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Selected AbstractsThe Oldest Old in the Last Year of Life: Population-Based Findings from Cambridge City over-75s Cohort Study Participants Aged 85 and Older at DeathJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2010Jun Zhao MSc OBJECTIVES: To characterize people of advanced old age in their last year of life and compare those dying in their late 80s with those dying aged 90 and older to inform policy and planning. DESIGN: Retrospective analysis of prospectively collected population-based data from the Cambridge City over-75s Cohort (CC75C) Study, United Kingdom. PARTICIPANTS: Men and women aged 85 and older at death who died less than 1 year after taking part in any CC75C survey (N=321). MEASUREMENTS: Physical health, functional disability, self-rated health, cognitive status. RESULTS: Functional and cognitive impairments were markedly higher for those who died aged 90 and older, predominantly women,than for those who died aged 85 to 89. At least half (49.4,93.6%) of subjects aged 90 and older needed maximum assistance in virtually every daily activity; those aged 85 to 89 needed this only for shopping and laundry. Disability in basic and instrumental activities rose from 59.1% before to 85.4% after the age of 90 and cognitive impairment (Mini-Mental State Examination score ,21) from 41.7% to 69.4%. Despite this and proximity to death, 60.5% and 67.0%, respectively, rated their health positively. Only one in five reported needing more help. CONCLUSION: This study provides new data identifying high levels of physical and cognitive disability in very old people in the year before death. As the very old population rises, so will support needs for people dying in extreme old age. The mismatch between health perceptions and functional limitations suggests that these vulnerable older adults may not seek help from which they could benefit. These findings have major policy and planning implications for end-of-life care for the oldest old. [source] A brief alcohol intervention for hazardously drinking incarcerated womenADDICTION, Issue 3 2010Michael D. Stein ABSTRACT Objective To test the hypothesis that among hazardously drinking incarcerated women who are returning to the community, a brief alcohol intervention will result in less alcohol use at follow-up relative to standard of care. Methods Eligible participants endorsed hazardous alcohol consumption,four or more drinks at a time on at least 3 separate days in the previous 3 months or a score of 8 or above on the Alcohol Use Disorders Identification Test. Participants were randomized to either an assessment-only condition or to two brief motivationally focused sessions, the first delivered during incarceration, the second 1 month later after community re-entry. Participants recalled drinking behaviors at 3 and 6 months after the baseline interview using a 90-day time-line follow-back method. Results The 245 female participants averaged 34 years of age, and were 71% Caucasian. The mean percentage of alcohol use days in the 3 months prior to incarceration was 51.7% and heavy alcohol use days was 43.9%. Intervention effects on abstinent days were statistically significant at 3 months (odds ratio = 1.96, 95% confidence interval 1.17, 3.30); the percentage of days abstinent was 68% for those randomized to intervention and 57% for controls. At 6 months the effect of the intervention was attenuated and no longer statistically significant. Conclusions Among incarcerated women who reported hazardous drinking, a two-session brief alcohol intervention increased abstinent days at 3 months, but this effect decayed by 6 months. Study participants continued to drink heavily after return to the community. More intensive intervention pre-release and after re-entry may benefit hazardously drinking incarcerated women. [source] Undergraduate teaching in gerodontology in Austria, Switzerland and GermanyGERODONTOLOGY, Issue 3 2004Ina Nitschke Objective:, To survey the present state of undergraduate teaching in the domain of gerodontology in Germany, Switzerland and Austria. Study participants:, All universities of Austria (A), Germany (D) and Switzerland (CH). Protocol:, A questionnaire on undergraduate teaching in gerodontology was mailed to all Deans (A: n = 3; CH: n = 4; D: n = 31) and all independent departments except paediatric dentistry and orthodontics (A: n = 11; CH: n = 15; D: n = 111). Results:, The questionnaires were completed and returned by 29 Deans (A: n = 2; CH: n = 4; D: n = 23) and 102 departments (A: n = 7; CH: n = 8; D: n = 87). In Austria, gerodontology is a very small component of the dental curriculum and the Deans did not want this to be increased. Most German universities claimed to teach some aspects of gerodontology to undergraduate students and 87.4% of the Deans voted for separate lectures in gerodontology. In Switzerland, gerodontology seems well established. The results of questionnaires from the independent departments revealed that in all three countries lectures were more prevalent (A: n = 0; CH: n = 4; D: n = 6) than practical training in nursing homes (A: n = 0; CH: n = 3; D: n = 6). Conclusion:, Considering the demographical shift which is leading to an increasing proportion of elderly in the population, the weighting of gerodontology in the undergraduate dental curriculum should be considered for revision in Austria and Germany. [source] Barriers and strategies affecting the utilisation of primary preventive services for people with physical disabilities: a qualitative inquiryHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2006Thilo Kroll PhD Abstract Individuals with physical disabilities are less likely to utilise primary preventive healthcare services than the general population. At the same time they are at greater risk for secondary conditions and as likely as the general population to engage in health risk behaviours. This qualitative exploratory study had two principal objectives: (1) to investigate access barriers to obtaining preventive healthcare services for adults with physical disabilities and (2) to identify strategies to increase access to these services. We conducted five focus group interviews with adults (median age: 46) with various physically disabling conditions. Most participants were male Caucasians residing in Virginia, USA. Study participants reported a variety of barriers that prevented them from receiving the primary preventive services commonly recommended by the US Preventive Services Task Force. We used a health services framework to distinguish structural,environmental (to include inaccessible facilities and