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Women's perceptions of cesarean and vaginal delivery: another look.

Perception of the birth experience was examined in a sample of 106 women who had unplanned cesarean deliveries, 113 who had planned cesarean deliveries, and 254 who had vaginal deliveries. Vaginally delivered women had more positive perceptions than their unplanned cesarean counterparts (p < .001). There were no differences in perceptions between the unplanned and planned cesarean groups, or between the planned cesarean and vaginal groups. General anesthesia for cesarean delivery was associated with more negative perceptions than regional anesthesia, and regional anesthesia for vaginal delivery was associated with more negative perceptions than no or local anesthesia. Pain intensity and physical distress were negatively correlated with perceptions.

Anesthesia, Obstetrical↗

Residents' perceptions of water quality improvements following remediation work in the Pymme's Brook catchment, north London, UK.

Residents' perceptions of water quality change following remediation work in the upper Pymme's Brook catchment (north London) were elicited by questionnaire and compared with monitored changes in Escherichia coli count and BMWP (The Biological Monitoring Working Party (BMWP)) score. The wider usefulness of consumer perception surveys was then discussed. Monthly data collected between 1990 and 1996 shows that both E. coli count and BMWP score improved following flushing of the foul sewerage system in 1992, but that only E. coli count improved following the subsequent completion of large-scale remedial engineering works. Local residents were surveyed regarding their awareness of the scheme, and the causes of pollution, together with their perceptions as to the effects of the engineering works and of the resulting water quality improvements. Most respondents selected and ranked indicators in a way that suggested they had an awareness of the significance of various indicators of pollution severity. Following completion of the remediation scheme, residents perceived the watercourse to contain less rubbish and sewage fungus, and to have an improved colour and smell, which corresponds favourably to the monitored improvements. However, respondents' perceptions were found to vary when the study population was sub-divided using a range of parameters. For instance, frequent observers of the brook were most likely to correctly identify sewage as the main form of pollution. These divergent perceptions suggest that there may be considerable difficulties when perception surveys are used to quantify 'benefits' following environmental improvement programmes. Nevertheless, the survey was clearly beneficial in enhancing residents' awareness of their environment and the role of their voice in its management.

Adolescent↗

Experimental analysis of the human perception threshold of a DC electric field.

To study the biological effects of extremely low frequency (ELF) electric fields, a fundamental study is conducted of the human perception threshold of an electric field. The perception threshold is measured with human subjects, and the results are analysed. It is clear that field perception is based on the movement of hair and not on other sensations. Variance in the perception threshold and its causes are investigated. The perception threshold decreases by almost 30% as the relative humidity increases from 50 to 90%. The perception threshold is also dependent on the physical condition (length and density) of the hair and the psychological condition (degree of awareness) of the subject. The dependence on these is much smaller than that on relative humidity. The cause of the gender difference in the threshold is ascribed to the difference in the physical condition of the hair. Through this study, some factors to be taken into account for the safety standard are made clear.

Adult↗

Tourist perceptions of degradation caused by coastal nature-based recreation.

Tourist perceptions of environmental degradation caused by nature-based tourism activities in a coastal environment were determined in the Central Coast Region of Western Australia. Structured surveys were administered to 702 visitors over two peak seasons. Visitors were required to indicate their perceptions on a Likert-type scale. Activities assessed were swimming, boating, fishing, diving and snorkelling, (wind)surfing, sandboarding, four-wheel driving, (bush)walking, camping, horseriding and sightseeing. Tourists had significantly variable demographic characteristics over two seasons and participated in different activities. However, perception of environmental degradation of individual activities did not vary significantly between seasons, except for fishing, four-wheel driving and sandboarding. The age, origin and level of education of visitors had more effect on perceptions than gender or income group. Participation in an activity affected perceptions only for those who went fishing, sandboarding, four-wheel driving and sightseeing. Visitor perceptions were comparable to 'real' impacts documented in the recreation ecology literature. The results of this research indicate a need for improved visitor education and interpretation facilities.

Adolescent↗

Maternal perceptions of her child's body weight in infancy and early childhood and their relation to body weight status at age 7.

