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Biomedical subjects

G Welch

Publications and source records attributed to G Welch.

At least 19 recordsLinked to original sources
PubMed1995

Assessment of diabetes-related distress.

OBJECTIVE: To describe a new measure of psychosocial adjustment specific to diabetes, the Problem Areas in Diabetes Survey (PAID), and to present initial information on its reliability and validity. RESEARCH DESIGN AND METHODS: Before their routine clinic appointments, 451 female patients with type I and type II diabetes, all of whom required insulin, completed a self-report survey. Included in the survey was the PAID, a 20-item questionnaire in which each item represents a unique area of diabetes-related psychosocial distress. Each item is rated on a six-point Likert scale, reflecting the degree to which the item is perceived as currently problematic. A total scale score, hypothesized to reflect the overall level of diabetes-related emotional distress, is computed by summing the total item responses. To examine the concurrent validity of the PAID, the survey also included a series of standardized questionnaires assessing psychosocial functioning (general emotional distress, fear of hypoglycemia, and disordered eating), attitudes toward diabetes, and self-care behaviors. All subjects were assessed for HbA1, within 30 days of survey completion and again approximately 1-2 years later. Finally, long-term diabetic complications were determined through chart review. RESULTS: Internal reliability of the PAID was high, with good item-to-total correlations. Approximately 60% of the subject sample reported at least one serious diabetes-related concern. As expected, the PAID was positively associated with relevant psychosocial measures of distress, including general emotional distress, disordered eating, and fear of hypoglycemia, short- and long-term diabetic complications, and HbA1, and negatively associated with reported self-care behaviors. The PAID accounted for approximately 9% of the variance in HbA1. Diabetes-related emotional distress, as measured by the PAID, was found to be a unique contributor to adherence to self-care behaviors after adjustment for age, diabetes duration, and general emotional distress. In addition, the PAID was associated with HbA1 even after adjustment for age, diabetes duration, general emotional distress, and adherence to self-care behaviors. CONCLUSIONS: These findings suggest that the PAID, a brief, easy-to-administer instrument, may be valuable in assessing psychosocial adjustment to diabetes. In addition to high internal reliability, the consistent pattern of correlational findings indicates that the PAID is tapping into relevant aspects of emotional distress and that its particular feature, the measurement of diabetes-related emotional distress, is uniquely associated with diabetes-relevant outcomes. These data are also consistent with the hypothesis that diabetes-related emotional distress, separate from general emotional distress, is an independent and major contributor to poor adherence. Given that the study was limited to female patients using insulin, further examination of the clinical usefulness of the PAID will need to focus on more heterogeneous samples.

Adult↗
PubMed1992

The evaluation of a behavioural food and weight control programme for obese patients with noninsulin dependent diabetes.

We report here on the evaluation of a behaviour modification programme for food and weight control in noninsulin dependent diabetes mellitus (NIDDM). The results of this pilot study, involving a highly selected group of patients, showed that weight was reduced by an average of 4.5% over 11 weeks and that this difference was statistically significant. This average weight loss is in the range typically found for similar programmes. Glycosylated haemoglobin fell by 7.8% on average and serum total cholesterol fell by 3%, both statistically significant changes. Triglycerides fell by 17%, although this was not significant. The programme in its present form appears helpful in aiding motivated patients to make modest improvements in their blood sugars and lipids. However, we have identified a number of modifications and additions that could be made to improve it.

Adult↗
PubMed1992

Styles of psychological adjustment in diabetes: a focus on key psychometric issues and the ATT39.

While knowledge of the biomedical factors in diabetes has grown in a steady and systematic fashion over the past 60 years, attempts to define, measure, and understand the relevant psychological constructs have only begun recently. In particular, there is need for psychometrically sound tests to tap these dimensions. This study examined the psychometric characteristics of the ATT39, a promising measure of psychological adjustment to diabetes. The results, based on three patient samples and using the FACTOREP factor-matching procedure, suggested that the ATT39 has a large single factor only. This new subscale appears clinically to measure the integration of diabetes and its treatment into the lifestyle and personality of a patient with diabetes.

Adaptation, Psychological↗
PubMed1990

Is the prevalence of bulimia nervosa higher among tertiary education populations?

In this study the prevalence of bulimia nervosa was estimated among 243 women in a tertiary educational setting. The results showed 43.6% (95% CI, 37.4 to 49.8) to report binge eating, the cardinal feature of bulimia nervosa, at some stage in the past and 2.5% (95% CI, 1.0 to 5.6) the full criteria for current bulimia nervosa. These figures are significantly higher than those reported recently for a general population sample in the same age range. Despite methodological differences between the two surveys the results give some support to claims that women in these settings are at a greater risk of developing eating disorders.