examination equipment) or process barriers (to include a lack of disability-related provider knowledge, respect, and skilled assistance during office visits). Participants suggested a range of strategies to address these barriers including disability-specific continuing education for providers, the development of accessible prevention-focused information portals for people with physical disabilities, and consumer self-education, and assertiveness in requesting recommended services. Study findings point to the need for a more responsive healthcare system to effectively meet the primary prevention needs of people with physical disabilities. The authors propose the development of a consumer- and provider-focused resource and information kit that reflects the strategies that were suggested by study participants. [source] The cost effectiveness of specialised facilities for service users with persistent challenging behavioursHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2001Angela Hallam MSc Abstract Little systematic research relates specifically to the last people to leave a psychiatric hospital at the end of a closure programme. The long-running evaluation of the reprovision of services from Friern Hospital in North London allowed a special study to be made of such a group (67 people in all), whose range of problem behaviours made placement in community settings most difficult. The patients were relatively young, with a shorter length of stay than the remainder of the former long-stay hospital population. They were assessed three times: before leaving Friern, and one and 5 years after relocation. The social and clinical characteristics of each person were measured, and the full costs of their care calculated. The ,difficult-to-place' patients moved to four highly staffed rehabilitation facilities, where the total cost of their care was, on average, £1230 per week. There was no overall change in their psychiatric state over the 5 years after they left Friern Hospital although, in the longer-term, they gained skills in several areas of daily functioning. Most importantly, there was a fall of almost 50% in the number of challenging behaviours exhibited by the study group. At the five-year follow-up point, the cost of care had fallen, on average, by £170 per week, and 24 people had been able to move to more independent accommodation arrangements. Study participants had gained a new network of community service contacts, and used services provided by a greater variety of agencies. The indicators suggest that high expenditure on alternative care was justified retrospectively by overall long-term outcomes. An important policy lesson from the Friern Hospital reprovision study is that adequate funds should be reserved until the end of the closure programme to allow the investment of resources in provision for patients with the most severe problem behaviours. [source] Survey Conditioning in Self-Reported Mental Health Service Use: Randomized Comparison of Alternative Instrument FormatsHEALTH SERVICES RESEARCH, Issue 2 2007Naihua Duan Objective. To test the effect of survey conditioning (whether observed survey responses are affected by previous experience in the same survey or similar surveys) in a survey instrument used to assess mental health service use. Data Sources. Primary data collected in the National Latino and Asian American Study, a cross-sectional household survey of Latinos and Asian Americans residing in the United States. Study Design. Study participants are randomly assigned to a Traditional Instrument with an interleafed format placing service use questions after detailed questions on disorders, or a Modified Instrument with an ensemble format screening for service use near the beginning of the survey. We hypothesize the ensemble format to be less susceptible to survey conditioning than the interleafed format. We compare self-reported mental health services use measures (overall, aggregate categories, and specific categories) between recipients of the two instruments, using 2 × 2 ,2 tests and logistic regressions that control for key covariates. Data Collection. In-person computer-assisted interviews, conducted in respondent's preferred language (English, Spanish, Mandarin Chinese, Tagalog, or Vietnamese). Principal Findings. Higher service use rates are reported with the Modified Instrument than with the Traditional Instrument for all service use measures; odds ratios range from 1.41 to 3.10, all p -values <.001. Results are similar across ethnic groups and insensitive to model specification. Conclusions. Survey conditioning biases downward reported mental health service use when the instrument follows an interleafed format. An ensemble format should be used when it is feasible for measures that are susceptible to survey conditioning. [source] The Cost-Effectiveness of Independent Housing for the Chronically Mentally Ill: Do Housing and Neighborhood Features Matter?HEALTH SERVICES RESEARCH, Issue 5 2004Joseph Harkness Objective. To determine the effects of housing and neighborhood features on residential instability and the costs of mental health services for individuals with chronic mental illness (CMI). Data Sources. Medicaid and service provider data on the mental health service utilization of 670 individuals with CMI between 1988 and 1993 were combined with primary data on housing attributes and costs, as well as census data on neighborhood characteristics. Study participants were living in independent housing units developed under the Robert Wood Johnson Foundation Program on Chronic Mental Illness in four of nine demonstration cities between 1988 and 1993. Study Design. Participants were assigned on a first-come, first-served basis to housing units as they became available for occupancy after renovation by the housing providers. Multivariate statistical models are used to examine the relationship between features of the residential environment and three outcomes that were measured during the participant's occupancy in a study property: residential instability, community-based service costs, and hospital-based service costs. To assess cost-effectiveness, the mental health care cost savings associated with some residential features are compared with the cost of providing housing with these features. Data Collection/Extraction Methods. Health service utilization data were obtained from Medicaid and from state and local departments of mental health. Non-mental-health services, substance abuse services, and pharmaceuticals were screened out. Principal Findings. Study participants living in newer and properly maintained buildings had lower mental health care