INTRODUCTION: Maternal perception of her child's weight status has been hypothesised to affect a child's weight development. OBJECTIVE: The aim of this analysis was to determine in how far the maternal weight perception of her child's weight at different ages is related to its future body weight status. MATERIALS AND METHODS: Longitudinal data on body weight, height and skinfolds from the Dortmund Nutritional and Anthropometric Longitudinally Designed Study were used to determine the risk of being overweight at age 7. Complete data on anthropometry, maternal weight perception and confounding variables were available for 253 children. RESULTS AND DISCUSSION: Maternal weight perception assessments at age 6 months, 12 months, 2 years and 4 years of age were related to body weight status as well as changes in body mass index standard deviation score (BMI-SDS) and skinfold SDS between age at assessment and age 7. With respect to the risk of being overweight at age 7, no independent effect of maternal perception was found. When changes in anthropometric measures were considered, it could be observed that children whose weight was considered too low gained more weight until age 7, and those who were considered to be too heavy lost more weight as compared to the children whose weight was considered to be just right. Among infants aged 6 months who were above the 85th percentile, maternal misperception appeared to promote an unfavourable weight development. These latter results support the hypothesis that maternal weight perception might affect a child's weight development. CONCLUSION: As our data suggest, this effect might begin to operate already in infancy.

Adolescent↗

Oral and oropharyngeal perceptions of fluid viscosity across the age span.

Research demonstrates that varying sensory input, including the characteristics of a bolus, changes swallow physiology. Altering the consistency of fluids is a common compensatory technique used in dysphagia management to facilitate change. However, it is not known what variations in viscosity can be perceived in the oral cavity or oropharynx or if age affects oral and oropharyngeal perceptions of fluid viscosity. This study aims to establish the ability of normal adults to perceive fluid viscosity in the oral cavity and oropharynx and to determine if, within this population, there are age-related changes in oral and oropharyngeal perceptions. Sensitivity was established by deriving the exponent for the psychophysical law for fluid viscosity in both the oral cavity and the oropharynx, using modulus-free magnitude estimation with Newtonian fluids of corn syrup and water. Sixty normal volunteers, aged 21-84 years, participated. Results indicate that the exponent for oral perception of fluid viscosity was 0.3298, while for oropharyngeal perception it was 0.3148. Viscosity perception deteriorates with increasing age. Men exhibited a more marked deterioration in sensitivity than women. This study contributes to the literature on oral and oropharyngeal perceptions and on aging. The results provide a basis for work with individuals with dysphagia.

Adult↗

Pain perception threshold in major depression.

Somatosensory perception threshold (SPT) and pain perception threshold (PPT) were studied in 16 patients with major depression, compared to the findings in an age-matched and gender-matched control group and related to the psychopathological state evaluated by means of the Hamilton Depression Scale. Perception thresholds were assessed by means of a noninvasive high-frequency electric skin stimulation. Absolute perception thresholds were increased in the patients. However, the relative pain perception threshold (RPPT = PPT: SPT) was significantly reduced. RPPT was positively correlated with retardation. It was negatively correlated with anxiety, suggesting that a reduction of pain perception thresholds in depressive patients may be attributed to anxiety and impaired stress-coping.

Adult↗

A somatostatin analogue inhibits afferent pathways mediating perception of rectal distention.

BACKGROUND: Octreotide, a somatostatin analogue, has antinociceptive activity in several models. We studied whether octreotide modifies perception of rectal distention in healthy volunteers and examined its mechanism of action. METHODS: Octreotide (100 micrograms, subcutaneously) and placebo were injected in double-blind fashion. Rectal balloons measured volumes that evoked increasing levels of perception. Octreotide's effects on rectal sensation were compared with actions on rectal resistance, rectal motor activity, afferent and efferent anal activity, and somatic perception. RESULTS: After octreotide administration, threshold perception, pressure, urgency, and maximal tolerated volume were reported at 62 +/- 4, 185 +/- 11, 269 +/- 17, and 362 +/- 25 mL, which were greater than after administration of placebo (25 +/- 4, 95 +/- 9, 153 +/- 10, and 211 +/- 13 mL, P < 0.01). Rectal pressures, which increased from 9.2 +/- 1.2 mm Hg at 30 mL to 20.2 +/- 1.7 mm Hg at 180 mL after administration of placebo, were not modified by octreotide; this shows a lack of effect on rectal resistance. However, in addition to enhancing volumetric tolerance, maximally tolerated pressures were increased to 42.4 +/- 5.1 mm Hg (P < 0.01) by octreotide. Octreotide increased phasic rectal contractions but did not change anal pressures or block the rectoanal inhibitory reflex, confirming that local rectal reflex arcs are unaffected. Perception of thermal or electrical cutaneous stimulation was unaffected by octreotide showing selectivity for visceral afferent pathways. CONCLUSIONS: Octreotide reduces sensation of rectal distention via inhibition of visceral afferent pathways. In contrast, afferent pathways involved in local reflexes and cutaneous perception are not inhibited by octreotide.

