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PubMed2000

A group-level model of safety climate: testing the effect of group climate on microaccidents in manufacturing jobs.

This article presents and tests a group-level model of safety climate to supplement the available organization-level model. Climate perceptions in this case are related to supervisory safety practices rather than to company policies and procedures. The study included 53 work groups in a single manufacturing company. Safety climate perceptions, measured with a newly developed scale, revealed both within-group homogeneity and between-groups variation. Predictive validity was measured with a new outcome measure, microaccidents, that refers to behavior-dependent on-the-job minor injuries requiring medical attention. Climate perceptions significantly predicted microaccident records during the 5-month recording period that followed climate measurement, when the effects of group- and individual-level risk factors were controlled. The study establishes an empirical link between safety climate perceptions and objective injury data.

Accidents, Occupational↗

PubMed2001

Minority dissent and team innovation: the importance of participation in decision making.

This study integrates research on minority dissent and individual creativity, as well as team diversity and the quality of group decision making, with research on team participation in decision making. From these lines of research, it was proposed that minority dissent would predict innovation in teams but only when teams have high levels of participation in decision making. This hypothesis was tested in 2 studies, 1 involving a homogeneous sample of self-managed teams and 1 involving a heterogeneous sample of cross-functional teams. Study 1 suggested that a newly developed scale to measure minority dissent has discriminant validity. Both Study 1 and Study 2 showed more innovations under high rather than low levels of minority dissent but only when there was a high degree of participation in team decision making. It is concluded that minority dissent stimulates creativity and divergent thought, which, through participation, manifest as innovation.

Adult↗

PubMed2005

The problem of measurement model misspecification in behavioral and organizational research and some recommended solutions.

The purpose of this study was to review the distinction between formative- and reflective-indicator measurement models, articulate a set of criteria for deciding whether measures are formative or reflective, illustrate some commonly researched constructs that have formative indicators, empirically test the effects of measurement model misspecification using a Monte Carlo simulation, and recommend new scale development procedures for latent constructs with formative indicators. Results of the Monte Carlo simulation indicated that measurement model misspecification can inflate unstandardized structural parameter estimates by as much as 400% or deflate them by as much as 80% and lead to Type I or Type II errors of inference, depending on whether the exogenous or the endogenous latent construct is misspecified. Implications of this research are discussed.

Health Planning Guidelines↗

PubMed1989

In search of the Seven Dwarves: issues of measurement and meaning in alcohol expectancy research.

Discusses substantive issues in predicting drinking patterns from expectancies, as well as issues of content and measurement of the scales developed to measure these expectancies. In recent years, much research has suggested that alcohol expectancies--or the beliefs that individuals hold about the effects of alcohol on their behavior, moods, and emotions--are an important factor in motivating drinking behavior. Although measures of these expectancies have consistently been shown to be correlated with measures of alcohol use, conceptual and methodological problems remain to be addressed. In order to progress in understanding this potentially important psychosocial factor in abusive and nonabusive drinking, alcohol expectancy research, which has been atheoretical in nature, should attend to potential contributions from other areas of research in psychology.

Alcohol Drinking↗

PubMed1999

Corneal guttata: a comparative clinical and specular micrographic study.

BACKGROUND: The relationship between corneal guttata and Fuchs' endothelial dystrophy is unclear, with the result that the clinical differentiation of the two conditions is often made on the basis of the presence or absence of symptoms. METHODS: In this study the authors compare the clinical and specular micrographic findings, as recorded from 20 patients noted to have biomicroscopic clinical findings consistent with corneal guttata or early Fuchs' endothelial dystrophy. RESULTS: Results confirm the increased prevalence of corneal findings in elderly women. The topographical distribution of guttata, across the posterior corneal surface, as observed clinically was confirmed specular micrographically (rS = 0.55, p = 0.01). Increased numbers of guttata correlated with a statistically significant reduction in the endothelial cell counts recorded from the midperipheral cornea (rS = 0.49, p = 0.02). The relationship between the presence of guttata and a reduction in cellular hexagonality or an increase in polymegethism failed to reach a statistically significant level. Pigment deposits adherent to the posterior endothelial surface were also noted in all but one of the eyes examined. CONCLUSIONS: The authors advocate the use of a grading scale, developed from specular micrographs taken during the course of the study, to assist in the clinical classification of corneal guttata and pre-clinical Fuchs' dystrophy. The authors also recommend specular microscopy as a tool capable of differentiating corneal guttata from pigment deposits in even the most severely affected cases.

Aged↗

PubMed1997

Estimating social adjustment following spinal trauma--II: Population trends and effects of compensation on adjustment.