costs and residential instability. Buildings with a richer set of amenity features, neighborhoods with no outward signs of physical deterioration, and neighborhoods with newer housing stock were also associated with reduced mental health care costs. Study participants were more residentially stable in buildings with fewer units and where a greater proportion of tenants were other individuals with CMI. Mental health care costs and residential instability tend to be reduced in neighborhoods with many nonresidential land uses and a higher proportion of renters. Mixed-race neighborhoods are associated with reduced probability of mental health hospitalization, but they also are associated with much higher hospitalization costs if hospitalized. The degree of income mixing in the neighborhood has no effect. Conclusions. Several of the key findings are consistent with theoretical expectations that higher-quality housing and neighborhoods lead to better mental health outcomes among individuals with CMI. The mental health care cost savings associated with these favorable features far outweigh the costs of developing and operating properties with them. Support for the hypothesis that "diverse-disorganized" neighborhoods are more accepting of individuals with CMI and, hence, associated with better mental health outcomes, is mixed. [source] Being liked activates primary reward and midline self-related brain regionsHUMAN BRAIN MAPPING, Issue 4 2010Christopher G. Davey Abstract The experience of being liked is a key social event and fundamental to motivating human behavior, though little is known about its neural underpinnings. In this study, we examined the experience of being liked in a group of 15- to 24-year-old: a cohort for whom forming friendships has a great degree of salience, and for whom the explicit representation of relationships is familiar from their frequent use of social networking technologies. Study participants (n = 19) were led to believe that other participants had formed an opinion on their likability based on their appearance in a photograph, and during fMRI scanning viewed the photographs of people who had purportedly responded favorably to them (alongside photographs of control participants). Results indicated that being liked activated primary reward- and self-related regions, including the nucleus accumbens, midbrain (in an area corresponding to the ventral tegmentum), ventromedial prefrontal cortex, posterior cingulate cortex (including retrosplenial cortex), amygdala, and insula/opercular cortex. Participants showed greater activation of ventromedial prefrontal cortex and amygdala in response to being liked by people that they regarded highly compared to those they regarded less so. Finally, being liked by the opposite compared to the same gender activated the right caudal orbitofrontal cortex and right anterior insula: areas important for the representation of primary somatic rewards. This study demonstrates that neural response to being liked has features that are consistent with response to other rewarding events, but it has additional features that reflect its intrinsically interpersonal character. Hum Brain Mapp, 2010. © 2009 Wiley-Liss, Inc. [source] Next-day cognition, psychomotor function, and driving-related skills following nighttime administration of eszopicloneHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 5 2008Julia Boyle Abstract Objective To evaluate next-day driving ability, as assessed by brake reaction time (BRT), and cognitive/psychomotor function following nighttime administration of 3,mg eszopiclone. Methods Two randomized, double-blind, placebo-controlled, cross-over studies were performed in healthy volunteers (n,=,32) and patients with primary insomnia (n,=,32). Study participants received nighttime dosing of 3,mg eszopiclone or placebo. BRT and a psychometric test battery were used to assess the next-day effects of eszopiclone treatment. Results In both studies, driving ability and measures of cognitive and psychomotor function were not impaired the morning after eszopiclone, as compared to placebo. All eszopiclone subjects reported improved ease in getting to sleep and quality of sleep with no significant changes in behavior upon awakening. A significant increase in next-day feelings of sedation was reported in healthy volunteers, but not in patients with primary insomnia, following eszopiclone treatment relative to placebo. Sleep induction, maintenance, duration, and efficiency, as assessed by PSG, were significantly improved following eszopiclone treatment in patients with insomnia. Conclusions Nighttime administration of 3,mg eszopiclone improved objective and subjective sleep measures in patients with insomnia (and subjective sleep measures in healthy patients) and did not impair next-day driving-related skills or measures of cognition in either study population relative to placebo. Copyright © 2008 John Wiley & Sons, Ltd. [source] Oral hygiene practices, periodontal conditions, dentition status and self-reported bad mouth breath among young mothers, TanzaniaINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 4 2006EGS Mumghamba Abstract:,Objectives:,To determine the oral hygiene practices, periodontal conditions, dentition status and self-reported bad mouth breath (S-BMB) among young mothers. Study participants and methods:,This was a cross-sectional descriptive study conducted at Muhimbili National Hospital, Dar es Salaam, Tanzania. A total of 302 postpartum mothers, aged 14,44 years, were interviewed on oral hygiene practices and S-BMB using structured questionnaire. Oral hygiene, dentition and periodontal status were assessed using the Community Periodontal Index probe and gingival recessions (GR) using Williams Periodontal probe. Results:,Tooth brushing practice was 99%; tongue brushing (95%), plastic toothbrush users (96%), chewing stick (1%), wooden toothpicks (76%), dental floss (<1%); and toothpaste (93%). The prevalence of plaque and gingival bleeding on probing was 100%, gum bleeding during tooth brushing (33%), calculus (99%), probing periodontal pocket depth (PPD) 4,5 mm (27%), PPD 6+ mm (3%), GR 1+ mm (27%) and tooth decay (55%). The prevalence of S-BMB was 14%; the S-BMB had higher mean number of sites with plaque compared to the no S-BMB group (P = 0.04). Factors associated with S-BMB were gum bleeding on tooth brushing (OR = 2.4) and PPD 6+ mm (OR = 5.4). Conclusion:,Self-reported bad mouth breath is a cause of concern among young mothers, and associated significant factors were gum bleeding on tooth brushing and deep periodontal pockets of 6+ mm. Further research involving clinical diagnosis of