Sample records for total problem score

  1. Understanding sleep problems in children with epilepsy: Associations with quality of life, Attention-Deficit Hyperactivity Disorder and maternal emotional symptoms.

    PubMed

    Ekinci, Ozalp; Isik, Uğur; Gunes, Serkan; Ekinci, Nuran

    2016-08-01

    This study aimed to (1) compare sleep problems between children and adolescents with epilepsy and non-epileptic controls, and (2) examine whether there is an association between sleep problems and quality of life, Attention-Deficit Hyperactivity Disorder (ADHD) and mothers' emotional symptoms. Fifty-three patients from a cohort of epilepsy (aged 7-18 years) and 28 controls with minor medical problems (aged 7-18 years) were included. Parents completed Children's Sleep Habits Questionnaire (CSHQ) and Kinder Lebensqualitätsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R) for patients and controls. Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) parent and teacher forms were used to assess ADHD symptoms for patients. Mothers of the patients completed Beck Depression Inventory and State-Trait Anxiety Inventory (STAI). Neurology clinic charts were reviewed for the epilepsy-related variables. Children with epilepsy had a higher CSHQ Total score than the control group. Those with a CSHQ score >56 (which indicates moderate to severe sleep problems) had lower scores on KINDL-R. Parent-rated T-DSM-IV-S Total and Hyperactivity-Impulsivity scores, STAI trait and Beck scores were found to be higher in those with a CSHQ score >56. Significant positive correlations were found between CSHQ Total score and T-DSM-IV-S, STAI trait and Beck scores. Binary logistic regression analysis revealed that T-DSM-IV-S Total, Inattention and Hyperactivity-Impulsivity scores were significantly associated with a higher CSHQ Total score. None of the epilepsy-related variables were found to be related with the CSHQ Total score. Among children with epilepsy, sleep problems lead to a poor quality of life. The link between sleep problems and psychiatric symptoms must be conceptualized as a bilateral relationship. ADHD appears to be the strongest predictor of sleep problems. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  2. Behavior problems in school-aged physically abused and neglected children in Spain.

    PubMed

    de Paúl, J; Arruabarrena, M I

    1995-04-01

    The present study investigated behavior problems in school-aged physically abused, neglected, and comparison children in the Basque Country (Spain). Data from the Teacher's Report Form of the Child Behavior Checklist was obtained on 66 children consisting of three groups (17 physically abused children, 24 physically neglected children, and 25 low-risk comparison children). The three groups were matched on seven sociodemographic variables. Overall, the abused and neglected children were higher than the comparison group on Total Behavior Problems scores. However, only neglected children obtained higher scores than the comparison group on the total score of the Externalized Scale, and only abused children scored higher than the comparison group on the total score of the Internalized Scale. Follow-up analysis indicated that both abused and neglected children had higher scores on the Social Problems, Delinquent Behavior, and Attention Problems subscales. Moreover, neglected children had higher scores on the Aggressive Behavior subscale than the comparison children, and abused children had higher scores on the Withdrawn subscale than the comparison children. The abused and neglected children also showed a lower school adjustment than the comparison group. Possible explanations of these findings are discussed and their implications for research and treatment are considered.

  3. Skin problems of the stump in lower-limb amputees: 2. Influence on functioning in daily life.

    PubMed

    Meulenbelt, Henk E J; Geertzen, Jan H B; Jonkman, Marcel F; Dijkstra, Pieter U

    2011-03-01

    The aim of this study was to analyse the influence of stump skin problems on functioning in daily life in lower-limb amputees. A cross-sectional study was performed by means of a questionnaire containing 9 questions assessing functioning in daily life. Question scores were added to give a total score (range 0 (no influence) to 27 (maximum negative influence)). Two thousand and thirty-nine people were invited to participate, with 805 participants completing a questionnaire. Of these, 507 reported one or more skin problems. Skin problems had a negative influence on ability to perform household tasks, prosthesis use, social functioning, and participation in sports. The mean total score was 5.5 ± 4.1. This correlated significantly with the number of skin complaints (r = 0.483; p = 0.01). In linear regression analyses, gender (β = -0.15) and number of skin problems (β = 0.25) accounted for 23% of the total score. This study confirms the influence of skin problems on functioning in daily life.

  4. Behavior, Social Competence, and Voice Disorders in Childhood and Adolescence.

    PubMed

    Krohling, Lívia Lima; Pereira de Paula, Kely Maria; Behlau, Mara Suzana

    2016-11-01

    This study aimed to verify the relationships among voice change complaints, indicators of competence, and behavioral problems in children and adolescents. This is a prospective study. A sample of 103 parents/guardians completed the Child Behavior Checklist for ages 6-18 years. The mean age and gender were very similar between the participants with and without voice complaints. Regarding the competences, no differences were found between the participants with and without voice complaints. The group with voice complaints presented higher total scores and T-scores in the both anxiety/depression and somatic complaints domains and in the internalising, externalizing, and total scales. The total scores and T-scores on the internalising, externalizing, and total scales, as well as those of their domains (anxiety/depression, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, and aggressive behavior), differed between children and adolescents with and without voice complaints. Children and adolescents with complaints of voice disorder demonstrate a potential risk of developing emotional/behavioral problems. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. Increase in child behavior problems among urban Brazilian 4-year olds: 1993 and 2004 Pelotas birth cohorts

    PubMed Central

    Matijasevich, Alicia; Murray, Elizabeth; Stein, Alan; Anselmi, Luciana; Menezes, Ana M; Santos, Iná S; Barros, Aluísio JD; Gigante, Denise P; Barros, Fernando C; Victora, Cesar G

    2014-01-01

    Background There are an increasing number of reports on time trends in child and adolescent psychological problems but none from low- and middle-income countries, and very few covering the preschool period. The aim was to investigate changes in preschool behavioral/emotional problems in two birth cohorts from a middle-income country born 11 years apart. Methods We analyzed data from the 1993 and 2004 Pelotas birth cohort studies from Brazil. A subsample of 4-year olds from the 1993 cohort (634) and all 4-year olds from the 2004 cohort (3750) were assessed for behavioral/emotional problems through maternal report using the Child Behavior Checklist (CBCL). Response rates in these two population-based cohorts were above 90%. Results We found a significant increase in CBCL total problems, internalizing and externalizing mean scores over the 11-year period. For 1993 and 2004 Pelotas cohorts, respectively, CBCL mean values (SE) total problems scores were 27.9 (0.8) and 34.7 (0.3); for internalizing scores, 5.7 (0.2) and 6.3 (0.1) and for externalizing scores, 12.4 (0.4) and 15.5 (0.1). After adjusting for confounding variables, the largest increase from 1993 to 2004 was identified in the aggressive behavior syndrome score (Cohen's d = .50), followed by the externalizing problem score (Cohen's d = .40) and CBCL total problem score (Cohen's d = .36), respectively. The rise in child psychological problems was more marked in children from families with fewer assets and with less educated mothers. Conclusions Our findings provide evidence for a substantial increase in preschool behavioral problems among children in Brazil over an 11-year period. PMID:24735354

  6. Behavioral/Emotional Problems of Preschoolers: Caregiver/Teacher Reports From 15 Societies.

    PubMed

    Rescorla, Leslie A; Achenbach, Thomas M; Ivanova, Masha Y; Bilenberg, Niels; Bjarnadottir, Gudrun; Denner, Silvia; Dias, Pedro; Dobrean, Anca; Döpfner, Manfred; Frigerio, Alessandra; Gonçalves, Miguel; Guđmundsson, Halldór; Jusiene, Roma; Kristensen, Solvejg; Lecannelier, Felipe; Leung, Patrick W L; Liu, Jianghong; Löbel, Sofia P; Machado, Bárbara César; Markovic, Jasminka; Mas, Paola A; Esmaeili, Elaheh Mohammad; Montirosso, Rosario; Plück, Julia; Pronaj, Adelina Ahmeti; Rodriguez, Jorge T; Rojas, Pamela O; Schmeck, Klaus; Shahini, Mimoza; Silva, Jaime R; van der Ende, Jan; Verhulst, Frank C

    2012-01-01

    This study tested societal effects on caregiver/teacher ratings of behavioral/emotional problems for 10,521 preschoolers from 15 societies. Many societies had problem scale scores within a relatively narrow range, despite differences in language, culture, and other characteristics. The small age and gender effects were quite similar across societies. The rank orders of mean item ratings were similar across diverse societies. For 7,380 children from 13 societies, ratings were also obtained from a parent. In all 13 societies, mean Total Problems scores derived from parent ratings were significantly higher than mean Total Problems scores derived from caregiver/teacher ratings, although the size of the difference varied somewhat across societies. Mean cross-informant agreement for problem scale scores varied across societies. Societies were very similar with respect to which problem items, on average, received high versus low ratings from parents and caregivers/teachers. Within every society, cross-informant agreement for item ratings varied widely across children. In most respects, results were quite similar across 15 very diverse societies.

  7. Behavioral/Emotional Problems of Preschoolers: Caregiver/Teacher Reports From 15 Societies

    PubMed Central

    Rescorla, Leslie A.; Achenbach, Thomas M.; Ivanova, Masha Y.; Bilenberg, Niels; Bjarnadottir, Gudrun; Denner, Silvia; Dias, Pedro; Dobrean, Anca; Döpfner, Manfred; Frigerio, Alessandra; Gonçalves, Miguel; Guđmundsson, Halldór; Jusiene, Roma; Kristensen, Solvejg; Lecannelier, Felipe; Leung, Patrick W. L.; Liu, Jianghong; Löbel, Sofia P.; Machado, Bárbara César; Markovic, Jasminka; Mas, Paola A.; Esmaeili, Elaheh Mohammad; Montirosso, Rosario; Plück, Julia; Pronaj, Adelina Ahmeti; Rodriguez, Jorge T.; Rojas, Pamela O.; Schmeck, Klaus; Shahini, Mimoza; Silva, Jaime R.; van der Ende, Jan; Verhulst, Frank C.

    2017-01-01

    This study tested societal effects on caregiver/teacher ratings of behavioral/emotional problems for 10,521 preschoolers from 15 societies. Many societies had problem scale scores within a relatively narrow range, despite differences in language, culture, and other characteristics. The small age and gender effects were quite similar across societies. The rank orders of mean item ratings were similar across diverse societies. For 7,380 children from 13 societies, ratings were also obtained from a parent. In all 13 societies, mean Total Problems scores derived from parent ratings were significantly higher than mean Total Problems scores derived from caregiver/teacher ratings, although the size of the difference varied somewhat across societies. Mean cross-informant agreement for problem scale scores varied across societies. Societies were very similar with respect to which problem items, on average, received high versus low ratings from parents and caregivers/teachers. Within every society, cross-informant agreement for item ratings varied widely across children. In most respects, results were quite similar across 15 very diverse societies. PMID:29416292

  8. Oral impacts on quality of life and problem-oriented attendance among South East London adults.

    PubMed

    Gaewkhiew, Piyada; Bernabé, Eduardo; Gallagher, Jennifer E; Klass, Charlotte; Delgado-Angulo, Elsa K

    2017-04-26

    Dental care seeking behaviour is often driven by symptoms. The value of oral health related quality of life (OHRQoL) measures to predict utilisation of dental services is unknown. This study aims to explore the association between OHRQoL and problem-oriented dental attendance among adults. We analysed cross-sectional data for 705 adults, aged 16 years and above, living in three boroughs of Inner South East London. Data were collected during structured interviews at home. The short form of the Oral Health Impact Profile (OHIP-14) was used to assess the frequency of oral impacts on daily life in the last year. Problem-oriented attendance was defined based on time elapsed since last visit (last 6 months) and reason for that visit (trouble with teeth). The association between OHIP-14 (total and domain) scores and problem-oriented attendance was tested in logistic regression models adjusting for participants' sociodemographic characteristics. Problem-oriented attenders had a higher OHIP-14 total score than regular attenders (6.73 and 3.73, respectively). In regression models, there was a positive association between OHIP-14 total score and problem-oriented attendance. The odds of visiting the dentist for trouble with teeth were 1.07 greater (95% Confidence Interval: 1.04-1.10) per unit increase in the OHIP-14 total score, after adjustment for participants' sociodemographic characteristics. In subsequent analysis by OHIP-14 domains, greater scores in all domains but handicap were significantly associated with problem-oriented attendance. This study shows that oral impacts on quality of life are associated with recent problem-oriented dental attendance among London adults. Six of the seven domains in the OHIP-14 questionnaire were also associated with dental visits for trouble with teeth.

  9. Competence and emotional/behavioural problems in 7-16-year-old Norwegian school children as reported by parents.

    PubMed

    Jozefiak, Thomas; Larsson, Bo; Wichstrøm, Lars; Rimehaug, Tormod

    2012-10-01

    Previous studies from Nordic countries suggest that parent ratings of children's emotional and behavioural problems using the Child Behavior Checklist (CBCL) are among the lowest in the world. However, there has been no Norwegian population study with acceptable response rates to provide valid Norwegian reference data. Firstly, to compare CBCL Internalizing, Externalizing, Total Problems and Competence scores of Norwegian children and adolescents with those from 1) previous Norwegian studies, 2) other Nordic countries, and 3) international data. Secondly, to present Norwegian reference data in order to perform these comparisons. Thirdly, to investigate the effects of age, gender, socio-economic and urban/rural status on the CBCL. A stratified cluster sample of 2582 school children (1302 girls and 1280 boys) was identified from the general Norwegian population and their parents were asked to complete the CBCL. The response rate was 65.5%. The mean Total Problems score for the whole sample was 14.2 (standard deviation, s = 14.1). Girls were rated as having greater Competence and fewer Total Problems than boys. Younger children had more Total Problems than adolescents. Parents with low education reported more child Total Problems and lower Competence than those with high education. All effect sizes were small, except for the effect of parental education on child Competence, which was moderate. Total Problems scores were lower than in other societies. The data from this study obtained from one county in central Norway provide an important reference for clinical practice and treatment outcome research.

  10. Psychopathology from adolescence into young adulthood: an 8-year follow-up study.

    PubMed

    Ferdinand, R F; Verhulst, F C

    1995-11-01

    This study investigated the stability of behavioral and emotional problems from adolescence into young adulthood. Subjects from the general population (N = 459), aged 13-16 years, were evaluated initially with the Child Behavior Checklist (completed by parents) and 8 years later with the Young Adult Self-Report. The scoring format and factor structure of the two assessment instruments are similar; syndromes constructed from the two instruments are based on parents', teachers', and self-report information derived from large clinical samples. Signs of maladjustment also were assessed at follow-up through interviews. Of the individuals with total problem scores in the deviant range on the Child Behavior Checklist, 27.3% had total problem scores in the deviant range on the Young Adult Self-Report at follow-up. The probability of having a total problem score in the deviant range at follow-up was raised 7.4-fold by having deviant-range scores on the Child Behavior Checklist somatic complaints and anxious/depressed syndromes (simultaneously) at the initial assessment. Referral to mental health services was predicted by deviant-range scores on the anxious/depressed syndrome, while suicide attempts were predicted by deviance on the withdrawn syndrome. Adolescent problems tended to persist into young adulthood to a moderate degree. High rates of withdrawal from social contacts, anxiety or depression, somatic complaints without known medical origin, social problems, attention problems, delinquent behavior, and aggressive behavior during adolescence were risk factors for specific types of psychopathology and maladjustment at 8-year follow-up. The presence of psychopathology in adolescence should not be regarded as normative.

  11. Are online poker problem gamblers sensation seekers?

    PubMed

    Bonnaire, Céline; Barrault, Servane

    2018-06-01

    The purpose of this research was to examine the relationship between sensation seeking and online poker gambling in a community sample of adult online poker players, when controlling for age, gender, anxiety and depression. In total, 288 online poker gamblers were recruited. Sociodemographic data, gambling behavior (CPGI), sensation seeking (SSS), depression and anxiety (HADS) were evaluated. Problem online poker gamblers have higher sensation seeking scores (total, thrill and adventure, disinhibition and boredom susceptibility subscores) and depression scores than non-problem online poker gamblers. Being male, with total sensation seeking, disinhibition and depression scores are factors associated with online poker problem gambling. These findings are interesting in terms of harm reduction. For example, because disinhibition could lead to increased time and money spent, protective behavioral strategies like setting time and monetary limits should be encouraged in poker online gamblers. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Relationship of early-life stress and resilience to military adjustment in a young adulthood population.

    PubMed

    Choi, Kang; Im, Hyoungjune; Kim, Joohan; Choi, Kwang H; Jon, Duk-In; Hong, Hyunju; Hong, Narei; Lee, Eunjung; Seok, Jeong-Ho

    2013-11-01

    Early-life stress (ELS) may mediate adjustment problems while resilience may protect individuals against adjustment problems during military service. We investigated the relationship of ELS and resilience with adjustment problem factor scores in the Korea Military Personality Test (KMPT) in candidates for the military service. Four hundred and sixty-one candidates participated in this study. Vulnerability traits for military adjustment, ELS, and resilience were assessed using the KMPT, the Korean Early-Life Abuse Experience Questionnaire, and the Resilience Quotient Test, respectively. Data were analyzed using multiple linear regression analyses. The final model of the multiple linear regression analyses explained 30.2 % of the total variances of the sum of the adjustment problem factor scores of the KMPT. Neglect and exposure to domestic violence had a positive association with the total adjustment problem factor scores of the KMPT, but emotion control, impulse control, and optimism factor scores as well as education and occupational status were inversely associated with the total military adjustment problem score. ELS and resilience are important modulating factors in adjusting to military service. We suggest that neglect and exposure to domestic violence during early life may increase problem with adjustment, but capacity to control emotion and impulse as well as optimistic attitude may play protective roles in adjustment to military life. The screening procedures for ELS and the development of psychological interventions may be helpful for young adults to adjust to military service.

  13. Emotional and behavioural problems in Swedish 7- to 9-year olds with asthma.

    PubMed

    Reichenberg, K; Broberg, A G

    2004-01-01

    The purpose of this study is to compare emotional and behavioural problems between preadolescent children with asthma and healthy children, and to explore if disease factors relate to problem scores. This was a cross-sectional study of 59 children, 34 boys and 25 girls, aged 7-9 years with mild (n = 11), moderate (n = 38) or severe (n = 10) asthma. A normative sample of 306 children in the same age range, 150 boys and 156 girls, was used as a comparison group. Parents assessed emotional and behavioural problems using the Child Behaviour Checklist. Peak expiratory flow rate and urinary eosinophil protein X were used as measures of lung function and inflammation. Children were interviewed about activity restriction and symptoms during the last week using the Paediatric Asthma Quality of Life Questionnaire. Parents scored day, night and exercise-induced symptoms during the same week. On average, children with asthma were attributed more problems than healthy children of the same age and comparable family socio-economic status. Effect sizes were 0.80 (95% confidence interval 0.52-1.09) for total problems, 0.89 (0.60-1.18) for internalizing problems and 0.67 (0.38-0.95) for externalizing problems. The relative risk for children with asthma exceeding the 95% cut-offpoint for total problems was 4.2 (2.1-8.3) compared to healthy children. Children with parent-reported exercise-induced asthma symptoms were attributed more total problems than asthmatic children without such symptoms. Parent-reported day symptoms and child report of symptoms and restricted activities related with problem scores to a lesser degree. Objective measures of lung function and inflammation were not related to problem scores. Concurrent eczema increased problem scores. It is concluded that asthma in preadolescent children is associated with emotional and behavioural problems. Special attention should be paid to children reported to have exercise-induced symptoms.

  14. Association Between Internet Use and Sleep Problems in Adolescents.

    PubMed

    Ekinci, Özalp; Çelik, Tanju; Savaş, Nazan; Toros, Fevziye

    2014-06-01

    Sleep problems are commonly encountered in adolescents. It has been shown that electronic media have a negative influence on the sleep quality and daytime functioning in adolescents. This study aims to investigate the association between internet use and sleep problems in adolescents. A total of 1212 adolescents were recruited to the study. Self-report study questionnaire included two main parts: Young's Internet Addiction Scale (IAS) and a semi-structured inquiry on sleep habits/problems. Of the study sample, 16% (n=198) reported their sleep quality as bad or very bad. One-fourth of the sample reported using internet everyday and 27% of them reported spending more than one hour when online. The mean IAS total score was 35.56±13.87. Adolescents with a higher IAS score reported getting to bed later in the night, needing more time to fall asleep and having an increased number of awakenings in the night than the adolescents with lower IAS score (p=.001). They were also found to have higher frequencies of several sleep problems including difficulty in initiating and sustaining sleep, difficulty in waking up and feelings of sleepiness in day. In addition, sleep quality of them was worse when compared to the adolescents with a lower IAS score (p=.001). Problematic sleep habits and sleep problems were found to be more frequent in adolescents with a higher IAS total score. Health care providers must be aware of the possible negative impact of excessive and uncontrolled internet use on adolescents' sleep habits.

  15. Fourth Graders and Non-Routine Problems: Are Strategies Decisive for Success?

    ERIC Educational Resources Information Center

    Yazgan, Yeliz

    2016-01-01

    This study aims to determine the explanatory and discriminative powers of non-routine problem solving strategies used by fourth graders. Six problems were asked to 240 pupils. After scoring answers between 0 and 10, bottom and top segments of 27% were determined based on total scores. Lastly, all scripts of students in these segments were…

  16. Academic Performance in Primary School Children With Common Emotional and Behavioral Problems.

    PubMed

    Mundy, Lisa K; Canterford, Louise; Tucker, Dawn; Bayer, Jordana; Romaniuk, Helena; Sawyer, Susan; Lietz, Petra; Redmond, Gerry; Proimos, Jenny; Allen, Nicholas; Patton, George

    2017-08-01

    Many emotional and behavioral problems first emerge in primary school and are the forerunners of mental health problems occurring in adolescence. However, the extent that these problems may be associated with academic failure has been explored less. We aimed to quantify the association between emotional and behavioral problems with academic performance. A stratified random sample of 8- to 9-year-olds (N = 1239) were recruited from schools in Australia. Data linkage was performed with a national assessment of academic performance to assess reading and numeracy. Parent report assessed emotional and behavioral problems with students dichotomized into "borderline/abnormal" and "normal" categories. One in 5 grade 3 students fell in the "borderline/abnormal" category. Boys with total difficulties (β = -47.8, 95% CI: -62.8 to -32.8), conduct problems, and peer problems scored lower on reading. Numeracy scores were lower in boys with total difficulties (β = -37.7, 95% CI: -53.9 to -21.5) and emotional symptoms. Children with hyperactivity/inattention scored lower in numeracy. Girls with peer problems scored lower in numeracy. Boys with emotional and behavioral problems in mid-primary school were 12 months behind their peers. Children with emotional and behavioral problems are at high risk for academic failure, and this risk is evident in mid-primary school. © 2017, American School Health Association.

