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PubMed1980

Couple interactional classification of sexual dysfunction--a new theoretical conceptualization.

Sex therapists traditionally speak of the couple's relationship as "the patient." However, existing diagnostic classifications prove to be random lists of dysfunctions and are unrelated to the dyad as a couple. Each partner is classified independently and out of context of the dyad on the basis of lists of male/female dysfunctions. A merging of gynecosexological and behavioral psychosexological approaches has led us to develop a new holistic classification--and, what we believe to be, a more rational one--of sexual dysfunctions. It is based on a ranking of the disorders according to the seriousness of the disruption to the dyad's functioning as a couple. The sexual dysfunctions are classified according to the degree of stress activated within the couple's relationship, thus enabling the therapist, from the beginning, to develop rapport and increased motivation by the clients, which will positively affect the therapeutic outcome, even in the so-called serious cases.

Female↗
PubMed1997

Drug use by the elderly in Italy.

OBJECTIVES: To evaluate drug consumption in the elderly aged 75 years or more living at home. DESIGN: Cross-sectional study. SETTING: Old-old (i.e., > or = 75 y) people living in central Turin, a city in northern Italy. PARTICIPANTS: Thirty-four general practitioners (GPs), with 50 or more old-old people in their patient list, randomly chosen among the GPs working in the Unità Socio-Sanitaria Locale I (Local Health Unit I) of Turin; 261 old-old people (135 men and 126 women) randomly selected from the practice records. METHODS: Data were collected by the GP through a structured questionnaire during an office visit and by a social worker in a home interview within 14 days of the GP visit. GPs were asked to record every diagnosis and drug currently taken by the patient; social workers were trained in the administration of a structured questionnaire exploring sociodemographic variables, drug use (following the medication inventory strategy), disability, cognitive functions, and depressive symptoms. RESULTS: Nearly all subjects (95% of the women and 91% of the men) were taking at least 1 drug. The overall number of drugs recorded was 917 (47.1% for men and 52.9% for women), of which 172 (18.8%) were not reported by the GP but were recorded during the social worker's visit. The mean number of drugs was 3.2 for men and 3.8 for women, with a statistically significant difference (p = 0.02), while the mean number of diagnoses was 2.3 and 2.6, respectively. The study of correlates of drug consumption showed a strong association with number of diagnoses at univariate analysis (p < 0.0001, with a linear correlation coefficient of 0.64). No multivariate model showed a clear superiority over the simple one containing only the number of diagnoses in predicting the total number of drugs taken. Cardiovascular, nervous system, and alimentary tract drugs were the most frequently used. A total of 107 subjects (41%) were taking at least 1 unreported drug. CONCLUSIONS: Our study shows high drug consumption among old-old people, with nearly 20% of drugs taken not reported by the GP. These results emphasize the need for an essential therapeutic approach in old-old people, prescribing only drugs of scientifically proven efficacy. Furthermore, the GP must make more effort when collecting a drug history from old-old patients.

Aged↗
PubMed1978

Evidence for language recoding in autistic, retarded and normal children: a re-examination.

In a replication and extension of earlier studies by Hermelin & O'Connor, language recoding abilities in autistic, retarded and normal children matched for mental age and digit span, were compared in a verbal recall task. Random word lists, sentences, and anomalous sentences, eight or 12 items in length (for high and low memory span subgroups) were presented and the number of words recalled from each type of input was scored. All low span children recalled sentences better than random lists with normal children superior to retarded and autistic children and the latter group poorer than the retarded group. Autistic children showed a recency effect with both types of input. There were no group differences amongst high span children and sentences were again better recalled than random lists. In Expt II sentences were better recalled than anomalous sentences, with autistic and retarded children equivalent in performance and poorer than normal children. Although low span autistic children were clearly deficient in recall of sentence material when compared with the two control groups, the effect of conditions showed that they were able to use structure to improve recall. Since high span autistic children did not perform differently from controls it is suggested that results from this kind of study may not be generalizable, and that claims for a specific coding deficit in autistic children need further substantiation.

Autistic Disorder↗
PubMed1995

Multiple births and risk of breast cancer.

