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PubMed2006

The Nicotine Dependence Syndrome Scale in Finnish smokers.

The Nicotine Dependence Syndrome Scale (NDSS) is a new multidimensional measure of nicotine dependence. The study aim was to examine the structure and heritability of the NDSS and its associations with nicotine dependence defined by FTND and DSM-IV criteria among Finnish smokers participating in an ongoing twin-family study. Adult twin pairs concordant for smoking from the Finnish Twin Cohort Study, and their siblings and parents were interviewed. Among 1370 smokers, the sum score of the NDSS (a summary measure of dependence) correlated moderately highly with FTND score (r=0.62). Subjects in the highest NDSS sum score groups were more likely to be nicotine dependent according to DSM-IV criteria compared with those in the lowest quintile (odds ratio=36.7, 95% confidence interval 13.0-103). In exploratory factor analysis, we derived three factors, named drive/priority, stereotypy/continuity and tolerance. The drive/priority factor correlated best with FTND (r=0.54). Genetic modeling showed no differences in the genetic architecture of NDSS or FTND by gender; the overall heritability estimate for NDSS was 0.30 (95% CI 0.06-0.47), and for FTND 0.40 (95% CI 0.23-0.55). The sum score of the NDSS is moderately highly associated with DSM-IV nicotine dependence as well as FTND. These analyses indicate that the NDSS functions well in a Finnish family-based sample and provide additional validation of a new scale developed to capture complex behavioural features of nicotine dependence.

Adult↗

PubMed2006

Symptom experience, psychological distress, and quality of life in Korean patients with liver cirrhosis: a cross-sectional survey.

BACKGROUND: In patients with cirrhosis, quality of life (QOL) is seriously impaired and associated with particular symptoms such as fatigue, muscle cramps or pruritus. However, there is lack of evidence about the overall symptom experience in patients with cirrhosis, in addition, most studies on QOL have focused only on identifying the relationship between disease-related variables such as disease severity, etiology or serological markers and QOL. OBJECTIVES: This study aimed to describe symptom experience, psychological distress, and QOL in Korean patients with liver cirrhosis, and to identify the factors that predict their quality of life. DESIGN: This study is a cross-sectional, descriptive design. SETTINGS: The participants were recruited over a 2-month period, September 27 to November 25, 2003 from the outpatient or inpatient departments of gastroenterology at two large university hospitals in Seoul, Korea. PARTICIPANTS: There were 129 patients, mean age was 53.6 years, who met eligibility criteria and agreed to participate in the study. METHODS: Symptom experience was measured with a scale developed by the researchers through a literature review on liver cirrhosis. Psychological distress was measured with the anxiety/depression category from the modified Korean version of the profile of mood states (POMS) [Shin, 1996. A study on verification of the profile of mood states (POMS) for Korean elders. Journal of Korean Academic Nursing 26, 743-758], and QOL was measured with quality of life index (QLI) developed by Ferrans and Powers [1985, Quality of life index: development and psychometric properties. Advances in Nursing Science 8, 15-24. ]. RESULTS: The results indicated that (1) overall symptom experience score was relatively low, major symptoms needing a management were fatigue, ascites and/or edema, and muscle cramps; (2) the mean score of psychological distress revealed mild to moderate levels of anxiety and depression; (3) quality of life was found to be seriously impaired; (4) psychological distress, employment status, and symptom experience were significant predictors of QOL, and explained 29.8% of the total variance. CONCLUSION: These results indicate that symptom management, which includes attention to associated psychological intervention, is imperative for improvement in the QOL in Korean patients with liver cirrhosis.

Adaptation, Psychological↗

PubMed2006

"Precision" and "accuracy": two terms that are neither.

OBJECTIVE: In some publications, the terms "precision" and "accuracy" are used as if they were synonyms for "reliability" and "validity." METHODS AND RESULTS: This article shows that these terms are neither precise nor accurate when used in this way. Scales can demonstrate high test-retest or interrater reliability (i.e., they are "precise") but still be unreliable in certain circumstances; and "imprecise" scales can still show good reliability. Further, "accuracy" as a synonym for validity reflects an outdated conceptualization of validity, which has been superseded by one that emphasizes that validity tells us what conclusions can be drawn about a person based on a test result. CONCLUSION: The article ends with a call for the use of the more traditional terms as better reflecting the process of scale development and the uses to which they are put.