Adult↗

The sympathetic nervous system modulates perception and reflex responses to gut distention in humans.

BACKGROUND/AIMS: Intestinal distention induces perception and gut reflexes via sympathetic and vagal pathways, but the modulatory mechanisms of such responses remain obscure. The aim of this study was to determine the effects of sympathetic nervous activity on sympathetic and vagal reflexes as well as on intestinal and somatic perception. METHODS: In 9 healthy volunteers, proximal duodenal distentions were produced in 4-mL increments and hand transcutaneous electrical nerve stimulation was produced in 3-mA increments. Increasing stimuli of 1-minute duration were randomly performed at 10-minute intervals both with and without sympathetic activation (induced by means of lower body negative pressure). Intestinal and somatic perception was scored by specific questionnaires; vagal enterogastric and sympathetic intestinointestinal relaxatory reflexes were simultaneously measured by gastric and distal duodenal barostats. RESULTS: Sympathetic activation significantly heightened perception of intestinal distention without modifying perception of somatic stimuli (perception scores increased by 41% and -2%, respectively). The reflex responses to duodenal distention significantly increased during sympathetic activation both in the stomach and in the intestine (relaxation increased by 91% and 69%, respectively; P < 0.05 for both). CONCLUSIONS: Activation of the sympathetic nervous system selectively increases visceral but not somatic sensitivity and enhances both vagally and sympathetically driven reflexes in the gut.

Adult↗

Effects of sweetness perception and caloric value of a preload on short term intake.

To determine the effects of calories and sweetness perception on intake, fasted normal weight subjects drank a preload sweetened with sucrose (1.1 g/kg) or L-asparthyl-L-phenylalanyl-methyl ester (Aspartame, 0.011 g/kg), or with no added sweetener. Sweetness perception of the load was reduced in half of the subjects by oral application of Gymnema sylvestre extracts. One hour after the preload, a meal of snack foods was presented and amounts of nutrients eaten were calculated. Subjects whose perception of sweetness had been decreased for the preload ate less total and sweet calories than did those with normal perception. Calories did not affect intake. The effect of calories and perception of the load was also assessed on variables presumed to correlate with satiety. Sucrose pleasantness ratings were not related to calories, perception or intake. Subjects' estimates of the amount of milkshake that they would drink if given the opportunity to do so and hunger ratings were related to overall intake and carbohydrate intake, respectively. The findings indicate that hedonistic aspects of taste are of greater importance than calories in determining short term intake.

Diet↗

Parent and adolescent perceptions of family functioning: a comparison of clinic and non-clinic families.

In this paper two studies are reported which compare (a) the perceptions of family functioning held by clinic and non-clinic adolescents, and (b) the perceptions of family functioning held by adolescents and their mothers in clinic and non-clinic families. In Study 1, matched group of clinic and non-clinic adolescents were compared on their responses to a 30-item scale (ICPS) designed to measure three factors of family functioning: Intimacy (high vs. low), Parenting Style (democratic vs. controlled) and Conflict (high vs. low). Clinic and non-clinic adolescents were also compared on their responses to a multi-dimensional measure of adolescent self-concept. Although there was little difference between the two groups of adolescents in terms of their perceptions of family functioning, there were strong relationships between the self-concept variables and the family functioning variables. In Study 2, comparisons were made between the perceptions of family functioning held by mothers and adolescents for both clinical and non-clinic families. There were no differences between the two groups of adolescents in terms of their perceptions of family functioning, although there were clear differences between the two groups of mothers. In addition, clinic adolescents and their mothers did not differ in their perceptions of the family, whereas adolescents in the non-clinic group saw their families significantly as less intimate and more conflicted than did their mothers.