Adult↗
PubMed1990

Adverse learning strategy: the Adelaide Diagnostic Learning Inventory and its subscale replicability in a medical student population.

The Adelaide Diagnostic Learning Inventory (ADLIMS) is a measure of learning styles and learning pathologies that was designed to investigate the impact of traditional approaches to learning versus problem-based learning and to identify students whose approach to learning tasks predicted poor academic performance. In this study, some important psychometric properties of the ADLIMS were examined, including its factor structure. In this study, factor replicability across samples was argued to provide a more robust and psychologically meaningful factor solution than that which can be obtained using traditional mathematical criteria. The results of the factor analysis did not confirm the presence of the four factor solution earlier reported for the ADLIMS, but did identify three clear factors that had very high replicability. An inspection of the items comprising these three factors showed that factor 1 tapped subjective distress related to poor study habits, lack of motivation to study, and distraction from social activities. Factor 2 tapped distress arising from high achievement expectations that were hampered by superficial or disorganized study habits that did not enable the student to grasp the relationships between concepts and ideas. Factor 3 tapped positive feelings and a sense of satisfaction associated with a problem-based approach to the learning of new study material. Although the internal reliability of the ADLIMS subscales met the requirements of a measure to be used in general research such as in the investigation of correlates among groups of medical students, they did not meet the higher requirements of a measure to be used to identify or predict individuals with pathological learning styles.

Humans↗
PubMed1990

'Normal but dead': perinatal mortality in non-malformed babies of birthweight 2.5 kg and over in the northern region in 1983.

The case notes relating to 75 of the 91 perinatal deaths of nonmalformed babies of birthweight greater than or equal to 2.5 kg born in the Northern Region in 1983 were examined. The major groups involved antepartum deaths of unknown cause (40%), and deaths due to intrapartum anoxia or trauma (35%). A case-control study compared each of the 75 cases with two controls matched for place of birth, obtained by taking the next two babies born in the same maternity unit (excluding perinatal deaths, birthweight less than 2.5 kg, and malformations). Four factors were found to be significantly associated with risk of perinatal death in this group: primigravidity, parity greater than or equal to 3, not booked for antenatal care by 20 weeks, and corrected birthweight less than 3.2 kg (adjusted for gestation). Two further factors were related only to the risk of perinatal death consequent upon intrapartum events: labour post-term and malpresentation in labour. All four factors relevant to the whole group remained independently associated with risk of perinatal death after multivariate analysis by two techniques. Adjusted odds ratios (95% CI) were estimated as: primigravidity 2.1 (1.1 to 4.1); parity three or more 5.7 (1.9 to 17); not booked for antenatal care by 20 weeks 15.7 (3.0 to 81); and corrected birthweight less than 3.25 kg 2.5 (1.3 to 4.6). An avoidable factor, as defined, was detected in 50% of deaths. In 30% of deaths there was an avoidable factor (grade 2) such that absence may have been expected to lead to a different outcome had all other factors remained equal. Of the avoidable factors detected, 61% related to intrapartum management, as did 76% of the grade 2 factors. Most of these involved failure to respond to evidence of fetal distress in labour. The defined group constituted 21% of all perinatal deaths, suggesting that this is an important category, particularly as their potential for normal survival should otherwise have been high.

Birth Weight↗
PubMed1990

Australasian field trials of the Mental and Behavioural Disorders section of the draft ICD-10.

Field trials of the "Mental and Behavioural Disorders" section of the 1987 draft of the ICD-10 have been co-ordinated for the World Health Organisation by a number of regional centres. The design of the field trials and the major features of ICD-10 are briefly discussed. The results of the field trial in the Western Pacific region are described, and compared with the results of the original DSM-III field trials. ICD-10 appears to be an acceptably reliable diagnostic system, and the ratings of its feasibility and utility by participating clinicians suggest that it will be seen as a distinct advance over ICD-9.

Australia↗
PubMed1990

The replicable dimensions of the Beck Depression Inventory.

Numerous studies have focused on the factor structure of the Beck Depression Inventory (BDI) because its underlying structure, once identified, may improve our conceptualizations of the cognitive processes in depression. These studies have produced a wide range of interpretations for the BDI, yet the replicability of these factor solutions across independent samples has not been demonstrated. In this study, a series of factor analyses were conducted that involved the use of a new factor matching procedure (FACTOREP), and both depressed patient and normal population samples. The results supported the presence of a large general factor only, which suggests that the items of the BDI are tapping a general construct of depressive symptoms rather than the variety of more specific constructs suggested by previous researchers.

Adult↗
PubMed1989

The reliability and discriminant validity of three potential measures of bulimic behaviours.