Health Status Indicators↗

PubMed2006

Overall Assessment of the Speaker's Experience of Stuttering (OASES): documenting multiple outcomes in stuttering treatment.

UNLABELLED: This paper describes a new instrument for evaluating the experience of the stuttering disorder from the perspective of individuals who stutter. Based on the World Health Organization's International Classification of Functioning, Disability, and Health [World Health Organization (2001). The International Classification of Functioning, Disability, & Health. Geneva: World Health Organization], the Overall Assessment of the Speaker's Experience of Stuttering (OASES) collects information about the totality of the stuttering disorder, including: (a) general perspectives about stuttering, (b) affective, behavioral, and cognitive reactions to stuttering, (c) functional communication difficulties, and (d) impact of stuttering on the speaker's quality of life. This paper summarizes scale development, reliability and validity assessment, and scoring procedures so clinicians and researchers can use the OASES to add to the available evidence about the outcomes of a variety of treatment approaches for adults who stutter. EDUCATIONAL OBJECTIVES: As a result of this activity, participants will be able to: (1) identify key issues related to the documentation of treatment outcomes in stuttering; (2) discuss the components of the international classification of functioning, disability, and health as they relate to the documentation of stuttering treatment outcomes; (3) evaluate and use a new measurement instrument for assessing the outcomes of stuttering treatment from the perspective of the person who stutters.

Adult↗

PubMed2006

Symptom experience in Korean patients with liver cirrhosis.

This study was done to examine the level of symptom experience, and symptom variation in relation to demographic and clinical variables, in Korean patients with liver cirrhosis (LC). Symptom experience was measured using a scale developed by the researchers through a literature review on LC. Participants were 129 patients whose mean age was 53.6 (standard deviation [SD] = 9.28) years. The results indicated that (1) overall symptom experience was relatively low (mean 41.67, SD 24.71); (2) the main symptoms needing a management were fatigue, abdominal distension and/or peripheral edema, and muscle cramps; and (3) among the study variables, the severity of LC (P < 0.001) and the number of hospitalizations (P = 0.014) showed a significant relationship with overall symptom experience. These results suggest that symptom assessment requires a multidimensional approach and that it is imperative to consider disease severity in developing tailored symptom management programs for Korean patients with LC.

Adult↗

PubMed2006

A preliminary validation of a new measure of occupational health and safety.

INTRODUCTION: This article describes the validation of an instrument designed to conduct an Occupational Health and Safety (OHS) self-diagnosis using workers observations of tangible facts and actions in the workplace. The instrument puts the emphasis on observable factors that make it possible to act proactively before accidents actually occur. METHOD: Three companies were recruited from the printing sector in Québec based on their OHS performance (low, medium, and high), their interest in the project, and their availability. The master sample was composed of 269 people. Partial least squares (PLS) and vanishing tetrad analyses were used to study the behavior of the formative scales developed. RESULTS: The results indicate that partial revision of the instrument will be necessary to reach a fully satisfying level of validity. With regards to the statistical approach adopted, the use of a macro called CTA-SAS 2.0 developed by Bollen and Ting [Bollen, K.A., & Ting, K.-F. (1993). Confirmatory tetrad analysis. In P.V. Marsden (Ed.), Social methodology.Vol.23 (pp.147-176). Cambridge, MA: Blackwell, 23] has proven to be effective in providing a suitable statistical treatment of the latent formative variables on which our instrument's development is based. CONCLUSION: The results suggest that the instrument appears to be relatively robust and appropriate to diagnose OHS leading measures. IMPACT ON INDUSTRY: In the long run, this instrument will make it possible for companies to draw a more refined picture of OHS evolution, even in the absence of occupational injuries.

Accidents, Occupational↗

PubMed2005

Determining student satisfaction in a nursing college.

