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PubMed1994

Health locus of control and psychological distress in cancer patients: interactive effects of context.

Delineation of the relationship between health locus of control (HLOC) and psychological adjustment in chronic disease has been hampered by the failure to consider the moderating effect of contextual factors. The extent to which HLOC beliefs match the control realities in a situation (Reality Matching hypothesis) as well as the degree of threat (Threat hypothesis) posed by the situation were hypothesized to moderate the HLOC-distress relationship. Distress, disease severity (i.e., threat), and HLOC were assessed in 69 individuals with malignant disease undergoing evaluation for bone marrow transplantation. Hierarchical regression analyses indicated that the HLOC-distress relationship was moderated by disease severity and treatment history (i.e., whether an individual had failed prior cancer therapy). However, in some instances, the specific interaction relationships obtained differed from those evident in previous research with ESRD patients. It was concluded that there is no simple main effect relationship between HLOC beliefs and psychological adjustment. Rather, this relationship is best described by joint consideration of factors descriptive of the context in which the individual is embedded.

Acute Disease↗

PubMed1997

Primary care physicians and capitated reimbursement. Experience, attitudes, and predictors.

Given the explosive expansion of capitated reimbursement for the services of primary care physicians, we conducted a national survey of a random sample of these practitioners to measure attitudes toward capitated payment and identify predictors of important attitudes. Descriptive, factor analytic, and regression techniques were used. The response rate was 54%. As measured by scales derived from factor analysis, perceptions were strong that capitation was costly to professional and patient relationships. Patients' access to care was perceived as slightly reduced. Actual participation in capitation attenuated feelings of lack of access but not those of capitation's costly effects. Physicians' attitudes toward capitation remain negative, but participants perceive their patients' access to appropriate care as reasonable.

Attitude of Health Personnel↗

PubMed1993

Practice activities and career satisfaction among fellows of the South Atlantic Association of Obstetricians and Gynecologists.

OBJECTIVE: The practice activities and career satisfaction of obstetricians and gynecologists in private practice were compared with those in a teaching faculty setting. STUDY DESIGN: The 475 fellows of the South Atlantic Association of Obstetricians and Gynecologists were surveyed; 314 responses (66.1%) were received. Private practice and teaching faculty respondents were compared regarding practice description, factors influencing choice of practice type, practice activities, and career satisfaction. Data were examined by chi 2 testing and analysis of variance. RESULTS: Patient care involvement was the primary influence in practice choice by 86.0% of private practitioners; interest in teaching was the most important single factor for 58.2% of the teaching faculty. Significantly more teaching faculty than private practitioners had done research work during residency (81.2% vs 53.4%, p < 0.001). There were no differences regarding presentations at medical meetings during residency or publications from work performed during residency. The private practice group recorded more nights on call and more scheduled time off. The teaching faculty showed more publications, continuing medical education credits, hours worked per week, and medical meeting attendance. There were no differences in vacation days, malpractice charges, or expert witness appearances. The group showed no significant differences in their ratings of career satisfaction, but more of the teaching faculty group would elect again to enter obstetrics and gynecology if completing school today (82.4% vs 55.3%, p < 0.001). CONCLUSION: Professional activities of private practice physicians differ from those of teaching faculty physicians. The great majority of both groups are satisfied with their careers.

Adult↗

PubMed1988

The TILT formula for brain lesions.

A formula to evaluate and grade brain lesions is reported. The formula is based on 4 descriptive factors which characterize the lesion severity and potential outcome on the subject. The factors are, type of lesion, intensity of lesion, location and time of lesion duration before therapy is applied (TILT). A relative value is assigned to each TILT factor and the sum of these values determines the severity of the injury or traumindex. The relative benefit of specific therapy can then be assessed quickly and objectively by applying its effect on TILT. Three examples picked at random from the literature, illustrate application of TILT comparing "claimed" and "apparent" benefit of specific treatments. The formula is useful for both model-induced basic and sustained clinical injuries of the brain.

Animals↗

PubMed1998

Epidemiology.

Epidemiological research in the field of paediatric rheumatology is important for reasons such as the identification of possible aetiological factors, description of the natural history, identification of biologically homogeneous disease groups and health care planning. This review will focus on the epidemiology of 'idiopathic' juvenile arthritis (JA) where data are available for comparison in terms of time, space and ethnic origin. Methodological issues that make comparisons of data difficult, such as case definition, source population and case ascertainment, will be discussed in relation to the data presented. The incidence and prevalence of JA cover a wide range, but, in studies that use similar methodology, an incidence of 5-18 and a prevalence of 30-150 per 100,000 children under the age of 16 is found in Europe and on the American continent. Studies from other parts of the world indicate differences in age of onset and subgroup distribution related to geographical location and/or race.