Adaptation to, or acceptance of, acquired spinal cord injury is accepted as an essentially longitudinal process. Changes in an individual's social, financial and domestic positions in turn affect issues concerning quality of life and self-image. The responses of 302 individuals with spinal cord injury in the United Kingdom and United States of America are presented to produce individual profiles of social adjustment. The differences between the UK and USA groups are presented, together with a combined analysis which addresses, in particular, the effects which being involved in litigation has on the process of social adjustment. Individual data concerning social adjustment, provided through a scale developed by the authors, and the utility of graphical presentation of the data is also presented. Such presentation has been found to have particular importance in clinical interview, situations by providing a framework for further exploration of individual adjustment difficulties, and in legal settings.

Adult↗

PubMed1998

Alterations in self-perceptions following childhood onset of spinal cord injury.

Most research into psychological aspects of spinal cord injury (SCI) has focused on adult onset. This is a retrospective study of self-perceptions following a childhood onset of SCI. Self-esteem, depression and self-perception were examined in 86 people who had a traumatic SCI before the age of 16. Depression was measured using the Beck Depression Inventory, and self-esteem using the Culture-Free Self-Esteem Inventory Self-perception was measured using a scale developed for this study, consisting of 20 adjectives, with participants themselves on dimensions of 'As I am', 'As I would be without the injury', and 'as I would be ideally'. The participants' self perceptions of the injured self and the uninjured self were found to be significantly different on only nine of the 20 adjectives. Low self-perception was found to be associated with low self-esteem and high depression levels, but independent of age at injury, level of injury and gender. The change noted by the participants between how they see themselves now and how they would have been without the injury is not as great as might have been expected.

Adolescent↗

PubMed2002

Rasch analysis of the Catz-Itzkovich spinal cord independence measure.

BACKGROUND: The Spinal Cord Independence Measure (SCIM) is a new disability scale developed specifically for patients with spinal cord lesions (SCL). Its original and second versions (SCIM and SCIM II) were found to be reliable and more sensitive than the Functional Independence Measure (FIM) to functional changes in SCL patients. OBJECTIVE: To further validate the SCIM II, examining its components on a larger population. DESIGN: Retrospective cohort study. SETTING: Two rehabilitation centers in Israel. SUBJECTS: Two hundred and two inpatients with SCL. INTERVENTIONS: Routine SCIM assessments by staff nurses. Rasch and accompanying analyses. MAIN OUTCOME MEASURES: Unidimensionality of subscales (areas of function); goodness of fit of the tasks to the Rasch model; relationship of total-patient and single-task performance-ability; usability of task categories and the order of threshold locations between them; subscale discrimination of ability and difficulty and hierarchical nature; discrimination of task-categories ability, ie, distribution of thresholds along ability levels; and differential task behavior by age, gender and examination subgroups. RESULTS: Four unidimensional subscales were identified, and an acceptable goodness of fit to the Rasch model was demonstrated in most of their tasks (infit mean square=0.8-1.2, outfit mean square=0.6-1.4). However, some tasks showed overfit (bathing lower body) and some showed misfit (wheelchair-car transfer). Additional analyses performed to check for reasons for less than acceptable fit revealed flaws in a minority of the outcome measures. CONCLUSIONS: The findings of this analysis confirm the validity and reliability of the SCIM II. To a large extent we can infer that the SCIM II construct allows for the detection of any level of disability in any patient with SCL. A few item categories, however, should be rephrased or removed.

Activities of Daily Living↗

PubMed2003

Synthesis and acid-base properties of (1H-benzimidazol-2-yl-methyl)phosphonate (Bimp2-). Evidence for intramolecular hydrogen-bond formation in aqueous solution between (N-1)H and the phosphonate group.

The synthesis of (1H-benzimidazol-2-yl-methyl)phosphonic acid, H2(Bimp)+/-, is described: 2-chloromethylbenzimidazole was reacted with ethylchloroformate to give 1-carboethoxy-2-chloromethylbenzimidazole which was treated with trimethyl phosphite and after hydrolysis with aqueous HBr H2(Bimp)+/- was obtained. In H2(Bimp)+/- one proton is at the N-3 site and the other at the phosphonate group; both acidity constants were determined in aqueous solution by potentiometric pH titrations (25 degrees C; I = 0.1 M, NaNO3) and this furnished the pKa values of 5.37 +/- 0.02 and 7.41 +/- 0.02, respectively. The acidity constant for the release of the primary proton from the P(O)(OH)2 group of H3(Bimp)+ was estimated: pKa = 1.5 +/- 0.2. Moreover, Bimp2- can be further deprotonated at its neutral (N-1/N-3)H site to give the benzimidazolate residue, but this reaction occurs only in strongly alkaline solution (KOH); application of the H_ scale developed by G. Yagil (J. Phys. Chem., 1967, 71, 1034) together with UV spectrophotometric measurements gave pKa = 14.65 +/- 0.12. Comparisons with acidity constants taken from the literature show that this latter pKa value is far too large and this allows the conclusion that an intramolecular hydrogen bond is formed between the (N-1/N-3)H site and the phosphonate group of Bimp2-; the formation degree of this hydrogen-bonded isomer is estimated to be 98 +/- 2%. The general relevance of this and the other results are shortly discussed and the species distribution for the Bimp system in dependence on pH is provided.

