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Acculturation of Japanese Americans:: Use of the SL­ASIA with a Community Sample.

PURPOSE. The present article summarizes the use of the Suinn­Lew Asian Self Identity Acculturation Scale (SL­ASIA) with a community sample of Japanese Americans. METHODOLOGY. The SL­ASIA was administered to 123 Japanese Americans in Los Angeles, CA. Analyses of internal consistency and concurrent validity were conducted. PRINCIPAL FINDINGS. Results indicated that the mean SL­ASIA score for this sample was 3.25, which according to the scale developers' conceptualization of acculturation, indicates a medium level of acculturation. Analyses revealed no gender differences. Psychometric properties of the SL­ASIA with this community sample of Japanese Americans appear to be adequate. Obtained correlation coefficients were somewhat lower than those found for college students; however, they still were in a reasonable range. Concurrent validity of the SL-ASIA was demonstrated with several other variables such as generational status and self-identification. CONCLUSIONS. This article presented the results of analyses of the SL­ASIA with a community sample of Japanese Americans. Results indicated that, although the correlation coefficients obtained from analyses examining internal consistency and concurrent validity were lower for this sample as compared to those found with college student samples, the SL­ASIA was found to have adequate psychometric properties with this community sample. Thus, results indicate that the SL­ASIA would be an appropriate screening measure to assess acculturation level among Japanese Americans in the community. RELEVANCE TO ASIAN AMERICAN AND PACIFIC ISLANDER POPULATIONS. This article is particularly relevant to Japanese Americans. KEY WORDS. Acculturation, Japanese Americans, moderator variables, psychometric analyses.

Journal Article↗

[Indicators for population and individual risk in assessing the effect of environmental factors on the health of children].

Populational studies define a risk for abnormalities forming in children residing in varying polluted areas and compare it with the risk due to other health-forming factors. To define an individual risk, the authors have developed scales rating the likelihood of abnormalities that can occur in each child in relation to the biomedical or social risk factors in children, to their residence in poor environmental areas, to the child's age and sex.

Child↗

[Problems with dental information given to patients. A report by the consumer organisation].

The objective of this study was to investigate the information problems of Dutch dental patients in the years 1993-1995. Using a self-developed scale, the dental files of a consumer organisation were analysed and the information problems counted and categorised. Of all the dental dossiers 48% concerned information problems. The largest categories were: insufficient information about finances, insufficient information about the treatment/outcomes and the negligence of the information, complaints and questions of the patients. Together these categories make up 75% of the information problems. The results of this study stress that dentists should offer better structured information. More attention should also be paid to the abilities of the dentists to be communicative and to manage conflicts.

Communication↗

Chinese adolescents' perceptions of family functioning: personal, school-related, and family correlates.

The author used two translated measures (Self-Report Family Inventory; D. T. L. Shek, 1998); and Family Assessment Device; N. B. Epstein, L. M. Baldwin, & D. S. Bishop, 1983) and a locally developed scale (Chinese Family Assessment Instrument; D. T. L. Shek, in press-a) to assess 3,649 Chinese adolescents' perceptions of how well their families function. He found that boys perceived their families to function worse than did girls and that younger adolescents perceived their families to function better than did older adolescents. Perceived family functioning was negatively related to grade level; students attending schools with higher academic standards perceived their families to function better than did students attending schools with lower academic standards; and students attending government and aided schools had higher levels of family functioning than did students attending private schools. Family types (intact vs. nonintact families) and the duration of parents' stay in Hong Kong were also related to the adolescents' perceptions of family functioning. Findings for the personal, school-related, and family correlates of perceived family functioning were statistically significant and stable across different measures of family functioning, but the practical significance of the findings was not high.

Adolescent↗

Provider order entry with integrated decision support: from academia to industry.