This study was carried out to determine the satisfaction and expectations of students in a nursing college in Turkey and is descriptive and prospective in nature. A student satisfaction scale developed by the researchers was used in this study. With no method of sampling employed, a total of 694 students attending the nursing college during the years of 1999, 2000 and 2001 were included in the study. The results showed that student satisfaction increased in 2001. Mean satisfaction score was high in the first year (x = 126) but decreased in the second year (x = 98). The third year was when the score reached its highest level (x = 128), and the fourth year was when it decreased to its lowest level (x = 95). The students included in this study strongly believed that there was room for improvement in the present education system, recreational activities and other services rendered by their college. Most of the students felt that the nursing college they were attending fell short of their expectations. Of note, many of them declared to have started nursing education as a last resort, that it was not their first choice, and that they did not score high enough in the university entrance exam to enable them to study a different subject.

Analysis of Variance↗

PubMed2006

The path to nurse registration.

The aim of this study was to identify factors promoting or impeding pre-registration degree level education at the first School of Nursing in Scotland offering transfer from diploma to degree programmes. A questionnaire was used to collect data from third year student nurses (adult branch). This included an "attitude towards obtaining a degree" scale, developed using psychometric techniques to maximise reliability and validity. Attitudes were generally positive. The majority of participants believed obtaining a degree would help nurses develop their career and increase their professional status. However, the majority disagreed with views that obtaining a degree was essential to be a good nurse, would make nurses better at their jobs and would improve patient care provided by nurses. Only 25% believed obtaining a degree ought to be essential for all student nurses. Twenty-nine participants did not accept transfer to a degree programme. Of these, four-fifths reported this was due to the combined pressures of academic workload, family and work. None of these participants believed that obtaining a degree would make nurses better at their jobs. A theory-practice divide seemed to exist whereby many participants did not relate increased degree knowledge to improved clinical practice.

Adult↗

PubMed2005

The significant other version of the Pain Catastrophizing Scale (PCS-S): preliminary validation.

Researchers have hypothesized that pain catastrophizing has a social function. Although work has focused on the catastrophizing of individuals with chronic pain (ICPs), little is known about the pain catastrophizing of their significant others. The purpose of this study was to test the validity of a revised version of the original PCS [Sullivan MJL, Bishop S, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995; 7: 432-524.] in which individuals were instructed to report on their own catastrophizing about their significant other's pain. In Study 1, a confirmatory factor analysis was conducted to determine the factor structure of the PCS-Significant Other (PCS-S) in a diverse sample of university undergraduates (n=264). An oblique second-order 3-factor model with two cross-loadings provided the best fit and this model was invariant across gender and racial groups. This factor structure was cross-validated in Study 2 with a second sample of university undergraduates (n=213). Results indicated that the 3-factor structure with two cross-loadings was a viable model of significant others' pain catastrophizing across gender and racial groups. In Study 3, this factor structure was replicated and the content validity of the PCS-S was examined in a sample of adult ICPs and their spouses (n=111). Spouse catastrophizing was related to ICP pain severity and interference as well as both spouses' depressive symptoms. In addition, ICPs were at a greater risk for psychological distress when both spouses had higher levels of catastrophizing. The PCS-S has the potential to be a useful and valid measure of pain catastrophizing in the significant others of ICPs.

Adult↗

PubMed2006

Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years.

Observational (behavioral) scales of pain for children aged 3 to 18 years were systematically reviewed to identify those recommended as outcome measures in clinical trials. This review was commissioned by the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (www.immpact.org). In an extensive literature search, 20 observational pain scales were identified for review including behavior checklists, behavior rating scales, and global rating scales. These scales varied in their reliance on time sampling and inclusion of physiological items, facial and postural items, as well as their inclusion of multiple dimensions of assessment (e.g., pain and distress). Each measure was evaluated based on its reported psychometric properties and clinical utility. Scales were judged to be indicated for use in specific acute pain contexts rather than for general use. Two scales were recommended for assessing pain intensity associated with medical procedures and other brief painful events. Two scales were recommended for post-operative pain assessment, one for use in hospital and the other at home. Another scale was recommended for use in critical care. Finally, two scales were recommended for assessing pain-related distress or fear. No observational measures were recommended for assessing chronic or recurrent pain because the overt behavioral signs of chronic pain tend to habituate or dissipate as time passes, making them difficult to observe reliably. In conclusion, no single observational measure is broadly recommended for pain assessment across all contexts. Directions for further research and scale development are offered.

