Biomedical subjects

R J Spruijt

Publications and source records attributed to R J Spruijt.

15 recordsLinked to original sources

PubMed1998

Disease-specific quality of life: is it one construct?

The objective of this study was to examine the structure of disease-specific quality of life (QoL). Models of QoL with either one overall construct or more constructs were tested and the relationships (factor loadings) between the constructs and dimensions were established, using structural equation modelling. The models were tested over time to assess the stability of the structure. To generalize the results further, disease-specific questionnaires of two very different chronic diseases have been compared: inflammatory bowel disease (IBD) and Parkinson's disease (PD). Questionnaires were mailed in 1994 and a repeated measurement was conducted in 1995. Data were obtained from 222 IBD patients and 235 PD patients. The results show that for both diseases, disease-specific QoL can be considered as one construct. The stability over time of the structure of the QoL models was satisfactory. In PD the factor loadings between the dimensions and QoL were within a small range and remained the same over time, while in IBD, the factor loadings had a larger range and fluctuated more. These results imply that one meaningful sum score can be obtained from these questionnaires.

Adult↗

PubMed1998

Agreement between radiographic and photographic trabecular patterns.

PURPOSE: It has been hypothesized that photographs can facilitate the interpretation of the radiographic characteristics of trabecular bone. The reliability of these photographic and radiographic approaches has been determined, as have various agreements between the two approaches and their correlations with biomechanical characteristics. MATERIAL AND METHODS: Fourteen vertebral bodies were obtained at autopsy from 6 women and 8 men aged 22-76 years. Photographs (n = 28) and radiographs (n = 28) were taken of midsagittal slices from the third lumbar vertebra. The radiographs and photographs were digitized and the geometric properties of the trabecular architecture were then determined with a digital image analysis technique. Information on the compressive strength and ash density of the vertebral body was also available. RESULTS: The geometric properties of both radiographs and photographs could be measured with a high degree of reliability (Cronbach's alpha > 0.85). Agreement between the radiographic and photographic approaches was mediocre as only the radiographic measurements showed significant correlations (p < 0.05) with the biomechanical characteristics. We suggest that optical phenomena may result in the insignificant correlations between the photographs and the biomechanical characteristics. CONCLUSION: For digital image processing, radiography offers a superior description of the architecture of trabecular bone to that offered by photography.

Adult↗

PubMed1997

Reliability of an image analysis system for quantifying the radiographic trabecular pattern.

A reliability evaluation technique was used to examine the reliability of an image analysis system of the trabecular pattern and to determine the contribution of three possible sources of error variance. Two series of radiographs were taken of 14 lumbar vertebral slices (28 radiographs). Every radiograph was placed on a viewing box for digitization four times by a single operator (112 positions of radiographs) and from every position of a radiograph an area of 15 mm x 15 mm was digitized twice (224 samples for analysis). Ten geometrical characteristics of the trabecular pattern were studied and its orientation was analyzed in 12 directions. Reliability was determined by calculating Cronbach's alpha. This design enabled dividing the measurement error (1-alpha) into fractions associated with the X-ray procedure, the operator and the system. Using this reliability evaluation technique, it was found that the orientation variables are more reliable than the geometric variables. It was found that effort to increase the reliability should be directed toward improving the technical procedure of this image analysis system. Also, repeated measurements will increase the reliability. The number of repeated measurements based on a desired reliability can be calculated. This procedure of evaluation gives the opportunity to select a source of error variance which have to be reduced to increase reliability most effectively.

Adult↗

PubMed1997

[Problems with dental information given to patients. A report by the consumer organisation].

The objective of this study was to investigate the information problems of Dutch dental patients in the years 1993-1995. Using a self-developed scale, the dental files of a consumer organisation were analysed and the information problems counted and categorised. Of all the dental dossiers 48% concerned information problems. The largest categories were: insufficient information about finances, insufficient information about the treatment/outcomes and the negligence of the information, complaints and questions of the patients. Together these categories make up 75% of the information problems. The results of this study stress that dentists should offer better structured information. More attention should also be paid to the abilities of the dentists to be communicative and to manage conflicts.

Communication↗

PubMed1996

An extended replication study of dental factors associated with temporomandibular joint sounds.