OBJECTIVES: To describe the evolution of a provider order entry system with integrated decision support, from a research prototype to full implementation at one academic center, and finally to a commercial product. METHODS: Describe the institutional environment and planning process in which the system originated. Highlight the historical evolution of the provider entry system, and analyze its system architecture and functionality. Describe the requirements for successful design and deployment both within a single health care organization and as part of a commercial product line. RESULTS: Over a period of eight years the system evolved from a research prototype to a fully integrated order entry system in routine use on most inpatient units of a large academic medical center. Around 12,000 orders are entered every day into the computer system; 70% of those are entered directly by the responsible physician. The system embeds best-of-care practice guidelines, and is used to reduce resource utilization by limiting unnecessary testing and suggesting more effective or less costly therapeutic replacements. The system was recently acquired by a large HIS software vendor and is being rapidly implemented at numerous customer sites. CONCLUSIONS: Large-scale development or deployment of complex health information systems requires considerable organizational agreement and resources, as well as close attention to iterative system design that explicitly includes constant feedback from the user community. The transformation of such a system from a single-site success to a widely deployed product requires convergence of resources and needs.

Academic Medical Centers↗

Cavernous carotid artery calcification and white matter ischemia.

BACKGROUND AND PURPOSE: The relevance of cavernous carotid artery calcification on unenhanced CT scans of the brain has recently been investigated against the backdrop of the widespread implementation of coronary artery calcification scoring. We sought to determine whether the degree of cavernous carotid artery calcification correlated with scores of white matter hyperintensity seen on MR images. In so doing, we sought to establish a relative risk for future stroke on the grade of carotid calcification. METHODS: Neuroradiologic findings in 187 patients who underwent CT and MR imaging examinations within 1 month of each other were retrospectively reviewed. The degree of circumferential calcification and thickness of calcification were graded for the cavernous carotid arteries on the basis of CT findings. Using the scale developed by the Cardiovascular Health Study, the white matter was graded for degree of disease on the basis of MR findings. Correlation tests and regression analyses were performed to determine the impact of age, race, and sex on results. RESULTS: Although the cavernous carotid calcification scores and the MR imaging white matter scores showed good correlation (P <.001), the effect was mediated by age. With age factored in as a covariant, no correlation was shown between CT calcification scores and MR imaging white matter scores. Sex had no effect, but African American study participants had worse MR imaging white matter scores than did white participants. CONCLUSION: After adjusting for age, cavernous carotid calcification grades and MR imaging white matter scores do not show a significant correlation. The relative risk for future stroke cannot be predicted from cavernous carotid calcifications.

Adult↗

Regaining functional independence by neurological patients.

The aim of the study was to evaluate the effect of nursing care on the process of regaining functional independence by neurological patients. The study covered 80 patients--28 males and 52 females, aged 39-67. The data concerning patients were collected by means of a questionnaire and observation. The results obtained were expressed as a definite number of scores on the Neurological Patient's Functional Independence Scale developed by the author. The study was conducted twice among the same patients.

Activities of Daily Living↗

Shaping of psycho-social independence in neurological patients.

The aim of the study was to determine the degree of psycho-social independence among neurological patients. The study was conducted by means of the Neurological Patients' Psycho-Social Independence Scale developed by the author, and covered 120 patients--51 males and 69 females aged 21-72; unmarried--34 and married--86, with the level of education: elementary--33, secondary school--79 and university--8; who had cerebral stroke--67, multiple sclerosis--31, radicular syndrome--22. During the first stage of the study psycho-social independence remained primarily on the medium level with respect to the knowledge concerning life style, apart from the consumption of alcohol, strong tea and coffee, the patients showing a good knowledge of this problem prior to the implementation of the education programme. With respect to skills and the remaining psycho-social aspects (motivation, self-acceptance, social functioning, intellectual efficiency) the respondents represented primarily a very high or high level during the second study. Unfortunately, a considerable number of patients still showed a medium or low level. Population who represented a very high and high levels of psycho-social independence, increased by 25.0%.

Activities of Daily Living↗

A new phosphate-selective sorbent for the Rem Nut process. Laboratory investigation and field experience at a medium size wastewater treatment plant.