Age Distribution↗

PubMedDate not supplied

Genetic testing for prostate cancer. Willingness and predictors of interest.

PURPOSE: As researchers come closer to identifying the genes responsible for prostate cancer, the possibility of genetic testing for men at risk for prostate cancer becomes more likely. This study examined the following: 1) the degree to which men with (n = 43) or without (n = 83) a family history of prostate cancer would be interested in genetic testing; and 2) the degree to which interest in testing was associated with demographic, family history, and psychosocial factors. DESCRIPTION OF STUDY: Participants (N = 126) were accrued through patients who had been treated for prostate cancer at Fox Chase Cancer Center (n = 39) and through newspaper advertisements (n = 87). All participants completed a questionnaire sent by mail. RESULTS: Seventy-four percent of men were probably (50%) or definitely (24%) interested in testing. Participants with a family history of prostate cancer reported that they would be willing to pay substantially more for a genetic test compared with those without a family history. Elevated worry about prostate cancer and concerns about treatment-related side effects were associated with greater interest in genetic testing. CLINICAL IMPLICATIONS: Findings demonstrate a need for the development of genetic counseling protocols for at-risk men who are interested in genetic testing, once this test becomes available.

Adult↗

PubMed1986

Polymicrobial septicemia in the cancer patient.

The medical records of 507 patients with polymicrobial septicemia were examined to determine prognostic and descriptive factors. Over 50% of the episodes occurred in patients with solid tumors and 80% originated during hospitalization. Invasive procedures and immunosuppressive therapy frequently preceded development of polymicrobial septicemia, and infection was often accompanied by shock and pneumonia. A majority of infections were caused by at least 1 aerobic gram-negative bacillus (76%) and anaerobic infections were not infrequent. Overall response among these patients was 50%, with poorest response seen among patients with persistent neutropenia (25%), pneumonia (19%), and gram-negative bacillary infection (46%). Therapy with an antibiotic regimen to which all causative organisms were sensitive was of greatest prognostic significance. Response to appropriate therapy was 58%, whereas only 10% of those who received inappropriate therapy were cured (p less than .0001).

Adolescent↗

PubMed1986

Tear layer thickness characteristics of rigid gas permeable lenses.

The tear layer thickness profiles of two groups of clinically successful wearers of rigid contact lenses were calculated from the measured anterior corneal surface and posterior contact lens surface characteristics. These profiles showed good agreement with their theoretical values for all parameters considered. However, as large individual variations were found, it was concluded that the tear layer thickness profile is only one of the descriptive factors needed to classify the fitting relations of rigid lenses.

Contact Lenses↗

PubMed2001

The non-evaluative circumplex of personality adjectives.

In judgments about personality, descriptive and evaluative aspects are ordinarily combined; separating them can be important both theoretically and practically. Study 1 showed that two similar descriptive factors can be found in analyses of personality terms, selected independently in English and in German and using different methods to control for evaluation. The factors relate to two pairs of independent axes suggested by previous work: Assertive-Unassertive and Tight-Loose, or alternatively, Interactional Orientation (Extraversion-Introversion) and Affective Orientation. These two pairs of axes are shown to be rotations of each other, and to form the prime non-evaluative circumplex. As in previous studies, non-evaluative scales elicited higher levels of self-peer agreement than did more typical evaluation-confounded scales. Study 2 showed that adjective scales for the octants of this circumplex have circular ordering, can fit even very stringent constraints of a circumplex model, have mild to strong isomorphism with the interpersonal circumplex, but represent somewhat broader constructs, and are systematically related to the Big Five and the Big Three personality factors.

Factor Analysis, Statistical↗

PubMed2004

Protein classification using comparative molecular interaction profile analysis system.

We recently introduced a new molecular description factor, interaction profile Factor (IPF) that is useful for evaluating molecular interactions. IPF is a data set of interaction energies calculated by the Comparative Molecular Interaction Profile Analysis system (CoMIPA). CoMIPA utilizes AutoDock 3.0 docking program, and the system has shown to be a powerful tool in clustering the interacting properties between small molecules and proteins. In this report, we describe the application of CoMIPA for protein clustering. A sample set of 15 proteins that share less than 20% homology and have no common functional motifs in primary structure were chosen. Using CoMIPA, we were able to cluster proteins that bound to the same small molecule. Other structural homology-based clustering programs such as PSI-BLAST or PFAM were unable to achieve the same classification. The results are striking because it is difficult to find any common features in the active sites of these proteins that share the same ligand. CoMIPA adds new dimensions for protein classification and has the potential to be a helpful tool in predicting and analyzing molecular interactions.

