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PubMed2000

Protective correlates of stages in adolescent substance use: a Swiss National Study.

OBJECTIVE: To identify factors potentially protective against involvement with additional illicit drugs among adolescent users of marijuana. DESIGN AND METHODS: A cross-sectional, secondary analysis of a national data set of Swiss adolescents was performed. The original survey was conducted in 1992-1993 (N= 9268). Stages of substance use were conceptualized as lifetime use of marijuana of three or more times and as use of marijuana and other illicit drugs (opiates, inhalants, cocaine, hallucinogens, or stimulants) more than twice in the past month. Behavioral characteristics associated with level of drug use were examined. Based on the resilience literature, factors potentially protective against progression of drug use were examined in their bivariate relationships and analyzed in a multiple regression model. RESULTS: Almost one quarter of the surveyed adolescents were classified as past or current marijuana users. One in 20 of these adolescents also used other illicit drugs. Prevalence of risk-related behaviors (e.g., antisocial behavior, accidents, suicide attempts) was elevated for marijuana users compared to nonusers and even more elevated for users of marijuana with other illicit drugs. In a multivariate logistic regression model, communicating well with a parent was significantly associated with not having progressed to use of illicit drugs other than marijuana [for males, odds ratio (OR) = 0.72, confidence interval (CI) = 0.55, 0.92; for females, OR = 0.60, CI = 0.39, 0.93]. Other significant protective correlates for boys were academic achievement (OR = 0.66, CI = 0.47, 0.92), type of education: school versus apprenticeship (OR = 0.42, CI = 0.21, 0.87), confiding in a family member (OR = 0.49, CI = 0.28, 0.85), and regular participation in a sports club (OR = 0.39, CI = 0.22, 0.77). CONCLUSION: Within this national sample of Swiss adolescents, a cross-sectional analysis identified the quality of relationships within the family and factors related to school associated with lack of progression of illicit substance use. However, longitudinal studies will be necessary to confirm these associations and to allow for designing interventions targeting the enhancement of protective factors among young people already at risk for serious substance use.

Adolescent↗

PubMedDate not supplied

Pregnancy outcome in natural family planning users: cohort and case-control studies evaluating safety.

Conceptions involving aging gametes are of relevance to natural family planning (NFP) because women using NFP to avoid pregnancy abstain from intercourse during the fertile time of the cycle. To help verify the safety of pregnancies occurring among NFP practitioners, our group has, since 1986, conducted a large cohort study involving six experienced NFP centers. Timing of conception was determined from NFP charts, in which women recorded days on which intercourse occurred. The number of days from the most probable conception intercourse to probable day of ovulation was first determined, and used as an estimate of the time gametes remained in the genital tract before fertilization. Several studies have already been completed, cohort as well as case-control in nature.

Abortion, Spontaneous↗

PubMed2001

International mental health outcomes and benchmarking using the FACE (functional analysis of care environments) approach.

This article describes and compares the nature and severity of problems encountered by persons receiving mental health services in the United Kingdom and Australia, and the outcome of their treatment. The perspective of service providers and service users in the two countries was strikingly similar. Treatment was effective in alleviating problems with social circumstances, and in increasing adaptive and interpersonal functioning. Treatment was less effective in addressing psychological or physical problems. Service users in the United Kingdom were more involved in developing their treatment care plan than those in Australia. The study demonstrates how data required for benchmarking and outcome evaluation purposes can be generated as part of routine clinical processes.

Activities of Daily Living↗

PubMed2005

A home education program for older adults with hearing impairment and their significant others: a randomized trial evaluating short- and long-term effects.

This paper addresses the development and effectiveness of a home education program. The program, designed for hearing-impaired elders and their significant others (SO), deals with communication strategies and speech reading. Participants were randomly assigned to a training group (hearing aid fitting+home education program) or a control group (hearing aid fitting). The training group included 24 hearing-impaired subjects and 24 SO's. Controls were 24 affected individuals and 22 SO's. Questionnaires addressing emotional response, communication strategies and the IOI-HA, IOI-AI and IOI-SO were used. A repeated measures analysis of variance was applied to test group differences between pre, post, and 6-months follow-up measures. Increased awareness of benefits of speech reading and improved interaction with the SO were observed in the training group only (p < 0.05). No group difference on 'emotional response' was found. IOI-AI and IOI-SO demonstrated favorable attitudes towards the program. Follow-up measures showed improved quality of life and satisfaction in the training group, while a decrease was observed among the controls (p < 0.05). Some effects differed between first-time and experienced hearing aid users. Addition of services to amplification and involvement of the SO are relevant in aural rehabilitation.