  17. Behavioural problems in children who weigh 1000 g or less at birth in four countries.

    PubMed

    Hille, E T; den Ouden, A L; Saigal, S; Wolke, D; Lambert, M; Whitaker, A; Pinto-Martin, J A; Hoult, L; Meyer, R; Feldman, J F; Verloove-Vanhorick, S P; Paneth, N

    2001-05-26

    The increased survival chances of extremely low-birthweight (ELBW) infants (weighing <1000 g at birth) has led to concern about their behavioural outcome in childhood. In reports from several countries with different assessments at various ages, investigators have noted a higher frequency of behavioural problems in such infants, but cross-cultural comparisons are lacking. Our aim was to compare behavioural problems in ELBW children of similar ages from four countries. We prospectively studied 408 ELBW children aged 8-10 years, whose parents completed the child behaviour checklist. The children came from the Netherlands, Germany, Canada, and USA. The checklist provides a total problem score consisting of eight narrow-band scales. Of these, two (aggressive and delinquent behaviour) give a broad-band externalising score, three (anxious, somatic, and withdrawn behaviour) give a broad-band internalising score, and three (social, thought, and attention problems) indicate difficulties fitting neither broad-band dimension. For each cohort we analysed scores in ELBW children and those in normal- birthweight controls (two cohorts) or national normative controls (two cohorts). Across countries, we assessed deviations of the ELBW children from normative or control groups. ELBW children had higher total problem scores than normative or control children, but this increase was only significant in European countries. Narrow-band scores were raised only for the social, thought, and attention difficulty scales, which were 0.5-1.2 SD higher in ELBW children than in others. Except for the increase in internalising scores recorded for one cohort, ELBW children did not differ from normative or control children on internalising or externalising scales. Despite cultural differences, types of behavioural problems seen in ELBW children were very similar in the four countries. This finding suggests that biological mechanisms contribute to behavioural problems of ELBW children.

  18. Importance of stability of early living arrangements on behavior outcomes of children with and without prenatal drug exposure.

    PubMed

    Bada, Henrietta S; Langer, John; Twomey, Jean; Bursi, Charlotte; Lagasse, Linda; Bauer, Charles R; Shankaran, Seetha; Lester, Barry M; Higgins, Rosemary; Maza, Penelope L

    2008-06-01

    We evaluated whether living arrangements of children with or without prenatal drug exposure would be associated with their behavior outcomes and adaptive functioning. A total of 1388 children with or without prenatal cocaine or opiate exposure were enrolled in a longitudinal cohort study at 1 month of age, were seen at intervals, tracked over time for their living situation, and evaluated for behavior problems and adaptive functioning at 3 years of age. The Child Behavior Checklist and Vineland Adaptive Behavior Scales were administered. Using multiple regression models, we determined the factors that would predict behavior problems and adaptive functioning. Of the children enrolled, 1092 children were evaluated. Total and externalizing behavior problems T scores of children in relative care were lower (better) than those in parental care; externalizing behavior scores were lower than those in nonrelative care (p < .05). Total behavior problem scores increased 2.3 and 1.3 points, respectively, with each move per year and each year of Child Protective Services involvement. Compared to children in nonrelative care, those in parental or relative care had higher (better) scores in the Vineland Adaptive Behavior Scales total composite (p < .023), communication (p < .045), and daily living (p < .001). Each caretaker change was associated with a decrease of 2.65 and 2.19 points, respectively, in communication and daily living scores. Children's living arrangements were significantly associated with childhood behavior problems and adaptive functioning. The instability of living situation was also a significant predictor of these outcomes. While family preservation continues to be the goal of the child welfare system, expediting decision toward permanency remains paramount once children are placed in foster care.

  19. Media use and psychosocial adjustment in children and adolescents.

    PubMed

    Limtrakul, Nicha; Louthrenoo, Orawan; Narkpongphun, Atsawin; Boonchooduang, Nonglak; Chonchaiya, Weerasak

    2018-03-01

    Currently, television and new forms of media are readily available to children and adolescents in their daily lives. Excessive use of media can lead to negative physical and psychosocial health effects. This study aimed to describe children's media use, including media multitasking, as well as the associations between media use and their psychosocial adjustment. This study recruited 339 participants aged 10-15 years from an international school. The children and their care givers were asked to complete the Strengths and Difficulties Questionnaire independently to evaluate the psychosocial problems of the children. The mean age of the study participants was 12.4 ± 1.5 years, who were recruited from grades 5 to 9. Multitasking media use was reported in 59.3% of participants. The average total media exposure time was 7.0 h/day. The behavioural problem scores from self-reports were greater with increased media use time. After adjusting for confounding variables, the school report and sleep problems were among the factors associated with the total behavioural problem scores from the multiple linear regression analysis (P = 0.001 and <0.001, respectively), whereas age and average total media exposure time were significantly associated with the prosocial behaviour scores reported by the children (P = 0.004 and 0.02, respectively). Multitasking media use was not significantly associated with the total difficulties scores or the prosocial behaviour scores in this study. Increased media use time was significantly associated with decreased prosocial behaviour scores in children in this study. This can provide important information to parents regarding media use in children. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  20. Coping, problem solving, depression, and health-related quality of life in patients receiving outpatient stroke rehabilitation.

    PubMed

    Visser, Marieke M; Heijenbrok-Kal, Majanka H; Spijker, Adriaan Van't; Oostra, Kristine M; Busschbach, Jan J; Ribbers, Gerard M

    2015-08-01

    To investigate whether patients with high and low depression scores after stroke use different coping strategies and problem-solving skills and whether these variables are related to psychosocial health-related quality of life (HRQOL) independent of depression. Cross-sectional study. Two rehabilitation centers. Patients participating in outpatient stroke rehabilitation (N=166; mean age, 53.06±10.19y; 53% men; median time poststroke, 7.29mo). Not applicable. Coping strategy was measured using the Coping Inventory for Stressful Situations; problem-solving skills were measured using the Social Problem Solving Inventory-Revised: Short Form; depression was assessed using the Center for Epidemiologic Studies Depression Scale; and HRQOL was measured using the five-level EuroQol five-dimensional questionnaire and the Stroke-Specific Quality of Life Scale. Independent samples t tests and multivariable regression analyses, adjusted for patient characteristics, were performed. Compared with patients with low depression scores, patients with high depression scores used less positive problem orientation (P=.002) and emotion-oriented coping (P<.001) and more negative problem orientation (P<.001) and avoidance style (P<.001). Depression score was related to all domains of both general HRQOL (visual analog scale: β=-.679; P<.001; utility: β=-.009; P<.001) and stroke-specific HRQOL (physical HRQOL: β=-.020; P=.001; psychosocial HRQOL: β=-.054, P<.001; total HRQOL: β=-.037; P<.001). Positive problem orientation was independently related to psychosocial HRQOL (β=.086; P=.018) and total HRQOL (β=.058; P=.031). Patients with high depression scores use different coping strategies and problem-solving skills than do patients with low depression scores. Independent of depression, positive problem-solving skills appear to be most significantly related to better HRQOL. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Child behavioural problems and body size among 2-6 year old children predisposed to overweight. results from the "healthy start" study.

    PubMed

    Olsen, Nanna J; Pedersen, Jeanett; Händel, Mina N; Stougaard, Maria; Mortensen, Erik L; Heitmann, Berit L

    2013-01-01

    Psychological adversities among young children may be associated with childhood overweight and obesity. We examined if an increased level of child behavioural problems was associated with body size among a selected group of 2-6 year old children, who were all predisposed to develop overweight. Cross-sectional analyses were conducted using baseline data from the "Healthy Start" intervention study. A total of 3058 children were invited to participate, and data from 583 children who were all predisposed for obesity was analyzed. The Danish version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess child stress by the SDQ Total Difficulties (SDQ-TD) score and the Prosocial Behavior (PSB) score. Height and weight were measured, and BMI z-scores were calculated. A direct, but non-significant linear trend was found between SDQ-TD score and BMI z-score (β = 0.021, p = 0.11). Having an SDQ-TD score above the 90(th) percentile was associated with BMI z-score (β = 0.36, p = 0.05). PSB score was not associated with BMI z-score. Analyses were adjusted for parental socioeconomic status, parental BMI, family structure, dietary factors, physical activity, and family stress level. The results suggested a threshold effect between SDQ-TD score and BMI z-score, where BMI z-score was associated with childhood behavioural problems only for those with the highest scores of SDQ-TD. No significant association between PSB score and BMI z-score was found.

  2. Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study.

    PubMed

    Rabbani, Ali; Mahmoudi-Gharaei, Javad; Mohammadi, Mohammad Reza; Motlagh, Mohammad Esmaeil; Mohammad, Kazem; Ardalan, Gelayol; Maftoon, Farzaneh; Shahryari, Safiyeh; Khodaei, Shahnaz; Sotoudeh, Aria; Ziaaldini, Hassan; Kamali, Kobra; Motaghian, Molouk

    2012-01-01

    Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire (SDQ). The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 ± 2.19 years. The mean total score of difficulties in participants was 14.34 ± 5.81. According to these results 813 (17.8%) adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems (20.5%). According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle.

  3. Reliability and Validity of the KIPPPI: An Early Detection Tool for Psychosocial Problems in Toddlers

    PubMed Central

    Kruizinga, Ingrid; Jansen, Wilma; de Haan, Carolien L.; Raat, Hein

    2012-01-01

    Background The KIPPPI (Brief Instrument Psychological and Pedagogical Problem Inventory) is a Dutch questionnaire that measures psychosocial and pedagogical problems in 2-year olds and consists of a KIPPPI Total score, Wellbeing scale, Competence scale, and Autonomy scale. This study examined the reliability, validity, screening accuracy and clinical application of the KIPPPI. Methods Parents of 5959 2-year-old children in the Rotterdam area, the Netherlands, were invited to participate in the study. Parents of 3164 children (53.1% of all invited parents) completed the questionnaire. The internal consistency was evaluated and in subsamples the test-retest reliability and concurrent validity with regard to the Child Behavioral Checklist (CBCL). Discriminative validity was evaluated by comparing scores of parents who worried about their child’s upbringing and parent’s that did not. Screening accuracy of the KIPPPI was evaluated against the CBCL by calculating the Receiver Operating Characteristic (ROC) curves. The clinical application was evaluated by the relation between KIPPPI scores and the clinical decision made by the child health professionals. Results Psychometric properties of the KIPPPI Total score, Wellbeing scale, Competence scale and Autonomy scale were respectively: Cronbach’s alphas: 0.88, 0.86, 0.83, 0.58. Test-retest correlations: 0.80, 0.76, 0.73, 0.60. Concurrent validity was as hypothesised. The KIPPPI was able to discriminate between parents that worried about their child and parents that did not. Screening accuracy was high (>0.90) for the KIPPPI Total score and for the Wellbeing scale. The KIPPPI scale scores and clinical decision of the child health professional were related (p<0.05), indicating a good clinical application. Conclusion The results in this large-scale study of a diverse general population sample support the reliability, validity and clinical application of the KIPPPI Total score, Wellbeing scale and Competence scale. Also, the screening accuracy of the KIPPPI Total score and Wellbeing scale were supported. The Autonomy scale needs further study. PMID:23185388

  4. Behaviour of 4- to 5-year-old nondisabled ELBW children: Outcomes following group-based physiotherapy intervention.

    PubMed

    Brown, L; Burns, Y R; Watter, P; Gray, P H; Gibbons, K S

    2018-03-01

    Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5 years of age and whether intervention had a positive influence on behaviour. The relationship between behaviour, gender, and other areas of performance at 5 years was explored. Fifty 4-year-old children (born <28 weeks gestation or birth weight <1,000 g) with minimal/mild motor impairment were randomly allocated to intervention (n = 24) or standard care (n = 26). Intervention was 6 group-based physiotherapy weekly sessions and home programme. Standard care was best practice advice. The Child Behavior Checklist (CBCL) for preschool children was completed at baseline and at 1-year post-baseline. Other measures at follow-up included Movement Assessment Battery for Children Second Edition, Beery Visual-Motor Integration Test 5th Edition, and Peabody Picture Vocabulary Test 4th Edition. The whole cohort improved on CBCL total problems score between baseline (mean 50.0, SD 11.1) and 1-year follow-up (mean 45.2, SD 10.3), p = .004. There were no significant differences between groups over time on CBCL internalizing, externalizing, or total problems scores. The intervention group showed a mean difference in total problems score of -3.8 (CI [1.5, 9.1]) between times, with standard care group values being -4.4 (CI [1.6, 7.1]). Males had higher total problems scores than females (p = .026), although still performed within the "normal" range. CBCL scores did not correlate with other scores. The behaviour of nondisabled ELBW children was within the "normal" range at 4 to 5 years, and both intervention and standard care may have contributed to improved behavioural outcomes. Behaviour was not related to performance in other developmental domains. © 2017 John Wiley & Sons Ltd.

  5. Behavioral and emotional problems in Chinese children of divorced parents.

    PubMed

    Liu, X; Guo, C; Okawa, M; Zhai, J; Li, Y; Uchiyama, M; Neiderhiser, J M; Kurita, H

    2000-07-01

    This study examined the behavioral problems in Chinese children of divorced parents. A total of 58 children of divorce and 116 gender-, age-, and school class-matched controls were ascertained from a general population sample of children aged 6 through 15 years. Parents completed the Child Behavior Checklist (CBCL), and teachers completed the Teacher's Report Form (TRF) and Conners Hyperkinesis Index. Parent-reported problem scores on the CBCL total scale and each subscale, and prevalence of all CBCL syndromes except for Somatic Complaints, were significantly higher in children of divorce than in controls. Teacher-reported problem scores on the TRF total scale and Social and Attention Problems and prevalence of Attention Problems were significantly different for the 2 groups of children. Social competence was rated significantly lower in children of divorce than in controls. Discriminant function analysis showed that behavioral problems in children of divorce were characterized by aggressive behavior, withdrawal, and social problems. The findings emanating from China provide the first evidence of the link between parental divorce and children's psychopathology and clarify the psychopathological dimensions in Chinese children of divorced parents.

  6. Mental health problems in Kosovar adolescents: results from a national mental health survey.

    PubMed

    Shahini, Mimoza; Rescorla, Leslie; Wancata, Johannes; Ahmeti, Adelina

    2015-01-01

    Our purpose was to determine the effects of gender and age on Kosovar YSR scores and the prevalence of self-reported behavioral/emotional problems in Kosovar adolescents based on scores above a cutpoint. Participants were 1351 adolescents recruited from secondary schools in seven regions of Kosova who completed the Youth Self-Report. The oldest adolescents had the highest scores on many YSR scales. Although Kosova's mean problems scores were not elevated relative to international norms, the percentage of adolescents scoring in the deviant range (borderline + clinical) was much higher than expected for almost all YSR problem scales, including Total Problems (31.2%), Internalizing (40.8%), and Externalizing (23.4%). The 23% prevalence of elevated scores on Stress Problems was triple the expected 7% prevalence based on a 93rd percentile cutpoint. Results revealed much higher prevalence of psychopathology than would be expected based on international norms, with 25-40% of Kosovar adolescents scoring in the deviant range on YSR scales, Thus, our research indicates a need for expanding psychiatry services to meet the pressing mental health needs of Kosovar adolescents as well as the importance of considering mental health problems in their social context.

  7. Standardized Observational Assessment of Attention Deficit Hyperactivity Disorder Combined and Predominantly Inattentive Subtypes. II. Classroom Observations.

    PubMed

    McConaughy, Stephanie H; Ivanova, Masha Y; Antshel, Kevin; Eiraldi, Ricardo B; Dumenci, Levent

    2009-07-01

    Trained classroom observers used the Direct Observation Form (DOF; McConaughy & Achenbach, 2009) to rate observations of 163 6- to 11-year-old children in their school classrooms. Participants were assigned to four groups based on a parent diagnostic interview and parent and teacher rating scales: Attention Deficit Hyperactivity Disorder (ADHD)-Combined type (n = 64); ADHD-Inattentive type (n = 22); clinically referred without ADHD (n = 51); and nonreferred control children (n = 26). The ADHD-Combined group scored significantly higher than the referred without ADHD group and controls on the DOF Intrusive and Oppositional syndromes, Attention Deficit Hyperactivity Problems scale, Hyperactivity-Impulsivity subscale, and Total Problems; and significantly lower on the DOF On-Task score. The ADHD-Inattentive group scored significantly higher than controls on the DOF Sluggish Cognitive Tempo and Attention Problems syndromes, Inattention subscale, and Total Problems; and significantly lower on the DOF On-Task score. Implications are discussed regarding the discriminative validity of standardized classroom observations for identifying children with ADHD and differentiating between the two ADHD subtypes.

  8. Standardized Observational Assessment of Attention Deficit Hyperactivity Disorder Combined and Predominantly Inattentive Subtypes. II. Classroom Observations

    PubMed Central

    McConaughy, Stephanie H.; Ivanova, Masha Y.; Antshel, Kevin; Eiraldi, Ricardo B.; Dumenci, Levent

    2010-01-01

    Trained classroom observers used the Direct Observation Form (DOF; McConaughy & Achenbach, 2009) to rate observations of 163 6- to 11-year-old children in their school classrooms. Participants were assigned to four groups based on a parent diagnostic interview and parent and teacher rating scales: Attention Deficit Hyperactivity Disorder (ADHD)—Combined type (n = 64); ADHD—Inattentive type (n = 22); clinically referred without ADHD (n = 51); and nonreferred control children (n = 26). The ADHD—Combined group scored significantly higher than the referred without ADHD group and controls on the DOF Intrusive and Oppositional syndromes, Attention Deficit Hyperactivity Problems scale, Hyperactivity-Impulsivity subscale, and Total Problems; and significantly lower on the DOF On-Task score. The ADHD—Inattentive group scored significantly higher than controls on the DOF Sluggish Cognitive Tempo and Attention Problems syndromes, Inattention subscale, and Total Problems; and significantly lower on the DOF On-Task score. Implications are discussed regarding the discriminative validity of standardized classroom observations for identifying children with ADHD and differentiating between the two ADHD subtypes. PMID:20802813

  9. Relationships between behavioral symptoms of non-medicated Chinese children with attention deficit hyperactivity disorder and parenting stress: Comparison of different subtypes and comorbidities.

    PubMed

    Li, Yan; Jiang, Wen-Qing; Du, Ya-Song; Coghill, David

    2016-06-01

    To identify the characteristics of behavior problems among children with attention deficit hyperactivity disorder (ADHD) and their relation with parenting stress. The Conners Parent Symptom Questionnaire (PSQ) and Parenting Stress Index (PSI) were used to assess the symptoms and parenting stress of 132 non-medicated children with ADHD as compared with 88 healthy controls. Every PSQ factor of ADHD children was higher than in the control group; children with the combined subtype of ADHD had the highest scores in conduct and learning problems, impulsivity/hyperactivity, and overall hyperactivity index; the PSI total stress, child domain, and parent domain scores were all higher in the ADHD group than in the control group; children with the combined subtype of ADHD had the highest score in the competence subscale of the parent domain, whereas the PSI total stress score of parents of children with ADHD and comorbid oppositional defiant disorder (ODD) was higher than that of parents of children with only ADHD. The PSI total stress score was positively correlated with all PSQ factor scores. The PSQ factors of conduct problems and learning problems were found to be significant predictors in a regression analysis. The children with ADHD exhibited abnormal parenting stress compared with healthy controls, which was much more pronounced when the children had comorbid ODD. Furthermore, parenting stress was related with the severity of ADHD symptoms, suggesting that children with the combined subtype of ADHD require particular attention in the future. © 2015 Wiley Publishing Asia Pty Ltd.

  10. Sleep disturbances in preschool age children with cerebral palsy: a questionnaire study.

    PubMed

    Romeo, Domenico M; Brogna, Claudia; Musto, Elisa; Baranello, Giovanni; Pagliano, Emanuela; Casalino, Tiziana; Ricci, Daniela; Mallardi, Maria; Sivo, Serena; Cota, Francesco; Battaglia, Domenica; Bruni, Oliviero; Mercuri, Eugenio

    2014-09-01

    The study aimed to analyze (i) the prevalence of sleep disorders in pre-school children with cerebral palsy (CP) using the Sleep Disturbance Scale for Children (SDSC), (ii) the possible association with motor, cognitive and behavioral problems, and (iii) the possible differences with typically developing children matched for age and gender. One-hundred children with CP (age range: 3-5 years, mean: 3.8 years) were assessed using the SDSC, the Gross Motor Function Classification System (GMFCS), the Wechsler Preschool and Primary Scale of Intelligence, and the Child Behaviour Check List (CBCL) to assess sleep, motor, cognitive, and behavioral problems, respectively. Further 100 healthy children matched for age and sex were assessed using the SDSC. An abnormal total sleep score was found in 13% of children with CP while 35% had an abnormal score on at least one SDSC factor. SDSC total score was significantly associated with pathological internalizing scores on CBCL and active epilepsy on multivariate analysis. CP group reported higher significant median scores on SDSC total, parasomnias, and difficulty in initiating and maintaining sleep factors. In pre-school children sleep disorders are more common in children with CP than in healthy control group and are often associated with epilepsy and behavioral problems. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. [Conduct problems in a sample of institutionalized minors with previous mistreatment].

    PubMed

    Carrasco-Ortiz, M A; Rodríguez-Testal, J F; Hesse, B M

    2001-06-01

    The present study tries to analyse the maltreatment effects and the expected relation, according to the reviewed literature, with behaviour problems in a sample of children in residential care in a protection centre in Seville county (Spain). The sample was conformed by a group of maltreated subjects in a protection setting (n = 30) and two groups of equivalent comparison (n = 30 and n = 30). The first group was conformed by subjects living in a marginal area of Sevilla, similar to the origin setting of the study group, and the second group comes from a wealthy area of this city. The behaviour problems index CBC of Achenbach (1978; 1979; Achenbach & Edelbrock, 1983) was used. No significant differences between groups in the CBC total score was found. However, significant differences were found in the extemalising dimension and in the delinquency, somatic anxiety, somatic problems, and social withdrawal dimensions. Victims of corruption presented higher scores on the CBC total score, extemalising dimension, and delinquency. Young people, victims of child maltreatment and living in an institution, showed problems of withdrawal. Victims of corruption or emotional abuse presented more psychopathological problems.