There is currently a need for a reliable and valid self-report measure of bulimic behaviours that is brief and economical to administer and that can be used to assess response to treatment and to investigate correlates of bulimic symptoms. Three potential screening measures of bulimic behaviours (the Bulimia Test, the Conroy-Healy Eating Questionnaire and the Bulimia subscale of the Eating Disorder Inventory) were evaluated using internal consistency analysis and Receiver (or Relative) Operating Characteristic curve analysis, to determine their internal reliability and ability correctly to identify bulimic patients seen at an eating disorders outpatients clinic. The results showed that the three measures examined were all good discriminators of bulimic and non-bulimic patients. However, the results showed that the Bulimia Test was clearly the most reliable measure, apparently because of its greater length. It is suggested that further investigations be conducted to establish the sensitivity of the Bulimia Test to changes in the severity of bulimic behaviours in patients, since this will increase knowledge of its utility as a measure of response to treatment.

Adult↗
PubMed1988

The factor structure of the eating disorders inventory.

The Eating Disorders Inventory (EDI) is a promising new measure of the cognitive and behavioral characteristics of anorexia nervosa and bulimia, although the replicability of its eight subscales has not been evaluated. Therefore, a factor analysis of the EDI was carried out that used the FACTOREP procedure. The results, using non-patient responses, did not confirm the original eight subscales, but did show three clear and replicable factors to exist. It was suggested that these may be of clinical value as preliminary screening measures or as indices of response to treatment, although further validation would be required to establish their utility.

Adult↗
PubMed1986

Mitochondrial DNA of two independent oligomycin-resistant Chinese hamster ovary cell lines contains a single nucleotide change in the ATPase 6 gene.

We have determined the nucleotide sequence of the URF A6L and ATPase 6 genes of the mitochondrial DNA of wild-type Chinese hamster ovary (CHO) cells and of two independently isolated, cytoplasmically inherited CHO mutant cell lines that are resistant to oligomycin, an inhibitor of the mitochondrial ATP synthase (ATPase) complex. Comparison of the nucleotide sequences of the mutants with that of their parental cell line revealed a single nucleotide difference, a G-to-A transition at nucleotide 433 of the ATPase 6 gene. This single base pair change predicts a nonconservative amino acid change, with a glutamic acid residue being replaced by a lysine residue at amino acid 145 of the ATPase 6 gene product in the mutants. This glutamic acid residue and several others in the surrounding amino acid sequence are conserved among all species examined to date. Analyses of several of the biochemical properties of the oligomycin-resistant CHO mutants indicate that the glutamic acid residue at position 145 of subunit 6 of the mitochondrial ATP synthase complex is important for the binding of oligomycin to the enzyme complex, but is not essential for proton translocation.

Adenosine Triphosphatases↗
PubMed1986

Investigation of 'weight pathology' of 58 mothers of anorexia nervosa patients and 204 mothers of schoolgirls.

'Weight pathology'--defined by Kalucy et al. (1977) as 'deviations in weight, shape, eating behaviour and activity'--has been hypothesized to be unduly common in families with anorexia nervosa. It was investigated in this study by means of questionnaires evaluating both weight history and attitudes towards weight-related matters in 58 mothers of anorexia nervosa patients and 204 mothers of schoolgirls of similar age and socioeconomic status (SES). No support was found for the hypothesis. A family history of aberrant weight and mother's current weight and past weight histories showed no significant differences between the groups. 142 other mothers of schoolchildren and 446 attenders at Weight Watchers also completed the questionnaire on attitudes towards weight-related matters. Mothers of patients showed a lower concern on all scales than did all other groups. The findings are discussed in relation to earlier controlled studies of family factors in anorexia nervosa.

Adolescent↗
PubMed1976

Effects of high-LET particles (40A) on the brain of Drosophila melanogaster.

To investigate the effects of galactic heavy particles on nervous tissue, Drosophila melanogaster flies were exposed to 40A from the Super-HILAC accelerator at the Lawrence Berkeley Laboratory. The energy of the particles reaching the Drosophila neurons was 4-8 MeV/nucleon, and the fluence ranged from 6 X 10(4) to 8 X 10(7) particles/cm2. Thirty-five days after irrdiation at the higher fluences, extensive tissue fragmentation and cysts were found. At fluences as low as one hit/two cell bodies (about 5 X 10(6)) and one hit/90 cell bodies (about 9 X 10(4) particles/cm2 or 21 rad average dose) swelling of neuronal cytoplasm and focally fragmented membranes were noted; at fluences ranging from one hit/six to one hit/135 cell bodies, there was frequently a marked increase in glial lamellae around nerve-cell processes, which often had degenerative features. These findings support the view that single hits by heavy particles may injure nervous tissue.

Animals↗