bad mouth breath and intervention through oral health promotion and periodontal therapy are recommended. Clinical relevance:,This study provides baseline information on oral health status and the complaint on bad mouth breath which necessitates in the future need for objective assessment, diagnosis and management of bad mouth breath for enhanced social and professional interaction without embarrassments. [source] Lifestyle limitations of children and young people with severe cerebral palsy: a population study protocolJOURNAL OF ADVANCED NURSING, Issue 5 2008Collette Donnelly Abstract Title.,Lifestyle limitations of children and young people with severe cerebral palsy: a population study protocol Aim., This paper is a presentation of a study protocol to establish the prevalence of orthopaedic problems (hip dislocation, pelvic obliquity, spinal deformity and contractures) and their impact on pain, function, participation and health in a population of children and young people with severe cerebral palsy. Background., Cerebral palsy is the commonest cause of motor impairment in childhood and is associated with life-long disability. An estimated 30% of people with cerebral palsy have severe forms and are non-ambulant. Although the underlying neurological damage is not amenable to correction, many health services are dedicated to providing therapeutic and adaptive support to help people with the condition reach their potential. Method., A cross-sectional survey of children and young people, aged 4,25 years with severe, non-ambulant cerebral palsy as defined using the Gross Motor Function Classification System (Levels IV and V). Study participants will be identified from a pre-existing, geographically defined case register and recruited via a healthcare professional known to them. Two assessments will be undertaken: one involving parents/carers at home and using questionnaires; the other involving the child/young person ideally in one of three settings and including X-rays if clinically indicated. Discussion., This study will contribute to our knowledge of the history and epidemiology of orthopaedic problems in children and young people with cerebral palsy and how these problems accumulate and impact on participation, health and well-being. The study will also identify unmet need and make recommendations for good practice in relation to the orthopaedic care and management for people with severe cerebral palsy. [source] Gait Dysfunction in Mild Cognitive Impairment SyndromesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2008Joe Verghese MBBS OBJECTIVES: To conduct a systematic clinical and quantitative assessment of gait in older adults with mild cognitive impairment (MCI) syndromes. DESIGN: Cross-sectional. SETTING: Einstein Aging Study, a community-based longitudinal aging study. PARTICIPANTS: Fifty-four individuals with amnestic MCI (a-MCI), 62 with nonamnestic-MCI (na-MCI), and 295 healthy controls identified from the Einstein Aging Study participants. MEASUREMENTS: Comparison of clinical and quantitative gait performance in subjects with MCI subtypes with that of cognitively normal older adults. RESULTS: Neurological gaits were more common in a-MCI (31.5%, P=.008) but not in na-MCI (19.4%, P=.55), than in controls (16.3%). Quantitative gait in multiple parameters was worse in both MCI subtypes than in controls. Factor analysis revealed three independent factors representing pace, rhythm, and variability. Subjects with a-MCI had worse rhythm and variability scores than those with na-MCI and controls. Subjects with na-MCI had worse performance on the pace domain than the other two groups. Subjects with MCI and gait abnormalities had higher disability scores than subjects with MCI without gait abnormalities. CONCLUSION: Gait dysfunction is common in older individuals with amnestic and nonamnestic subtypes of MCI. [source] Effect of Antipsychotic Withdrawal on Behavior and Sleep/Wake Activity in Nursing Home Residents with Dementia: A Randomized, Placebo-Controlled, Double-Blinded Study The Bergen District Nursing Home StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Sabine Ruths MD Objectives: To explore the effect on sleep/wake activity and on behavioral and psychological symptoms of the withdrawal of antipsychotic medications from nursing home (NH) patients with dementia. Design: Randomized, placebo-controlled, double-blind trial. Setting: NHs in Bergen, Norway. Participants: Thirty patients (mean age 83.5) taking haloperidol, risperidone, or olanzapine for nonpsychotic symptoms. Intervention: Study participants were randomly assigned to withdrawal (intervention group) or continued treatment with antipsychotic medications (reference group) for 4 consecutive weeks. Measurements: Behavioral rating using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and actigraphy. Results: After antipsychotic withdrawal, behavioral scores remained stable or improved in 11 of 15 patients, whereas four had worsening scores. Actigraphy revealed decreased sleep efficiency after drug discontinuation and increased 24-hour and night activity in both groups. Actigraphy records of nighttime and daytime activity indicated sleep problems and restlessness, in terms of the NPI-Q. One patient was restarted on antipsychotics. Conclusion: Antipsychotic drug withdrawal affected activity and sleep efficiency over the short term. Increases in total activity and impaired sleep quality after drug discontinuation should be monitored, because the long-term effect of these changes is not known. The NPI-Q and actigraphy are feasible tools that disclose relevant changes occurring during antipsychotic withdrawal in NH patients with dementia. Their use in clinical practice should be substantiated by larger studies. [source] When Will Older Patients Follow Doctors' Recommendations?JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 5 2008Interpersonal Treatment, Outcome Favorability, Perceived Age Differences Study participants were 104 older patients (M age = 76 years) who rated their last visit to a doctor. If they felt respectfully and honestly treated by the doctor, they were more willing to confide in a medical professional. If they received the information that they needed, they were more likely to follow the doctor's recommendations. However, if they perceived their doctor to be closer to them in age, respectful treatment was most closely related to compliance. If they perceived their doctor to be much younger than themselves, obtaining needed information was related most closely to compliance. The results illustrate the value of treating age as a salient social category that can shape older