  12. Sleep problems in pediatric epilepsy and ADHD: The impact of comorbidity.

    PubMed

    Ekinci, Ozalp; Okuyaz, Çetin; Gunes, Serkan; Ekinci, Nuran; Kalınlı, Merve; Tan, Muhammet Emin; Teke, Halenur; Direk, Meltem Çobanoğulları; Erdoğan, Semra

    2017-06-01

    Attention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in pediatric epilepsy. Although sleep problems are commonly reported in both children with primary ADHD and epilepsy, those with epilepsy-ADHD comorbidity have not been well studied. This study aimed to compare sleep problems among three groups of children: 1) children with epilepsy, 2) children with epilepsy and ADHD (epilepsy-ADHD), and 3) children with primary ADHD. 53 children with epilepsy, 35 children with epilepsy-ADHD, and 52 children with primary ADHD completed the Children's Sleep Habits Questionnaire (CSHQ). Neurology clinic charts were reviewed for the epilepsy-related variables. ADHD subtypes were diagnosed according to the DSM-IV. Children with epilepsy-ADHD had the highest CSHQ total scores, while children with primary ADHD had higher scores than those with epilepsy. Besides the total score, epilepsy-ADHD group differed from the primary ADHD and epilepsy groups with higher CSHQ subscores on sleep onset delay and sleep anxiety. The frequency of moderate-severe sleep problems (CSHQ>56) was 62.9% in children with epilepsy-ADHD, while it was 40.4% and 26.4% in children with primary ADHD and epilepsy, respectively. CSHQ total scores were not different between ADHD subtypes in both children with epilepsy-ADHD and those with primary ADHD. None of the epilepsy-related variables were found to be associated with CSHQ scores. Epilepsy-ADHD is associated with a significantly poor sleep quality which is beyond that of primary ADHD and epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Intelligence and psychosocial functioning during long-term growth hormone therapy in children born small for gestational age.

    PubMed

    van Pareren, Yvonne K; Duivenvoorden, Hugo J; Slijper, Froukje S M; Koot, Hans M; Hokken-Koelega, Anita C S

    2004-11-01

    Short stature is not the only problem faced by small for gestational age (SGA) children. Being born SGA has also been associated with lowered intelligence, poor academic performance, low social competence, and behavioral problems. Although GH treatment in short children born SGA can result in a normalization of height during childhood, the effect of GH treatment on intelligence and psychosocial functioning remains to be investigated. We show the longitudinal results of a randomized, double-blind, GH-dose response study initiated in 1991 to follow growth, intelligence quotient (IQ), and psychosocial functioning in SGA children during long-term GH treatment. Patients were assigned to one of two treatment groups (1 or 2 mg GH/m(2) body surface.d, or approximately 0.035 or 0.07 mg/kg.d). Intelligence and psychosocial functioning were evaluated at start of GH treatment (n = 74), after 2 yr of GH treatment (n = 76), and in 2001 (n = 53). IQ was assessed by a short-form Wechsler Intelligence Scale for Children-Revised or Wechsler Adult Intelligence Scale (Block-design and Vocabulary subtests). Behavioral problems were measured by the Achenbach Child Behavior Checklist or Young Adult Behavior Checklist, and self-perception was measured by the Harter Self-Perception Profile. Mean (sem) birth length sd score was -3.6 (0.2), mean age and height at start was 7.4 (0.2) yr and -3.0 (0.1) sd score, respectively, mean duration of GH treatment was 8.0 (0.2) yr, and mean age in 2001 was 16.5 (0.3) yr. After 2 yr of GH treatment, 96% of both GH groups showed a height gain sd score of 1 sd from the start of treatment or more, resulting in a normal height (i.e. height >/= -2.0 sd for age and sex) in 70% of the children. In 2001, 48 (91%) of the 53 children participating in this study had reached a normal height. Block-design s-score and the estimated total IQ significantly increased (P < 0.001 and P < 0.001, respectively) from scores significantly lower than Dutch peers at start (P < 0.001 and P < 0.001, respectively) to comparable scores in 2001. The increase over time for the Vocabulary s-score was not significant. Internalizing Behavior sd scores remained comparable to Dutch peers, whereas Externalizing Behavior sd scores and Total Problem Behavior sd scores improved significantly during GH therapy (P < 0.01 and P < 0.05, respectively) to scores comparable to Dutch peers. Self-perception sd scores improved from start of GH treatment until 2001 (P < 0.001) to scores significantly higher than Dutch peers (P < 0.05). No significant differences between the two GH dosage groups were found. Improvement in Externalizing and Total Problem Behavior sd scores over time was significantly related to change in height sd score (P < 0.05 and P < 0.01, respectively), whereas scores over time for Vocabulary, Block-design, Internalizing, or total Harter Self-Perception score were not related to change in height sd scores. In conclusion, parallel to a GH-induced catch-up growth in adolescents born SGA, IQ, behavior, and self-perception showed a significant improvement over time from scores below average to scores comparable to Dutch peers. In addition, children whose height over time became closer to that of their peers showed less problem behavior.

  14. Preliminary evidence for good psychometric properties of the Norwegian version of the Brief Problems Monitor (BPM).

    PubMed

    Richter, Jörg

    2015-04-01

    Methods to assess intervention progress and outcome for frequent use are needed. To provide preliminary information about psychometric properties for the Norwegian version of the Brief Problems Monitor. Cronbach's alpha scores and intra-class correlation coefficients as indicators for internal consistency (reliability) and Pearson correlation coefficients between corresponding subscales of the long and short ASEBA form versions as well as multiple regression coefficients to explore the predictive power of the reduced item-set related to the corresponding scale-scores of the long version were calculated in large, representative data sets of Norwegian children and adolescents. Cronbach's alpha scores of the Norwegian version of the BPM subscales varied between 0.67 (attention BPM-youth) and 0.88 (attention BPM-teacher) and between 0.90 (BPM-youth) and 0.96 (BPM-teacher) for its total problem score. Corresponding subscales from the long versions and the BPM as well as the total problems scores were closely correlated with coefficients of high effect size (all r > 0.80). The variance of the items of the BPM explained about three-quarters or more of the variance in the corresponding subscales of the long version. The Norwegian BPM has good psychometric properties in terms of 1) being acceptable to good internal consistency and in terms of 2) regression coefficients of high effect size from the BPM items to the problem-scale scores of the long versions as validity indicators. Its use in clinical practice and research can be recommended.

  15. Preformulation considerations for controlled release dosage forms. Part III. Candidate form selection using numerical weighting and scoring.

    PubMed

    Chrzanowski, Frank

    2008-01-01

    Two numerical methods, Decision Analysis (DA) and Potential Problem Analysis (PPA) are presented as alternative selection methods to the logical method presented in Part I. In DA properties are weighted and outcomes are scored. The weighted scores for each candidate are totaled and final selection is based on the totals. Higher scores indicate better candidates. In PPA potential problems are assigned a seriousness factor and test outcomes are used to define the probability of occurrence. The seriousness-probability products are totaled and forms with minimal scores are preferred. DA and PPA have never been compared to the logical-elimination method. Additional data were available for two forms of McN-5707 to provide complete preformulation data for five candidate forms. Weight and seriousness factors (independent variables) were obtained from a survey of experienced formulators. Scores and probabilities (dependent variables) were provided independently by Preformulation. The rankings of the five candidate forms, best to worst, were similar for all three methods. These results validate the applicability of DA and PPA for candidate form selection. DA and PPA are particularly applicable in cases where there are many candidate forms and where each form has some degree of unfavorable properties.

  16. Behavioral phenotype in adults with Prader-Willi syndrome.

    PubMed

    Sinnema, Margje; Einfeld, Stewart L; Schrander-Stumpel, Constance T R M; Maaskant, Marian A; Boer, Harm; Curfs, Leopold M G

    2011-01-01

    Prader-Willi syndrome (PWS) is characterized by temper tantrums, impulsivity, mood fluctuations, difficulty with change in routine, skinpicking, stubbornness and aggression. Many studies on behavior in PWS are limited by sample size, age range, a lack of genetically confirmed diagnosis of PWS and inconsistent assessment of behavior. The aim of this study was to explore systematically the relation between behavioral problems and age groups, genetic subtypes and BMI categories in an adult PWS population. Participants were contacted via the Dutch Prader-Willi Parent Association and through physicians specialized in persons with ID. Behaviors were studied using the Developmental Behavior Checklist for Adults (DBC-A). The forms were completed by the main caregivers of 98 adults with a genetically confirmed diagnosis of PWS. Differences between age groups were statistically significant (ANOVA, p=0.03). DBC-A total scores were higher in the consecutive age groups, with the most behavioral problems in the oldest age groups. Differences between genetic subtypes were also statistically significant (ANOVA, p<0.01). Persons with mUPD had higher total scores on the DBC-A than persons with a deletion. Those with a Type I deletion showed higher total DBC-A scores than persons with a Type II deletion. There were no statistically significant differences in DBC-A total scores between the different BMI categories. Individuals with a BMI<25 had higher scores on the self-absorbed subscale compared to persons with a BMI between 25 and 30. Unlike previous descriptions of the behavioral phenotype in adults with PWS, we did not find a reduction in behavioral problems in older adults. Therefore, special attention should be paid to behavioral problems as part of general management of adults with PWS. Longitudinal studies are warranted to gain more insight into the natural history and course of behavioral problems in adults and older people with PWS over the long term and possible risk and preventive factors. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Positive and Negative Thinking in Tinnitus: Factor Structure of the Tinnitus Cognitions Questionnaire.

    PubMed

    Handscomb, Lucy E; Hall, Deborah A; Shorter, Gillian W; Hoare, Derek J

    Researchers and clinicians consider thinking to be important in the development and maintenance of tinnitus distress, and altering thoughts or thinking style is an object of many forms of psychological therapy for tinnitus. Those working with people with tinnitus require a reliable, psychometrically robust means of measuring both positive and negative thinking related to it. The Tinnitus Cognitions Questionnaire (TCQ) was designed as such a measure and its authors showed it to be reliable, with good psychometric properties. However, no research teams have yet carried out independent validation. This study aimed to use the TCQ to investigate thinking amongst members of the general population with both bothersome and nonbothersome tinnitus and also to verify its factor structure. Three hundred forty-two members of the public with tinnitus completed the TCQ online or on paper. They also rated their tinnitus on a scale as "not a problem," "a small problem," "a moderate problem," "a big problem," or a "very big problem." The authors tested the original factor structure of the TCQ using confirmatory factor analysis and then calculated the mean scores for each item, comparing mean total scores across "problem categories" for the full questionnaire and for the positive and negative subscales. The original two-factor structure of the TCQ was a good fit to the data when the correlation between positive and negative factors was fixed at zero (root mean square error of approximation = 0.064, 90% confidence interval = 0.058 to 0.070). Items pertaining to wishing the tinnitus would go away and despairing that it would ever get better had the highest mean scores. The mean total score for the "no problem" group (M = 31.17, SD = 16.03) was not significantly different from the mean total score for the "small problem" group (M = 34.00, SD = 12.44, p = 0.99). Differences between mean scores for all other groups were statistically significant. For the negative subscale, differences were statistically significant between all problem categories. For the positive subscale, the differences between mean scores were only statistically significant for the "no problem" group (M = 28.40, SD = 17.11) compared with the "moderate problem" group (M = 18.55, SD = 8.64, p = 0.02) and for the "moderate problem" group compared with the "very big problem" group (M = 26.79, SD = 11.66, p = 0.002). Positive and negative factors were uncorrelated (ρ = -0.03.) CONCLUSIONS:: The TCQ is a valid measure of positive and negative thinking in tinnitus, and the authors recommend its use in research and therapeutic settings. Negative thinking appears to be associated with more problematic tinnitus, but positive thinking is not associated with unproblematic tinnitus, suggesting that reducing negative thinking may be more important than teaching positive thinking in therapy.

  18. International comparisons of behavioral and emotional problems in preschool children: parents' reports from 24 societies.

    PubMed

    Rescorla, Leslie A; Achenbach, Thomas M; Ivanova, Masha Y; Harder, Valerie S; Otten, Laura; Bilenberg, Niels; Bjarnadottir, Gudrun; Capron, Christiane; De Pauw, Sarah S W; Dias, Pedro; Dobrean, Anca; Döpfner, Manfred; Duyme, Michel; Eapen, Valsamma; Erol, Nese; Esmaeili, Elaheh Mohammad; Ezpeleta, Lourdes; Frigerio, Alessandra; Fung, Daniel S S; Gonçalves, Miguel; Guðmundsson, Halldór; Jeng, Suh-Fang; Jusiené, Roma; Ah Kim, Young; Kristensen, Solvejg; Liu, Jianghong; Lecannelier, Felipe; Leung, Patrick W L; Machado, Bárbara César; Montirosso, Rosario; Ja Oh, Kyung; Ooi, Yoon Phaik; Plück, Julia; Pomalima, Rolando; Pranvera, Jetishi; Schmeck, Klaus; Shahini, Mimoza; Silva, Jaime R; Simsek, Zeynep; Sourander, Andre; Valverde, José; van der Ende, Jan; Van Leeuwen, Karla G; Wu, Yen-Tzu; Yurdusen, Sema; Zubrick, Stephen R; Verhulst, Frank C

    2011-01-01

    International comparisons were conducted of preschool children's behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½-5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders-oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3-12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0-198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes < 1%). Across all pairs of societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies.

  19. International Comparisons of Behavioral and Emotional Problems in Preschool Children: Parents’ Reports From 24 Societies

    PubMed Central

    Rescorla, Leslie A.; Achenbach, Thomas M.; Ivanova, Masha Y.; Harder, Valerie S.; Otten, Laura; Bilenberg, Niels; Bjarnadottir, Gudrun; Capron, Christiane; De Pauw, Sarah S. W.; Dias, Pedro; Dobrean, Anca; Döpfner, Manfred; Duyme, Michel; Eapen, Valsamma; Erol, Nese; Esmaeili, Elaheh Mohammad; Ezpeleta, Lourdes; Frigerio, Alessandra; Fung, Daniel S. S.; Gonçalves, Miguel; Guđmundsson, Halldór; Jeng, Suh-Fang; Jusiené, Roma; Kim, Young Ah; Kristensen, Solvejg; Liu, Jianghong; Lecannelier, Felipe; Leung, Patrick W. L.; Machado, Bárbara César; Montirosso, Rosario; Oh, Kyung Ja; Ooi, Yoon Phaik; Plück, Julia; Pomalima, Rolando; Pranvera, Jetishi; Schmeck, Klaus; Shahini, Mimoza; Silva, Jaime R.; Simsek, Zeynep; Sourander, Andre; Valverde, José; van der Ende, Jan; Van Leeuwen, Karla G.; Wu, Yen-Tzu; Yurdusen, Sema; Zubrick, Stephen R.; Verhulst, Frank C.

    2014-01-01

    International comparisons were conducted of preschool children’s behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½–5 by parents in 24 societies (N =19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders–oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3–12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0–198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes <1%). Across all pairs of societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies. PMID:21534056

  20. Associations of Gross Motor Delay, Behavior, and Quality of Life in Young Children With Autism Spectrum Disorder.

    PubMed

    Hedgecock, James B; Dannemiller, Lisa A; Shui, Amy M; Rapport, Mary Jane; Katz, Terry

    2018-04-01

    Young children with autism spectrum disorder (ASD) often have gross motor delays that may accentuate problem daytime behavior and health-related quality of life (QoL). The objective of this study was to describe the degree of gross motor delays in young children with ASD and associations of gross motor delays with problem daytime behavior and QoL. The primary hypothesis was that Gross motor delays significantly modifies the associations between internalizing or externalizing problem daytime behavior and QoL. This study used a cross-sectional, retrospective analysis. Data from 3253 children who were 2 to 6 years old and who had ASD were obtained from the Autism Speaks Autism Treatment Network and analyzed using unadjusted and adjusted linear regression. Measures included the Vineland Adaptive Behavior Scales, 2nd edition, gross motor v-scale score (VABS-GM) (for Gross motor delays), the Child Behavior Checklist (CBCL) (for Problem daytime behavior), and the Pediatric Quality of Life Inventory (PedsQL) (for QoL). The mean VABS-GM was 12.12 (SD = 2.2), representing performance at or below the 16th percentile. After adjustment for covariates, the internalizing CBCL t score decreased with increasing VABS-GM (β = - 0.64 SE = 0.12). Total and subscale PedsQL scores increased with increasing VABS-GM (for total score: β = 1.79 SE = 0.17; for subscale score: β = 0.9-2.66 SE = 0.17-0.25). CBCL internalizing and externalizing t scores decreased with increasing PedsQL total score (β = - 0.39 SE = 0.01; β = - 0.36 SE = 0.01). The associations between CBCL internalizing or externalizing t scores and PedsQL were significantly modified by VABSGM (β = - 0.026 SE = 0.005]; β = - 0.019 SE = 0.007). The study lacked ethnic and socioeconomic diversity. Measures were collected via parent report without accompanying clinical assessment. Cross motor delay was independently associated with Problem daytime behavior and QoL in children with ASD. Gross motor delay modified the association between Problem daytime behavior and QoL. Children with ASD and co-occurring internalizing Problem daytime behavior had greater Gross motor delays than children without internalizing Problem daytime behavior; therefore, these children may be most appropriate for early physical therapist evaluation.

  1. Sleep disturbances in children with epilepsy compared with their nearest-aged siblings.

    PubMed

    Wirrell, Elaine; Blackman, Marlene; Barlow, Karen; Mah, Jean; Hamiwka, Lorie

    2005-11-01

    The aim of the study was to compare sleep patterns in children with epilepsy with those of their non-epileptic siblings and to determine which epilepsy-specific factors predict greater sleep disturbance. We conducted a case-control study of 55 children with epilepsy (mean age 10y, range 4 to 16y; 27 males, 28 females) and their nearest-aged non-epileptic sibling (mean age 10y, range 4 to 18y; 26 males, 29 females). Epilepsy was idiopathic generalized in eight children (15%), symptomatic generalized in seven (13%), and focal in 40 (73%); the mean duration was 5 years 8 months. Parents or caregivers completed the Sleep Behavior Questionnaire (SBQ) and Child Behavior Checklist (CBCL) for patients and controls, and the Quality of Life in Childhood Epilepsy (QOLCE) for patients. Patients had a higher (more adverse) Total Sleep score (p<0.001) and scored worse than controls on nearly all subscales of the SBQ. In patients, higher Total Sleep scores were correlated with higher scores on the Withdrawn, Somatic complaints, Social problems, and Attention subscales of the CBCL, and significantly lower Total Quality of Life Scores. Refractory epilepsy, mental retardation, and remote symptomatic etiology predicted greater sleep problems in those with epilepsy. We conclude that children with epilepsy in this current study had significantly greater sleep problems than their non-epileptic siblings.

  2. PARENTAL REPORTS OF EARLY SOCIOEMOTIONAL AND BEHAVIORAL PROBLEMS: DOES THE FATHER'S VIEW MAKE A DIFFERENCE?

    PubMed

    Alakortes, Jaana; Fyrstén, Jenni; Bloigu, Risto; Carter, Alice S; Moilanen, Irma K; Ebeling, Hanna E

    2017-05-01

    Although both mothers and fathers are essential sources of information to address early socioemotional/behavioral (SEB) problems, there continues to be a dearth of studies considering both parental views. A sample of 208 toddlers (M age = 19.3 months) was recruited through public child health centers. Both parents of 172 toddlers (76 boys, 96 girls) completed the Child Behavior Checklist (CBCL) 1-5 (T.M. Achenbach & L.A. Rescorla, 2000; Finnish translation by F. Almqvist, ). Correspondence (intraclass correlation coefficients; ICCs) between the maternal and paternal CBCL ratings was good (.64) for the Internalizing and excellent (.76) for the Externalizing and Total Problems scores whereas ICCs varied from .45 for the Withdrawn to .76 for the Sleep Problems and Aggressive Behavior syndrome scores. Regarding discrepancies, mothers consistently reported higher CBCL scale scores than did fathers. Most significant differences between the parental ratings were found on the Aggressive Behavior syndrome, Externalizing, and Total Problems scales. Interparental rating discrepancies increased with elevations in the corresponding CBCL scale scores. Positive correlations were found between maternal, but not paternal, parenting stress and interparental rating discrepancies on the CBCL. The observed differences between maternal and paternal ratings highlight the importance of gathering reports from both parents when assessing early SEB problems. The findings are more profoundly discussed in the article. © 2017 Michigan Association for Infant Mental Health.

  3. Socioeconomic deprivation is an independent risk factor for behavioral problems in children with epilepsy.

    PubMed

    Carson, Joanna; Weir, Andrew; Chin, Richard F; McLellan, Ailsa

    2015-04-01

    The aim of this study was to examine whether socioeconomic deprivation in children with epilepsy (CWE) increases risk for behavioral problems independent of seizure factors. A cross-sectional study was done in which parents of children attending a specialist epilepsy clinic were invited to complete a child behavior checklist (CBCL) questionnaire about their child. Medical and sociodemographic data on CWE were obtained through their pediatric neurologists. Home postal code was used to obtain quintiles of Scottish Index of Multiple Deprivation 2012 (SIMD2012) scores for individuals. Lower (1-3) quintiles correspond to higher socioeconomic deprivation. Regression analysis was used to investigate whether a lower quintile was an independent risk factor for scores >63 (significant behavioral problem). Parents of 87 children (42 male, mean age of 10.5years) were enrolled. Fifty-nine percent had total scores >63. A higher proportion of children from quintiles 1-3 compared to those from quintiles 4-5 had externalizing (49% vs. 25%, p=0.02) and total (54% vs. 30%, p=0.02) scores >63. Adjusted OR of quintiles 1-3 vs. 4-5 for scores >63=14.8, 95% CI=3.0, 68.0. Fewer children with scores >63 and from quintiles 1-3 were known to the child and adolescent mental health service (CAMHS) compared to those in quintiles 4-5 (p=0.01). Socioeconomic deprivation was an independent risk factor for behavioral problems in CWE. Children with epilepsy and behavioral problems who lived in socioeconomically deprived areas received less help. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Comparison of the Perceived Quality of Life between Medical and Veterinary Students in Tehran.