Journal Article↗

PubMed1998

Smoking habits among Finnish middle-aged men: experiences and attitudes.

The purpose of this study was to explain smoking habits amongst middle-aged men in Finland by describing their experiences of smoking and their attitudes towards smoking. As a pilot survey for a major health campaign targeted at 40-year-old men, the data for this study were collected using two questionnaires in connection with voluntary medical examinations. The first questionnaire was based on Prochaska's theory of stages of change in health behaviour. The second instrument was an attitude scale developed specifically for this study on the basis of Green and Kreuter's theory of factors influencing health behaviour. According to the results 31% of males aged 40 were regular smokers. Men with a lower level of education and out of work smoked more often than others. Non-smokers reported a better self-perceived health than smokers. Smoking cessation is a process in which men gradually proceed from one step to the next. In this study 12% of the men were in the contemplation stage and 11% in the preparation stage. One-quarter of the men had recently given up the habit and were in the action stage, while 2% had quit smoking over 6 months ago and were in the maintenance stage. One-quarter of the men regarded smoking as an integral part of their way of life and felt that public opinion towards smoking is hostile.

Adult↗

PubMed1998

The clinical diagnosis of the narcoleptic syndrome.

Sleep-wake habits and control of postural muscle tone were investigated by self-report questionnaire in 183 subjects considered to have the narcoleptic syndrome, 62 subjects with hypersomnia and 10 with obstructive sleep apnoea. Results were compared with those in a group of 188 control subjects with normal sleep wake habits. Excessive daytime sleepiness, determined by the Epworth Sleepiness Scale (ESS), was five times greater in the narcoleptic syndrome than in control subjects (score range 0-24, mean scores +/-SD 19.6+/-3.0; and 4.5+/-3.3 respectively; P<0.001). The propensity to cataplexy, as determined by a rating scale developed to estimate the likelihood of loss of postural tone in response to sudden emotional stimuli, including laughter, was 10 times greater in narcoleptic syndrome than in control subjects (postural atonia total score range 0-600; mean + SD 334+/-122 and 28+/-45, respectively; P<0.001). Narcoleptics had more disturbances of night sleep than controls with episodes of muscle jerking, sleep walking, sleep talking and sleep terrors, as well as sleep paralysis, and higher insomnia self-rating scores. Sleep latency from bedtime to sleep-onset time was shorter in narcoleptics than controls. The hypersomniac group of 62 subjects was heterogeneous. Subsequent investigation showed that 18 subjects (29%) had idiopathic hypersomnia, four (6%) 'incomplete' narcolepsy without cataplexy and 10 (16%) hypersomnia accompanying a mood disorder. The mean ESS scores in this group and in subjects with obstructive sleep apnoea were comparable to those of the narcoleptic syndrome subject group. Mean postural atonia scores were similar to those of control subjects.

Adult↗

PubMed2003

Y chromosome conserved anchored tagged sequences (YCATS) for the analysis of mammalian male-specific DNA.

Y chromosome haplotyping based on microsatellites or single nucleotide polymorphisms has recently proven to be a powerful approach for evolutionary studies of human populations, and also holds great promise for the studies of wild species. However, the use of the approach is hampered in most natural populations by the lack of Y chromosome markers and sequence information. Here, we report the large-scale development of Y chromosome conserved anchor tagged sequence (YCATS) markers in mammals by a polymerase chain reaction screening approach. Exonic primers flanking 48 different introns of Y-linked genes were developed based on human and mouse sequences, and screened on a set of 20 different mammals. On average about 10 introns were amplified for each species and a total of 100 kb of Y chromosome sequence were obtained. Intron size in humans was a reasonable predictor of intron size in other mammals (r2 = 0.45) and there was a negative correlation between human fragment size and amplification success. We discuss a number of factors affecting the possibility of developing conserved Y chromosome markers, including fast evolution of Y chromosome sequences due to male-biased mutation and adaptive evolution of male-specific genes, dynamic evolution of the Y chromosome due to being a nonrecombining unit, and homology with X chromosome sequences.