A previous study demonstrated associations between dental factors and joint sounds. To support these findings, this replication study was carried out in another sample of nonpatients. It was found that temporomandibular joint sounds are common in nonpatients. Their prevalence in young adults exceeded the prevalence in adults. The small size of the control group rendered the results of multivariate analysis statistically inconclusive. Tentative interpretation suggests that attrition of the anterior teeth or generally in the dentition, unilateral non-working-side interferences, morphologic occlusion, and premolar contacts are related to the presence of sounds. Temporomandibular joint sounds in nonpatients are considered to be normal and not a manifestation of subclinical problems. Definite answers on the causality of temporomandibular joint sounds will have to be based on prospective longitudinal studies.

Adolescent↗

PubMed1996

Relations between radiographic trabecular pattern and biomechanical characteristics of human vertebrae.

PURPOSE: Relations between the radiographic trabecular pattern and the biomechanical characteristics of bone were studied. MATERIAL AND METHODS: The material comprised L2 and L3 vertebral bodies of 14 individuals (aged 22-76 years; 6 women and 8 men). Compressive strength and ash density of the complete L2 vertebral body were determined. Of the L3 vertebral body, ash density and compressive strength in both horizontal and vertical directions were measured on cylinders of merely trabecular bone. Radiographs were taken of a midsagittal slice of L3 vertebrae. They were digitized to measure trabecular bone geometry and orientation. The procedure was repeated several times to obtain reliable measures. RESULTS: The radiographic trabecular pattern was significantly related to compressive strength, ash density and age. One of the radiographic geometric features in particular seems to offer information concerning the structural integrity of the trabecular architecture. CONCLUSION: Analysis of the radiographic trabecular pattern appears to be a promising technique for prediction of trabecular bone strength.

Aging↗

PubMed1996

[Temporomandibular joint sounds: a psychological problem?].

In this article the role of psychological variables in the etiology and presentation of temporomandibular joint sounds is studied. It is concluded that psychological differences observed in the literature are most likely not related to temporomandibular joint sounds. These differences probably are an artefact, caused by using self-report as a substitute for the objective presence of symptoms. A comparison between self-report and objective measurement shows that psychological variables are indeed mainly involved in the reporting of temporomandibular joint sounds. When objective measurements are used, no substantial psychological differences are found. A theory is presented that explains the reporting of symptoms from attention and interpretation. Using this theory the reporting of temporomandibular joint sounds can be predicted quite well.

Humans↗

PubMed1995

Spatial and morphologic aspects of temporomandibular joints with sounds.

Various spatial and morphological aspects of the temporomandibular joint may be involved in the development of TMJ sounds. The present study examines their contribution to the prediction of sounds. A non-patient sample was studied using sensitive sound measurement and panoramic radiography. It was found that temporomandibular joint sounds are common in asymptomatic subjects showing substantial variation in several spatial and morphological parameters. An autonomous contribution of spatial relationships, asymmetries or morphology of bony structures to the prediction of joint sounds could not be detected. When unilateral sounds were present, they were more likely to be found on the side with the less steep condylar movement path. Joint imaging is not indicated in the detection of relationships between bony structures and their eventual asymmetries and joint sounds.

Auscultation↗

PubMed1995

Psychological factors related to the prevalence of temporomandibular joint sounds.

This study focuses on the association between psychological factors and TMJ sounds, and the most suitable research design to establish this relation. A traditional research design is simulated to demonstrate how self-report may bias findings. A refined design is presented to obtain unbiased estimates of the role of psychological variables. In the 'naïve' design the importance of psychological variables was overestimated and the role of physiological variables was underestimated. It was concluded that future studies in the aetiology of TMJ clicking should abandon the use of self-report as a proxy for objective findings. With the refined design it was found that psychological factors play only a minor role in the prevalence of TMJ sounds. Findings do not support speculation about mechanisms that relate psychological factors to the presence of TMJ sounds.

Adaptation, Psychological↗

PubMed1994

The reliability of clinical methods for recording temporomandibular joint sounds.