    PubMed

    Labbafinejad, Yasser; Danesh, Hossein; Imanizade, Zahra

    2016-01-01

    Medical and veterinary professional programs are demanding and may have an impact on a student's quality of life (QOL). The aim of this study was to compare the perceived QOL of these two groups. In this study, we used the SF-36 questionnaire in which higher scores mean a better perceived QOL. Only the students in the internship phase of their program were selected so that we could compare the two groups in a similar way. In total, 308 valid questionnaires were gathered. Apart from age and body mass index (BMI), the two groups were demographically similar. The scores of five domains (physical activity limitation due to health problems, usual role limitation due to emotional problems, vitality, general mental health, and general health perception) and also the total score were statistically higher in medical students. Only the score of one domain (social activity limitation due to physical or emotional problems) was statistically higher in veterinary students. BMI, physical activity limitation due to health problems, and vitality lost their significance after binomial logistic regression. We found that, in general, veterinary students have lower scores for the perceived QOL with social function being the only exception. It can be assumed that in medical students, interaction with human patients may have a negative impact in the score of this domain. Even though medical students have shown lower perceived QOL than the general population in previous studies, veterinary students appear to have slightly lower perceived QOL than medical students.

  5. Psychopathology in Young People With Intellectual Disability

    PubMed Central

    Einfeld, Stewart L.; Piccinin, Andrea M.; Mackinnon, Andrew; Hofer, Scott M.; Taffe, John; Gray, Kylie M.; Bontempo, Daniel E.; Hoffman, Lesa R.; Parmenter, Trevor; Tonge, Bruce J.

    2008-01-01

    Context Comorbid severe mental health problems complicating intellectual disability are a common and costly public health problem. Although these problems are known to begin in early childhood, little is known of how they evolve over time or whether they continue into adulthood. Objective To study the course of psychopathology in a representative population of children and adolescents with intellectual disability. Design, Setting, and Participants The participants of the Australian Child to Adult Development Study, an epidemiological cohort of 578 children and adolescents recruited in 1991 from health, education, and family agencies that provided services to children with intellectual disability aged 5 to 19.5 years in 6 rural and urban census regions in Australia, were followed up for 14 years with 4 time waves of data collection. Data were obtained from 507 participants, with 84% of wave 1 (1991-1992) participants being followed up at wave 4 (2002-2003). Main Outcome Measures The Developmental Behaviour Checklist (DBC), a validated measure of psychopathology in young people with intellectual disability, completed by parents or other caregivers. Changes over time in the Total Behaviour Problem Score and 5 subscale scores of the DBC scores were modeled using growth curve analysis. Results High initial levels of behavioral and emotional disturbance decreased only slowly over time, remaining high into young adulthood, declining by 1.05 per year on the DBC Total Behaviour Problem Score. Overall severity of psychopathology was similar across mild to severe ranges of intellectual disability (with mean Total Behaviour Problem Scores of approximately 44). Psychopathology decreased more in boys than girls over time (boys starting with scores 2.61 points higher at baseline and ending with scores 2.57 points lower at wave 4), and more so in participants with mild intellectual disability compared with those with severe or profound intellectual disability who diverged from having scores 0.53 points lower at study commencement increasing to a difference of 6.98 points below severely affected children by wave 4. This trend was observed in each of the subscales, except the social-relating disturbance subscale, which increased over time. Prevalence of participants meeting criteria for major psychopathology or definite psychiatric disorder decreased from 41% at wave 1 to 31% at wave 4. Few of the participants (10%) with psychopathology received mental health interventions during the study period. Conclusion These results provide evidence that the problem of psychopathology comorbid with intellectual disability is both substantial and persistent and suggest the need for effective mental health interventions. PMID:17062861

  6. SCREENING FOR PSYCHOSOCIAL PROBLEMS IN CHILDREN ATTENDING THE PEDIATRIC CLINIC AT KING KHALID UNIVERSITY HOSPITAL (KKUH) IN RIYADH (KSA)

    PubMed Central

    Al-Ayed, Ibrahim H.; Al-Haider, Fatimah A.

    2008-01-01

    Introduction: Psychosocial problems are highly prevalent among children and adolescents. One approach to facilitating recognition and referral of these problems is to use parent-completed screening questionnaire as part of routine primary care. Aim and methods: The purpose of this study was to determine the prevalence and type of psychosocial problems in a random sample of children attending the pediatric clinic at KKUH at the time of the study. A 2-part questionnaire was designed for the study. The first part contained basic biographic data in addition to items which reflect the socioeconomic status of the family. The second part of the questionnaire comprised the inventory, which is a modified version of the Pediatric Symptoms Checklist (PSC).The inventory consisted of 38 items classified into five categories. The total score of the inventory ranged from 0-114. Results: Three-hundred-twelve questionnaires were completed. The average of the total score was only 22.3 out of 114. The lowest score was 0 and the highest 84. The average scores of behavioral symptoms (BS) were the highest (7.03 out of 27) while that of the learning problems (LP) was the lowest (1.5 out of 18). The average score for mood symptoms (MS) was 5.6 out of 24, that for personality characteristics (PC) was 4.5 out of 24 and that for somatic symptoms (SS) was 4.3 out of 24. Conclusion: This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics. PMID:23012163

  7. Screening for psychosocial problems in children attending the pediatric clinic at king khalid university hospital (kkuh) in riyadh (ksa).

    PubMed

    Al-Ayed, Ibrahim H; Al-Haider, Fatimah A

    2008-01-01

    Psychosocial problems are highly prevalent among children and adolescents. One approach to facilitating recognition and referral of these problems is to use parent-completed screening questionnaire as part of routine primary care. The purpose of this study was to determine the prevalence and type of psychosocial problems in a random sample of children attending the pediatric clinic at KKUH at the time of the study. A 2-part questionnaire was designed for the study. The first part contained basic biographic data in addition to items which reflect the socioeconomic status of the family. The second part of the questionnaire comprised the inventory, which is a modified version of the Pediatric Symptoms Checklist (PSC).The inventory consisted of 38 items classified into five categories. The total score of the inventory ranged from 0-114. Three-hundred-twelve questionnaires were completed. The average of the total score was only 22.3 out of 114. The lowest score was 0 and the highest 84. The average scores of behavioral symptoms (BS) were the highest (7.03 out of 27) while that of the learning problems (LP) was the lowest (1.5 out of 18). The average score for mood symptoms (MS) was 5.6 out of 24, that for personality characteristics (PC) was 4.5 out of 24 and that for somatic symptoms (SS) was 4.3 out of 24. This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics.

  8. Behavioral correlation with television watching and videogame playing among children in the United Arab Emirates.

    PubMed

    Yousef, Said; Eapen, Valsamma; Zoubeidi, Taoufik; Mabrouk, Abdelazim

    2014-08-01

    Television viewing and videogame use (TV/VG) appear to be associated with some childhood behavioral problems. There are no studies addressing this problem in the United Arab Emirates. One hundred ninety-seven school children (mean age, 8.7 ± 2.1 years) were assessed. Child Behavior Checklist (CBCL) subscale scores and socio-demographic characteristics were compared between children who were involved with TV/VG more than 2 hours/day and those involved less than 2 hours/day (the recommended upper limit by The American Academy of Pediatrics). Thirty-seven percent of children who were involved with TV/VG time of more than 2 hours/day scored significantly higher on CBCL syndrome scales of withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, internalizing problems, externalizing problems and the CBCL total scores compared with their counterparts. Moreover, these children were younger in birth order and had fewer siblings. After controlling for these confounders using logistic regression, we found that TV/VG time more than 2 hours/day was positively associated with withdrawn (p = 0.008), attention problem (p = 0.037), externalizing problems (p = 0.007), and CBCL total (p = 0.014). Involvement with TV/VG for more than 2 hours/day is associated with more childhood behavioral problems. Counteracting negative effects of the over-involvement with TV/VG in children requires increased parental awareness.

  9. Sex differences in the behavior of children with the 22q11 deletion syndrome

    PubMed Central

    Sobin, Christina; Kiley-Brabeck, Karen; Monk, Samantha Hadley; Khuri, Jananne; Karayiorgou, Maria

    2009-01-01

    High rates of psychiatric impairment in adults with 22q11DS suggest that behavioral trajectories of children with 22q11DS may provide critical etiologic insights. Past findings that report DSM diagnoses are extremely variable; moreover sex differences in behavior have not yet been examined. Dimensional CBCL ratings from 82 children, including 51 with the 22q11DS and 31 control siblings were analyzed. Strikingly consistent with rates of psychiatric impairment among affected adults, 25% percent of children with 22q11DS had high CBCL scores for Total Impairment, and 20% had high CBCL Internalizing Scale scores. Males accounted for 90% of high Internalizing scores and 67% of high Total Impairment scores. Attention and Social Problems were ubiquitous; more affected males than females (23% vs. 4%) scored high on Thought Problems. With regard to CBCL/DSM overlap, 20% of affected males as compared with 0 affected females had one or more high CBCL ratings in the absence of a DSM diagnosis. Behaviors of children with 22q11DS are characterized by marked sex differences when rated dimensionally, with significantly more males experiencing Internalizing and Thought Problems. Categorical diagnoses do not reflect behavioral differences between male and female children with 22q11DS, and may miss significant behavior problems in 20% of affected males. PMID:19217670

  10. Are behaviour problems in extremely low-birthweight children related to their motor ability?

    PubMed

    Danks, Marcella; Cherry, Kate; Burns, Yvonne R; Gray, Peter H

    2017-04-01

    To investigate whether behaviour problems are independently related to mild motor impairment in 11-13-year-old children born preterm with extremely low birthweight (ELBW). The cross-sectional study included 48 (27 males) non-disabled, otherwise healthy ELBW children (<1000 g) and 55 (28 males) term-born peers. Parents reported behaviour using the Child Behaviour Checklist (CBCL). Children completed the Movement Assessment Battery for Children (Movement ABC). Extremely low birthweight children had poorer behaviour scores (CBCL Total Problem T score: mean difference = 5.89, 95% confidence interval = 10.29, 1.49, p = 0.009) and Movement ABC Total Motor Impairment Scores (ELBW group median = 17.5, IQR = 12.3; term-born group median = 7.5, IQR = 9, p < 0.01) than term-born peers. Behaviour was related to motor score (regression coefficient 2.16; 95% confidence interval 0.34, 3.97, p = 0.02) independent of gender, socio-economic factors or birthweight. Motor score had the strongest association with attention (ρ = 0.51; p < 0.01) and social behaviours (ρ = 0.50; p < 0.01). Behaviour problems of otherwise healthy 11- to 13-year-old ELBW children are not related to prematurity independent of their motor difficulties. Supporting improved motor competence in ELBW preteen children may support improved behaviour, particularly attention and social behaviours. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  11. Behavior in children with Prader-Willi syndrome before and during growth hormone treatment: a randomized controlled trial and 8-year longitudinal study.

    PubMed

    Lo, Sin T; Siemensma, Elbrich P C; Festen, Dederieke A M; Collin, Philippe J L; Hokken-Koelega, Anita C S

    2015-09-01

    Information on behavior of children with Prader-Willi syndrome (PWS) and the effect of growth hormone (GH) treatment is scarce. Parents report less problem behavior during GH treatment. Forty-two pre-pubertal children, aged 3.5-14 years were studied in a randomized controlled GH trial (RCT) during 2 years, followed by a longitudinal study during 8 years of GH treatment. Behavior was measured annually by the Developmental Behavior Checklist for children with intellectual disability (DBC) and a Dutch questionnaire to evaluate social behavioral problems in children, the Children's Social Behavior Questionnaire (CSBQ). Problem behavior measured by the DBC in children with PWS was similar compared to peers with comparable intellectual disability. Scores on 'Social disabilities' subscale were however significantly higher compared to the DBC total score (p < 0.01). A lower IQ was associated with more self-absorbed behavior, more communication problems and more problem behavior in general. Problem behavior measured by the CSBQ was similar compared to peers with a comparable intellectual disability, but children with PWS scored significantly higher on the 'Not tuned', 'Understanding', and 'Stereotyped' subscales than the CSBQ total score (p < 0.05 for all subscales and p = 0.001 for the 'Not tuned'-subscale). There were no significant effects of GH treatment during the RCT and 8 years of GH treatment. Children with PWS showed similar problem behavior as a reference population with a comparable intellectual disability. Social problems were the most pronounced within-problem behavior in PWS. In contrast to our expectations and parents reports, our study shows no improvement but also no deterioration of behavioral problems in children with PWS during long-term GH treatment.

  12. Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy.

    PubMed

    Tian, L; An, R; Zhang, J; Sun, Y; Zhao, R; Liu, M

    2017-03-01

    The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.

  13. Protective factors can mitigate behavior problems after prenatal cocaine and other drug exposures.

    PubMed

    Bada, Henrietta S; Bann, Carla M; Whitaker, Toni M; Bauer, Charles R; Shankaran, Seetha; Lagasse, Linda; Lester, Barry M; Hammond, Jane; Higgins, Rosemary

    2012-12-01

    We determined the role of risk and protective factors on the trajectories of behavior problems associated with high prenatal cocaine exposure (PCE)/polydrug exposure. The Maternal Lifestyle Study enrolled 1388 children with or without PCE, assessed through age 15 years. Because most women using cocaine during pregnancy also used other substances, we analyzed for the effects of 4 categories of prenatal drug exposure: high PCE/other drugs (OD), some PCE/OD, OD/no PCE, and no PCE/no OD. Risks and protective factors at individual, family, and community levels that may be associated with behavior outcomes were entered stepwise into latent growth curve models, then replaced by cumulative risk and protective indexes, and finally by a combination of levels of risk and protective indexes. Main outcome measures were the trajectories of externalizing, internalizing, total behavior, and attention problems scores from the Child Behavior Checklist (parent). A total of 1022 (73.6%) children had known outcomes. High PCE/OD significantly predicted externalizing, total, and attention problems when considering the balance between risk and protective indexes. Some PCE/OD predicted externalizing and attention problems. OD/no PCE also predicted behavior outcomes except for internalizing behavior. High level of protective factors was associated with declining trajectories of problem behavior scores over time, independent of drug exposure and risk index scores. High PCE/OD is a significant risk for behavior problems in adolescence; protective factors may attenuate its detrimental effects. Clinical practice and public health policies should consider enhancing protective factors while minimizing risks to improve outcomes of drug-exposed children.

  14. Stability and Predictive Validity of the Parent-Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers.

    PubMed

    Barrios, Chelsey S; Jay, Samantha Y; Smith, Victoria C; Alfano, Candice A; Dougherty, Lea R

    2018-01-01

    Little research has examined the processes underlying children's persistent sleep problems and links with later psychopathology. The current study examined the stability of parent-child sleep interactions as assessed with the parent-reported Parent-Child Sleep Interactions Scale (PSIS) and examined whether sleep interactions in preschool-age children predict sleep problems and psychiatric symptoms later in childhood. Participants included 108 preschool-age children (50% female) and their parents. Parents completed the PSIS when children were 3-5 years (T1) and again when they were 6-9 years (T2). The PSIS includes three subscales-Sleep Reinforcement (reassurance of child sleep behaviors), Sleep Conflict (parent-child conflict at bedtime), Sleep Dependence (difficulty going to sleep without parent)-and a total score. Higher scores indicate more problematic bedtime interactions. Children's sleep problems and psychiatric symptoms at T1 and T2 were assessed with a clinical interview. PSIS scores were moderately stable from T1 to T2, and the factor structure of the PSIS remained relatively consistent over time. Higher total PSIS scores at T1 predicted increases in children's sleep problems at T2. Higher PSIS Sleep Conflict scores at T1 predicted increases in oppositional defiant disorder symptoms at T2. Children with more sleep problems and higher PSIS Sleep Reinforcement scores at T1 showed increases in attention deficit/hyperactivity disorder, depressive, and anxiety symptoms at T2. These findings provide evidence for the predictive validity of the PSIS and highlight the importance of early parent-child sleep interactions in the development of sleep and psychiatric symptoms in childhood. Parent-child sleep interactions may serve as a useful target for interventions.

  15. [Knowledge of Emotion Regulation Strategies, Problem Behavior, and Prosocial Behavior in Preschool Age].

    PubMed

    Gust, Nicole; Koglin, Ute; Petermann, Franz

    2015-01-01

    The present study examines the relation between knowledge of emotion regulation strategies and social behavior in preschoolers. Knowledge of emotion regulation strategies of 210 children (mean age 55 months) was assessed. Teachers rated children's social behavior with SDQ. Linear regression analysis examined how knowledge of emotion regulation strategies influenced social behavior of children. Significant effects of gender on SDQ scales "prosocial behavior", "hyperactivity", "behavior problems", and SDQ total problem scale were identified. Age was a significant predictor of SDQ scales "prosocial behavior", "hyperactivity", "problems with peers" and SDQ total problem scale. Knowledge of emotion regulation strategies predicted SDQ total problem scores. Results suggest that deficits in knowledge of emotion regulation strategies are linked with increased problem behavior.

  16. Severity of eczema and mental health problems in Japanese schoolchildren: The ToMMo Child Health Study.

    PubMed

    Kuniyoshi, Yasutaka; Kikuya, Masahiro; Miyashita, Masako; Yamanaka, Chizuru; Ishikuro, Mami; Obara, Taku; Metoki, Hirohito; Nakaya, Naoki; Nagami, Fuji; Tomita, Hiroaki; Hozawa, Atsushi; Tsuji, Ichiro; Kure, Shigeo; Yaegashi, Nobuo; Yamamoto, Masayuki; Kuriyama, Shinichi

    2018-04-13

    The association between eczema and mental health problems in schoolchildren has been underexplored. We aimed to investigate this association with the validated questionnaires. Of 46,648 invited children, we analyzed 9954 (21.3%) in the 2nd to the 8th grades from the ToMMo Child Health Study conducted in 2014 and 2015, a cross-sectional survey in Miyagi Prefecture, Japan. We defined eczema status as "normal," "mild/moderate," or "severe," based on the presence of persistent flexural eczema and sleep disturbance, according to the International Study of Asthma and Allergies in Childhood (ISAAC) Eczema Symptom Questionnaire. Clinical ranges of Strengths and Difficulties Questionnaire (SDQ) total difficulties scores and four SDQ subcategories of emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems were defined as scores ≥16, ≥5, ≥5, ≥7, and ≥5, respectively. The mean SDQ total difficulties score significantly increased as eczema status worsened (all P ≤ 0.004 for trend). The OR of scores in the clinical range for SDQ total difficulties were 1.51 (95% CI, 1.31-1.74) for mild/moderate eczema and 2.63 (95% CI, 1.91-3.63) for severe eczema (P < 0.001 for trend), adjusted for sex, school grade, current wheeze, and disaster-related factors, using normal eczema as a reference. The association between severity of eczema and four SDQ subcategories showed a similar trend (all P ≤ 0.017 for trend). We found a significant association between severity of eczema and mental health problems. The presence of eczema was associated with four SDQ subcategories. Copyright © 2018 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  17. The association of minor and major depression with health problem-solving and diabetes self-care activities in a clinic-based population of adults with type 2 diabetes mellitus.

    PubMed

    Shin, Na; Hill-Briggs, Felicia; Langan, Susan; Payne, Jennifer L; Lyketsos, Constantine; Golden, Sherita Hill

    2017-05-01

    We examined whether problem-solving and diabetes self-management behaviors differ by depression diagnosis - major depressive disorder (MDD) and minor depressive disorder (MinDD) - in adults with Type 2 diabetes (T2DM). We screened a clinical sample of 702 adults with T2DM for depression, identified 52 positive and a sample of 51 negative individuals, and performed a structured diagnostic psychiatric interview. MDD (n=24), MinDD (n=17), and no depression (n=62) were diagnosed using Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) Text Revised criteria. Health Problem-Solving Scale (HPSS) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaires determined problem-solving and T2DM self-management skills, respectively. We compared HPSS and SDSCA scores by depression diagnosis, adjusting for age, sex, race, and diabetes duration, using linear regression. Total HPSS scores for MDD (β=-4.38; p<0.001) and MinDD (β=-2.77; p<0.01) were lower than no depression. Total SDSCA score for MDD (β=-10.1; p<0.01) was lower than for no depression, and was partially explained by total HPSS. MinDD and MDD individuals with T2DM have impaired problem-solving ability. MDD individuals had impaired diabetes self-management, partially explained by impaired problem-solving. Future studies should assess problem-solving therapy to treat T2DM and MinDD and integrated problem-solving with diabetes self-management for those with T2DM and MDD. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Sleep, Fatigue, and Problems with Cognitive Function in Adults Living with HIV

    PubMed Central

    Gay, Caryl L.; Lee, Kathryn A.

    2015-01-01

    Up to 50% of people living with HIV have some neurocognitive impairment. We examined associations of sleep and fatigue with self-reported cognitive problems in 268 adults living with HIV. Multivariate regression was used to examine associations between cognitive problems, self-reported sleep quality, actigraphy-measured total sleep time and wake after sleep onset, and fatigue severity. Poorer self-reported sleep quality (p < .001), short or long total sleep time (< 7 or > 8 vs. 7–8 hours, p = .015), and greater fatigue (p < .001) were associated with lower self-reported cognitive function scores after controlling for demographic and clinical characteristics. However, objective measure of wake after sleep onset was unrelated to self-reported cognitive function scores. Findings suggest that assessing and treating poor sleep and complaints about fatigue would be areas for intervention that could have a greater impact on improving cognition function than interventions that only target cognitive problems. PMID:26547298

  19. Do Acute Myocardial Infarction and Heart Failure Readmissions Flagged as Potentially Preventable by the 3M Potentially Preventable Readmissions Software Have More Process-of-Care Problems?