Aged↗

PubMed1994

Research priorities and recommendations for dietary assessment methodology. First International Conference on Dietary Assessment Methods.

A list of research priorities related to dietary assessment methodology is presented. The priorities are based on a consensus of opinion by a multidisciplinary international group of experts who participated in the First International Conference on Dietary Assessment Methods. These experts included researchers in dietary assessment methodology, major users of dietary assessment methods, and policymakers involved in setting food and nutrition policies. The list of priorities may be used as a guide for planning future research in dietary assessment methods, for prioritizing the allocation of available research resources, and for planning subsequent conferences. A list of recommendations related to dietary assessment methodology is also presented. Procedures used by the conference planners to select the experts are described, and the need for developing objective criteria for ranking priorities is discussed. An ongoing function of the conference series will be to continue the process of revising the priorities and recommendations to reflect progress made and newly identified needs in dietary assessment methodology.

Data Collection↗

PubMedDate not supplied

Encouraging GP alcohol intervention: pilot study of change-orientated reflective listening (CORL).

AIMS: To test the feasibility of delivery and potential value of a brief motivational enhancement intervention targeting GPs in relation to alcohol as a public health issue, and to compare data obtained with similar attempts to influence GP intervention with drug users. METHOD: 21 GPs who were not involved in the treatment of drug dependence received a telephone-administered 'change-orientated reflective listening' (CORL) intervention, based on Motivational Interviewing, with an informational adjunct. Assessments were made at baseline and at 2-3 months of activity and willingness to deliver specified alcohol-related interventions, plus overall therapeutic commitment and motivation. Qualitative data was obtained. RESULTS: There was no change over time in the sample as a whole, with very modest evidence of benefit among individual practitioners. Comparisons with cannabis and drug misuse intervention targets suggest that it may be more difficult to alter views on intervening with drinkers. CONCLUSIONS: Further attempts are needed to influence practitioner motivation, based on improved understanding of GP views on the delivery of alcohol interventions.

Adult↗

PubMed2006

The acquisition of spatial constructions in American sign language and English.

Spatial relations in American Sign Language (ASL) are often signed from the perspective of the signer and so involve a shift in perspective and mental rotation. This study examined developing knowledge of language used to refer to the spatial relations front, behind, left, right, towards, away, above, and below by children learning ASL and English. Because ASL is a classifier language in which noun referents are placed into groups, each spatial relation also appeared with person, animal, and vehicle classifiers. Twenty-three children and adults who learned ASL before the age of 5 years and 23 native English-speaking adults and children participated. Both language groups participated in a comprehension task in which they chose which of 2 pictures depicted a signed or spoken relation. Results showed that children learning ASL acquired the constructions for spatial relations that typically involve perspective shifts and mental rotation later than constructions that do not involve these abilities and later than English-speaking children. Children learning ASL did not differ from English-speaking children in learning constructions that did not involve these abilities. Results also suggest that users of ASL initially comprehend spatial relations more accurately with person and animal classifiers than with the classifier for vehicles. The results are relevant to understanding the acquisition of spatial relations in ASL.

Adolescent↗

PubMedDate not supplied

Three fatal cases of PMA and PMMA poisoning in Denmark.

Paramethoxyamphetamine (PMA) and paramethoxymetamphetamine (PMMA) are methoxylated phenylethylamine derivatives with effects similar to methylenedioxymetamphetamine (MDMA) and sold as such. However, PMA and PMMA are more potent than MDMA, but have a slower onset of action, which encourages users to take more. Three fatal cases involving PMA and PMMA in Denmark in year 2000 are investigated including history, pathological, and toxicological findings. The methods used for extraction, identification, and quantitation of PMA and PMMA are described. In two of the cases, lethal postmortem blood concentrations of PMA and PMMA were determined at 3.4 and 3.3 mg/kg (case 1) and 0.78 and 0.68 mg/kg (case 3), respectively. In addition, other drugs such as MDMA, tetrahydrocannabinol, cocaine, and alcohol were involved in these cases. In the third case, death occurred four days after the ingestion of tablets containing PMA and PMMA, and therefore only low postmortem concentrations of PMA and amphetamine were detected. However, in a serum sample taken at admission to the hospital, PMA and PMMA were found, but not quantitated. It is believed that the cause of death in case 2, multiple-organ failure, was caused by overdoses of PMA and PMMA.