patients' reactions to their medical visits. [source] Efficacy of progressive muscle relaxation training in reducing anxiety in patients with acute schizophreniaJOURNAL OF CLINICAL NURSING, Issue 15 2009Wen-Chun Chen Aim and objectives., The objective of this study was to examine the efficacy of progressive muscle relaxation training on anxiety in patients with acute schizophrenia. Background., Many empirical studies have found progressive muscle relaxation training beneficial in reducing the psychological effects of anxiety. Progressive muscle relaxation training is also effective in reducing the distress symptoms associated with the symptomatology of schizophrenia. Design., An experimental randomised controlled trial using repeated measures. Method., The study was designed to examine the effects of progressive muscle relaxation training on patients diagnosed with schizophrenia. Study participants were acute psychiatric inpatients in Taiwan. Eighteen patients were block randomised and then assigned to an experimental or control group. The experimental group received progressive muscle relaxation training and the control group received a placebo intervention. Results from the Beck anxiety inventory were compared between groups as a pretest before intervention, on day 11 of intervention and one week post-test after the intervention was completed. Changes in finger temperature were measured throughout the experiment. Results., The degree of anxiety improvement was significantly higher in the progressive muscle relaxation training group than in the control group after progressive muscle relaxation training intervention (p < 0·0001) and at follow-up (p = 0·0446; the mean BAI score fell from 16·4 pretest to ,5·8 post-test. After adjusting for the change in patient finger temperature, the mean change in temperature was significantly different between the two patient groups. The average body temperature increased significantly after applying the progressive muscle relaxation training to patients with schizophrenia. Conclusion., This study demonstrated that progressive muscle relaxation training can effectively alleviate anxiety in patients with schizophrenia. Relevance to clinical practice., Progressive muscle relaxation training is potentially an effective nursing intervention in the reduction of anxiety in patients diagnosed with schizophrenia, depending on the quality of their mental status at the time of intervention. Progressive muscle relaxation training is a useful intervention as it is proven to reduce anxiety levels across a spectrum of psychiatric disorders. [source] The relationship among psychological distress, employment, and drug use over time in a sample of female welfare recipientsJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 3 2003John S. Atkinson In this study we examined the relationship over time among work experience, psychological distress, and illegal substance use in a sample of 534 women receiving Temporary Assistance for Needy Families. Study participants were interviewed at intake and at 4-month intervals for a period of 2 years. Each interview recorded the number of hours worked in the previous 4 months and the use of powder cocaine, crack cocaine, heroin, or methamphetamines during the same period. To measure the extent of psychological distress, participants were also administered the personal adjustment problems subscales of the Multidimensional Addictions and Personality Profile (MAPP) at intake and at 1-year intervals. A path model was analyzed to assess the temporal effects of employment, drug use, and emotional and psychological distress. Results suggest a cycle in which employment at one time period can reduce the likelihood of drug use in the following period, which, in turn, can lead to improvement in distress. This improvement can lead to an increase in the number of hours worked and further improvement in distress levels. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 223,234, 2003. [source] Effects of Campaign-to-User and Text-Based Interactivity in Political Candidate Campaign Web sitesJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 3 2005Barbara Warnick This study examined the effects on users of two forms of interactivity commonly found on political candidate campaign Web sites in the 2002 U.S. House election cycle. The first form, campaign-to-user interactivity, focuses on features or mechanisms used to enable or facilitate communication between site users and the campaign. The second form, text-based interactivity, focuses on how site content is verbally and visually expressed. Study participants viewed one of four versions of either a Democratic or Republican campaign website. Both text-based and campaign-to-user interactivity increased the amount of time users spent on the site and their accurate recall of candidates' issue stances. The co-occurrence of both forms of interactivity, however, showed a noticeably lower level of issue recall, confirming earlier findings that too much interactivity can interfere with user recall of site content. [source] Childhood Sleep Problems, Response Inhibition, and Alcohol and Drug Outcomes in Adolescence and Young AdulthoodALCOHOLISM, Issue 6 2010Maria M. Wong Background:, To our knowledge, no prospective studies examine the relationships among childhood sleep problems, adolescent executive functioning, and substance outcomes (i.e., substance use and substance-related problems). In this study, we examined whether childhood sleep problems predicted adolescent sleep problems and response inhibition. We also tested whether adolescent sleep problems and poor response inhibition mediated the relationship between childhood sleep problems and substance (alcohol and drug) outcomes in young adulthood. Methods:, Study participants were 292 boys and 94 girls (M = 4.85, SD = 1.47) from a community sample of high-risk families and controls. Results:, When compared to their counterparts, those with trouble sleeping in childhood were twice as likely to have the same problem in adolescence. Childhood overtiredness predicted poor response inhibition in adolescence. Persistent trouble sleeping from childhood to adolescence and response inhibition in adolescence mediated the relationship between childhood sleep problems and drug outcomes in young adulthood, whereas overtiredness in childhood directly predicted alcohol use outcomes and alcohol-related problems in young adulthood. Conclusions:, This is the first study showing a long-term relationship between childhood sleep measures and subsequent alcohol and drug outcomes. The developmental and clinical implications of these findings were