    PubMed

    Borzecki, Ann M; Chen, Qi; Mull, Hillary J; Shwartz, Michael; Bhatt, Deepak L; Hanchate, Amresh; Rosen, Amy K

    2016-09-01

    The 3M Potentially Preventable Readmissions (3M-PPR) software matches clinically related index admission and readmission diagnoses that may signify in-hospital or postdischarge quality problems. To assess whether the PPR algorithm identifies preventable readmissions, we compared processes of care between PPR software-flagged and nonflagged cases. Using 2006 to 2010 national VA administrative data, we identified acute myocardial infarction and heart failure discharges associated with 30-day all-cause readmissions, then flagged cases (PPR-Yes/PPR-No) using the 3M-PPR software. To assess care quality, we abstracted medical records of 100 readmissions per condition using tools containing explicit processes organized into admission work-up, in-hospital evaluation/treatment, discharge readiness, postdischarge period. We derived quality scores, scaled to a maximum of 25 per section (maximum total score=100) and compared cases on total and section-specific mean scores. For acute myocardial infarction, 77 of 100 cases were flagged as PPR-Yes. Section quality scores were highest for in-hospital evaluation/treatment (20.5±2.8) and lowest for postdischarge care (6.8±9.1). Total and section-related mean scores did not differ by PPR status; respective PPR-Yes versus PPR-No total scores were 61.6±11.1 and 60.4±9.4; P=0.98. For heart failure, 86 of 100 cases were flagged as PPR-Yes. Section scores were highest for discharge readiness (18.8±2.4) and lowest for postdischarge care (7.3±8.1). Like acute myocardial infarction, total and section-related mean scores did not differ by PPR status; PPR-Yes versus PPR-No total scores were 61.2±10.8 and 63.4±7.0, respectively; P=0.47. Among VA acute myocardial infarction and heart failure readmissions, the 3M-PPR software does not distinguish differences in case-level quality of care. Whether 3M-PPR software better identifies preventable readmissions by using other methods to capture poorly documented processes or performing different comparisons requires further study. © 2016 American Heart Association, Inc.

  20. The relationship between job search skills and employability for persons with mild mental retardation.

    PubMed

    Suzuki, Y

    1998-01-01

    Persons with mental retardation who possess applicable adaptive skills are usually able to obtain jobs in labor markets. However, some persons who show high scores with social and prevocational skills are unable to obtain jobs and the reasons for their unemployability are unknown. Twelve subjects with mild retardation who failed to obtain jobs were evaluated for their social and prevocational skills at the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Handicapped. The evaluation was performed using the Social and Prevocational Information Battery-Revised which was developed by Halpen and Irvin. The results showed 12 subjects presented lower scores either in the Job Search Skills area or in other areas in spite of their high scores on the Total Battery. Moreover, these subjects also showed behavior problems. The study suggests that those with high scores on the Total Battery, but low scores in Job Search Skills, show a tendency to fail to obtain a job in competitive job placement. It seems that these persons have adjustment problems and need special support services to secure their employability.

  1. Population heterogeneity of trait anger and differential associations of trait anger facets with borderline personality features, neuroticism, depression, Attention Deficit Hyperactivity Disorder (ADHD), and alcohol problems

    PubMed Central

    Lubke, Gitta H.; Ouwens, Klaasjan G.; de Moor, Marleen H.M.; Trull, Timothy J.; Boomsma, Dorret I.

    2015-01-01

    Anger is an emotion consisting of feelings of variable intensity ranging from mild irritation to intense fury. High levels of trait anger are associated with a range of psychiatric, interpersonal, and health problems. The objectives of this study were to explore heterogeneity of anger as measured by the Spielberger Trait Anger Scale (STAS), and to assess the association of the different anger facets with a selection of psychiatric disorders covering externalizing and internalizing problems, personality disorders, and substance use. Factor mixture models differentiated between a high and low scoring class (28% vs. 72%), and between three factors (anger-temperament, anger-reaction, and immediacy of an anger response). Whereas all psychiatric scales correlated significantly with the STAS total score, regressing the three STAS factors on psychiatric behaviors model showed a more detailed pattern. Only borderline affect instability and depression were significantly associated with all three factors in both classes whereas other problem behaviors were associated only with 1 or 2 of the factors. Alcohol problems were associated with immediacy only in the high scoring class, indicating a non-linear relation in the total sample. Taking into account these more specific associations is likely to be beneficial when investigating differential treatment strategies. PMID:26454404

  2. Neurotic manifestations in adolescents with thalassemia major.

    PubMed

    Moorjani, J D; Issac, Chithira

    2006-07-01

    To study the neurotic manifestations in thalassemic adolescents as a consequence of long-term illness. From July 2003, thirty six thalassemic adolescents and forty normal adolescents were selected with age ranging from 13 to 18 and with same socio economic status and family background. Middlesex Hospital Questionnaire by Crown and Crisp [1966] was administered and Mann Whiteny 'U' test was employed to measure free-floating anxiety, phobia, somatic anxiety, obsession, depression, hysteria and total neuroticism score. An interview was conducted along with the questionnaire to detect the problems in depth. Parents of thalassemic adolescents were interviewed subsequently to realize the behavioral problems existing along with neuroticism. Thirty-six of thalassemic and all forty normal adolescents returned the questionnaires. The responses suggest a marked difference in total neuroticism score and all other variables except that of hysteria. The interview on parents of thalassemic adolescents exposed various behavioral problems in these adolescents. Thalassemic adolescents were having higher scores in neuroticism. Some behavioral problems are also found to exist along with neurotic manifestations. There remains a need to improve the management of thalassemia in terms of psychological aspects in order to improve the mental health of this group.

  3. Evaluation of Singing Vocal Health in Yakshagana Singers.

    PubMed

    Gunjawate, Dhanshree R; Aithal, Venkataraja U; Devadas, Usha; Guddattu, Vasudeva

    2017-03-01

    Yakshagana, a popular traditional folk art from Karnataka, India, includes singing and dancing. Yakshagana singer or Bhagavata plays an important role in singing and conducting the performance. The present study aims to assess the singing vocal health using Singing Voice Handicap Index-10 (SVHI-10) in these singers and to compare between those who report voice problem and those who do not. A cross-sectional study was carried out on 26 Bhagavata using demographic questionnaire and SVHI-10 in the Kannada language. Descriptive statistics was used to summarize the data. Independent sample t test was used to compare the responses for demographic variables between the two groups of singers with and without voice problems. The difference in scores of SVHI-10 between the two groups was analyzed using Pearson's chi-square test. Of the Bhagavata, 38% reported to have experienced voice problems, which affected their singing, with higher total SVHI-10 score (31.2 ± 5.7) compared with those who did not report any problems (16.81 ± 9.56). A statistically significant difference between the groups was noted in the emotional domain and total scores. The present study provides preliminary information on the voice handicap reported by Bhagavata. The singers reporting voice problems scored higher on SVHI-10. A healthy singing voice is essential for Yakshagana singers, and voice problems can have a significant impact on their performance and livelihood. Hence, results of the present study indicate the need to understand these singers' voice problems and their impact more comprehensively, and educate them about voice care. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  4. Is greater improvement in early self-regulation associated with fewer behavioral problems later in childhood?

    PubMed

    Sawyer, Alyssa C P; Miller-Lewis, Lauren R; Searle, Amelia K; Sawyer, Michael G; Lynch, John W

    2015-12-01

    The aim of this study was to determine whether the extent of improvement in self-regulation achieved between ages 4 and 6 years is associated with the level of behavioral problems later in childhood. Participants were 4-year-old children (n = 510) attending preschools in South Australia. Children's level of self-regulation was assessed using the parent-completed Devereux Early Childhood Assessment when children were aged 4, 5, and 6. Children's level of behavioral problems was assessed using total, internalizing, and externalizing scores on parent- and teacher-rated Strengths and Difficulties Questionnaires (SDQs) when children were 6 years old. Random effects regression was used to describe the changes to children's self-regulation between 4 and 6 years. Linear regression models were then used to determine the strength of the association between the extent of self-regulation improvement and level of behavioral problems. Greater improvement in self-regulation, adjusted for family characteristics and baseline self-regulation scores, was associated with lower levels of parent- (B = -3.57, 95% confidence interval [CI] [-4.49, -2.65]) and teacher-rated SDQ total difficulties scores at 6 years (B = -2.42, 95% CI [-3.50, -1.34]). These effects remained after adjustment for level of parent-rated behavioral problems at 4 years. Similar effects were found for internalizing and externalizing scores at age 6 years. The results highlight the importance of improvements in self-regulation from 4-6 years for childhood behavioral problems during the early school years. Children with lower levels of improvement in self-regulation early in life are at risk for higher levels of behavioral problems both at home and at school. (c) 2015 APA, all rights reserved).

  5. Mental problems and their socio-demographic determinants in young schoolchildren in Sweden, a country with high gender and income equality.

    PubMed

    Stenmark, Helena; Bergström, Erik; Hägglöf, Bruno; Öhman, Ann; Petersen, Solveig

    2016-02-01

    Mental problems and their potential socio-demographic determinants were investigated in young schoolchildren in Sweden, a high-income country in the top of income- and gender-equality rankings. Cross-sectional study of 1465 schoolchildren in grades 3 and 6. Mental health was measured by the Child Behavior Checklist and the Youth Self Report (Total problems and 14 specific problem areas). Potential socio-demographic determinants were sex, parental education and occupation, family structure, and immigrant status. Mental problems were present in 14% of the sixth graders and in 7% of the third graders. In grade 3, the mean total problem score was lower in girls than in boys, but the prevalence of problems at a subclinical/clinical level did not differ by sex. Furthermore, in nine to 13 of the 14 specific problem areas, problems were equally distributed by sex, parental education, parental occupation, immigrant status, and family structure. In grade 6, both the total mean score and the overall odds of subclinical/clinical problems were similar in girls and boys. Likewise, in all the specific problem areas, problems were evenly distributed by parental education and occupation, and only independently associated with immigrant status and family structure in one problem area. In five specific problem areas, boys had higher odds of problems than girls. This study shows that also in a relatively wealthy and equal country such as Sweden, mental problems are a significant child public health issue. The association between socio-demographic background and mental problems seems to be rather weak, but differ dependent on the type of mental problem in focus. © 2015 the Nordic Societies of Public Health.

  6. Adaptive functioning and behaviour problems in relation to level of education in children and adolescents with intellectual disability.

    PubMed

    de Bildt, A; Sytema, S; Kraijer, D; Sparrow, S; Minderaa, R

    2005-09-01

    The interrelationship between adaptive functioning, behaviour problems and level of special education was studied in 186 children with IQs ranging from 61 to 70. The objective was to increase the insight into the contribution of adaptive functioning and general and autistic behaviour problems to the level of education in children with intellectual disability (ID). Children from two levels of special education in the Netherlands were compared with respect to adaptive functioning [Vineland Adaptive Behavior Scales (VABS)], general behaviour problems [Child Behavior Checklist (CBCL)] and autistic behaviour problems [Autism Behavior Checklist (ABC)]. The effect of behaviour problems on adaptive functioning, and the causal relationships between behaviour problems, adaptive functioning and level of education were investigated. Children in schools for mild learning problems had higher VABS scores, and lower CBCL and ABC scores. The ABC had a significant effect on the total age equivalent of the VABS in schools for severe learning problems, the CBCL in schools for mild learning problems. A direct effect of the ABC and CBCL total scores on the VABS age equivalent was found, together with a direct effect of the VABS age equivalent on level of education and therefore an indirect effect of ABC and CBCL on level of education. In the children with the highest level of mild ID, adaptive functioning seems to be the most important factor that directly influences the level of education that a child attends. Autistic and general behaviour problems directly influence the level of adaptive functioning. Especially, autistic problems seem to have such a restrictive effect on the level of adaptive functioning that children do not reach the level of education that would be expected based on IQ. Clinical implications are discussed.

  7. Validating MMI Scores: Are We Measuring Multiple Attributes?

    ERIC Educational Resources Information Center

    Oliver, Tom; Hecker, Kent; Hausdorf, Peter A.; Conlon, Peter

    2014-01-01

    The multiple mini-interview (MMI) used in health professional schools' admission processes is reported to assess multiple non-cognitive constructs such as ethical reasoning, oral communication, or problem evaluation. Though validation studies have been performed with total MMI scores, there is a paucity of information regarding how well MMI…

  8. Voice Handicap Index associated with common mental disorders in elementary school teachers.

    PubMed

    da Rocha, Luise Marques; de Mattos Souza, Luciano Dias

    2013-09-01

    To verify the relationship between common mental disorders (CMDs) and the Voice Handicap Index (VHI) in elementary school teachers from municipal schools. The VHI mean scores in the group of teachers with symptoms of mental disorder were significantly higher than those in the group of teachers with no symptoms in the total scores of three subscales: disability (functional domain), handicap (emotional domain), and impairment (organic domain). An observational cross-sectional, quantitative study was conducted in the public schools of urban and rural areas of the city of Pelotas. A total of 575 teachers participated. Vocal handicap was measured using VHI, producing a total score and three subscales, including emotional, functional, and organic domains. The Self-Reporting Questionnaire, 20 items scale was used to measure mental disorder symptoms. A log transformation was used, followed by linear regression, to evaluate the relationship between the independent variables and the outcomes. Teachers with CMD symptoms and who took a sick leave from teaching because of voice problems obtained the lowest scores in VHI (P < 0.050). Emotional, functional, and organic voice handicap scores were significantly higher in teachers with CMD symptoms (P < 0.001). A close association between voice problems and mental disorders was identified based on the statistically significant association between high levels of voice handicap and the mental disorders. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  9. Assessing for suicidal behavior in youth using the Achenbach System of Empirically Based Assessment.

    PubMed

    Van Meter, Anna R; Algorta, Guillermo Perez; Youngstrom, Eric A; Lechtman, Yana; Youngstrom, Jen K; Feeny, Norah C; Findling, Robert L

    2018-02-01

    This study investigated the clinical utility of the Achenbach System of Empirically Based Assessment (ASEBA) for identifying youth at risk for suicide. Specifically, we investigated how well the Total Problems scores and the sum of two suicide-related items (#18 "Deliberately harms self or attempts suicide" and #91 "Talks about killing self") were able to distinguish youth with a history of suicidal behavior. Youth (N = 1117) aged 5-18 were recruited for two studies of mental illness. History of suicidal behavior was assessed by semi-structured interviews (K-SADS) with youth and caregivers. Youth, caregivers, and a primary teacher each completed the appropriate form (YSR, CBCL, and TRF, respectively) of the ASEBA. Areas under the curve (AUCs) from ROC analyses and diagnostic likelihood ratios (DLRs) were used to measure the ability of both Total Problems T scores, as well as the summed score of two suicide-related items, to identify youth with a history of suicidal behavior. The Suicide Items from the CBCL and YSR performed well (AUCs = 0.85 and 0.70, respectively). The TRF Suicide Items did not perform better than chance, AUC = 0.45. The AUCs for the Total Problems scores were poor-to-fair (0.33-0.65). The CBCL Suicide Items outperformed all other scores (ps = 0.04 to <0.0005). Combining the CBCL and YSR items did not lead to incremental improvement in prediction over the CBCL alone. The sum of two questions from a commonly used assessment tool can offer important information about a youth's risk for suicidal behavior. The low burden of this approach could facilitate wide-spread screening for suicide in an increasingly at-risk population.

  10. Mixed ethnicity and behavioural problems in the Millennium Cohort Study

    PubMed Central

    Zilanawala, Afshin; Sacker, Amanda; Kelly, Yvonne

    2018-01-01

    Background The population of mixed ethnicity individuals in the UK is growing. Despite this demographic trend, little is known about mixed ethnicity children and their problem behaviours. We examine trajectories of behavioural problems among non-mixed and mixed ethnicity children from early to middle childhood using nationally representative cohort data in the UK. Methods Data from 16 330 children from the Millennium Cohort Study with total difficulties scores were analysed. We estimated trajectories of behavioural problems by mixed ethnicity using growth curve models. Results White mixed (mean total difficulties score: 8.3), Indian mixed (7.7), Pakistani mixed (8.9) and Bangladeshi mixed (7.2) children had fewer problem behaviours than their non-mixed counterparts at age 3 (9.4, 10.1, 13.1 and 11.9, respectively). White mixed, Pakistani mixed and Bangladeshi mixed children had growth trajectories in problem behaviours significantly different from that of their non-mixed counterparts. Conclusions Using a detailed mixed ethnic classification revealed diverging trajectories between some non-mixed and mixed children across the early life course. Future studies should investigate the mechanisms, which may influence increasing behavioural problems in mixed ethnicity children. PMID:26912571

  11. Development of the Seasonal Migrant Agricultural Worker Stress Scale in Sanliurfa, Southeast Turkey.

    PubMed

    Simsek, Zeynep; Ersin, Fatma; Kirmizitoprak, Evin

    2016-01-01

    Stress is one of the main causes of health problems, especially mental disorders. These health problems cause a significant amount of ability loss and increase cost. It is estimated that by 2020, mental disorders will constitute 15% of the total disease burden, and depression will rank second only after ischemic heart disease. Environmental experiences are paramount in increasing the liability of mental disorders in those who constantly face sustained high levels of stress. The objective of this study was to develop a stress scale for seasonal migrant agricultural workers aged 18 years and older. The sample consisted of 270 randomly selected seasonal migrant agricultural workers. The average age of the participants was 33.1 ± 14, and 50.7% were male. The Cronbach alpha coefficient and test-retest methods were used for reliability analyses. Although the factor analysis was performed for the structure validity of the scale, the Kaiser-Meyer-Olkin coefficient and Bartlett test were used to determine the convenience of the data for the factor analysis. In the reliability analyses, the Cronbach alpha coefficient of internal consistency was calculated as .96, and the test-retest reliability coefficient was .81. In the exploratory factor analysis for validity of the scale, four factors were obtained, and the factors represented workplace physical conditions (25.7% of the total variance), workplace psychosocial and economic factors (19.3% of the total variance), workplace health problems (15.2% of the total variance), and school problems (10.1% of the total variance). The four factors explained 70.3% of the total variance. As a result of the expert opinions and analyses, a stress scale with 48 items was developed. The highest score to be obtained from the scale was 144, and the lowest score was 0. The increase in the score indicates the increase in the stress levels. The findings show that the scale is a valid and reliable assessment instrument that can be used in epidemiological research and planning interventions.

  12. [Pilot study to resolve problems of visual acuity assessment in grading vision of the physically handicapped--visual acuity and difficulties in daily life of age-related macular degeneration-].

    PubMed

    Yuzawa, Mitsuko; Ishibashi, Tatsuro; Honda, Yoshihito; Kubota, Nobue

    2010-09-01

    To resolve the problems of visual acuity assessment in grading the vision of the physically handicapped as proposed by the Subcommittee for Promoting the Realization of a Cohesive Society with the Visually Disabled, Science Council of Japan, a method suitable for assessing visual disturbances, and the relationship between the degree of visual disturbances and the degree of difficulty in activities of daily life are clarified. 151 persons with age-related macular degeneration were studied. Examination methods for measuring visual acuity and reading performance were studied, and interviews using the daily living task dependent on vision (DLTV) questionnaire were performed. The correlations between total DLTV score and each examination method were analyzed. The median total DLTV score for each grade of visual acuity of the better eye was calculated. Spearman's correlation coefficient between distance corrected visual acuity of the better eye and total DLTV score was 0.76. Median DLTV scores for visual acuities (better eye) of 0.2, 0.3, 0.4, 0.5 were 65, 73.5, 62, 79 respectively. Visual acuity can be assessed by measuring distant corrected visual acuity of the better eye and setting the upper limit of visual disturbance at either 0.3 or 0.4.

  13. Population heterogeneity of trait anger and differential associations of trait anger facets with borderline personality features, neuroticism, depression, Attention Deficit Hyperactivity Disorder (ADHD), and alcohol problems.

    PubMed

    Lubke, Gitta H; Ouwens, Klaasjan G; de Moor, Marleen H M; Trull, Timothy J; Boomsma, Dorret I

    2015-12-15

    Anger is an emotion consisting of feelings of variable intensity ranging from mild irritation to intense fury. High levels of trait anger are associated with a range of psychiatric, interpersonal, and health problems. The objectives of this study were to explore heterogeneity of anger as measured by the Spielberger Trait Anger Scale (STAS), and to assess the association of the different anger facets with a selection of psychiatric disorders covering externalizing and internalizing problems, personality disorders, and substance use. Factor mixture models differentiated between a high and low scoring class (28% vs. 72%), and between three factors (anger-temperament, anger-reaction, and immediacy of an anger response). Whereas all psychiatric scales correlated significantly with the STAS total score, regressing the three STAS factors on psychiatric behaviors model showed a more detailed pattern. Only borderline affect instability and depression were significantly associated with all three factors in both classes whereas other problem behaviors were associated only with 1 or 2 of the factors. Alcohol problems were associated with immediacy only in the high scoring class, indicating a non-linear relation in the total sample. Taking into account these more specific associations is likely to be beneficial when investigating differential treatment strategies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Psychological Adjustment in Adolescents with Vision Impairment

    ERIC Educational Resources Information Center

    Pinquart, Martin; Pfeiffer, Jens P.