Animals↗

PubMed2001

Psoriasis vulgaris and acute guttate psoriasis in a family.

A 33-year-old man (Case 1) developed scaling and erythema on the extensor side of his extremities, head, and back, 3 years before his first visit to our hospital. The lesions spread out to form several plaques and became persistent (Fig. 1a). Serum antistreptolysin O (ASO) was within the normal range and a pharyngeal culture showed normal flora. Histologic findings were compatible with psoriasis vulgaris (Fig. 1b). Topical steroid therapy was effective; however, scaling and erythema persisted. The 8-year-old daughter (Case 2) of Case 1 had suffered severe tonsillitis 2 months prior to the skin eruptions. Numerous rain drop-like scaly papules appeared on her legs and generalized rapidly (Fig. 2a). Her tonsils were swollen and reddish. Streptococcus pyogenes was detected by pharyngeal smear. The ASO value was at a high level. Histologic examination showed slightly elongated rete ridges, focal lack of the granular layer, parakeratosis, mild spongiosis, and exostosis of neutrophils (Fig. 2b). She was diagnosed with acute guttate psoriasis. Administration of oral antimicrobials reduced the ASO value and led to remission of the disease. After 1 month of antimicrobial treatment, the erythematous papules disappeared. The human leukocyte antigen (HLA) typing of the father was HLA-A24, A31, B7, B39, and Cw7, and that of the daughter was HLA-A24, A31, B39, and Cw7. Both possessed HLA-A24, B39, and Cw7. The HLA typing of other family members was also studied. The mother had HLA-A11, A24, B39, B62, Cw4, and Cw7, and her son had HLA-A11, A24, B7, B62, Cw4, and Cw7. The result of HLA typing is shown in Table 1. Lymphocyte stimulating test was performed using heat-killed S. pyogenes which were boiled at 70 degrees C for 10 min and sonicated. The stimulation index was twofold higher in the daughter than in the father (Fig. 3).

Acute Disease↗

PubMedDate not supplied

Sexual functioning in patients following radical hysterectomy for stage IB cancer of the cervix.

Despite extensive research on sexual dysfunction after gynecological cancer, uncertainty remains regarding the nature and extent of sexual problems following surgery for early cervical cancer. This study investigated whether radical hysterectomy for stage IB cancer of the cervix without adjuvant treatment entails short- or long-term sexual difficulties. Twenty patients with stage IB cervical cancer undergoing radical hysterectomy (CG), 18 women treated with hysterectomy for a benign gynecological condition (BG), and 20 gynecologically healthy women (HG) were studied. At 0, 4, and 8 months postoperatively, data were prospectively gathered using standardized questionnaires and specifically developed scales. Sexual functioning was covered in 15 specifically designed items and analyzed using Fisher's exact tests. For all other variables, group comparisons were computed using analysis of variance (ANOVA) or nonparametric statistical equivalents. Nonsignificant trends, consistent across time and groups, resulted for most of the sexual variables. Preoperatively, cancer patients exhibited slightly better sexual functioning than the other two groups, but over time this decreased slightly. Conversely, sexual functioning among the patients with benign disease showed steady improvement. These results indicate that radical hysterectomy for stage IB cervical cancer does not entail major sexual sequelae. Because of the limited sample size of our study, conclusions must be drawn cautiously.

Adult↗

PubMed2001

Environmental risk factors for delirium in hospitalized older people.

OBJECTIVES: To evaluate the relationship of environmental risk factors in hospitals to changes over time in delirium symptom severity scores. DESIGN: Observational prospective clinical study with repeated measurements, several times during the first week of hospitalization and then weekly during hospitalization. SETTING: University-affiliated general community hospital. PARTICIPANTS: Four hundred forty-four patients age 65 and older admitted to the medical wards: 326 with delirium and 118 without delirium. Patients with prior cognitive impairment were oversampled. MEASUREMENTS: The severity of delirium symptoms was measured with the Delirium Index, a scale developed and validated by our group, based on the Confusion Assessment Method. Potential environmental risk factors assessed included isolation, hospital unit, room changes, levels of sensory stimulation, aids to orientation, and presence of medical (e.g., intravenous) or physical restraints. RESULTS: Controlling for initial severity of delirium and patient characteristics, variables significantly related to an increase in delirium severity scores included hospital unit (intensive care or long-term care unit), number of room changes, absence of a clock or watch, absence of reading glasses, presence of a family member, and presence of medical or physical restraints. CONCLUSION: The associations of intensive care and medical and physical restraints with severity of delirium symptoms may be due to uncontrolled confounding by indication. However, the other factors identified suggest potentially modifiable risk factors for symptoms of delirium in hospitalized older people.