Adolescent↗

PubMed2005

How surgeons disclose medical errors to patients: a study using standardized patients.

BACKGROUND: Calls are increasing for physicians to disclose harmful medical errors to patients, but little is known about how physicians perform this challenging task. For surgeons, communication about errors is particularly important since surgical errors can have devastating consequences. Our objective was to explore how surgeons disclose medical errors using standardized patients. METHODS: Thirty academic surgeons participated in the study. Each surgeon discussed 2 of 3 error scenarios (wrong-side lumpectomy, retained surgical sponge, and hyperkalemia-induced arrhythmia) with standardized patients, yielding a total of 60 encounters. Each encounter was scored by using a scale developed to rate 5 communication elements of effective error disclosure. Half of the encounters took place face-to-face; the remainder occurred by videoconference. RESULTS: Surgeons were rated highest on their ability to explain the medical facts about the error (mean scores for the 3 scenarios ranged from 3.93 to 4.20; maximum possible score, 5). Surgeons used the word error or mistake in only 57% of disclosure conversations, took responsibility for the error in 65% of encounters, and offered a verbal apology in 47%. Surgeons acknowledged or validated patients' emotions in 55% of scenarios. Eight percent discussed how similar errors would be prevented, and 20% offered a second opinion or transfer of care to another surgeon. CONCLUSIONS: The patient safety movement calls for disclosure of medical errors, but significant gaps exist between how surgeons disclose errors and patient preferences. Programs should be developed to teach surgeons how to communicate more effectively with patients about errors.

Communication↗

PubMed2001

Dietary fat reduction strategies used by a group of adults aged 50 years and older.

OBJECTIVE: To investigate the fat-reduction strategies used by a group of older adults who successfully made and maintained positive dietary changes for 5 years or longer. DESIGN: Participants completed 2 copies of a self-administered food frequency questionaire: The first copy assessed diet before they began making changes and the second copy assessed diet after initiation of healthful dietary changes. Positive food changes were identified from the food frequency questionnaires. During in-person interviews, participants placed food changes onto a time line according to the nearest estimated date of initiation of the change. SUBJECTS: Participants were 65 free-living older adults (aged >50 years) who had maintained substantial changes to decrease fat intake in their diet for at least 5 years. Statistical analyses performed Quantitative and qualitative data were used to identify the fat-reduction strategies and to confirm and validate the fat-reduction strategy model. Confirmatory factor analysis was performed to confirm the new model. The Kuder-Richardson-20 reliability coefficient (kr) was used to determine internal consistency of the scales developed for the study. RESULTS: The majority of participants decreased their fat intake gradually, at different time points in their lives, and over a long period of time (5 to 43 years). Mean percent energy intake from fat decreased from 44.3 +/- 5.9% before dietary improvement to 25.9 +/- 7.1% at the time of the study. The final model consisted of 5 fat-reduction strategies with 63 food changes. The strategies were: increase summer fruits (4 items; kr=0.66), increase vegetables and grains (14 items; kr=0.79), decrease recreational foods (14 items; kr=0.76), decrease cooking fat (20 items; kr=0.86), and use fat-modified foods (11 items; kr=0.80). APPLICATIONS/CONCLUSIONS: Dietetics professionals should base their advice on the dietary strategies used by consumers rather than hypothetical premises such as food or nutrient groupings. Nutrition education interventions will have better chances for success if they are based on a set of customized programs that guide appropriate consumer segments through a series of small, comfortable, and sustainable dietary changes over a prolonged period of time.

Aged↗

PubMed1998

The role of esophagectomy in the management of esophageal perforations.