    2012-01-01

    The present study compared psychological adjustment of 158 adolescents with vision impairment and 158 sighted adolescents with a matched-pair design using the Strengths and Difficulties Questionnaire. Adolescent self-reports and teacher reports on emotional problems, peer problems, and total difficulties showed higher scores in students with…

  15. Are mental health problems and depression associated with bruxism in children?

    PubMed

    Renner, Andréa Coimbra; da Silva, Antônio Augusto Moura; Rodriguez, Juliana Dalla Martha; Simões, Vanda Maria Ferreira; Barbieri, Marco Antonio; Bettiol, Heloísa; Thomaz, Erika Bárbara Abreu Fonseca; Saraiva, Maria da Conceição

    2012-06-01

    Previous studies have found an association between bruxism and emotional and behavioral problems in children, but reported data are inconsistent. The objective of this study was to estimate the prevalence of bruxism, and of its components clenching and grinding, and its associations with mental problems and depression. Data from two Brazilian birth cohorts were analyzed: one from 869 children in Ribeirão Preto - RP (São Paulo), a more developed city, and the other from 805 children in São Luís - SL (Maranhão). Current bruxism - evaluated by means of a questionnaire applied to the parents/persons responsible for the children - was defined when the habit of tooth clenching during daytime and/or tooth grinding at night still persisted until the time of the assessment. Additionally, the lifetime prevalence of clenching during daytime only and grinding at night only was also evaluated. Mental health problems were investigated using the Strength and Difficulties Questionnaire (SDQ) and depression using the Children's Depression Inventory (CDI). Analyses were carried out for each city: with the SDQ subscales (emotional symptoms, conduct problems, peer problems, attention/hyperactivity disorder), with the total score (sum of the subscales), and with the CDI. These analyses were performed considering different response variables: bruxism, clenching only, and grinding only. The risks were estimated using a Poisson regression model. Statistical inferences were based on 95% confidence intervals (95% CI). There was a high prevalence of current bruxism: 28.7% in RP and 30.0% in SL. The prevalence of clenching was 20.3% in RP and 18.8% in SL, and grinding was found in 35.7% of the children in RP and 39.1% in SL. Multivariable analysis showed a significant association of bruxism with emotional symptoms and total SDQ score in both cities. When analyzed separately, teeth clenching was associated with emotional symptoms, peer problems, and total SDQ score; grinding was significantly associated with emotional symptoms and total SDQ score in RP and SL. Female sex appeared as a protective factor for bruxism, and for clenching and grinding in RP. Furthermore, maternal employment outside the home and white skin color of children were associated with increased prevalence of teeth clenching in SL. Mental health problems were associated with bruxism, with teeth clenching only and grinding at night only. No association was detected between depression and bruxism, neither clenching nor grinding. But it is necessary to be cautious regarding the inferences from some of our results. © 2011 John Wiley & Sons A/S.

  16. Behavioral and emotional problems in a Kuala Lumpur children's home.

    PubMed

    Abd Rahman, Fairuz Nazri; Mohd Daud, Tuti Iryani; Nik Jaafar, Nik Ruzyanei; Shah, Shamsul Azhar; Tan, Susan Mooi Koon; Wan Ismail, Wan Salwina

    2013-08-01

    There is a dearth of studies on behavioral and emotional problems in residential care children in Malaysia. This study describes the behavioral and emotional problems in a sample of children in a government residential care home and compares them with their classmates living with their birth parents. A comparative cross-sectional study was carried out where carers from both groups were asked to fill in the translated Bahasa Melayu version of the Child Behavior Check List. Forms for 53 residential care children and 61 classmates were completed. The residential care children had significantly higher scores on the rule-breaking (P < 0.001) and Diagnostic and Statistical Manual of Mental Disorders (DSM) conduct problem subscales (P < 0.001). Residential care children's age significantly correlated with DSM somatic problems (P = 0.03) and post-traumatic stress (P = 0.023). Duration of care was significantly positively correlated with rule-breaking (P = 0.008), DSM conduct problems (P = 0.018) and externalizing scores (P = 0.017). Abuse and neglect cases had higher anxiety and depression scores (P = 0.024). Number of reasons in care positively correlated with several subscales, including total behavioral problem score (P = 0.005). Logistic regression revealed the greater number of reasons for placement a child had was significantly associated with having externalizing scores in the clinical range (P = 0.016). However, after Bonferroni correction, only the initial findings regarding rule-breaking and DSM conduct problem scores remained significant. Challenges exist in managing residential care children in Malaysia, especially regarding externalizing behavior. More studies are required to describe the Malaysian scene. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  17. Women with breast cancer: self-reported distress in early survivorship.

    PubMed

    Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L

    2015-01-01

    To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Descriptive, cross-sectional. A National Cancer Institute-designated comprehensive cancer center. 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Distress scores, problem reports, and time groups. Participants scored in range of the cutoff of more than 4 (range = 4.1-5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Interventions to reduce or prevent distress may improve outcomes in early survivorship.

  18. Is there an association between the level of grandiose narcissism severity of psychopathology?

    PubMed

    Olssøn, Ingrid; Svindseth, Marit F; Dahl, Alv A

    2016-01-01

    Narcissism is a personality trait associated with both psychological health and resilience as well as with aggression and interpersonal problems. This study compares levels of total narcissism and subscale scores in inpatients, outpatients and a community sample. Inpatients (N = 186) were recruited from consecutively admitted patients to two closed units, and the outpatient group (N = 144) consisted of patients attending a psychiatric outpatient clinic. The patients and a normative community sample (N = 437) all filled in the Narcissistic Personality Inventory questionnaire (NPI-29). The NPI total and subscales scores showed considerable gender differences. Among men only the Uniqueness/Entitlement subscale showed significant group differences, with inpatients showing higher mean score than the two other groups. Among women three factors, Leadership/Power, Superiority/Arrogance, and Uniqueness/ Entitlement, showed significant differences between the different levels of psychopathology. The outpatient female group regularly had the lowest group mean scores. The NPI-29 scores of the normative group showed weak internal consistencies. Our hypothesis of a significant association between mean levels of total narcissism and subscale scores and severity of psychopathology was not supported.

  19. Study of Behaviour Problems in a Paediatric Outpatient Department.

    PubMed

    Prakash, J; Sudarsanan, S; Pardal, P K; Chaudhury, S

    2006-10-01

    Behaviour problems in children still needs precise definition, explicit criterion and assessment on multiple paradigms. Fifty children of the age group 6-14 years, from paediatric outpatient department, selected after randomisation were assessed for behaviour problems with the child behaviour checklist. The data collected was analysed using appropriate statistical tests. 40% children were above cutoff score. Mean child behaviour check list (CBCL) score was 40.6. Total of 72% children were from armed forces background of whom 9% were siblings of officers. 30.6% children from the armed forces background were above the cutoff score. There was no significant difference in the behaviour problems between different age groups and sex. There was no significant difference in behaviour problems between children of officers, other ranks or various income groups. Female children had behaviour problems like "too concerned with neatness or cleanliness", "feels has to be perfect" and "argues a lot" where as male children had behaviour problems like "Does not feel guilty after misbehaving", "argues a lot" and "restless". Behaviour problems in the subjects were externalizing ones. No specific trend was found in children of defence personnel vis-a-vis children of civilian population.

  20. Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program.

    PubMed

    Franco, José G; Petersen, Claudia G; Mauri, Ana L; Vagnini, Laura D; Renzi, Adriana; Petersen, Bruna; Mattila, M C; Comar, Vanessa A; Ricci, Juliana; Dieamant, Felipe; Oliveira, João Batista A; Baruffi, Ricardo L R

    2017-06-01

    KPIs have been employed for internal quality control (IQC) in ART. However, clinical KPIs (C-KPIs) such as age, AMH and number of oocytes collected are never added to laboratory KPIs (L-KPIs), such as fertilization rate and morphological quality of the embryos for analysis, even though the final endpoint is the evaluation of clinical pregnancy rates. This paper analyzed if a KPIs-score strategy with clinical and laboratorial parameters could be used to establish benchmarks for IQC in ART cycles. In this prospective cohort study, 280 patients (36.4±4.3years) underwent ART. The total KPIs-score was obtained by the analysis of age, AMH (AMH Gen II ELISA/pre-mixing modified, Beckman Coulter Inc.), number of metaphase-II oocytes, fertilization rates and morphological quality of the embryonic lot. The total KPIs-score (C-KPIs+L-KPIs) was correlated with the presence or absence of clinical pregnancy. The relationship between the C-KPIs and L-KPIs scores was analyzed to establish quality standards, to increase the performance of clinical and laboratorial processes in ART. The logistic regression model (LRM), with respect to pregnancy and total KPIs-score (280 patients/102 clinical pregnancies), yielded an odds ratio of 1.24 (95%CI = 1.16-1.32). There was also a significant difference (p<0.0001) with respect to the total KPIs-score mean value between the group of patients with clinical pregnancies (total KPIs-score=20.4±3.7) and the group without clinical pregnancies (total KPIs-score=15.9±5). Clinical pregnancy probabilities (CPP) can be obtained using the LRM (prediction key) with the total KPIs-score as a predictor variable. The mean C-KPIs and L-KPIs scores obtained in the pregnancy group were 11.9±2.9 and 8.5±1.7, respectively. Routinely, in all cases where the C-KPIs score was ≥9, after the procedure, the L-KPIs score obtained was ≤6, a revision of the laboratory procedure was performed to assess quality standards. This total KPIs-score could set up benchmarks for clinical pregnancy. Moreover, IQC can use C-KPIs and L-KPIs scores to detect problems in the clinical-laboratorial interface.

  1. A Model Intervention for Girls with Disruptive Behaviour Disorders: The Earlscourt Girls Connection.

    ERIC Educational Resources Information Center

    Walsh, Margaret M.; Pepler, Debra J.; Levene, Kathryn S.

    2002-01-01

    Reports on the evaluation of the Earlscourt Girls Connection, a program for young girls with conduct problems. Analyses of behavioral change according to primary caregivers' ratings were conducted comparing admission scores with 6-month and 12-month follow-up. At follow-up, the girls were rated as lower on the total score for externalizing…

  2. Self-concept in children and adolescents with epilepsy: The role of family functioning, mothers' emotional symptoms and ADHD.

    PubMed

    Ekinci, Ozalp; Isik, Uğur; Gunes, Serkan; Yildirim, Canan; Killi, Yunus; Guler, Gülen

    2016-09-01

    This study aimed to identify the associated factors of poor self-concept in children and adolescents with epilepsy. Fifty-three patients with uncomplicated epilepsy (aged 7-18years) and 28 healthy controls were included. Study measures included the Piers-Harris 2 Self-Concept Scale, Family Assessment Device (FAD), Turgay DSM-IV based ADHD rating Scale (T-DSM-IV-S), Conners' Teacher Rating Scale (CTRS-R), Beck Depression Inventory and State-Trait Anxiety Inventory (STAI). Neurology clinic charts were reviewed for the epilepsy-related variables. While the Piers-Harris 2 total score was not significantly different between the groups, patients with epilepsy had lower (poorer) scores on freedom from anxiety and popularity subscales. Linear regression analysis revealed that the problem solving, affective responsiveness, general functioning and communication scores of FAD; total and inattentiveness scores of T-DSM-IV-S and mothers' Beck scores were associated with the total score of Piers-Harris 2. Epilepsy-related factors were not found to be associated with self-concept scores. Poor self-concept in children with epilepsy is associated with negative family functioning, mothers' emotional symptoms and ADHD, especially the symptoms of inattentiveness. Copyright © 2016. Published by Elsevier B.V.

  3. Positive and Negative Thinking in Tinnitus: Factor Structure of the Tinnitus Cognitions Questionnaire

    PubMed Central

    Hall, Deborah A.; Shorter, Gillian W.; Hoare, Derek J.

    2017-01-01

    Objectives: Researchers and clinicians consider thinking to be important in the development and maintenance of tinnitus distress, and altering thoughts or thinking style is an object of many forms of psychological therapy for tinnitus. Those working with people with tinnitus require a reliable, psychometrically robust means of measuring both positive and negative thinking related to it. The Tinnitus Cognitions Questionnaire (TCQ) was designed as such a measure and its authors showed it to be reliable, with good psychometric properties. However, no research teams have yet carried out independent validation. This study aimed to use the TCQ to investigate thinking amongst members of the general population with both bothersome and nonbothersome tinnitus and also to verify its factor structure. Design: Three hundred forty-two members of the public with tinnitus completed the TCQ online or on paper. They also rated their tinnitus on a scale as “not a problem,” “a small problem,” “a moderate problem,” “a big problem,” or a “very big problem.” The authors tested the original factor structure of the TCQ using confirmatory factor analysis and then calculated the mean scores for each item, comparing mean total scores across “problem categories” for the full questionnaire and for the positive and negative subscales. Results: The original two-factor structure of the TCQ was a good fit to the data when the correlation between positive and negative factors was fixed at zero (root mean square error of approximation = 0.064, 90% confidence interval = 0.058 to 0.070). Items pertaining to wishing the tinnitus would go away and despairing that it would ever get better had the highest mean scores. The mean total score for the “no problem” group (M = 31.17, SD = 16.03) was not significantly different from the mean total score for the “small problem” group (M = 34.00, SD = 12.44, p = 0.99). Differences between mean scores for all other groups were statistically significant. For the negative subscale, differences were statistically significant between all problem categories. For the positive subscale, the differences between mean scores were only statistically significant for the “no problem” group (M = 28.40, SD = 17.11) compared with the “moderate problem” group (M = 18.55, SD = 8.64, p = 0.02) and for the “moderate problem” group compared with the “very big problem” group (M = 26.79, SD = 11.66, p = 0.002). Positive and negative factors were uncorrelated (ρ = −0.03.) Conclusions: The TCQ is a valid measure of positive and negative thinking in tinnitus, and the authors recommend its use in research and therapeutic settings. Negative thinking appears to be associated with more problematic tinnitus, but positive thinking is not associated with unproblematic tinnitus, suggesting that reducing negative thinking may be more important than teaching positive thinking in therapy. PMID:27560491

  4. Prevalence of female sexual dysfunction during pregnancy among Egyptian women.

    PubMed

    Ahmed, Magdy R; Madny, Elham H; Sayed Ahmed, Waleed A

    2014-04-01

    The aim of this study was to assess the prevalence of female sexual dysfunction (FSD) during pregnancy in a sample of women from Egypt. This prospective cohort study was conducted among pregnant women who presented to the Obstetrics Outpatient Clinic - Suez Canal University Hospital for routine antenatal care between February 2012 and February 2013. The 451 women who completed the study attended during their first trimester with a singleton pregnancy and were in a stable relationship with their partners for the last 6 months. Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire during the 4 weeks preceding pregnancy and then in each trimester during the antenatal visits. Prevalence of FSD during pregnancy was estimated to be 68.8%. According to the FSFI, scores of all domains and total score were significantly reduced during the whole period of pregnancy (average 22.5 ± 3.7) compared to the pre-conception period (30.5 ± 5.6). However, there was significant increase of all domains and total score during the second trimester (26.6 ± 3.9) in comparison to the first and third trimesters (22.4 ± 4.1 and 18.6 ± 3.8, respectively). Total FSFI score was found to be positively correlated to pre-conception total FSFI score. However, age, parity and duration of marriage were negatively correlated. FSD is a prevalent problem during pregnancy among Egyptian women. The magnitude of the problem is highest during the third trimester while the second trimester represents the peak of sexual function during pregnancy. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  5. Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study.

    PubMed

    Donovan, Dennis M; Kivlahan, Daniel R; Doyle, Suzanne R; Longabaugh, Richard; Greenfield, Shelly F

    2006-12-01

    To examine among alcohol-dependent out-patient clients the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) total score and 'zones' suggested by the World Health Organization for defining levels of severity of alcohol use problems. Participants were classified into AUDIT zones (AUDIT total score = 8-15, 16-19, 20-40) and compared on measures of demographics, treatment goals, alcohol consumption, alcohol-related consequences, severity of dependence, physiological dependence, tolerance, withdrawal and biomarkers of alcohol use. Eleven out-patient academic clinical research centers across the United States. Participants Alcohol dependent individuals (n = 1335) entering out-patient treatment in the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) study. The AUDIT was administered as part of an initial screening. Baseline measures used for concurrent validation included the Structured Clinical Interview for Diagnostic and Statistical Manual, 4th edition (DSM-IV) Disorders, the Alcohol Dependence Scale, the Drinker Inventory of Consequences, the Obsessive-Compulsive Drinking Scale, the University of Rhode Island Change Assessment, the Thoughts about Abstinence Scale, the Form-90, %carbohydrate-deficient transferrin and gamma-glutamyl transferase. Findings Indicators of severity of dependence and alcohol-related problems increased linearly with total score and differed significantly across AUDIT zones. The highest zone, with scores of 20 and above, was markedly different with respect to severity from the other two zones and members of this group endorsed an abstinence goal more strongly. The AUDIT total score is a brief measure that appears to provide an index of severity of dependence in a sample of alcohol-dependent individuals seeking out-patient treatment, extending its potential utility beyond its more traditional role as a screening instrument in general populations.

  6. Psychometric Evaluation of the Social Problem-Solving Inventory-Revised among Overweight or Obese Adults

    ERIC Educational Resources Information Center

    Wang, Jing; Matthews, Judith T.; Sereika, Susan M.; Chasens, Eileen R.; Ewing, Linda J.; Burke, Lora E.

    2013-01-01

    Problem solving is a key component of weight loss programs. The Social Problem Solving Inventory-Revised (SPSI-R) has not been evaluated in weight loss studies. The purpose of this study was to evaluate the psychometrics of the SPSI-R. Cronbach's a (0.95 for total score; 0.67-0.92 for subscales) confirmed internal consistency reliability. The…

  7. Misleading University Rankings: Cause and Cure for Discrepancies between Nominal and Attained Weights

    ERIC Educational Resources Information Center

    Soh, Kaycheng

    2013-01-01

    Recent research into university ranking methodologies uncovered several methodological problems among the systems currently in vogue. One of these is the discrepancy between the nominal and attained weights. The problem is the summation of unstandardized indicators for the total scores used in ranking. It is demonstrated that weight discrepancy…

  8. Effects of Aggression Replacement Training on Problem Solving, Anger and Aggressive Behaviour among Adolescents with Criminal Attempts in Turkey: A Quasi-Experimental Study.

    PubMed

    Kaya, Fadime; Buzlu, Sevim

    2016-12-01

    The research was conducted by a pretest and post-test conducted in a quasi-experimental design which aimed to determine effectiveness of Aggression Replacement Training (ART) on problem solving, anger and aggressive behaviour among adolescents with criminal attempts in Turkey. The study included 65 adolescents with criminal attempts (32 intervention, 33 control). There was no difference between the groups in terms of average age (16.13±1.10 in the experimental group and 16.21±0.89 in the control group). After the intervention, the experimental group showed significantly decreased Trait Anger levels (t=1.906; P=0.033), increased Anger Control scores (t=2.522; P=0.008), decreased Physical Aggression scores (t=1.925; P=0.031), decreased Hostility scores (t=2.496; P=0.009), increased Social Problem Solving total scores (t=2.937; P=0.005). Increased Anger Control scores were found to be significant when compared with the control group (t=2.273, P=0.026). These results showed that ART was effective on problem solving, anger and aggressive behaviour and can be used to develop positive behaviours among adolescents with criminal attempts. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Pattern and predictors of interpersonal violence among adolescent female students in Egypt.

    PubMed

    Zayed, Mouchira; Ahmed, Dalia; Halawa, Eman Fawzy

    2014-12-01

    Violence among female adolescents is a major public health problem. The objective of this study is to detect the pattern and predicting factors of interpersonal violence among adolescent female students in a nursing high school in Cairo. A cross-sectional study was conducted during the academic year 2011-2012 and included a total of 220 students using a self-administered questionnaire. Physical violence exposure at home, school and community among studied adolescents were 65.5, 30.4 and 25.9% respectively. Verbal violence was found in 55, 69 and 60% at home, school and community respectively. Finally 5 and 41.3% of studied students were exposed to sexual violence at home and community respectively. The highest violence exposure score was at school from teachers while the highest score of being violent was mainly towards the community. Multivariate regression analysis for violence scores revealed that younger students, students from urban residence and higher crowding index were significant predictors for total violence exposure and being violent scores. Prevention programmes should be given for all students especially high risk ones (young age, urban residence and high crowdness index families) and their families to address and overcome this problem.

  10. Sleep disorders in children with cerebral palsy: neurodevelopmental and behavioral correlates.

    PubMed

    Romeo, Domenico M; Brogna, Claudia; Quintiliani, Michela; Baranello, Giovanni; Pagliano, Emanuela; Casalino, Tiziana; Sacco, Annalisa; Ricci, Daniela; Mallardi, Maria; Musto, Elisa; Sivo, Serena; Cota, Francesco; Battaglia, Domenica; Bruni, Oliviero; Mercuri, Eugenio

    2014-02-01

    We aimed to estimate the frequency of sleep disorders in children with cerebral palsy (CP) using the Sleep Disturbance Scale for Children (SDSC) and to evaluate the relations between sleep disorders and motor, cognitive, and behavioral problems. One hundred and sixty-five children with CP ages 6-16 years (mean age, 11years) were assessed using the SDSC, the Gross Motor Function Classification System (GMFCS), the Wechsler Intelligence Scale for Children and the Child Behavior Check List (CBCL) to assess sleep, motor, cognitive, and behavioral problems, respectively. An abnormal total sleep score was found in 19% of children with CP; more than 40% of children had an abnormal score on at least one SDSC factor. The SDSC total score was significantly associated (P<.01) with mental retardation, epilepsy, CBCL scores, and level 5 on the GMFCS. Our results confirm that sleep disorders are common in children with cerebral palsy. The relationship between motor and cognitive behavior and epilepsy should be further explored to better understand how these factors influence one another to identify effective treatments and to improve the well-being of the child. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Sequential population study of the impact of earthquakes on the emotional and behavioural well-being of 4-year-olds in Canterbury, New Zealand.

    PubMed

    Thomson, Janine; Seers, Kara; Frampton, Chris; Hider, Phil; Moor, Stephanie

    2016-01-01

    Exposure to a large natural disaster can lead to behavioural disturbances, developmental delay and anxiety among young children. Although most children are resilient, some will develop mental health problems. Major earthquakes occurred in Canterbury, New Zealand, in September 2010 and February 2011. A community screening tool assessing behavioural and emotional problems in children, the Strengths and Difficulties Questionnaire, has been reported by parents (SDQ-P) and teachers (SDQ-T) of all 4-year-olds in the region since 2008. Mean total and subtest scores for the SDQ-P and SDQ-T were compared across periods before, during and after the earthquakes in sequential population cohorts of children. Comparisons across the periods were made in relation to the proportions of children defined by New Zealand norms as 'abnormal'. Results were also compared between zones considered to have been exposed to higher or lower impact from the earthquakes. Parent mean total SDQ scores did not change between periods before, during and after the earthquakes. Teacher mean SDQ total scores significantly reduced (improved) when compared between baseline and post-earthquake periods. Mean SDQ pro-social scores from both teachers and parents increased (strengthened) when compared between baseline and post-earthquake periods. Results did not significantly vary according to a measure of impact from the earthquakes. The main finding that a population-based measure of behavioural and emotional problems among children was not deleteriously impacted by the earthquakes is surprising and is not consistent with other research findings. Further work is needed to explore the health needs of children in Canterbury based on methodological improvements. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  12. Prenatal exposure to very severe maternal obesity is associated with adverse neuropsychiatric outcomes in children.