Data from a large, multicenter, population-based case-control study were analyzed to investigate the relation between multiple birth pregnancies and subsequent breast-cancer risk in the gravidas. Women less than 75 years old who had breast cancer were identified from statewide tumor registries in Wisconsin, western Massachusetts, Maine and New Hampshire. Controls aged less than 65 years were selected randomly from lists of licensed drivers, and controls aged between 65 and 74 were selected randomly from lists of Medicare beneficiaries. Information on reproductive history and other factors was obtained by means of telephone interviews. After excluding nulliparous women, 5,880 case subjects and 8,217 controls remained for analysis. Multiple birth pregnancies occurred in 146 cases and 218 controls. Adjusted for the number of full-term pregnancies and other confounders, the odds ratio (OR) for any multiple birth pregnancy was 0.94 (95% confidence interval, 0.75 to 1.17). The null association between multiple birth pregnancies and breast cancer remained if the mother's first pregnancy or last pregnancy resulted in a multiple birth. In addition, no trend in risk emerged for age at first multiple birth or time since last multiple birth. While other investigators have suggested biological mechanisms to explain both protective and detrimental effects of multiple births and subsequent development of breast cancer, this study does not support either assertion.

Adult↗
PubMed1970

Forgetting: trace erosion or retrieval failure?

A series of lists of random words was presented. Following each list, the subject attempted to recall the words of the list prior to the list just presented. Recall probability for a given word depended on the length of the list in which it was embedded, not on the length of the list intervening between presentation and test. These results indicate that forgetting is a failure in the memory search during retrieval rather than a degradation of the memory trace occurring between presentation and test.

Humans↗
PubMed1993

Effects of structure and clustering on recall and recognition memory in clinical depression.

The present study compared retrieval of high, medium, and low structured material, using word lists consisting of uncategorized words and categorized words presented in randomized and clustered order. Clinically depressed subjects were found to be significantly impaired relative to controls only on the medium level of structure and the randomized categories list when measured by free recall. There were no effects of group nor any interactions for recognition memory, although there was a main effect for group on d' when signal detection analysis was applied. The implications of the findings for models of memory deficits in depression are discussed.

Adult↗
PubMed1980

A clinician-judged technique for quantifying dysarthric speech based on single-word intelligibility.

A clinician-judged technique for quantifying dysarthric speech based on single-word intelligibility was developed and evaluated in three experiments. Dysarthric speakers were audio-recorded as they read 50-word lists that had been randomly generated from sets of similar sounding words. These tapes were judged by speech pathologists using listening formats that were systematically altered by varying the number of choices available to the judges. Results indicated that some formats were more sensitive to differences that exist among severely dysarthric speakers and others were more sensitive to differences that exist among mild to moderately dysarthric speakers. Judge familiarity with the master word pool increased scores slightly but in a consistent and predictable fashion. Scores from different randomly generated word lists were similar when the influence of a speaker's day-to-day variability was controlled. Clinical implications and uses of this technique for the monitoring of change in speaker performance were discussed.

Adolescent↗
PubMed1982

[Immunoglobulins in bacterial and viral meningitis. Results of a controlled randomized clinical study of intravenous and intrathecal application].

The efficacy of additional intravenous and intrathecal immunoglobulin (Ig) therapy was investigated in a randomized clinical trial with 68 patients divided with the aid of a list of random numbers into two groups according to their infection. The group of bacterial infections of the CNS included 29 patients and the group of virus infections of the CNS 39 patients. The statistical evaluation of patients with bacterial infections and of those with virus infections was done separately. Group 1 received 10 g Ig each as a short infusion on two consecutive days. Patients with bacterial infections received in addition on every second day and patients with viral infections on every fifth day 500 mg of the same preparation by intrathecal injection. In contrast to this, a control group received the usual therapy only, principally antibiotics for purulent meningitis. The following characteristics were investigated and compared as variable criteria of the course of the disease and consequently of the efficacy of the additional therapy with Ig: CSF cell count, CSF protein, pyrexia, general condition, paralyses, neuropsychological defects, vigilance and EEG recording. As overall criteria of the course of the disease the length of stay in hospital and the rise in temperature were considered. The results of the statistical analysis showed a statistically significant superiority for the Ig-treatment which was most marked in the regression of the CSF pleocytosis, total CSF protein and pyrexia. For the subjectively graded clinical evaluations such as general condition, disturbances of vigilance, transient paralyses, neuropsychological defects and EEG tracings the statistical significance still applied, even if not so pronounced as for the previously mentioned criteria.

Adult↗
PubMed1991

Semantic organization and verbal episodic memory in patients with mild and moderate Alzheimer's disease.

The objective of the present research was to investigate the relationship between semantic organization and cue utilization in mildly and moderately demented patients with Alzheimer's disease (AD). In Experiment 1, subjects were presented with two lists of words: a list with semantically unrelated words and a list with words from four semantic categories presented randomly intermixed. Free recall was assessed and following the organizable list, subjects received a cued recall test. Normal controls, as opposed to mildly and moderately demented patients, showed higher performance in the organizable list as compared to the random list. In addition, normal controls and mildly demented patients benefited from semantic cues in the organizable list and performed at a higher level in total recall as compared to free recall. In Experiment 2, subjects were presented with two lists of words: a list with words from four semantic categories presented randomly intermixed and a list with words from four semantic categories presented clustered, together with information about the organization of the list. Free recall and cued recall, with the category names serving as cues, were assessed. Free recall performance of normal controls was higher in the clustered than in the organizable list, whereas no such effect was observed for the AD patients. Normal controls and mildly demented patients performed at a higher level in total as compared to free recall in both lists, whereas this effect was present only in the clustered list for the moderately demented patients. The overall pattern of results indicates that there are conditions under which memory facilitation from semantic organization may be obtained in AD.