P-control technologies for municipal wastewater are essentially based on "destructive" methods, that lead to formation of concentrated solid-phases (sludge), usually disposed-off in controlled landfills. Ion exchange, as a "non-destructive" technology, allows for selective removal and simultaneous recovery of pollutants, which can be recycled to the same and/or related productive lines. In this context, the REM NUT process removes nutrient species (HPO4 = , NH4+, K+) present in biologically oxidised municipal effluents and recovers them in the form of struvites (MgNH4PO4; MgKPO4), premium quality slow release fertilisers. The main limitation to the extensive application of this ion exchange based process is the non-availability of selective exchangers for specific removal of nutrient species. This paper illustrates laboratory investigation and pilot scale development of a so-called "P-driven" modified REM NUT scheme based on a new phosphate-selective sorbent developed at Lehigh University, PA, USA.

Adsorption↗

The perceptions of stressors in coronary artery bypass graft patients.

A descriptive correlational study was conducted to compare the perceptions of 33 patients and their nurses of the stressors involved in the surgical procedure of Coronary Artery Bypass Graft (CABG). Five additional stressor items were added to the Stressor Scale developed by Carr (1982). Patients and nurses completed the questionnaires. Correlations and t tests were used to examine the relationship between the stressor scores. Overall, the nurses rated the stressors significantly higher than the patients. In the nursing group, nurses with more experience rated the stressors significantly lower than the nurses with less experience. These results were similar to the findings of Carr (1982). Implications for nursing theory, practice and research are discussed.

Adult↗

[126 small gestational age infants. Clinical characteristics and long-term observation].

From January 1, 1987 through June 30, 1990, 126 infants of small gestational age (SGA) born in our hospital were studied prospectively. The incidence of SGA infant > or = 37 weeks was 71.4%. The incidence of very low birth weight infants was only 6.3%. The incidence of birth asphyxia in this group (14.9%) was 3 times higher than that in full term infants; this incidence showed negative correlation with gestational age and birth weight. The morbidity rates of hypoglycemia (25.7%) and polycythemia (10.1%) were much higher than those in AGA infants. Malformation was the major cause of death in SGA infants. The mortality rate of SGA infant was 5.6% and the mortality rate of SGA infant > or = 37 weeks was only 1.1%. The results of follow-up showed that the physical development was normal in about 90% of cases at 2 years of age, and only 2 cases had low motor development scale when they were one-year old.

Asphyxia Neonatorum↗

[Epidemiological data about attention deficit hyperactivity disorder in a sample of Marabino children].

AIMS: This study reports the findings of a research project aimed at determining the rate of prevalence of attention deficit hyperactivity disorder (ADHD) in school aged children. PATIENTS AND METHODS: Different behavioural and cognitive measures were administered to a sample of children between 3 and 13 years of age obtained by means of a multistage sampling procedure that was stratified by socioeconomic and educational level. The sample was made up of 394 children; 33.25% (n = 131) were females and the remaining 66.75% (n = 263) males. The mean age of the sample was 7.64 years old (SD: 2.33). The assessment battery included the Conners Rating Scales adapted for parents and teachers, the abbreviated version of the Wechsler Intelligence Scale for Children (WISC III) and for Preschool children Revised (WPPSI R), several academic achievement scales, development history and DISC IV. RESULTS: The estimated prevalence of ADHD was 10.15%, and a figure of 2.03% was obtained for the hyperactive type, 0.51% for the inattentive subtype, and 7.61% for the combined subtype. Prevalence was higher for males, the ratio being 3:1. Subjects performance in the cognitive and academic measures was within the average interval. CONCLUSIONS: The prevalence of ADHD in our population oscillates around the average figures reported in other countries. This study confirms the prevalence of ADHD in the population of Venezuela, with a distribution of subtypes and in terms of gender similar to those reported in the literature.

Adolescent↗

Reliability of AIDS knowledge scales: conceptual issues.