    PubMed

    Mina, T H; Lahti, M; Drake, A J; Räikkönen, K; Minnis, H; Denison, F C; Norman, J E; Reynolds, R M

    2017-01-01

    Prenatal maternal obesity has been linked to adverse childhood neuropsychiatric outcomes, including increased symptoms of attention deficit hyperactivity disorder (ADHD), internalizing and externalizing problems, affective disorders and neurodevelopmental problems but few studies have studied neuropsychiatric outcomes among offspring born to very severely obese women or assessed potential familial confounding by maternal psychological distress. We evaluated neuropsychiatric symptoms in 112 children aged 3-5 years whose mothers had participated in a longitudinal study of obesity in pregnancy (50 very severe obesity, BMI ⩾40 kg/m2, obese class III and 62 lean, BMI 18.5-25 kg/m2). The mothers completed the Conners' Hyperactivity Scale, Early Symptomatic Syndrome Eliciting Neurodevelopmental Clinical Examination Questionnaire (ESSENCE-Q), Child's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and Child Behavior Checklist (CBCL) to assess child neuropsychiatric symptoms. Covariates included child's sex, age, birthweight, gestational age, socioeconomic deprivation levels, maternal age, parity, smoking status during pregnancy, gestational diabetes and maternal concurrent symptoms of anxiety and depression assessed using State Anxiety of Spielberger State-Trait Anxiety Index (STAI) and General Health Questionnaire (GHQ), respectively. Children exposed to prenatal maternal very severe obesity had significantly higher scores in the Conners' Hyperactivity Scale; ESSENCE-Q; total sleep problems in CSHQ; hyperactivity, conduct problems and total difficulties scales of the SDQ; higher externalizing and total problems, anxious/depressed, aggressive behaviour and other problem syndrome scores and higher DSM-oriented affective, anxiety and ADHD problems in CBCL. Prenatal maternal very severe obesity remained a significant predictor of child neuropsychiatric problems across multiple scales independent of demographic factors, prenatal factors and maternal concurrent symptoms of anxiety and depression. Prenatal maternal very severe obesity is a strong predictor of increased neuropsychiatric problems in early childhood.

  13. A comparison of swallowing dysfunction in Becker muscular dystrophy and Duchenne muscular dystrophy.

    PubMed

    Yamada, Yuka; Kawakami, Michiyuki; Wada, Ayako; Otsuka, Tomoyoshi; Muraoka, Kaori; Liu, Meigen

    2018-06-01

    Swallowing dysfunction has been reported in Duchenne muscular dystrophy (DMD), but has not been studied in Becker muscular dystrophy (BMD). The aims of this study were to report the characteristics of swallowing dysfunction in BMD compared with DMD. The study participants were 18 patients with BMD and 18 patients with DMD. All the patients were examined using videofluorography during swallowing of 5 mL of fluid. The penetration-aspiration scale (P-A scale) and the videofluorographic dysphagia scale (VDS) were used to evaluate dysphagia. Swinyard functional ability stage was not significantly different between the BMD and DMD groups. Rate of aspiration, P-A scale score, and total VDS score did not differ across groups, but the VDS item score for laryngeal elevation was lower in the BMD group than in the DMD group (median scores 4.5 and 9, respectively; p < 0.001). In the BMD group, total VDS score significantly correlated with Swinyard stage (r = 0.78, p < 0.001), but not with age or lung function. Patients with BMD have swallowing problems similar to those observed in patients with DMD when matched according to physical functional status. These patients should be evaluated and followed-up for the duration of their disease. Implications for rehabiliation Dysphagia is one of the most critical problems in patients with progressive neuromuscular disease but dysphagia in patients with Becker muscular dystrophy (BMD) was not well known. Eighteen patients with BMD and 18 patients with Duchenne muscular dystrophy were examined with videofluorography. Patients with BMD have swallowing problems similar to those observed in patients with DMD.

  14. Pre-cessation depressive mood predicts failure to quit smoking: the role of coping and personality traits.

    PubMed

    Berlin, Ivan; Covey, Lirio S

    2006-12-01

    To examine whether mood, personality and coping predict smoking cessation and whether the associations of personality and coping are mediated through depressed mood. Multicenter (n = 8) smoking cessation trial. A total of 600 smokers (> or = 15 cigarettes/day) without current depression who participated in a smoking cessation study. The outcome was continuous abstinence during the last 4 weeks of the 3-month trial: depressed mood was measured by the Beck Depression Inventory (BDI), personality by the Revised NEO Personality Inventory (NEO-PI-R) and coping by the Revised Ways of Coping Checklist (RWCC). A total of 14.7% (88/600) were abstainers. Controlling for potential confounders, baseline BDI independently predicted smoking cessation. Smokers with BDI > or = 10 were less likely to quit than those with BDI < 10 (odds ratio: 6.39, 95% CI: 1.44-28.3, P = 0.01). Compared to BDI < 10 smokers, BDI > or = 10 smokers had significantly higher scores for neuroticism and lower scores for extraversion and conscientiousness (NEO-PI-R). On the RWCC, BDI > or = 10 smokers scored higher for blame self, wishful thinking and problem avoidance and they scored lower on problem focus than smokers with BDI < 10. A mediational analysis showed that neither personality traits nor coping skills predicted directly smoking cessation. However, low level of problem focusing and social support seeking predicted a negative outcome via depressed mood. A BDI score > or = 10, even in smokers who do not meet a current diagnosis of major depression, directly predicts inability to quit. This suggests the utility of assessing depression symptoms in routine smoking cessation care.

  15. Validating office-based screening for psychosocial strengths and difficulties among youths in foster care.

    PubMed

    Jee, Sandra H; Szilagyi, Moira; Conn, Anne-Marie; Nilsen, Wendy; Toth, Sheree; Baldwin, Constance D; Szilagyi, Peter G

    2011-05-01

    To assess the effectiveness of social-emotional screening in the primary care setting for youths in foster care. The setting was a primary care practice for all youth in home-based foster care in 1 county. Subjects were youths, aged 11 to 17 years, and their foster parents; both completed a Strengths and Difficulties Questionnaire at well-child visits. The Strengths and Difficulties Questionnaire is a previously validated 25-item tool that has 5 domains: emotional symptoms; conduct problems; hyperactivity/inattention; peer problems; and prosocial behaviors and an overall total difficulties score. We first compared youth versus parent Strengths and Difficulties Questionnaire scores and then assessed the accuracy of these Strengths and Difficulties Questionnaire scores by comparing them in a subsample of youths (n = 50) with results of home-based structured clinical interviews using the Children's Interview for Psychiatric Syndromes. Of 138 subjects with both youth and parent reports, 78% had prosocial behaviors (strengths), and 70% had 1 or more social-emotional problems. Parents reported significantly more conduct problems (38% vs 16%; P < .0001) and total difficulties (30% vs 16%; P = .002) than did youth. The Strengths and Difficulties Questionnaire had better agreement with the Children's Interview for Psychiatric Syndromes (n = 50) for any Strengths and Difficulties Questionnaire-identified problem for combined youth and foster-parent reports (93%), compared with youth report alone (54%) or parent report alone (71%). Although most youths in foster care have social-emotional problems, most have strengths as well. Youth and foster-parent perspectives on these problems differ. Systematic social-emotional screening in primary care that includes both youth and parent reports can identify youths who may benefit from services.

  16. Can the multiple mini-interview predict academic achievement in medical school?

    PubMed

    Kim, Ja Kyoung; Kang, Seok Hoon; Lee, Hee Jae; Yang, JeongHee

    2014-09-01

    The purpose of this study was to determine whether the multiple mini-interview (MMI) predicts academic achievement for subjects in a medical school curriculum. Of 49 students who were admitted in 2008, 46 students finished the entire medical education curriculum within 4 years. We calculated the Pearson correlation coefficients between the total MMI score of the 46 graduates and their academic achievements in all subjects of the curriculum. The correlation coefficients between total MMI score and academic achievement in Medical Interview and History Taking, Problem-Based Learning, Doctoring I, and Clinical Practice of Surgery ranged from 0.4 to 0.7, indicating that they were moderately related. The values between total MMI score and achievement in Research Overview, Technical and Procedural Skills, Clinical Performance Examinations 1 and 3, Clinical Practice of Laboratory Medicine and Psychiatry, Neurology, and Orthopedics ranged from 0.2 to 0.4, which meant that they were weakly related. MMI score can predict medical student' academic achievement in subjects in the medical humanities and clinical practice.

  17. Elevated manganese exposure and school-aged children's behavior: a gender-stratified analysis.

    PubMed

    Menezes-Filho, José A; de Carvalho-Vivas, Chrissie F; Viana, Gustavo F S; Ferreira, Junia R D; Nunes, Lorena S; Mergler, Donna; Abreu, Neander

    2014-12-01

    High levels of waterborne manganese have been associated with problematic behavior in school-aged children, however to date this has not been reported for children exposed to airborne manganese. The objective of the present study was to examine behavioral traits among children with exposure to airborne manganese from a ferro-manganese alloy plant, located in the metropolitan region of Salvador, Brazil. The study included 34 boys and 36 girls, aged 7-12 years, living in two communities within a 3-km radius from the plant. For each child, hair manganese levels (MnH) and blood lead (PbB) levels were analyzed by graphite furnace atomic absorption spectrometry. The Children's Behavior Check List (CBCL) (Portuguese version validated in Brazil) was administered to parents or caregivers, providing scale scores of internalizing (withdrawn, somatic complaints, and anxious/depressed scales), externalizing (disruptive and aggressive) behaviors and a separate scale for attention problems. Median and range for MnH and PbB were 11.48 μg/g (range: 0.52-55.74); 1.1 μg/dL (range: 0.5-6.1), respectively. Spearman correlation analyses showed that several behavioral indices were significantly correlated with MnH levels for girls, but not for boys: total externalizing behavior (rho=0.484 vs rho=0.041) and attention problem scores (rho=0.542 vs rho=0.003) coefficients were significantly at p<0.001 level, respectively for girls and boys. No significant correlation was observed with any of the internalizing sub-scales. A linear regression model was fitted with the total externalizing behavior, inattention and total CBCL scores as dependent variables, with log transformed MnH stratified by sex, adjusting for age and maternal IQ. Total externalizing behaviors and attention problem scores were significantly associated with girls' MnH levels but not with boys'. Adjusting for maternal IQ, the β-coefficients for LogMnH associations with total externalizing and attention problems are 8.85 (95%CI 2.44-15.24) and 4.03 (95%CI 1.50-6.56) for girls. For boys, after adjusting for age, the β-coefficients are 0.08 (95%CI 11.51-11.66) and -0.05 (95%CI 4.34-4.25), respectively. The findings of this study suggest a positive association between elevated Mn exposure and externalizing behavioral problems and inattention, with girls presenting more pronounced effects. Future studies on Mn exposure in children should attempt to further elucidate sex and/or gender differences in Mn exposed populations. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. The relationship between twelve-month home stimulation and school achievement.

    PubMed

    van Doorninck, W J; Caldwell, B M; Wright, C; Frankenburg, W K

    1981-09-01

    Home Observation for Measurement of the Environment (HOME) was designed to reflect parental support of early cognitive and socioemotional development. 12-month HOME scores were correlated with elementary school achievement, 5--9 years later. 50 low-income children were rank ordered by a weighted average of centile estimates of achievement test scores, letter grades, and curriculum levels in reading and math. 24 children were classified as having significant school achievement problems. The HOME total score correlated significantly, r = .37, with school centile scores among the low-income families. The statistically more appropriate contingency table analysis revealed a 68% correct classification rate and a significantly reduced error rate over random or blanket prediction. The results supported the predictive value of the 12-month HOME for school achievement among low-income families. In an additional sample of 21 middle-income families, there was insufficient variability among HOME scores to allow prediction. The HOME total scores were highly correlated, r = .86, among siblings tested at least 10 months apart.

  19. Women With Breast Cancer: Self-Reported Distress in Early Survivorship

    PubMed Central

    Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N.; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L.

    2015-01-01

    Purpose/Objectives To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Design Descriptive, cross-sectional. Setting A National Cancer Institute–designated comprehensive cancer center. Sample 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Methods Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Main Research Variables Distress scores, problem reports, and time groups. Findings Participants scored in range of the cutoff of more than 4 (range = 4.1–5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Conclusions Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Implications for Nursing Interventions to reduce or prevent distress may improve outcomes in early survivorship. PMID:25542330

  20. Assessing oral health-related quality of life in general dental practice in Scotland: validation of the OHIP-14.

    PubMed

    Fernandes, Marcelo José; Ruta, Danny Adolph; Ogden, Graham Richard; Pitts, Nigel Berry; Ogston, Simon Alexander

    2006-02-01

    To validate the Oral Health Impact Profile (OHIP)-14 in a sample of patients attending general dental practice. Patients with pathology-free impacted wisdom teeth were recruited from six general dental practices in Tayside, Scotland, and followed for a year to assess the development of problems related to impaction. The OHIP-14 was completed at baseline and at 1-year follow-up, and analysed using three different scoring methods: a summary score, a weighted and standardized score and the total number of problems reported. Instrument reliability was measured by assessing internal consistency and test-retest reliability. Construct validity was assessed using a number of variables. Linear regression was then used to model the relationship between OHIP-14 and all significantly correlated variables. Responsiveness was measured using the standardized response mean (SRM). Adjusted R(2)s and SRMs were calculated for each of the three scoring methods. Estimates for the differences between adjusted R(2)s and the differences between SRMs were obtained with 95% confidence intervals. A total of 278 and 169 patients completed the questionnaire at baseline and follow-up, respectively. Reliability - Cronbach's alpha coefficients ranged from 0.30 to 0.75. Alpha coefficients for all 14 items were 0.88 and 0.87 for baseline and follow-up, respectively. Test-retest coefficients ranged from 0.72 to 0.78. Validity - OHIP-14 scores were significantly correlated with number of teeth, education, main activity, the use of mouthwash, frequency of seeing a dentist, the reason for the last dental appointment, smoking, alcohol intake, pain and symptoms. Adjusted R(2)s ranged from 0.123 to 0.202 and there were no statistically significant differences between those for the three different scoring methods. Responsiveness - The SRMs ranged from 0.37 to 0.56 and there was a statistically significant difference between the summary scores method and the total number of problems method for symptomatic patients. The OHIP-14 is a valid and reliable measure of oral health-related quality of life in general dental practice and is responsive to third molar clinical change. The summary score method demonstrated performance as good as, or better than, the other methods studied.

  1. Adolescents' strengths and difficulties: approach to attachment styles.

    PubMed

    Keskin, G; Cam, O

    2010-06-01

    This research is a descriptive field study conducted in order to investigate the relationship between adolescent difficulties and the attachment style. The study aims to investigate the relationship between adolescent attachment style and strength and difficulties in Turkey. Children attachment style and difficulties pattern in the group of adolescents aged 11-16 years old were compared with each other. Several different questionnaires, including The Strength and Difficulties Questionnaire, The Relationship Scale Questionnaire were applied to 384 (mean age 12.10 +/- 1.4 years) adolescents. The data were analysed using descriptive statistics, Pearson correlation coefficients, anova, t-test, Kruskall Wallis and effect sizes. The adolescent secure attachment style was associated with increased levels of prosocial behaviour, decreased levels of emotional symptoms, hyperactivity/inattention, peer relationship problems, conduct problems, total difficulties scores. The adolescent fearful attachment style was associated with increased levels of emotional symptoms, and total difficulties scores. The adolescent dismissing attachment style was significantly associated with higher levels of emotional symptoms, hyperactivity/inattention, total difficulties scores and lower levels of prosocial behaviour. Adolescent strengths and difficulties are associated with their attachment style. Insecure attachment styles of dismissing and fearful were associated with increased mental symptom reporting. It is suggested that further studies may illuminate the clinical value of the attachment disorder and quantify parental contribution to psychopathology. Giving the therapeutic, structured mental support programme to adolescents that have attachment problems could be beneficial in improving mental status of these individuals.

  2. Emotion dysregulation and amygdala dopamine D2-type receptor availability in methamphetamine users.

    PubMed

    Okita, Kyoji; Ghahremani, Dara G; Payer, Doris E; Robertson, Chelsea L; Dean, Andy C; Mandelkern, Mark A; London, Edythe D

    2016-04-01

    Individuals who use methamphetamine chronically exhibit emotional and dopaminergic neurochemical deficits. Although the amygdala has an important role in emotion processing and receives dopaminergic innervation, little is known about how dopamine transmission in this region contributes to emotion regulation. This investigation aimed to evaluate emotion regulation in subjects who met DSM-IV criteria for methamphetamine dependence, and to test for a relationship between self-reports of difficulty in emotion regulation and D2-type dopamine receptor availability in the amygdala. Ninety-four methamphetamine-using and 102 healthy-control subjects completed the Difficulties in Emotion Regulation Scale (DERS); 33 of those who used methamphetamine completed the Addiction Severity Index (ASI). A subset of 27 methamphetamine-group and 20 control-group subjects completed positron emission tomography with [(18)F]fallypride to assay amygdala D2-type dopamine receptor availability, measured as binding potential (BPND). The methamphetamine group scored higher than the control group on the DERS total score (p<0.001), with DERS total score positively correlated with the Drug Composite Score on the ASI (p=0.02) in the methamphetamine group. The DERS total score was positively correlated with amygdala BPND in both groups and the combined group of participants (combined: r=0.331, p=0.02), and the groups did not differ in this relationship. These findings highlight problems with emotion regulation linked to methamphetamine use, possibly contributing to personal and interpersonal behavioral problems. They also suggest that D2-type dopamine receptors in the amygdala contribute to emotion regulation in both healthy and methamphetamine-using subjects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Emotion Dysregulation and Amygdala Dopamine D2-type Receptor Availability in Methamphetamine Users

    PubMed Central

    Okita, Kyoji; Ghahremani, Dara G.; Payer, Doris E.; Robertson, Chelsea L.; Dean, Andy C.; Mandelkern, Mark A.; London, Edythe D.

    2016-01-01

    Background Individuals who use methamphetamine chronically exhibit emotional and dopaminergic neurochemical deficits. Although the amygdala has an important role in emotion processing and receives dopaminergic innervation, little is known about how dopamine transmission in this region contributes to emotion regulation. This investigation aimed to evaluate emotion regulation in subjects who met DSM-IV criteria for methamphetamine dependence, and to test for a relationship between self-reports of difficulty in emotion regulation and D2-type dopamine receptor availability in the amygdala. Method Ninety-four methamphetamine-using and 102 healthy-control subjects completed the Difficulties in Emotion Regulation Scale (DERS); 33 of those who used methamphetamine completed the Addiction Severity Index (ASI). A subset of 27 methamphetamine-group and 20 control-group subjects completed positron emission tomography with [18F]fallypride to assay amygdala D2-type dopamine receptor availability, measured as binding potential (BPND). Results The methamphetamine group scored higher than the control group on the DERS total score (p < 0.001), with DERS total score positively correlated with the Drug Composite Score on the ASI (p = 0.02) in the methamphetamine group. The DERS total score was positively correlated with amygdala BPND in both groups and the combined group of participants (combined: r = 0.331, p = 0.02), and the groups did not differ in this relationship. Conclusion These findings highlight problems with emotion regulation linked to methamphetamine use, possibly contributing to personal and interpersonal behavioral problems. They also suggest that D2-type dopamine receptors in the amygdala contribute to emotion regulation in both healthy and methamphetamine-using subjects. PMID:26880595

  4. Autism characteristics and behavioural disturbances in ~ 500 children with Down's syndrome in England and Wales.

    PubMed

    Warner, Georgina; Moss, Joanna; Smith, Patrick; Howlin, Patricia

    2014-08-01

    Recent research shows that a significant minority of children with Down's syndrome (DS) also meet diagnostic criteria for an autism spectrum disorder (ASD). The present study investigated what proportion of children aged 6-15 years with a confirmed diagnosis of DS in England and Wales display autistic-type behaviours, and explored the characteristics of this group of children. The Social Communication Questionnaire (SCQ) was used to screen for autism characteristics and the Strengths and Difficulties Questionnaire (SDQ) to explore behavioural difficulties. The proportion of children who met the cut-off score for ASD on the SCQ (total score ≥ 15) was 37.7% (95% CI: 33.4-42.0%); for autism (total score ≥ 22) the proportion was 16.5% (95% CI: 13.2-19.8%). Children who met the cut-off for ASD were significantly more likely to be reported as having emotional symptoms, conduct problems and hyperactivity on the SDQ than children who scored well below cut-off (total score < 10). However, the profile of their autism characteristics on the SCQ was atypical compared with individuals with idiopathic ASD. The pervasiveness of ASD in children with DS in England and Wales is substantially higher than in the general population. These children also experience significantly greater behavioural problems than children with DS only. Early detection of autism characteristics is important for appropriate intervention. However, the unusual profile of autism characteristics in this group may affect the recognition of the disorder and hinder the implementation of appropriate interventions. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

  5. A Study of Reading Comprehension in Older Children Using Selected Korean Bible Translations

    ERIC Educational Resources Information Center

    Kim, Jae Woo

    2014-01-01

    Problem: The problem of this study was to determine the difference in Bible comprehension scores among gender-based groups of older children using selected passages from three Bible translations: the Children's Bible, the Easy Bible, and the New Revised Korean Bible. Procedures: A total of 288 older children in three churches (Beautiful Baptist…

  6. How good is Google? The quality of otolaryngology information on the internet.

    PubMed

    Pusz, Max D; Brietzke, Scott E

    2012-09-01

    To assess the quality of the information a patient (parent) may encounter using a Google search for typical otolaryngology ailments. Cross-sectional study. Tertiary care center. A Google keyword search was performed for 10 common otolaryngology problems including ear infection, hearing loss, tonsillitis, and so on. The top 10 search results for each were critically examined using the 16-item (1-5 scale) standardized DISCERN instrument. The DISCERN instrument was developed to assess the quality and comprehensiveness of patient treatment choice literature. A total of 100 Web sites were assessed. Of these, 19 (19%) were primarily advertisements for products and were excluded from DISCERN scoring. Searches for more typically chronic otolaryngic problems (eg, tinnitus, sleep apnea, etc) resulted in more biased, advertisement-type results than those for typically acute problems (eg, ear infection, sinus infection, P = .03). The search for "sleep apnea treatment" produced the highest scoring results (mean overall DISCERN score = 3.49, range = 1.81-4.56), and the search for "hoarseness treatment" produced the lowest scores (mean = 2.49, range = 1.56-3.56). Results from major comprehensive Web sites (WebMD, EMedicinehealth.com, Wikipedia, etc.) scored higher than other Web sites (mean DISCERN score = 3.46 vs 2.48, P < .001). There is marked variability in the quality of Web site information for the treatment of common otolaryngologic problems. Searches on more chronic problems resulted in a higher proportion of biased advertisement Web sites. Larger, comprehensive Web sites generally provided better information but were less than perfect in presenting complete information on treatment options.