Aged↗
PubMed1980

Knowledge acquisition in oncology from randomized therapeutic trials.

Appreciating the impact, on the progress of our knowledge, of randomized therapeutic trials performed over a period of thirty years leads to a two-fold approach: a) Drawing up the list of randomized trials and assessing the impact of their conclusions on the progress of our knowledge and on the improvement of standard therapy; b) from recognised progress in oncology, appraising the part played by randomized trials in the acquisition of that knowledge.

Clinical Trials as Topic↗
PubMed1978

Color context as a factor in encoding and as an organization device for retrieval of word lists.

One hundred twenty female undergraduates were presented hierarchically organized or randomly arranged word lists within a context of hierarchically organized or randomly arranged color patterns. Recall scores were significantly higher with a hierarchic color pattern than with a random color pattern; this facilitating effect occurred for both hierarchic organizations and random arrangements of the word lists. The results suggest that Ss may use context as both a cueing of differentiating factor in encoding and as an organizational device for retrieval.

Color Perception↗
PubMed1987

A microcomputer program for the generation of random grid squares in quantitative analysis.

Subjectivity in selecting random grid squares for routine quantitative analysis can be circumvented through a combination of finder grids and a computer program. The simple BASIC program described in this paper generates a list of random grid-square numbers, which are sequentially analyzed. The concept was applied in the quantitation of asbestos and other microparticles in environmental samples. The use of finder grids and this program can also be useful in quality-control programs and in cross-referencing analyses, as well as in the study of biological specimens.

Asbestos↗
PubMed1995

Use of Spanish surnames to identify Latinos: comparison to self-identification.

Difficulties in identification of Latinos from secondary datasets have often been addressed by the use of a Spanish surname list. To evaluate the sensitivity and specificity of the 1980 U.S. Census Spanish surname list in correctly identifying Latino ethnicity, we conducted a cross-sectional survey of adult members of a prepaid health plan in the San Francisco Bay Area. We compared a randomly selected list of 1345 Spanish surnames and 717 non-Spanish surnames from health plan membership lists with their self-identified race and ethnicity obtained by telephone interviews. The sample was stratified according to surname group (Spanish or non-Spanish), sex, age, and county. Compared with self-identified ethnicity, a Spanish surname was 88.4% sensitive in identifying Latino men and 70.4% sensitive in identifying Latina women. The non-Spanish surname list was 94.1% sensitive and 95.0% specific in correctly identifying non-Latinos. Although the overall negative predictive value was 97.8%, the positive predictive value of a Spanish surname was only 68.3% for men and 55.7% for women. The low positive predictive value was largely due to the 316 (61%) Filipinos among the 517 persons with Spanish surnames who were not Latinos. We conclude that the use of the Spanish surname list alone to ascertain race and ethnicity in the San Francisco Bay Area both falsely identifies a large number of non-Latino persons as Latino and fails to identify a small proportion of Latinos. Although the level of sensitivity and specificity for Spanish surnames will vary with the area under study, this source of inaccuracy must be considered in studies that plan to use data based on Spanish surnames.

Adult↗
PubMed1994

A randomized double-blinded comparison of the antiemetic efficacy of ondansetron and droperidol in patients receiving high-dose interleukin-2.

Emesis and nausea are common toxicities seen during high-dose interleukin-2 (IL-2) therapy (720,000 IU/kg i.v. every 8 h). A growing list of randomized studies have documented the efficacy of ondansetron, a potent antagonist of the 5-hydroxytryptamine3 receptor, in preventing acute chemotherapy-induced emesis and nausea. However, no study has evaluated the efficacy of ondansetron in preventing IL-2-induced emesis and nausea. This double-blinded, randomized trial was performed to compare the antiemetic and antinausea efficacy of ondansetron with that of droperidol, a butyrophenone, in patients receiving high-dose IL-2 on protocols at the National Cancer Institute. Ondansetron or droperidol was given intravenously, 30 min prior to the first dose of IL-2 and then every 8 h for the duration of IL-2 treatment. No significant differences were seen between the two agents in complete freedom from emesis (p2 = 0.51), level of nausea (p2 = 0.17), antiemetic treatment failure (p2 = 0.89), and time to first emetic episode (p2 = 0.44). Equivalent doses of IL-2 were administered on each arm of the study, with a similar incidence of liver dysfunction (p2 = 0.15) and diarrhea (p2 = 0.64). Finally, there was no significant difference in the response rates to metastatic disease in either arm of the antiemetic study (p2 = 0.67), and these response rates were similar to those in other patients treated under immunotherapy protocols in the Surgery Branch of the National Cancer Institute with high-dose IL-2. We conclude that droperidol is equally effective in preventing emesis and controlling nausea when compared with ondansetron for patients receiving high-dose IL-2.