Adult↗

PubMed1988

Use and usefulness of lower limb prostheses.

This article concerns a study of the use and usefulness of lower limb prostheses. The method used is discussed: the combining of quantitative data gathered via structured questions with qualitative data about the experiences, wishes and opinions of the people most involved. Some of the results regarding the users, the use and usefulness of prostheses and the wishes of the users are mentioned. Recommendations based on the results are also mentioned.

Adaptation, Psychological↗

PubMed1990

A critical review of clinical applications of topographic mapping of brain potentials.

A brief review of several aspects of topographic mapping of brain potentials is presented. Some general factors of importance for the construction of brain maps are considered, namely, how to sample in space and how to deal with the influence of the reference electrode. The issue of what is a representative map is examined for the cases of both steady and dynamic states. Special attention is paid to the methodology of assessing whether a brain map may be considered "normal" or "abnormal" on the basis of multivariate statistical considerations. Besides being used to visualize statistical comparisons between sets of EEG data, brain maps may be used as a first step for a model-based analysis in order to estimate the localization of equivalent dipolar sources of the electrical activity within the brain. The question of whether brain maps may yield added value to multivariate quantitative EEG analysis is examined for the following clinical cases: (1) developmental disorders; (2) space-occupying lesions; (3) epilepsy; (4) cerebrovascular diseases; (5) dementia; and (6) psychiatric diseases. It is concluded that brain mapping may be valuable as a comprehensive and attractive form of data reduction to represent a complex set of multichannel (optimally at least 64) EEG signals, but only if the user is well aware of the pitfalls involved. Brain mapping might supplement quantitative topographic analysis if it can be used as the basis for solving the inverse problem in EEG. More extensive and well-controlled studies are necessary in order to establish the clinical value of complementing a routine EEG examination with brain mapping.

Brain↗

PubMedDate not supplied

The methamphetamine burn patient.

Early aggressive fluid resuscitation has significantly decreased the morbidity and mortality associated with volume losses from large burns. Although most patients are adequately resuscitated using the Parkland formula, we noted increased fluid requirements for shock resuscitation in patients involved in methamphetamine laboratory explosions. Because predominant users are young healthy individuals in their 20s and 30s, we had not anticipated burn shock resuscitation failures in this patient group. We reviewed our experience with burn patients with documented methamphetamine use to determine whether this patient group presents new dilemmas to the burn surgeon. A 2-year retrospective study of 30 patients (15 methamphetamine users, 15 controls) revealed that the methamphetamine burn patient requires two to three times the standard Parkland formula resuscitation. In this study, methamphetamine burns larger than 40% TBSA had a 100% mortality.

Adult↗

PubMedDate not supplied

Risk factors, confounding, and the illusion of statistical control.

When experimental designs are premature, impractical, or impossible, researchers must rely on statistical methods to adjust for potentially confounding effects. Such procedures, however, are quite fallible. We examine several errors that often follow the use of statistical adjustment. The first is inferring a factor is causal because it predicts an outcome even after "statistical control" for other factors. This inference is fallacious when (as usual) such control involves removing the linear contribution of imperfectly measured variables, or when some confounders remain unmeasured. The converse fallacy is inferring a factor is not causally important because its association with the outcome is attenuated or eliminated by the inclusion of covariates in the adjustment process. This attenuation may only reflect that the covariates treated as confounders are actually mediators (intermediates) and critical to the causal chain from the study factor to the study outcome. Other problems arise due to mismeasurement of the study factor or outcome, or because these study variables are only proxies for underlying constructs. Statistical adjustment serves a useful function, but it cannot transform observational studies into natural experiments, and involves far more subjective judgment than many users realize.

Bias↗

PubMed1995

Cognitive sequelae of repeated head injury in a population of intravenous drug users.

The relationship between closed head injury and performance on neuropsychological (NP) tests was investigated in a group of intravenous drug users (IVDUs). Subjects with repeated head traumas involving loss of consciousness (LOC) performed worse than both a control group without LOC and reference group with only a single episode of LOC. There were no significant differences between the last two groups. Performance on tests of memory, attention, and motor performance was significantly worse in the group with repeated head injury. The average time since the last episode of LOC was more than 11 years. We conclude from these findings that a single episode of LOC does not result in significant cognitive impairment in this population. Two or more episodes, however, are more likely to produce chronic cognitive impairment.