A common approach to evaluating the reliability of AIDS knowledge scales has relied on the demonstration of internal consistency through the use of Kuder-Richardson formula 20 (KR-20) or coefficient alpha. In this study, the argument was made that, in a knowledge-based scale with diverse content (exemplified by AIDS knowledge scales), internal consistency does not make sense conceptually and underestimates the scale's true reliability. It was therefore hypothesized that a split-half approach, in which items in each half were matched for content, would provide superior estimates of reliability when compared to either KR-20 or an odd-even split-half approach. Reliability analyses performed on a knowledge scale developed by the author supported this hypothesis.

Acquired Immunodeficiency Syndrome↗

Issues associated with measuring symptom status: HIV/AIDS case illustration.

The purpose of this article is to illustrate issues associated with measuring one aspect of health, symptom status, through a comparison of two specific symptom scales developed for use with persons with HIV/AIDS. A number of decisions are necessary to evaluate the appropriateness of different health measurement instruments. These include: whether the purpose is to evaluate a program of care or to study individual patients; characteristics that are being assessed; the time frame being assessed; how broad-ranging an assessment is desired; and the scope of detail that is desired. This descriptive survey with a HIV+ sample (N = 100) found that there were 8 items that assessed identical symptoms on the Sign and Symptom Checklist-HIV and the HIV Assessment Tool. There were no significant correlations between similar items on the two instruments. There were significant differences between the mean scores only for headaches (t = -3.4, p = .001). Issues related to symptom appraisal, the time frame, and the nature of symptom-related variables need to be carefully considered before choosing a measurement instrument.

Adult↗

Effectiveness and ergonomic features of different light sources for polymerization of composite resin materials.

INTRODUCTION: Besides the halogen curing lights, already accepted as standard equipment, diode and plasma-arc units for polymerization of filling materials have also been commercially available in Bulgaria in recent years. The present study was prompted by the lack of detailed scientific information about these novel light curing devices. AIM: 1. To evaluate the quality of polymerization achieved by different light curing units by measuring the quantity of residual monomer in the test specimens. 2. To classify the units according to their convenience features and polymerization abilities. MATERIALS AND METHODS: Five diode units from three different manufacturers, one plasma-arc unit and one halogen unit were used. The test specimens, made from the hybrid photopolymerizing material Illumine (Ortho Plus, France), Type II, radiopaque, color C1, were 2 mm high and 4 mm in diameter. They were cured for 40 seconds with the respective unit after which they were ground and 25 mg from each sample were immersed in 8 ml of 95% ethanol for extraction of the residual monomer. The quantity of the residual monomer was determined by the method of the standard straight line. Statistical analysis was performed with the analysis of variance and F-test. The comparisons in each group were made by the Tukey-Kramer test, the level of significance for the null hypothesis being P = 0.05. The complex evaluation of the units was made with the help of a scale, developed by us. RESULTS: The material polymerized by the halogen light demonstrated the smallest quantities of residual monomer of all the specimens. There was no statistically significant difference between the quantities of the residual monomer in the specimens polymerized by the plasma arc unit (PAC), OL2 and Elipar Free Light exp. Such a difference, however, existed when comparing the PAC unit and the 3M ESPE unit, working in a continuous irradiation mode, the former having more residual monomer. Polymerization by Elipar Free Light produced the smallest quantities of residual monomer of all other diode lights. The only exception was the comparison between OL2 and Elipar Free Light exp., where there was no difference. The diode light of 3M ESPE performed best of all units according to the criteria we used for evaluation of the light curing devices. CONCLUSIONS: 1. The intensity of radiation of the light source and the duration of polymerization are of crucial importance for the complete conversion of the monomer into polymer. 2. Diode technology has not yet been able to reach any halogen equipment with respect to quality of polymerization, despite some of its unquestionable advantages. 3. When choosing a light curing unit, the quality of polymerization is more important than the price and the offered additional features.