Adolescent↗

Status of life-areas: congruence/noncongruence in ESRD patient and spouse perceptions.

Perceptions of ESRD patients' satisfaction with, and abilities in, 13 life-areas were assessed in 50 patients and their spouses by means of a series of linear rating scales. Patient and spouse views were congruent on 10 dimensions. Noncongruence existed only on perception of the patient's satisfaction with his/her medical situation, perception of the patient's ability to care for self, and perception of the patient's satisfaction with feelings about self. This noncongruence was especially pronounced in certain patient subgroups, and explanations related to the nature of ESRD and its treatment are suggested. We recommend that future studies examine not only perceptions of patients' satisfaction but also perceptions of the spouse's own satisfaction with various life-areas.

Activities of Daily Living↗

Childhood discipline, perceptions of parents, and current functioning in female college students.

This study examined the relationships among the childhood discipline styles experienced by 116 female college students, their perceptions of their parents, and their current functioning. Results of this study indicated that female college students' report of childhood discipline, their perceptions of their parents, and their outcomes were related uniquely when examining responses for mothers and fathers. Further, regression analyses suggested that negative perceptions of mothers may mediate the relationship between maternal psychologically assaultive discipline and female college students' depression and self-esteem and mediate partially the relationship between maternal psychologically and physically assaultive discipline and female college students' anxiety. In contrast, fathers' use of psychologically assaultive discipline and female college students' positive and negative perceptions of their fathers predicted depression, whereas only their perceptions predicted anxiety and self-esteem. These results suggested the importance of examining discipline and perceptions of parents when examining the functioning of late adolescents and emerging adults.

Adolescent↗

Sulpiride plus hydroxyzine decrease tinnitus perception.

OBJECTIVES: The aim of the study is to confirm the effectiveness of sulpiride and hydroxyzine in tinnitus patients. The administration of sulpiride, a D2 antagonist of dopamine receptors, together with hydroxyzine, a subcortical sedative, covers the areas of tinnitus perception. METHODS: A prospective, randomized, single blinded, placebo-control study was done in general otorhinolaryngology consultations for 2002-2004 in Seville and Zaragoza (Spain). One hundred and fifty patients consulted for subjective tinnitus. They were included randomly in three groups of 50. A group took sulpiride (50 mg/8 h) alone, other the same dose of sulpiride plus hydroxyzine (25 mg/12 h), and the third placebo (lactose), for 1 month. One hundred and twenty-two patients completed the study. Clinical history, tonal audiometry, tympanometry, and tinnitometry were done in the beginning and end of the study. Subjective Grading of Tinnitus Perception and visual analogical scale (0-10) were done for result evaluation. RESULTS: Based on the Subjective Grading of Tinnitus Perception, tinnitus perception diminished by 56% in patients treated with sulpiride and by 81% in patients treated with sulpiride plus hydroxyzine. Based on the visual analogical scale, tinnitus perception diminished from 7.8 to 6.3 in the patients treated with sulpiride, and from 7.8 to 5.1 in those treated with sulpiride plus hydroxyzine. CONCLUSIONS: Sulpiride plus hydroxyzine decreases tinnitus perception. Tinnitus auditolimbic dopaminergic pathway opens wide therapeutical implications.

Adult↗

Caregiving in the Philippines: a quantitative survey on adult-child caregivers' perceptions of burden, stressors, and social support.

This study aims to describe the present caregiving situation of Filipino adult-child caregivers (CGs) particularly aiming to identify the predictors of CG burden and to assess the effect of social support on stressors and perception of burden. A cross-sectional survey employing face-to-face interviews with 193 adult-child CGs in Davao City, Philippines, measured the perception of burden using the Cost of Care Index (CCI) by Kosberg and Cairl. Results indicated the majority were daughter CGs living with their elderly parents, who were receiving high levels of informal social support. A moderate to high level of burden perception (mean+/-S.D. score of 47.0+/-9.1) was found among respondents. CGs with higher educational attainment showed low burden perception. However, higher family income and higher State-Trait Anxiety Inventory (STAI) anxiety scores were associated with higher burden perception. Also, longer caregiving hours, a male care recipient (CR), and the presence of CR's memory and behavior problems predicted higher CG burden. The interaction between stressors and perceived burden showed that social support provided a buffering effect for CGs experiencing higher burden perception. This suggests that respite and support resources including community-based counseling and education programs to assist CGs in dealing with stress may positively contribute to reduce burden.