Aged↗

PubMed2005

[Is there a connection between right-wing extremism and social distancing from mentally ill people? Results from a representative survey among the adult German population].

OBJECTIVE: There are indications of a link between right-wing extremist orientation and attitudes towards people with mental illnesses. Social distance is used to investigate this. METHOD: In 2002, a representative survey was conducted among the German adult population (n = 2089). Social distance was measured using a question from the European values surveys. Right-wing extremist attitudes were measured with a scale developed by Niedermayer and Faller. RESULTS: Only a marginal link between right-wing extremism and social distance towards people with mental illnesses was found which, moreover, showed an inconsistent pattern. DISCUSSION: It would be premature to conclude from this "negative" finding that a right-wing extremist orientation has no influence on the attitude towards people with mental illnesses, especially in the light of only one form of discrimination being investigated here.

Adolescent↗

PubMed2006

Neurodevelopmental outcome at 2 years in 23 to 26 weeks old gestation infants.

BACKGROUND: Assessment of neurologic and developmental outcome at 2 years age of infants with gestational age (GA)<27 weeks, born between 1996-2001. PATIENTS: A total of 110 live-born preterm infants with GA<27 weeks. METHODS: Main outcome criterions: Neurologic examination (according to Touwen) and classification of cerebral palsy by using the Gross Motor Function Classification System (GMFCS) at the corrected age of 1 and 2 years; assessment of mental and psychomotor development by using the Griffith Mental Development scales at the corrected age of 2 years; growth assessment at birth, 1 and 2 years. RESULTS: Mortality was 52%. Regular follow up was performed in 48 (91%) of the 53 surviving infants. Neurologic outcome: at 1 year age: 2% nonambulant cerebral palsy, 25% mild neurologic signs and 73% normal; at 2 years age: 4% nonambulant cerebral palsy, 2% ambulant cerebral palsy, 4% mild neurologic signs and 90% normal neurology. Developmental outcome at 2 years age: 40% DQ>-1 SD, 6% DQ between -1 SD and -2 SD (mild delay), 35% DQ between -2 SD and -3 SD (moderate delay) and 19% DQ<-3 SD (severe delay). Overall disability was found in 64%, severe disability in 27% of the infants. Profound growth failure in weight and head circumference<3rd centile at 2 years age was recorded in 39 and 19% of the infants, respectively. CONCLUSION: Developmental delay is very common in preterm infants<27 GA and exceeds the number of neurological disabilities (including cerebral palsy).

Body Weight↗

PubMed2006

Domestic violence during pregnancy in Turkey and responsibility of prenatal healthcare providers.

The purpose of this study was to estimate prevalence and risk groups of domestic violence during pregnancy in Manisa, Turkey, and to determine antenatal complications or health problems and health service use. This study was a population-based, cross-sectional, and household survey. The study universe included two primary health units situated in two different socioeconomic areas (rural and urban) in the city of Manisa, Turkey, from January to June 2004; the homes of 246 women were visited and the study sample included 217 women. A questionnaire was used that comprised sociodemographic and reproductive characteristics, and the Domestic Violence Against Women Determination Scale, developed by Yanikkerem in 2002 to measure the frequencies of type and severity of violence. The Statistical Package for the Social Sciences (SPSS, version 10.0 for Windows) was used to analyze the data. Student t test and Mann-Whitney U test were used to evaluate data. Results indicated that 9.7% of women were beaten by their partner during the pregnancy (17.3% in the rural area and 2.7% in the urban area) and 14.3% of women were beaten before pregnancy. A total of 10.6% of women said they had been slapped, 9.1% reported an object was thrown at them by their partner, and 6.5% admitted to having been kicked during pregnancy. A total of 36.4% of women reported experiencing forced sexual activity. Abused pregnant women were less educated, had lower income, were unmarried, were multiparous, had more children, had a longer duration of marriage, lived rural areas, were more likely to have unplanned pregnancies, had miscarriage, had an interpregnancy interval of 2 years or less, smoked more cigarettes, did not visit a health institution for control during pregnancy and did not know the sex or knew the fetus was female when compared with nonabused women. Abused women who live with various problems during pregnancy and are victims of violence tend to feel isolated, insecure, and depressed. Our results indicate that most pregnant women do not report that their prenatal care providers discussed violence with them. Healthcare provides have an important role in this issue. Antenatal care protocols should be modified to address domestic violence and contributing factors during pregnancy so that identified women can be counseled appropriately and attempts can be made to intervene to prevent further episodes of domestic violence in primary care settings.

Confidence Intervals↗