Algorithms↗

PubMed1989

Nosocomial pneumonia in patients receiving continuous mechanical ventilation. Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques.

Epidemiologic studies of nosocomial bacterial pneumonia in patients requiring mechanical ventilation have been limited because of the poor reliability of diagnosis procedures in this setting. To determine prognostic and descriptive factors of ventilator-associated (V-A) pneumonia, we prospectively studied 567 patients who had been receiving mechanical ventilation for more than 3 days in our unit. Fiberoptic bronchoscopy using a protected specimen brush (PSB) was performed on each patient suspected of having pneumonia because of the presence of a new pulmonary infiltrate and purulent tracheal secretions. The diagnosis of V-A pneumonia was retained only if PSB specimens yielded greater than 10(3) cfu/ml of at least one microorganism, unless this result was established to be a false positive result on follow-up. V-A pneumonia developed in 49 patients for a total of 52 episodes (9%). The actuarial risk of V-A pneumonia was 6.5% at 10 days, 19% at 20 days, and 28% at 30 days of ventilation. Patients with pneumonia were significantly older (65 versus 57 yr of age, p less than 0.01) and more frequently had severe underlying illnesses (24 versus 10%, p less than 0.01) than did patients without pneumonia. A total of 84 microorganisms (51 gram-negative and 33 gram-positive) were isolated in significant concentrations from PSB specimens. Pseudomonas aeruginosa and Staphylococcus aureus were involved in 31 and 33% of these pneumonias, respectively. Forty percent of all specimens yielded a polymicrobial flora with more than one potential pathogen.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1990

Blood glucose area under the curve. Methodological aspects.

To specify the influence of methods used in estimating area under the curve (AUC) and the meaning of total and incremental AUC, 75 glycemic responses to a mixed meal were studied in 75 diabetic patients, 39 with insulin-dependent diabetes mellitus and 36 with non-insulin-dependent diabetes mellitus. AUC was integrated with five computerized methods: polynomial interpolation of third and fourth degree, trapezoidal rule, Simpson's integration, and cubic interpolatory splines. Although these methods gave significantly different results (P less than 0.001), a strong correlation was found between estimations of AUC with different methods (r greater than 0.99, P less than 0.001). In addition, variation between methods was less than or equal to 2%, whereas the coefficient of variation between subjects was 38%. Total AUC was strongly correlated with basal blood glucose value (r = 0.90, P less than 0.001), whereas incremental and positive AUC were not (r = 0.12 and 0.07, respectively, NS). Incremental and positive AUC were strongly correlated with glycemic rise (r = 0.89 and 0.93, respectively, P less than 0.001), whereas total AUC was only slightly so (r = 0.31, P less than 0.01). Incremental and positive AUC gave slightly but significantly different information on glucose response. These results suggest that variations related to the method used in estimating AUC are not clinically relevant and that a simple method such as trapezoidal rule can be used. Total AUC is a descriptive factor related to basal blood glucose value, whereas incremental and positive AUC more accurately describe glycemic response to foods.

Analysis of Variance↗

PubMed1984

Individual characteristics of aggressive beer and distilled beverage drinkers.

Sixty male social drinkers completed the MMPI and a drinking history and attitude questionnaire. These individuals were then randomly divided into four groups, receiving either a distilled or brewed beverage, or two comparable placebos. Subjects in the alcohol groups became equally intoxicated (BAC = .71) and rated themselves as significantly more intoxicated than placebo subjects. All subjects then participated in a Buss aggression task. Aggression scales were related to the pretask personality, history, and attitude measures. Differences were found between factors descriptive of subjects who became aggressive after consuming or believing they had consumed a distilled versus a brewed beverage. In particular, a history of lack of positive alcohol effects and social maladjustment were typical of high-aggressive distilled alcohol and alcohol-placebo subjects, while the presence of family problems and anxiety typified high-aggressive beer and placebo-beer subjects.

Adult↗

PubMed2000

Molecular modeling on solvent effect and interaction mechanism of fentanyl analogs to mu-opioid receptor.

AIM: To do theoretical study about solvation effect and interaction mechanism of fentanyl analogs (FA) to mu opioid receptor (microOR). METHODS: Flexible docking (FlexiDock) was performed by using the possible active conformations of FA and optimized 3D structure of mu opioid receptor. Binding energies were calculated. Comparative molecular force field analysis (CoMFA) and quantitative structure activity relationship (QSAR) studies were carried out based on results of flexible docking. Solvation effects were considered by studying interaction of FA with water molecules. Partial least square (PLS) analysis was used to calculate regression equation for analgesic activities using binding energies as descriptive factor. RESULTS: 1) Binding conformations of these analogs derived by flexible docking were reasonable. 2) It was most possible for the FA to exist in water solution in the form of binding conformations. 3) Energetic calculation and QSAR analysis showed a good correlation between the calculated binding energies of FA and their analgesic activities. 4) Based on the 3D-model, the possible interaction mechanism of FA with mu opioid receptor can be illustrated reasonably. CONCLUSION: The nature of the correlation between the binding affinities and analgesic activities of FA was explained by our modeling result.