BACKGROUND: Despite the many advancements made in thoracic surgery, the management of patients with esophageal perforation remains problematic and controversial. METHODS: Between 1985 and 1995, 27 esophagectomies were performed for perforation of the thoracic esophagus. A retrospective review of the records of these patients was carried out, and a scoring scale developed by Elebute and Stoner to grade the severity of sepsis was applied. RESULTS: Among the 27 patients undergoing esophagectomy for a perforation, the interval between rupture and esophagectomy was less than 24 hours in only 11 patients (40.7%). Postoperative surgical complications occurred in 4 patients (14.8%) and nonsurgical complications, in 7 (25.9%). The hospital mortality rate was 3.7% (1/27). In 14 patients, primary reconstruction was performed in the bed of the excised esophagus. There were no anastomotic leaks in this subgroup. This suggests that an anastomosis between viable, well-vascularized tissues is more important for successful healing than avoidance of some degree of contamination of the adjacent mediastinum. On follow-up, which averages 41 months, 73% of patients (16/22) have neither symptoms nor complaints. CONCLUSIONS: Esophageal resection definitively eliminates the source of intrathoracic sepsis, the perforation, and the affected esophagus. Reconstruction carried out in one stage does not increase operative morbidity. Esophageal resection and reconstruction is a valid approach even in cases of spontaneous perforation in which the diagnosis is markedly delayed.

Adult↗

PubMed2003

Thermal comfort and clothing insulation of resting tent occupants at high altitude.

Thirty-nine males and 18 females, in six groups, participated in six high altitude treks (each lasting 3-4 weeks and climbing up to 5500m) in the Himalaya and Karakoram. Inverse relationships between mean overnight total insulation (sleeping bag plus clothing) and air temperature in tents were recorded for all treks. Average overnight thermal sensations varied little with air temperature as the subjects modified their clothing insulation to maintain thermal sensations warmer than 'neutral' for all treks. For combined treks, subjects adjusted their mean overnight total insulation up to 7clo for thermal sensations of between 0 ('neutral') and +1 ('slightly warm') on average, measured on the standard seven-point thermal sensation scale developed for everyday low-altitude conditions. Very few subjects (3% of all daily responses, on average) reported 'cool' or 'cold' sensations. General tent discomfort increased with altitude suggesting that subjects interpreted tent comfort predominantly in terms of thermal outdoor conditions.

Adult↗

PubMed2001

Sequence-dependent B<-->A transition in DNA evaluated with dimeric and trimeric scales.

Experimental data on the sequence-dependent B<-->A conformational transition in 24 oligo- and polymeric duplexes yield optimal dimeric and trimeric scales for this transition. The 10 sequence dimers and the 32 trimers of the DNA duplex were characterized by the free energy differences between the B and A forms in water solution. In general, the trimeric scale describes the sequence-dependent DNA conformational propensities more accurately than the dimeric scale, which is likely related to the trimeric model accounting for the two interfaces between adjacent base pairs on both sides (rather than only one interface in the dimeric model). The exceptional preference of the B form for the AA:TT dimers and AAN:N'TT trimers is consistent with the cooperative interactions in both grooves. In the minor groove, this is the hydration spine that stabilizes adenine runs in B form. In the major groove, these are hydrophobic interactions between the thymine methyls and the sugar methylene groups from the preceding nucleotides, occurring in B form. This interpretation is in accord with the key role played by hydration in the B<-->A transition in DNA. Importantly, our trimeric scale is consistent with the relative occurrences of the DNA trimers in A form in protein-DNA cocrystals. Thus, we suggest that the B/A scales developed here can be used for analyzing genome sequences in search for A-philic motifs, putatively operative in the protein-DNA recognition.

Carbohydrates↗

PubMed2001

Molecular dynamics study of peptide-bilayer adsorption.