discussed. Prevention and intervention programs may want to consider the role of sleep problems and response inhibition on substance use and abuse. [source] Sleep Problems in Early Childhood and Early Onset of Alcohol and Other Drug Use in AdolescenceALCOHOLISM, Issue 4 2004Maria M. Wong Abstract: Background: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood. Methods: This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families. Results: Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use. Conclusions: This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed. [source] Industrial tools for the feature location problem: an exploratory studyJOURNAL OF SOFTWARE MAINTENANCE AND EVOLUTION: RESEARCH AND PRACTICE, Issue 6 2006Sharon Simmons Abstract Software engineers who maintain and enhance large systems often encounter the feature location problem: where in the many thousands of lines of code is a particular user feature implemented? Several methods of addressing the problem have been proposed, most of which involve tracing the execution of the system and analyzing the traces. Some supporting academic tools are available. However, companies that depend on the successful evolution of large systems are more likely to use new methods if they are supported by industrial-strength tools of known reliability. This article describes a study performed with Motorola, Inc. to see whether there were any pitfalls in using Metrowerks CodeTEST and Klocwork inSight for feature location on message-passing software similar to systems that Motorola maintains. These two tools were combined with TraceGraph, an academic trace comparison tool. The study identified two main problems. First, some ,glue' code and workarounds were needed to get CodeTEST to generate a trace for an interval of time in which the feature was operating. Second, getting information out of TraceGraph and into inSight was needlessly complicated for a user. However, with a moderate amount of work, the tool combination was effective in locating, understanding and documenting features. Study participants completed these steps in typically 3,4 hours per feature, studying only a few hundred lines out of a 200,000 line system. An ongoing project with Motorola is focused on improving tool integration with the hope of making feature location common practice at Motorola. Copyright © 2006 John Wiley & Sons, Ltd. [source] User perspectives on relevance criteria: A comparison among relevant, partially relevant, and not-relevant judgmentsJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 5 2002Kelly L. Maglaughlin This study investigates the use of criteria to assess relevant, partially relevant, and not-relevant documents. Study participants identified passages within 20 document representations that they used to make relevance judgments; judged each document representation as a whole to be relevant, partially relevant, or not relevant to their information need; and explained their decisions in an interview. Analysis revealed 29 criteria, discussed positively and negatively, that were used by the participants when selecting passages that contributed or detracted from a document's relevance. These criteria can be grouped into six categories: abstract (e.g., citability, informativeness), author (e.g., novelty, discipline, affiliation, perceived status), content (e.g., accuracy/validity, background, novelty, contrast, depth/scope, domain, citations, links, relevant to other interests, rarity, subject matter, thought catalyst), full text (e.g., audience, novelty, type, possible content, utility), journal/publisher (e.g., novelty, main focus, perceived quality), and personal (e.g., competition, time requirements). Results further indicate that multiple criteria are used when making relevant, partially relevant, and not-relevant judgments, and that most criteria can have either a positive or negative contribution to the relevance of a document. The criteria most frequently mentioned by study participants were content, followed by criteria characterizing the full text document. These findings may have implications for relevance feedback in information retrieval systems, suggesting that systems accept and utilize multiple positive and negative relevance criteria from users. Systems designers may want to focus on supporting content criteria followed by full text criteria as these may provide the greatest cost benefit. [source] Perceptions of psychological first aid among providers responding to Hurricanes Gustav and Ike,JOURNAL OF TRAUMATIC STRESS, Issue 4 2010Brian Allen Psychological First Aid (PFA), developed by the National Child Traumatic Stress Network and the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, has been widely disseminated both nationally and internationally, and adopted and used by a number of disaster response organizations and agencies after major catastrophic events across the United States. This study represents a first examination of the perceptions of providers who utilized PFA in response to a disaster. Study participants included 50 individuals who utilized PFA in their response to Hurricane Gustav or Ike. Findings indicated that participation in PFA training was perceived to increase confidence in working with adults and children. PFA was not seen as harmful to survivors, and was perceived as an appropriate intervention for responding in the aftermath of hurricanes. [source] Social Exchange and Knowledge Sharing among Knowledge Workers: The Moderating Role of Perceived Job SecurityMANAGEMENT AND ORGANIZATION REVIEW, Issue 2 2009Kathryn M. Bartol abstract Drawing on perceived organizational support (POS) theory and employee,organizational relationship theories, this research investigated the association between POS and knowledge sharing as well as the potential moderating effects of perceived job security. Study participants were 255 information technology professionals and their supervisors working in the information technology industry in China. Findings showed that POS was positively related to knowledge sharing, and, as expected, perceived job security moderated the association. More specifically, the positive association between POS and employee knowledge sharing held only for employees who perceived higher job security from their organization. In contrast, POS was not significantly associated with knowledge sharing when employees perceived their job security to be relatively low. This latter result is consistent with contentions from employee,organizational relationships theories that limited investment by employers is likely to lead to lower contributions from employees. The findings are