Analgesics↗

PubMed2001

[Effectiveness of the Mannheim Peritonitis Index in patients with peritonitis].

Classification of patients regarding to outcome in early periods of peritonitis or intra-abdominal sepsis, has always been a primary goal of intensive care physicians. In order to predict outcome, a wide variety of scoring systems have been proposed. Mannheim Peritonitis Index (MPI) is one of the most effective scoring systems and its predictive value has been shown previously. Three hundred and twenty five patients that were admitted to Emergency Services in both Ege and Dokuz Eylül University Hospitals between 1995 and 1999, have been evaluated retrospectively by using patient records. Among them, 258 patients (79.4%) have been discharged in well condition and 67 patients died (20.6%). In the latter, MPI scores were always equal or more than 26. Mean MPI scores were 30.23 7.05 and 18.55 6.67 in exitus group and discharged group respectively. When all descriptive factors in MPI have been evaluated separately, every predictor was revealed statistically significant differences between exitus and discharged groups. It has been concluded that MPI is effective scoring system in terms of predicting final outcome in patients with peritonitis and intraabdominal sepsis.

Emergency Service, Hospital↗

PubMedDate not supplied

Characteristics of participants visiting the Canada on the move website.

BACKGROUND: The Internet is a potential medium to attain large groups of Canadians for physical activity monitoring and interventions, however, little is known about the characteristics of participants who could be recruited on a national level. Our objectives were to determine: 1) the extent to which our sample was representative of the Canadian population; 2) the demographic, social-cognitive and physical activity behaviour, and environmental characteristics of one-time and multi-time users of the Canada on the Move website; and 3) whether certain recruitment strategies were more likely to reach specific demographic subgroups. METHODS: Web-based self-report measures were collected on demographic, social-cognitive, physical activity behaviour, and environmental factors. Descriptive statistics were employed to address the study's research objectives. RESULTS: Significant differences (p<0.001) were found between our total sample and 2001 Canadian census/Canadian Community Health Survey (CCHS) data on all demographic and physical activity behaviour measures. One-time and multi-time users significantly differed on age (p<0.005) and being responsible for children under age 13 (p=0.01). No differences existed between the groups on any of the social-cognitive, behavioural or environmental variables. Source of knowledge about the Canada on the Move website between one-time and multi-time users was not significantly different. CONCLUSION: The Canada on the Move website presents a viable approach to reaching diverse demographic groups. Further work needs to be undertaken to: 1) develop engaging websites; 2) detail the monitoring of the web-based access information; 3) integrate the website with other organizations promoting physical activity; and 4) expand the number of recruitment sources.

Adolescent↗

PubMed1991

[Quantitative descriptive analysis of maxillary arch in unilateral cleft].

The need for a simple, routinely applicable method for morphologic analysis of maxillary arch in cleft patients resulted in development of a new original, objective and computerized method. The authors present the rationale and procedure of this method which is extremely suitable for clinical documentation, follow up and clinical investigation of cleft patients. The descriptive factors are expressed in relative numbers--rations of asymmetry and segment displacement. The relative numbers enable comparative analysis between arches of different size.

Cleft Palate↗

PubMed2006

Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention.

Burn prevention requires adequate knowledge of the epidemiological characteristics and associated risk factors. While much has been accomplished in the areas of primary and secondary prevention of fires and burns in many developed or high-income countries (HICs), such as the United States, due to sustained research on the descriptive epidemiology and risk factors, the same cannot be said of developing or low- and middle-income countries (LMICs). To move from data to action and assist preventive efforts in LMICs, a review of the available literature was conducted to assess the current status of burn preventive efforts. A MEDLINE search (1974-2003) was conducted on empirical studies published in English on the descriptive epidemiology, risk factors, treatment, and prevention of burns in LMICs. Review of the 117 identified studies revealed basically the same descriptive epidemiological characteristics but slightly different risk factors of burns including the presence of pre-existing impairments in children, lapses in child supervision, storage of flammable substances in the home, low maternal education, and overcrowding as well as several treatment modalities and preventive efforts including immediate application of cool water to a burned area. Continuous evaluation of promising interventions and those with unknown efficacy that have been attempted in LMICs, along with testing interventions that have proven effective in HICs in these LIMC settings, is needed to spearhead the move from data to action in preventing burns in LMICs.

Adult↗