Two 6-ns simulations of the somatostatin analog sandostatin and a 1-palmityl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) bilayer are presented. In the first simulation, the peptide was placed in a region of bulk water density and allowed to spontaneously move toward and bind to the bilayer surface. An attractive force between the peptide and bilayer drove the binding process, which was opposed by a significant frictional force caused by the solvent (water). During the approach of the peptide toward the bilayer the area of the interacting surface between the species was inversely proportional to the distance between them, supporting the application of such a relationship in continuum calculations of peptide-bilayer binding free energies. In the second simulation, the N-terminus of the surface-bound peptide was deprotonated. Consistent with experiment, this strengthened interactions between the peptide and the bilayer. Details of both peptide-bilayer complexes, including the orientation, percent buried surface area, and orientation of the lipid headgroups are in good agreement with those obtained from experiment. The location of the different side chains in the bilayer is in direct correlation with an interfacial hydrophobicity scale developed using model peptides. The aromatic side chains of the Phe and Trp residues all lie flat with respect to the bilayer surface in both complexes. Changes in lipid and water ordering due to peptide binding suggest a possible domination of lipophobic over hydrophobic effects, as proposed by other workers. Where appropriate, peptide and lipid properties in the bound states are compared with separate simulations of sandostatin and the bilayer in water, respectively, so as to monitor the response of the system to the binding process.

Adsorption↗

PubMed1998

Neuronal stress and injury in C57/BL mice after systemic kainic acid administration.

Kainate-induced seizures are widely studied as a model of human temporal lobe epilepsy due to behavioral and pathological similarities. While kainate-induced neuronal injury is well characterized in rats, relatively little data is available on the use of kainate and its consequences in mice. The growing availability of genetically altered mice has focused attention on the need for well characterized mouse seizure models in which the effects of specific genetic manipulations can be examined. We therefore examined the kainate dose-response relationship and the time-course of specific histopathological changes in C57/BL mice, a commonly used founder strain for transgenic technology. Seizures were induced in male C57/BL mice (kainate 10-40 mg/kg i.p.) and animals were sacrificed at various time-points after injection. Seizures were graded using a behavioral scale developed in our laboratory. Neuronal injury was assayed by examining DNA fragmentation using in situ nick translation histochemistry. In parallel experiments, we examined the expression an inducible member of the heat shock protein family, HSP-72, another putative marker of neuronal injury, using a monoclonal antibody. Seizure severity paralleled kainate dosage. At higher doses DNA fragmentation is seen mainly in hippocampus in area CA3, and variably in CA1, thalamus and amygdala within 24 h, is maximal within 72 h, and is largely gone by 7 days after administration of kainate. HSP-72 expression is also highly selective, occurring in limbic structures, and it evolves over a characteristic time-course. HSP-72 is expressed mainly in structures that also manifest DNA fragmentation. Using double-labeling techniques, however, we find essentially no overlap between neurons expressing HSP-72 and DNA fragmentation. These findings indicate that DNA fragmentation and HSP-72 expression are complementary markers of seizure-induced stress and injury, and support the notion that HSP-72 expression is neuroprotective following kainate-induced seizures.

Animals↗

PubMed2002

A cross-validation study of nurses' attitudes and commitment to organ donation in Hong Kong.

This study examined the attitudes and commitment to posthumous organ donation among a group of nurses (N=314) in a teaching hospital in Hong Kong. Attitude was operationally defined by a self-report measure of favorable or unfavorable feelings and beliefs about organ donation, whereas commitment was defined by having signed a donor card. Consistent with findings reported in the West, nurses who exhibited favorable attitudes towards organ donation were of greater proportion than those who had signed a donor card. Younger and unmarried nurses were more likely to commit to posthumous organ donation. More than half (55%) of the nurses were undecided about commitment to organ donation, but most of them were likely to sign a donor card. Principal component analysis confirmed the conceptual structure of the Organ Donation Attitude Scale developed by Parisi and Katz (Health Psychol. 5 (1986) 565-580). Reliability of the factor scores (Humanitarian and moral conviction, Fears of bodily mutilation, and Fears of medical neglect) was satisfactory (Cronbach alpha ranged from 0.80 to 0.86). Fears of bodily mutilation were most significantly related to unwillingness to commit to organ donation. Implications of the findings for nursing education are discussed and suggestions for future research made.

Adult↗