also congruent with arguments from social exchange theory that meaningful reciprocity is built on a history of open-ended exchanges whose development may be inconsistent with a shorter-term employment horizon. [source] Coping with Cerebral Palsy Pain: A Preliminary Longitudinal StudyPAIN MEDICINE, Issue 1 2006Mark P. Jensen PhD ABSTRACT Objective., To examine the association between pain-coping strategies and adjustment to cerebral palsy (CP)-related pain. Design., Longitudinal study of 48 adults with CP-related chronic pain. Study participants were interviewed on two occasions, separated by 6 months, to assess pain-coping strategies used and two domains of adjustment to chronic pain: depression and pain interference. Results., Changes in coping strategy use were associated with changes in functioning. Specifically, decreased use of catastrophizing and rest, and increased use of task persistence were associated with decreases in depression over a 6-month period. Increased use of task persistence was also associated with decreases in pain interference. Conclusion., Changes in pain-coping strategies over time are associated with changes in functioning in persons with CP-related pain, consistent with biopsychosocial models of chronic pain. Some coping strategies (e.g., catastrophizing, task persistence), however, appear to be more closely linked to functioning than others. These results provide preliminary empiric guidance for the coping strategies that may be most fruitfully targeted in the treatment of CP-related pain. [source] HFE, SLC40A1, HAMP, HJV, TFR2, and FTL mutations detected by denaturing high-performance liquid chromatography after iron phenotyping and HFE C282Y and H63D genotyping in 785 HEIRS Study participants,,AMERICAN JOURNAL OF HEMATOLOGY, Issue 11 2009James C. Barton We sought to identify mutations that could explain iron phenotype heterogeneity in adults with previous HFE genotyping to detect C282Y and H63D. HEIRS Study participants genotyped for C282Y and H63D were designated as high transferrin saturation (TS) and/or serum ferritin (SF) (high TS/SF), low TS/SF, or controls. We grouped 191 C282Y homozygotes as high TS/SF, low TS/SF, or controls, and 594 other participants by race/ethnicity as high TS/SF or controls. Using denaturing high-performance liquid chromatography (DHPLC), we screened 20 regions of HFE, SLC40A1, HAMP, HJV, TFR2, and FTL in each participant. DHPLC analyses were successful in 99.3% of 791 participants and detected 117 different mutations. In C282Y homozygotes, 4.0% of high TS/SF participants had SLC40A1 Q248H, HAMP -72C>T, or HAMP R59G heterozygosity (0% Controls; P = 0.1200). In whites, 4.1% with high TS/SF and 1.3% of controls had HFE S65C or E168Q (P = 0.3049). HJV c.-6C>G and FTL L55L frequencies were greater in whites with high TS/SF than controls (0.0811 vs. 0.0200, P = 0.0144; 0.5743 vs. 0.4400, P = 0.0204, respectively). One Hispanic with high TS/SF (1.3%) had HAMP G71D heterozygosity. In blacks, SLC40A1 Q248H frequencies did not differ significantly between high TS/SF and control participants. Among Asians, 2.8% with high TS/SF were HFE V295A heterozygotes. Mutations other than HFE C282Y and H63D reported to be pathogenic were infrequently detected in high TS/SF participants. Genetic regions in linkage disequilibrium with HJV c.-6C>G and FTL L55L could partly explain high TS/SF phenotypes in whites. Am. J. Hematol., 2009. Published 2009 Wiley-Liss, Inc. [source] Early wheeze as reported by mothers and lung function in 4-year-olds.PEDIATRIC PULMONOLOGY, Issue 9 2010Prospective cohort study in Krakow Abstract The purpose of the study was to check the hypothesis that early wheezing as reported by mothers would be associated with reduced lung function in 4-year olds. Study participants were recruited prenatally, as part of a prospective cohort study on the respiratory health of young children exposed to various ambient air pollutants. After delivery, infants were followed over 4 years and the interviewers visited participants at their home to record respiratory symptoms every 3 months in the child's first 2 years of life and every 6 months in the 3rd and 4th years. In the 4th year of follow-up, children were invited for standard lung function testing by spirometry quantified by forced vital capacity (FVC), forced expiratory volume in 1,sec (FEV1), and forced expiratory volume in 0.5,sec (FEV0.5) levels. Out of 258 children attending spirometry testing 139 performed at least two acceptable exhalation efforts. Cohort children with acceptable spirometric measurements did not differ with respect to wheezing experience and exposure characteristics from those without. The study shows that episodic wheeze was reported in 28.1% of 4-year olds, 6.5% had transient wheeze, and 4.3% had recurrent wheeze. There was an increased frequency of wheezing symptoms and their duration in transient and recurrent wheezers. Adjusted multivariable regression models for gender and height showed that children who reported more than two episodes of wheezing at any point over the follow-up had FVC values lower by 120.5,ml (P,=,0.016) and FEV1 values lower by 98.3,ml (P,=,0.034) compared to those who did not report any wheezing; children experiencing more than 10 wheezing days by age 4 showed FVC deficit of 87.4,ml (P,=,0.034) and FEV1 values of 65.7,ml (P,=,0.066). The ratios of FEV1/FVC%, and FEV0.5/FVC% were neither associated with wheezing episodes nor wheezing days. In recurrent wheezers, lung function decrement amounted to 207,ml of FVC, 175,ml of FEV1, and 104,ml of FEV0.5. In conclusion, our findings show that wheezing experience during early postnatal life may be associated with lung function deficit of restrictive character in preschool children and detailed history of wheeze in early postnatal life, even though not physician-confirmed, may help define the high risk group of children for poor lung function testing. Pediatr. Pulmonol. 