Adolescent↗

PubMed1995

Measuring pulmonary microvessel diameters using video image analysis.

To directly determine the pressure-diameter relationship of individual pulmonary microvessels, it is necessary to measure the width of the column of blood in the vessel because microvascular walls are invisible when using intravital microscopy. To identify the margins of the blood column accurately, we developed a method for computer enhancement and measurement of vessel images. After recording microvessels on videotape, consecutive frames from the videotape were digitized by a computer. Pixels that changed from frame to frame (moving erythrocytes) were turned white, and unchanging pixels were turned black. In this way an image of the erythrocyte column with distinct edges was produced. The width of this column was measured with a heuristic technique involving interactions between the computer and the user. The measurements were reproducible and accurate. This technique has been used to measure microvascular diameters over a range of well-defined microvascular pressures and construct precise pressure-diameter curves.

Animals↗

PubMed2003

An exploration of dignity in palliative care.

This paper presents a qualitative study exploring the meaning of 'dignity' to patients, relatives and professionals. It examines the impact of advanced illness and treatment and the issues pertinent to caring for dignity. Depth interviews were conducted with eight patients, six relatives and seven members of the multiprofessional team. A phenomenological approach to data analysis was adopted. Dignity was found to be a complex phenomenon. It is composed of the dimensions 'being human', 'having control', 'relationship and belonging' and 'maintaining the individual self'. These dimensions seemed to be held in equilibrium by each individual. The importance of each may alter in response to threats to dignity such as advancing illness and how one is treated within it, in an attempt to cope and adapt. Caring for dignity is challenging because it involves balancing the multiple needs of both users and providers of palliative care and the different perceptions and dimensions of dignity itself.

Activities of Daily Living↗

PubMed1977

Complete brachial plexus lesions: a ten-year follow-up of twenty cases.

Twenty patients with complete brachial plexus lesions were reviewed approximately nine and a half years after injury. Thirteen were amputees and seven had received no surgical treatment. Amputation did not alleviate pain and a prosthesis was frequently of no greater use of the patient than the useless limb it replaced: only two of the thirteen amputees were true prosthetic users and they both had dominant limb involvement, the rest adapting easily to being one-handed. Initial treatment should therefore be conservative, with intensive rehabilitation and retraining. It is recommended that amputation should not be considered until a year after injury and only if the flail limb causes repulsion, prevents sporting activities or if the patient has difficulty in converting to the non-dominant limb. In no instance should smputation be done for relief of pain.

Amputation, Surgical↗

PubMed2025

Generating correlated data for omics simulation.

Simulation of realistic omics data is a key input for benchmarking studies that help users obtain optimal computational pipelines. Omics data involves large numbers of measured features on each sample and these measures are generally correlated with each other. However, simulation too often ignores these correlations, perhaps due to computational and statistical hurdles of doing so. To alleviate this, we describe three approaches for generating omics-scale data with correlated measures which mimic real datasets. These approaches are all based on a Gaussian copula approach with a covariance matrix that decomposes into a diagonal part and a low-rank part. This decomposition allows for extremely efficient simulation, overcoming a hurdle for adoption of past methods. We use these approaches to demonstrate the importance of including correlation in two benchmarking applications. First, we show that variance of results from the popular DESeq2 method increases when dependence is included. Second, we demonstrate that CYCLOPS, a method for inferring circadian time of collection from transcriptomics, improves in performance when given gene-gene dependencies in some circumstances. We provide an R package, dependentsimr, that has efficient implementations of these methods and can generate dependent data with arbitrary marginal distributions, including discrete (binary, ordered categorical, Poisson, negative binomial), continuous (normal), or with an empirical distribution.

Computer Simulation↗

PubMed2004

[Nursing students' knowledge about psychotropic drugs].

The objective of this study is to characterize the learning situation of nursing students with regard to psychotropic drugs. Students from a public and a private school were interviewed. Data analysis was thematic. The results do not suggest substantial differences between the schools regarding: learning centered on psychopharmacology; influence of media and use of common sense in the epidemiology; motivations and problems related to drug use; myth repetition and prejudice of users; disrespect of the social conflicts that involve drug problems. It is necessary to improve education on this topic so that students will have adequate knowledge to act as professionals.

Education, Nursing↗