Adaptation, Psychological↗

Whose informational needs are considered? A comparison between cancer patients and their spouses' perceptions of their own and their partners' knowledge and informational needs.

The present study examines information exchange patterns between 98 married couples in Israel where one is a cancer patient and the other is the main caregiver. Specifically, the accuracy of each spouse's perception of the extent of knowledge and the need to receive more disease-related information is examined as a function of the role (patient-caregiver) and gender of the participants. The results showed that women, regardless of their role, were inaccurate in their perception of their husbands' knowledge and motivation to know more. For men, a difference between the roles was found for the perception of their wives' knowledge. As caregivers, they were inaccurate while as patients they were accurate in this estimation. Their perception of their wives' needs to know more was accurate. Moreover, female patients, more than male, relied on their perception of themselves when assessing their spouse's knowledge and informational needs. Thus, it is concluded that female patients were more egocentric and their perception of their spouse's preferences was influenced by their own needs. The results demonstrated that in the context of cancer patients and their spouse as caregivers, neither partner considered the informational needs of his or her spouse.

Adult↗

Perceptions of the environment, physical activity, and obesity.

Obesity rates are rising rapidly across the developed and developing world. Until recently obesity research has mainly focused on biological, psychological and behavioural factors. But there is growing agreement that environmental factors play an important role as well. In this study data from the 2003 Health Survey for England (n = 14,836) were analysed from a multilevel perspective to examine (1) the associations of the perceptions of the local environment with obesity, self-rated health, and physical activity, and (2) whether physical activity mediates the association between the perceptions of the environment, and obesity and self-rated health. This study found that perceptions of the friendliness of the local environment were mainly associated with self-rated health; perceived access to leisure facilities with sports activities; perceived access to a post office with walking; and the presence of social nuisances with obesity and poor self-rated health. In addition, positive perceptions of the social environment (i.e., social support and social capital) were associated with higher levels of physical activity, and lower levels of poor self-rated health and obesity. Only limited support was found for the idea that health behaviours mediate the associations between the perceptions of the environment, obesity, and self-rated health. Controlling for the three physical activity measures only rendered a small number of associations with self-rated health non-significant, and did not affect the associations with obesity. Overall, the results show that certain aspects of the environment may contribute to the risk of obesity and poor health. More research is needed to examine the specific mechanisms that link (the perceptions of) the environment to obesity and health.

Adolescent↗

Patient-reported outcomes in overactive bladder: the influence of perception of condition and expectation for treatment benefit.

Patient perceptions of overactive bladder (OAB) symptoms, expectations for treatment benefit, and overall treatment satisfaction share complex relations. Multiple studies have demonstrated associations between factors, such as age, sex, and ethnicity, and patient perceptions of OAB symptoms, especially urgency urinary incontinence. Perceptions of OAB are also shaped by symptom severity and impact on health-related quality of life, as well as by perceptions of family members, caregivers, and clinicians. The literature further suggests discrepancies in the reporting among patients, physicians, and family members/caregivers of the impact that urinary symptoms have on patients' emotional well-being, productivity, and daily life. Understanding the factors that affect patients' perceptions is important because these perceptions affect treatment expectations, which may predict treatment outcomes. Studies designed to evaluate the relations between expectations for OAB treatment and patient satisfaction have not been performed to date, but studies in other patient populations suggest that expectations of positive outcomes are associated with greater treatment satisfaction. We emphasize that patient satisfaction with treatment is directly related to fulfillment of positive expectations, and that patient expectations should be realistic and agreed on by patient and physician. We also discuss strategies that may be used by physicians managing patients with OAB to develop stronger patient-physician partnerships, including the effective communication required to make treatment decisions and set realistic expectations.

Age Factors↗