2010; 45:919,926. © 2010 Wiley-Liss, Inc. [source] Association between bone lead concentration and blood pressure among young adultsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2002Fredric Gerr MD Abstract Background Occupational and environmental exposure to lead has been examined for its effect on blood pressure (BP) in adults with varying results. The present analyses assessed the association between bone lead concentration and BP in early adult life in persons exposed during childhood. Methods Study participants included young adult members of two cohorts with different past histories of lead exposure. Lead exposure was assessed using noninvasive K-X-ray fluorescence spectroscopy to quantify bone lead concentration, an index of long-term lead exposure superior to current blood lead concentration. Systolic and diastolic BP measurements were obtained using conventional clinical methods. Multiple linear regression models were constructed to allow for control of covariates of BP identified a priori. Results Analyses were performed on 508 participants. While controlling for potential confounders, systolic BP was 4.3 mm,Hg greater among members of the highest of four bone lead concentration groups (>,10 ,gPb/g bone) when compared with the lowest bone lead concentration group (<,1 ,gPb/g bone; P,=,0.004), and diastolic BP was 2.8 mm,Hg greater among members of the highest bone lead concentration group when compared with the lowest bone lead concentration group (P,=,0.03). Conclusions These results suggest that substantial lead exposure during childhood can increase BP during young adulthood. Am. J. Ind. Med. 42:98,106, 2002. © 2002 Wiley-Liss, Inc. [source] The Role of Culture, Family Processes, and Anger Regulation in Korean American Adolescents' Adjustment ProblemsAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010Irene J. K. Park Using an ecologically informed, developmental psychopathology perspective, the present study examined contextual and intrapersonal predictors of depressive symptoms and externalizing problems among Korean American adolescents. Specifically, the role of cultural context (self-construals), family processes (family cohesion and conflict), and anger regulation (anger control, anger suppression, and outward anger expression) were examined. Study participants were N = 166 Korean American adolescents ranging from 11 to 15 years old (M = 13.0, SD = 1.2). Results showed that depressive symptoms were significantly associated with lower levels of perceived family cohesion, higher levels of perceived family conflict intensity, and higher levels of anger suppression. Externalizing problems were associated with male gender, a weaker interdependent self-construal, higher levels of perceived family conflict, lower levels of anger control, and higher levels of outward anger expression. The distinction between specific versus common factors associated with depressive symptoms and externalizing problems was discussed with an eye toward prevention or intervention strategies targeting specific coping mechanisms (e.g., generating alternatives to anger suppression) or developing psychoeducational approaches to facilitate family processes. [source] Anthropometry and Breast Cancer Risk in Nigerian WomenTHE BREAST JOURNAL, Issue 5 2006FWACS, Michael N. Okobia MBBS Abstract: The recent upsurge in global obesity and the recognition of the role of metabolic syndrome and other correlates of obesity in the etiology of breast cancer and other chronic diseases has created the impetus for renewed interest in the role of anthropometric measures in breast cancer risk. This case-control study was designed to evaluate the role of anthropometric variables in breast cancer susceptibility in an indigenous sub-Saharan African population drawn from midwestern and southeastern Nigeria, a population grossly underreported in the global epidemiologic literature. Study participants were 250 women with breast cancer who were receiving treatment in the surgical outpatient clinics and surgical wards of four university teaching hospitals located in midwestern and southeastern Nigeria, while the controls were 250 age-matched women without breast cancer or other malignant diseases being treated for other surgical diseases in the same institutions between September 2002 and April 2004. Waist:hip ratio (WHR) was associated with a significant 2.5-fold increased risk of premenopausal breast cancer (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.48,4.41] and a 2-fold increased risk of postmenopausal breast cancer (OR = 2.00, 95% CI 1.04,2.53). Increasing height conferred a modestly nonsignificant increased risk of premenopausal breast cancer (OR = 1.59, 95% CI 0.98,2.58). The study showed that WHR is a significant predictor of breast cancer risk in Nigerian women and measures to sustain increased physical activity and ensure healthy dietary practices are recommended to reduce the burden of obesity in the population. [source] ORIGINAL RESEARCH,ED PHARMACOTHERAPY: Can an Educational Program Optimize PDE5i Therapy?THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2007A Study of Canadian Primary Care Practices ABSTRACT Introduction., The importance of patient instructions, designed to optimize therapy with phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction (ED), has recently been demonstrated. Aim., To evaluate the impact of an educational program for new sildenafil users against usual ED management in Canadian primary care practices. Methods., This multicenter, 6-month cluster randomized prospective study was conducted across Canada in general practitioners' offices where sites were randomized to receive a treatment optimization program (TOP) tool at visit 1 (TOP sites) or not to receive the TOP tool (non-TOP sites) while continuing with usual practice. Study participants were men seeking medical attention for ED and who were sildenafil naïve. The TOP tool consisted of a tear-off sheet, a brochure, and a video. Study drug was not provided to the patients. Sildenafil samples and prescriptions were dispensed as per usual care practices. Main Outcome Measures., The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire was used to determine treatment satisfaction at visit 2 (month 3) and visit 3 (month 6). Patient and physician satisfaction with the TOP tool was assessed using self-reported questionnaires. Results., The intent-to-treat (ITT) population consisted of 2,573 patients from 231 primary care sites. At visits 2 and 3, treatment satisfaction with sildenafil was high with almost 9 patients out of 10 satisfied with treatment. No significant statistical differences were observed in the EDITS scores between the TOP and the non-TOP groups at visits 2 and 3. More than 80% of the participants were satisfied or very satisfied with the video and the brochure. More than 8 out of 10 participating physicians (84%) would use the TOP tool in their current practice if available. Conclusions., TOP is a valuable and time-efficient ED management tool providing benefits to newly diagnosed ED patients and to their physicians. Brock G, Carrier S, Casey R, Tarride J-E, Elliott S, Dugré H, Rousseau C, D'Angelo P, and Defoy I. Can an educational program optimize PDE5i Therapy? A study of Canadian primary care practices. J Sex Med 2007;4:1404,1413. 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