Adult↗
PubMed1996

Prevalence and treatment of chronic airways obstruction in adults over the age of 45.

BACKGROUND: Chronic airways obstruction is common in adults and the elderly. To investigate the possibility that older adults with obstructive airways disease frequently do not receive appropriate treatment, the respiratory symptoms, medication use, and pulmonary function were studied in a random sample of white adults aged over 45 living in central Manchester, UK. METHODS: A postal questionnaire survey was performed on 783 men and women aged 45 years and over selected from GP lists by random number tables. Subjects completing the questionnaire were invited to attend for pulmonary function testing and methacholine challenge (Newcastle dosimeter method). RESULTS: The questionnaire response rate was 92.3% (723 subjects). The mean age of the population was 66.1 years and 57.2% were women; 29.2% were current smokers and 37.3% were ex-smokers. Asthma or bronchitis was reported by 30.0%. Two hundred and forty seven representative subjects attended for pulmonary function testing and spirometric evidence of chronic airways obstruction was found in 26.4%. Respiratory symptoms were reported by 76.6% of subjects with chronic airways obstruction; 55.0% had features which may predict potential improvement on treatment (increased non-specific bronchial responsiveness or significant bronchodilator reversibility). However, only 55.4% of subjects with airways obstruction had received a diagnosis of asthma or chronic bronchitis and only 36.9% were using inhaled bronchodilators or steroids. CONCLUSIONS: Chronic airways obstruction is very common in adults in this inner city population, but is frequently overlooked. Most subjects with chronic airways obstruction are not receiving appropriate treatment.

Aged↗
PubMed1981

Practice effects for normal listeners' performance on a nonsense syllable test.

Each of 4 groups (N: 5) of normal-hearing young adults responded to the consonant-vowel-consonant-vowel Nonsense Syllable Test (Edgerton and Danhauer, 1979). Groups I and II on any one day for 5 consecutive days received one presentation of both Lists A and B at 16 and at 56 db re individual SRT, with (Group II) or without (Group I) visual reinforcement as to the correctness of the response. Groups III and IV received 15 randomizations of List A (non-reinforced) in a single session at 16 or 56 db SL, respectively. S's were tested individually diotically; verbal responses were phonetically transcribed using both audio and visual cues, and were scored phonetically. There were no significant differences in means between Groups I vs II as a result of reinforcement, but differences were noted in both groups for presentation levels and trials (days). No practice effects were noted in Groups III and IV. The NST may be used for multiple administrations within a single session, as in deriving performance-intensity functions, or in hearing aid evaluations, without biases due to practice.

Adult↗
PubMed1995

Evaluation of a prototype esophageal detection device.

OBJECTIVE: To determine the ability of a prototype esophageal detection device (EDD) to identify esophageal misplacement of an endotracheal (ET) tube. METHODS: A prospective, randomized, blinded study of detection of esophageal intubation was conducted using 51 elective surgical patients who met inclusion criteria. A squeeze-bulb aspirator that creates a negative pressure of -80 to -90 torr was used for detection of esophageal intubation. The bulb should reinflate rapidly if the tube is in the noncollapsible trachea, but should not reinflate if the tube is in the collapsible esophagus. Each patient was prepared for surgery in the usual manner. The anesthesiologist placed an ET tube into the trachea. An identical tube was advanced the same distance into the esophagus. The tubes were labeled "A" or "B" according to a computer-generated random number list. An evaluator, who was blinded to the placement of the tubes, assessed one tube with the EDD. For most patients, a second evaluator, who was blinded to both tube placement and the results of the first evaluator, assessed the other tube. During evaluation, the tube cuffs were deflated. After data collection, the esophageal tube was removed and surgery was completed. RESULTS: All 45 esophageal tube placements were correctly identified. Thirty-five of the 40 ET tubes were correctly identified. Of the five ET tubes mislabeled, three were found in a mainstem bronchus. All had delayed bulb re-expansion. CONCLUSION: This prototype EDD is a useful method of identifying esophageal misplacement of an ET tube in anesthetized adult surgical patients.

Adolescent↗