Measurement errors in recording temporomandibular joint sounds may originate from variation between observers and from variation in the phenomenon. Laboratory settings enable various procedures to be used to minimize both sources of variation. These procedures yield some excellent intra- and inter-examiner reliabilities, but this does not imply that dentists in a clinical setting are likely to evaluate temporomandibular joint sounds in a comparable way. This study was designed to evaluate clinical joint sound assessment methods (palpation and stethoscopy) without using special precautions to minimize variance. An attempt was made to quantify the signal variance. Within- and between-examiners agreement is estimated for both methods in a sample of 44 non-patients. The results show that two clinically experienced craniomandibular disorders specialists were able to reach fair to good agreement on the identification of (the number of) temporomandibular joint sounds. There was some disagreement with respect to the number of reciprocal clicks. Compared with the palpation technique, stethoscopy is more sensitive, especially with regard to crepitation. Based on the electronically recorded sounds, both examiners appeared to be overconsistent. It is concluded that the use of both palpation and stethoscopy in clinical settings can be justified but that both methods have limitations. When, in a given clinical setting, these limitations are acceptable, there appears to be no need for extra-sensitive but expensive electronic recording devices.

Auscultation↗

PubMed1993

Dental factors associated with temporomandibular joint sounds.

Dental factors commonly associated with signs and symptoms of temporomandibular disorders were investigated in a group of nonpatients. A highly sensitive technique was used to establish the presence of temporomandibular joint (TMJ) sounds. In a discriminant analysis nonworking side interferences, attrition, molar contacts, horizontal range of jaw movement, and morphologic occlusion contributed significantly to the prediction of sounds. Further study of morphologic aspects of the joint and stress-related parafunctions may contribute to the understanding of the development of TMJ sounds. We concluded that TMJ sounds are a fairly common sign associated with mild deviations in certain morphologic and functional aspects of the stomatognathic system.

Adult↗

PubMed1992

Evaluation of a technique for recording temporomandibular joint sounds.

Analysis of temporomandibular joints sounds may contribute to the differential diagnosis of temporomandibular joint disorders. In this article an advanced system for the recording of joint sounds is presented. The method proved to be reliable. The problem of filtering out artifacts has been solved to a great extent but not completely. Temporomandibular joint sounds measured with this technique vary considerably in energy, frequency spectrum, and peak-to-peak amplitude over 3 months, as well as within 1 day. These differences seem to reflect natural variations in joint sounds caused by the physical impossibility of performing identical jaw movements. The results indicate that joint sound characteristics do not yet offer a solid basis for inferences concerning the development of temporomandibular joint abnormalities in the clinical setting.

Adolescent↗

PubMed1992

Symptom reporting in temporomandibular joint clicking: some theoretical considerations.

Analysis of research on psychological aspects of temporomandibular disorders suggests that self-reports of symptoms do not constitute reliable instruments for the measurement of physiological processes. In TMJ clicking, the actual physiological signal can be measured and compared with self-reports of the sounds. In this article a model is presented to describe perception, interpretation, and reporting of TMJ sounds. Three questionnaires are presented that measure aspects of these psychological processes. Recommendations are made for future research.

Attitude to Health↗

PubMed1991

The research on temporomandibular joint clicking: a methodological review.

The large variance in the reported prevalence of TMJ clicking is a result of the study of nonrepresentative groups, the use of different instruments, and the lack of a definition of "abnormal" clicking. Etiologic studies must be regarded with caution because it is not clear which mechanisms trigger TMJ clicking (or how) and because TMJ research is usually quasi-experimental, which precludes definitive conclusions concerning cause and effect. The lack of objective criteria makes diagnosis difficult. It is suggested that psychological factors such as symptom perception and report play a role in the decision to seek help, in the diagnosis, and in the treatment.

Adult↗

PubMedDate not supplied

Cancer and caregiving: the impact on the caregiver's health.

A diagnosis of cancer affects not only the patient but also their significant others, especially when a lot of care tasks are involved. Some caregivers perceive the care as a burden, while others consider it a challenge. In this article, findings concerning the impact of cancer caregiving on informal caregivers will be described. No consistent results are reported, and little is known about patterns of caregiving changes in relation to the course of the patient's illness. Attention will be given to factors which have been identified as influencing the course and consequences of caregiving. These factors form the basis of a conceptual research model for caregivers of cancer patients. As cancer progresses, care tasks are generated, which can be perceived by the caregiver as either negative (i.e. burden) or positive. Furthermore, these caregiver experiences may lead to negative as well as positive effects on the caregiver's health and these relationships can be assumed to be bidirectional.

Adult↗