently associated with older age (compared to 18,44 years, odds ratio [OR] 4.3 [95% CI = 2.0 to 9.2] for 45,64 years and OR 3.4 [95% CI = 1.4 to 8.5] for ,65 years), less education (compared to high school graduates, OR 2.7 [95% CI = 1.1 to 7.3] for some high school or lower and OR 0.43 [95% CI = 0.21 to 0.88] for some college or higher), and lower income (OR 2.8 [95% CI = 1.2 to 6.6] for ,$40,000 compared to >$40,000). Although ethnicity, race, and language were associated with limited health literacy in unadjusted analyses, the associations were not significant on multivariate analysis. Conclusions:, In this sample, one-quarter of ED patients would be expected to have difficulty understanding health materials and following prescribed treatment regimens. Advanced age and low socioeconomic status were independently associated with limited health literacy. The ability of a significant subgroup of ED patients to understand health information, especially during illness or injury, requires further study. [source]


Individual differences in allocation of funds in the dictator game associated with length of the arginine vasopressin 1a receptor RS3 promoter region and correlation between RS3 length and hippocampal mRNA

GENES, BRAIN AND BEHAVIOR, Issue 3 2008
A. Knafo
Human altruism is a widespread phenomenon that puzzled evolutionary biologists since Darwin. Economic games illustrate human altruism by showing that behavior deviates from economic predictions of profit maximization. A game that most plainly shows this altruistic tendency is the Dictator Game. We hypothesized that human altruistic behavior is to some extent hardwired and that a likely candidate that may contribute to individual differences in altruistic behavior is the arginine vasopressin 1a (AVPR1a) receptor that in some mammals such as the vole has a profound impact on affiliative behaviors. In the current investigation, 203 male and female university students played an online version of the Dictator Game, for real money payoffs. All subjects and their parents were genotyped for AVPR1a RS1 and RS3 promoter-region repeat polymorphisms. Parents did not participate in online game playing. As variation in the length of a repetitive element in the vole AVPR1a promoter region is associated with differences in social behavior, we examined the relationship between RS1 and RS3 repeat length (base pairs) and allocation sums. Participants with short versions (308,325 bp) of the AVPR1a RS3 repeat allocated significantly (likelihood ratio = 14.75, P = 0.001, df = 2) fewer shekels to the ,other' than participants with long versions (327,343 bp). We also implemented a family-based association test, UNPHASED, to confirm and validate the correlation between the AVPR1a RS3 repeat and monetary allocations in the dictator game. Dictator game allocations were significantly associated with the RS3 repeat (global P value: likelihood ratio ,2 = 11.73, df = 4, P = 0.019). The association between the AVPR1a RS3 repeat and altruism was also confirmed using two self-report scales (the Bardi,Schwartz Universalism and Benevolence Value-expressive Behavior scales). RS3 long alleles were associated with higher scores on both measures. Finally, long AVPR1a RS3 repeats were associated with higher AVPR1a human post-mortem hippocampal messenger RNA levels than short RS3 repeats (one-way analysis of variance (ANOVA): F = 15.04, P = 0.001, df = 14) suggesting a functional molecular genetic basis for the observation that participants with the long RS3 repeats allocate more money than participants with the short repeats. This is the first investigation showing that a common human polymorphism, with antecedents in lower mammals, contributes to decision making in an economic game. The finding that the same gene contributing to social bonding in lower animals also appears to operate similarly in human behavior suggests a common evolutionary mechanism. [source]


International validation of ReQuest in patients with endoscopy-negative gastro-oesophageal reflux disease

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2004
K. D. Bardhan
Summary Background :,Reflux Questionnaire (ReQuest), a newly developed gastro-oesophageal reflux disease-sensitive scale, can be used to reliably evaluate the effect of treatment on gastro-oesophageal reflux disease symptoms. Aim :,International validation of this scale, in patients suffering from endoscopy-negative gastro-oesophageal reflux disease. Methods :,In this open, multicentre and multinational clinical trial 840 endoscopy-negative gastro-oesophageal reflux disease patients received pantoprazole 20 mg daily for 28 days. The long and short versions of ReQuest were completed both in the pre-treatment and treatment phases. For scale development an item reduction analysis was performed. Internal consistency, test,retest reliability and responsiveness were calculated for psychometric analysis. Construct validity was evaluated by comparison with the Gastrointestinal Symptom Rating Scale and the Psychological General Well-being questionnaire by means of correlation coefficients. Results :,Factor analyses confirmed the content validity of both long and short version of ReQuest. Psychometric calculations proved high internal consistency (Cronbach's alpha: 0.9), test,retest reliability [Intraclass Correlation Coefficient: 0.9 (long vs. long) and 0.8 (short vs. short)], and responsiveness (Responsiveness Index 320.3) of the scale, for which also good construct validity was achieved (correlation coefficient: Gastrointestinal Symptom Rating Scale ,0.6; Psychological General Well-being ,0.4). Conclusion :,ReQuest proved valid, reliable, and responsive in this multinational clinical trial to evaluate treatment response in endoscopy-negative gastro-oesophageal reflux disease patients. [source]