Composite Resins↗

Percutaneous intramedullary supracondylar nailing for fractures of distal femur.

A prospective study of 25 patients with supracondylar and intercondylar fracture of the femur was carried out from January 1999 to June 2003 at SSG Hospital, Baroda, India. Twenty-eight percent fractures were open and 72% were closed. Twelve pecent of the fractures had intraarticular extension. AO classification was used to classify the fractures. Eighty-four percent of the fractures were due to high velocity trauma. All the cases were operated by percutaneous supracondylar nailing. No postoperative complication related to fracture treatment was seen. Average follow up was 20.1 months (range 6-40 months). Average age of the patients was 31.5 years. Average time of union was 3.1 months (range 2-4 months). Average knee range of motion was 117 degrees. Even in open injuries, 85.7% had more than 110 infinity range of motion. All patients could return to their pre-injury lifestyle. Rating scale developed by Hospital for Special Surgery was used to quantify the results. Eighty-four percent showed excellent, 8% showed good and 8% showed fair results. Percutaneous supracondylar nailing is thus, an excellent method of treating fractures of distal femur.

Adult↗

Uterine cervical cancer: a holistic approach to mental health and it's socio-psychological implications.

This correlation study investigated outpatients with early stage uterine cervical cancer. The subjects' mental health and its' relationship with demographic characteristics, clinical characteristics, and quality of life were examined. One hundred and seventy six patients from three major hospitals in the Fukuoka area were surveyed with a structured questionnaire. The status of mental health measured by CES-D (Center for Epidemiologic Studies Depression Scale) indicated an average score of 13+/-8 (mean+/-SD). No clinical parameters were found to have significant correlation to CES-D. However, increased pain (p< 0.001) and the absence of a husband or a partner (p < 0 .01) had greater CES-D score which indicated worse mental health outcome. The QOL (Quality of Life) scale developed for this study consists of the four domains: "Feel satisfied with life" (r = -.526, p < 0. 01), "Find life worth living" (r= -.485, p < 0.01), "Feel no hindrance in daily life" (r= -.319, p<0.01), and "Feel no anxiety with illness" (r= -. 578, p < 0.01) all which have statistically significant correlations with CES-D scores respectively. Upon examination using the multi-regression model, a strong relationship between CES-D scores and "Feel no anxiety with illness" (r= -.331, p<0.001) was evident. This showed to be the strongest indicator affecting the depression outcome, followed by "Strong pain" (r= .231, p<0.01). Clinical parameters, such as performance status, clinical stage, and medical treatment did not show any correlation to CES-D scores. The research suggests that the mental health of outpatients with uterine cervical cancer was influenced by pain and quality of life, rather than the clinical parameters. The presence of a husband or a partner played the role as social support to reduce the level of depression. In order to provide complete care of patients, pain management, anxiety management, and spousal involvement are crucial to patients' mental health, especially in the ongoing care of uterine cervical cancer.

Anxiety↗

[Phytopathogenic bacteria in Agaricus bisporus culture].

Literature sources have been surveyed concerning the two-spore white button mushroom (Agaricus bisporus) affected by phytopathogenic bacteria. Yield losses and decrease of fruit body quality caused by bacterial spots and rot under the conditions of industrial cultivation have been estimated. It has been established that the button mushroom affection at the second fruiting break can reach 55% that causes the yield shortage of more than 5 kg from 1 m2 and financial losses of 1000 Euro for each growing cycle. The bacteria development intensity was found to depend on growing by shelves. The most favourable growing conditions were observed on the lower shelf; the number of affected mushrooms was 1145-1526 mushrooms 1 m2 or 95.4% that resulted in the yield losses of 9.5 kg/m2. The loss of mushrooms from bacterial rot reached 1.5 kg/m2. The degree of affection of fruit bodies was estimated by the developed scale. According to the scale 22.7% of mushrooms are fit for realization in fresh or canned form (the infection degree 5-10%).

Agaricus↗