  7. Culture, parenting, and child behavioral problems: a comparative study of cross-cultural immigrant families and native-born families in Taiwan.

    PubMed

    Yang, Hao-Jan; Kuo, Yi-Jin; Wang, Lee; Yang, Chien-Ying

    2014-08-01

    Little is known about the interplay of cultural, parenting, and sociodemographic/socioeconomic factors on children's behavioral problems, especially within culturally mixed families in Chinese society. This study compares the presence of behavioral problems between children from families with an immigrant mother and those from native-born families in a randomly selected sample of 957 children aged 6 to 12 years from three counties in central Taiwan. Behavioral problems were assessed using the Child Behavior Checklist completed by parents and the Teacher's Report Form. Parenting styles were assessed using the Parental Bonding Instrument completed by children. Children of immigrant mothers had higher scores for all behavioral syndromes based on the parent's report. However, in the teacher's report a difference was only observed for withdrawn/depressed syndrome. Children of immigrant mothers were more likely, and children with high paternal care were less likely, to have internalizing and total problems in the parent's report. For the teacher's report, only high education in fathers was associated with decreased internalizing and total problems in children. These findings suggest that children growing up in a cross-cultural environment with an immigrant mother, as opposed to a native-born Taiwanese family environment, are more likely to have higher internalizing problems and total behavioral problem scores, due to a number of cultural, parenting, and sociodemographic factors. Children's behaviors appear to be more influenced by fathers' than mothers' parenting styles, regardless of family type. The study findings imply that unequal health and social conditions exist between cross-cultural and native-born families. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Effects of internal displacement and resettlement on the mental health of Turkish children and adolescents.

    PubMed

    Erol, Neşe; Simşek, Zeynep; Oner, Ozgür; Munir, Kerim

    2005-03-01

    To evaluate the effects of internal displacement and resettlement within Turkey on the emotional and behavioral profile of children, age 5-18 after controlling for possible confounding and demographic variables. We conducted a national population survey using a self-weighted, equal probability sample. We compared the CBCL, TRF and YSR responses regarding children with (n = 1644) and without (n = 1855) experience of internal displacement. We examined the effects of gender, age, paternal employment, resettlement, urban residence and physical illness. The children and adolescents with internal displacement had significantly higher internalizing, externalizing and total problem scores on the CBCL and YSR, and higher internalizing scores on the TRF. The effect of displacement was related to higher internalizing problems when factors like physical illness, child age, child gender and urban residence were accounted. The overall effect was small explaining only 0.1-1.5% of the total variance by parent reports, and not evident by teacher reports. To our knowledge the present study is the first to examine Turkish children and adolescents with and without experience of internal displacement. The results are consistent with previous immigration studies: child age, gender, presence of physical illness and urban residence were more important predictors of internalization and externalization problem scores irrespective of informant source.

  9. Life events, locus of control, and behavioral problems among Chinese adolescents.

    PubMed

    Liu, X; Kurita, H; Uchiyama, M; Okawa, M; Liu, L; Ma, D

    2000-12-01

    This study examined associations of life events and locus of control with behavioral problems among 1,365 Chinese adolescents by using the Youth Self-Report (YSR), Adolescent Self-Rating Life Events Checklist (ASLEC), and the Nowicki-Strickland Locus of Control Scale for Children. Results indicated that the overall prevalence of behavioral and emotional problems was 10.7% (95% CI = 9.9-11.5%). Logistic-regression analyses showed that a total of 13 negative life events mainly coming from academic domain and interpersonal relationships, high life-stress score, and high external locus score significantly increased the risk for behavioral problems. Life stress and locus of control significantly interacted with behavioral problems. These findings support the linkage between stressful life events and psychopathology in a general population of adolescents from mainland China, and demonstrate the stress-moderating effects of locus of control on psychopathology as well.

  10. More Reasons to be Straightforward: Findings and Norms for Two Scales Relevant to Social Anxiety

    PubMed Central

    Rodebaugh, Thomas L.; Heimberg, Richard G.; Brown, Patrick J.; Fernandez, Katya C.; Blanco, Carlos; Schneier, Franklin R.; Liebowitz, Michael R.

    2011-01-01

    The validity of both the Social Interaction Anxiety Scale and Brief Fear of Negative Evaluation scale has been well-supported, yet the scales have a small number of reverse-scored items that may detract from the validity of their total scores. The current study investigates two characteristics of participants that may be associated with compromised validity of these items: higher age and lower levels of education. In community and clinical samples, the validity of each scale's reverse-scored items was moderated by age, years of education, or both. The straightforward items did not show this pattern. To encourage the use of the straightforward items of these scales, we provide normative data from the same samples as well as two large student samples. We contend that although response bias can be a substantial problem, the reverse-scored questions of these scales do not solve that problem and instead decrease overall validity. PMID:21388781

  11. Emotional distress is associated with poor self care in type 2 diabetes mellitus.

    PubMed

    Ogbera, Anthonia; Adeyemi-Doro, Adekunle

    2011-12-01

    The aim of the present study was to evaluate possible clinical and psychosocial variables that influence diabetes self-care management in patients with type 2 diabetes mellitus (T2DM). A total of 150 individuals with T2DM who had had diabetes for at least 6 months were recruited to this cross-sectional study. Levels of self-care and psychosocial status were determined using the Self-Care Inventory (SCI) and Problem Areas in Diabetes (PAID) scale. The PAID scores were calculated using a five-point Likert scale with options ranging from 0 (not a problem) to 4 (serious problem). Data were evaluated using non-parametric and parametric tests as appropriate. The mean age of the study participants was 69.97 ± 8.68 years. Cronbach's α for SCI and PAID scores was 0.85 and 0.98, respectively. People with poor glycemic control had significantly higher mean (±SD) total PAID scores than individuals with good glycemic control (29.5 ± 30.9 vs 16.7 ± 26.9, respectively; P = 0.012). There was a significant relationship between PAID scores and glycemic control (r = 0.2; P = 0.012). The present study demonstrates that psychosocial factors directly influence glycemic control and diabetes self-care habits. In addition, diabetes-specific distress in study population was unrelated to the duration of diabetes, the age of the patients and anthropometric indices. © 2011 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.

  12. Sixteen-year comparisons of parent-reported emotional and behaviour problems and competencies in Norwegian children aged 7-9 years.

    PubMed

    Nøvik, Torunn Stene; Jozefiak, Thomas

    2014-04-01

    Studies about changes in the prevalence of emotional and behaviour problems across time are lacking, especially among younger children. To determine if the level of parent-reported emotional and behaviour problems and competencies in young Norwegian school children had changed across a 16-year time interval. We compared parent reports obtained by the Child Behavior Checklist in two samples of children aged 7-9 years from the general population assessed in 1991 and 2007. The results demonstrated overall stability or slight decreases of emotional and behaviour problems and a significant increase in competencies, mainly due to increased activity and social competence scores in the 2007 sample. Boys obtained higher scores than girls in Total Problems, Externalizing and Attention problems at both time points and there was a high stability of the rank order of items. The findings suggest stability in child emotional and behaviour problems, and an increase of competencies across the period.

  13. Mental Health in School-Aged Children Prenatally Exposed to Alcohol and Other Substances

    PubMed Central

    Sandtorv, Lisbeth Beate; Hysing, Mari; Rognlid, Malin; Nilsen, Sondre Aasen; Elgen, Irene Bircow

    2017-01-01

    Prenatal exposure to substances can possibly influence a child’s neurodevelopment and may impact on subsequent mental health. We investigated the mental health status of school-aged children referred to a pediatric hospital with a history of prenatal exposure to alcohol or other substances. Mental health was assessed using the Strengths and Difficulties Questionnaire and compared with a reference group. A total of 105 of 128 (82%) eligible children prenatally exposed to substances participated in the study, with 48 children exposed to alcohol and 57 to other substances. Strengths and Difficulties Questionnaire subscale mean scores, total difficulties scores, and total impact scores were statistically significantly higher in the group of exposed children, compared with the reference group. In this hospital-based population of school-aged children prenatally exposed to alcohol or other substances, the exposed group had an increased risk of mental health problems, compared with the reference group. PMID:29581703

  14. Body dysmorphic factors and mental health problems in people seeking rhinoplastic surgery.

    PubMed

    Javanbakht, M; Nazari, A; Javanbakht, A; Moghaddam, L

    2012-02-01

    There has been increasing number of requests for cosmetic rhinoplastic surgery among Iranian people in different age groups in recent years. One risk for people who undergo such plastic operations is the presence of body dysmorphic disorder (BDD), which can complicate the result and decrease the rate of satisfaction from surgery. This study aimed to investigate mental health problems in people seeking rhinoplastic surgery. In this case-control study, the scores of General Health Questionnaire (GHQ) and DCQ (Dysmorphic Concerns Questionnaire) were obtained from 50 individuals who were candidates for rhinoplasty, and the results were compared with a normal control group. The total GHQ score and scores in anxiety, depression, and social dysfunction sub-scales were higher among the study group. This was the same for the DCQ score. However, the scores of somatization sub-scale of GHQ were not significantly different between the two groups. Psychiatric evaluation of candidates for rhinoplasty seems necessary for prevention of unnecessary and repetitive surgical operations.

  15. Family factors contributing to emotional and behavioral problems in Korean adolescents with epilepsy.

    PubMed

    Han, Su-Hyun; Lee, Sang-Ahm; Eom, Soyong; Kim, Heung-Dong

    2016-03-01

    We aimed to determine whether different aspects of family functioning are associated with emotional and behavioral problems in adolescents with epilepsy and, if not, to document any indirect associations mediated by other family factors. This was a cross-sectional, multicenter study. A total of 297 adolescents with epilepsy and their parents participated. Adolescent psychopathology was measured using the Youth Self-Report. Family factors were classified into proximal (parent-child interaction), distal (parent characteristics), and contextual factors (family characteristics) in accordance to their level of proximity to the adolescent's everyday life. Regression analyses were used to analyze the unique and combined predictive power of family factors in relation to psychopathology. In total, 44 (14.8%) and 51 (17.2%) adolescents with epilepsy scored above the borderline cutoff (T-score ≥ 60) of internalizing and externalizing problems, respectively. Proximal and distal factors were independently associated with both internalizing and externalizing problems. High levels of parental depressive mood and parental overcontrol were the strongest factors contributing to internalizing and externalizing problems, respectively. Contextual factors were indirectly associated with both internalizing and externalizing problems through more proximal factors. Both proximal and distal family factors affect psychopathology in Korean adolescents with epilepsy. Parental feelings of depression and parental overcontrol are the strongest factors contributing to internalizing and externalizing problems, respectively. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30.

    PubMed

    Ghandehari, Hasan; Mahabadi, Maryam Ameri; Mahdavi, Seyed Mani; Shahsavaripour, Ali; Seyed Tari, Hossein Vahid; Safdari, Farshad

    2015-04-01

    Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Cobb's angles and coronal balance. At the last visit, patients completed the SRS-30 questionnaire. We then assessed the correlation between radiographic measures, SRS-30 total score, and patient satisfaction. Cobb's angle and coronal balance improved significantly after surgery (P<0.001). The scores of functional activity, pain, self-image/cosmesis, mental health, and satisfaction were 27±4.3, 26±2.5, 33±5.2, 23±3.5, and 13±1.8, respectively. The total SRS-30 score was 127±13. Radiographic measures showed significant positive correlation with satisfaction and SRS-30 total scores. There was also a positive correlation between satisfaction and self-image/cosmesis domain scores. The greater the radiographic angles were corrected the higher the SRS-30 total score and patient satisfaction were. It is intuitive that the appearance and cosmesis is of most important factor associated with patient satisfaction.

  17. Measuring self-regulation in a physically active context: Psychometric analyses of scores derived from an observer-rated measure of self-regulation.

    PubMed

    Lakes, Kimberley D

    2013-10-01

    The purpose of this study is to report psychometric properties of scores obtained using a novel observer-rated measure of children's self-regulation, the Response to Challenge Scale (RCS). The RCS was developed to rate children's self-regulatory abilities in a physically active context (e.g., while completing a physical challenge course). The RCS and other study measures were administered in a private school sample of 207 children. Analyses of score distributions indicated that the RCS was able to capture variance among children in self-regulatory abilities; the distribution was normal for the Affective, Cognitive, and Total Self-Regulation scales. Validity analyses revealed significant positive correlations between Cognitive, Affective, Motor, and Total Self-Regulation and executive function task performance; significant negative correlations between Cognitive Regulation and teacher-rated hyperactivity and inattention; significant negative correlations between Affective, Motor, and Total Self-Regulation and teacher ratings of peer problems; and significant positive correlations between Cognitive and Affective Regulation and parent ratings of prosocial behavior. Parent and teacher rated Total Difficulties scores were both negatively correlated with RCS Total Self-Regulation scores. Results suggest that it is possible for observers to rate self-regulatory abilities in the context of physical activities, and that these ratings correspond with performance on tasks requiring executive function as well as teacher and parent ratings of children's difficulties.

  18. The relationships between migraine, depression, anxiety, stress, and sleep disturbances.

    PubMed

    Yalinay Dikmen, Pinar; Yavuz, Burcu Goksan; Aydinlar, Elif Ilgaz

    2015-06-01

    To assess the relationships between migraine, depression, anxiety, stress, and sleep problems. Psychiatric conditions and sleep disturbances are common in migraineurs. Depression, anxiety, stress, migraine, and sleep problems frequently coexist as comorbidities. Eighty-seven episodic migraineurs (62 females, 25 males; 32.8 ± 6.9) and 41 control subjects (25 females, 16 males; 31.5 ± 5.6) were prospectively enrolled for the study. The participants completed a sociodemographic data form and a migraine disability assessment scale (MIDAS), depression, anxiety, stress scale (DASS), and Pittsburg Sleep Quality Index (PSQI). In migraineurs, a significant positive correlation was found between PSQI total scores and MIDAS scores (migraine related disability for at least three consecutive months) (r = 0. 234, p = 0.04). Only 24.1 % of migraineus (n = 21) had minimal or no disability, 75.9 % of the patients (n = 66) had more than a little disability according to MIDAS scores. PSQI total scores were also correlated with pain intensity over a three month period (MIDAS B) (r = 0.221, p = 0.04). While PSQI scores were found significantly different between migraineurs and control subjects (5.5 ± 2.9 vs 4.5 ± 2.5; p = 0.04), the correlation of all the DASS subscale scores between the groups was not statistically significant. Our findings showed that episodic migraine was a risk factor on its own for sleep disturbances without comorbid depression, anxiety, and stress. Moreover, migraine-related disability and pain intensity in migraine attacks were related to poor sleep quality.

  19. A new mother-child play activity program to decrease parenting stress and improve child cognitive abilities: a cluster randomized controlled trial.

    PubMed

    Tachibana, Yoshiyuki; Fukushima, Ai; Saito, Hitomi; Yoneyama, Satoshi; Ushida, Kazuo; Yoneyama, Susumu; Kawashima, Ryuta

    2012-01-01

    We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial. Participants were 238 pairs of mothers and typically developing preschool children (ages 4-6 years old) from Wakakusa kindergarten in Japan. The pairs were asked to play at home for about 10 min a day, 5 days a week for 3 months. Participants were randomly assigned to the intervention or control group by class unit. The Parenting Stress Index (PSI) (for mothers), the Goodenough Draw-a-Man intelligence test (DAM), and the new S-S intelligence test (NS-SIT) (for children) were administered prior to and 3 months after the intervention period. Pre-post changes in test scores were compared between the groups using a linear mixed-effects model analysis. The primary outcomes were the Total score on the child domain of the PSI (for child psychosocial problems related to parenting stress), Total score on the parent domain of the PSI (for maternal psychosocial problems related to parenting stress), and the score on the DAM (for child cognitive abilities). The results of the PSI suggested that the program may reduce parenting stress. The results of the cognitive tests suggested that the program may improve the children's fluid intelligence, working memory, and processing speed. Our intervention program may ameliorate the children's psychosocial problems related to parenting stress and increase their cognitive abilities. UMIN Clinical Trials Registry UMIN000002265.

  20. A New Mother-Child Play Activity Program to Decrease Parenting Stress and Improve Child Cognitive Abilities: A Cluster Randomized Controlled Trial

    PubMed Central

    Tachibana, Yoshiyuki; Fukushima, Ai; Saito, Hitomi; Yoneyama, Satoshi; Ushida, Kazuo; Yoneyama, Susumu; Kawashima, Ryuta

    2012-01-01

    Background We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial. Methodology/Principal Findings Participants were 238 pairs of mothers and typically developing preschool children (ages 4–6 years old) from Wakakusa kindergarten in Japan. The pairs were asked to play at home for about 10 min a day, 5 days a week for 3 months. Participants were randomly assigned to the intervention or control group by class unit. The Parenting Stress Index (PSI) (for mothers), the Goodenough Draw-a-Man intelligence test (DAM), and the new S-S intelligence test (NS-SIT) (for children) were administered prior to and 3 months after the intervention period. Pre–post changes in test scores were compared between the groups using a linear mixed-effects model analysis. The primary outcomes were the Total score on the child domain of the PSI (for child psychosocial problems related to parenting stress), Total score on the parent domain of the PSI (for maternal psychosocial problems related to parenting stress), and the score on the DAM (for child cognitive abilities). The results of the PSI suggested that the program may reduce parenting stress. The results of the cognitive tests suggested that the program may improve the children's fluid intelligence, working memory, and processing speed. Conclusions/Significance Our intervention program may ameliorate the children's psychosocial problems related to parenting stress and increase their cognitive abilities. Trial Registration UMIN Clinical Trials Registry UMIN000002265 PMID:22848340

  1. Prevalence, course and determinants of carpal tunnel syndrome symptoms during pregnancy: a prospective study.

    PubMed

    Meems, M; Truijens, Sem; Spek, V; Visser, L H; Pop, V J M

    2015-07-01

    To investigate the prevalence, severity and relation to fluid retention of self-reported pregnancy-related carpal tunnel syndrome (CTS) symptoms in a large sample of pregnant women. A prospective longitudinal cohort study. Dutch women who became pregnant between January 2013 and January 2014 in the southeast of The Netherlands. A total of 639 Dutch pregnant women. Baseline characteristics were assessed at 12 weeks' gestation. CTS symptoms were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ) at 32 weeks and during the first postpartum week regarding the last weeks of pregnancy. Fluid retention, sleeping problems and depressive symptoms (using the Edinburgh Depression Scale) were assessed at several time points during pregnancy. BCTQ scores, fluid retention and sleeping problems. Of the 639 women, 219 (34%) reported CTS symptoms during pregnancy. Total mean scores on the BCTQ were significantly higher after 32 weeks' than up to 32 weeks' gestation. Most women experienced mild to moderate symptoms. Pregnant women with CTS symptoms reported significantly higher levels of fluid retention during gestation compared with pregnant women without CTS symptoms [F = 60.6, df (1598), P < 0.001], adjusted for body mass index (BMI), age, parity, and depression scores. Higher scores on fluid retention throughout the pregnancy were significantly related to CTS (OR = 1.8, 95%CI 1.5, 2.1, P < 0.001). Finally, the occurrence of CTS was independently related to sleeping problems. Although the severity of symptoms and functional impairment of CTS were relatively mild, health care professionals should be aware of the high prevalence. The occurrence of CTS symptoms is significantly higher in women who report fluid retention during gestation and it can contribute to sleeping problems. © 2015 Royal College of Obstetricians and Gynaecologists.

  2. Medical and psychosocial experiences of family caregivers with children fed enterally at home.

    PubMed

    Enrione, Evelyn B; Thomlison, Barbara; Rubin, Aviva

    2005-01-01

    Pediatric home enteral nutrition (HEN) studies that evaluate the psychosocial aspects of caregiving are limited. Overlooking the psychosocial needs of the caregiver may result in negative outcomes such as lack of adherence to the HEN regimen. This study determined whether caregivers report psychosocial situations more frequent and difficult to manage than medical situations. A questionnaire, which identified 10 psychosocial and 10 medical issues related to pediatric HEN, was mailed to 150 caregivers (37 responded), who rated the statements for frequency and difficulty. Each statement was ranked from most frequent/difficult to least frequent/difficult by mean cross-product score (frequency x difficulty). To indicate overall burden, a medical total composite score (MTCS) and a psychosocial total composite score (PTCS) were calculated by summing the cross-products of the respective problems. Paired t tests compared MTCS to PTCS and also the psychosocial frequency means and difficulty means to the same for the medical problems. Of the top 10 problems, 7 were psychosocial, whereas 3 were medical. Caregivers reported incidences of psychosocial problems more frequently (p < .003) than medical problems, and they had more difficulty (p < .001) with the psychosocial situations than with the medical ones. The PTCS was significantly higher (p < .001) than the MTCS. The psychosocial situations were perceived as causing a greater burden and greater difficulty in coping with everyday life. Health professionals need to understand and address the psychosocial difficulties of the caregiver in order to provide support for the caregiver and promote positive growth and development of the child.

  3. Is relatively young age within a school year a risk factor for mental health problems and poor school performance? A population-based cross-sectional study of adolescents in Oslo, Norway.

    PubMed

    Lien, Lars; Tambs, Kristian; Oppedal, Brit; Heyerdahl, Sonja; Bjertness, Espen

    2005-10-05

    Several studies have shown that children who are relatively young within a school year are at greater risk for poorer school performance compared with their older peers. One study also reported that relative age within a school year is an independent risk factor for emotional and behavioral problems. The objective of this study was to test the hypothesis that relatively younger adolescents in the multiethnic population of Oslo have poorer school performance and more mental health problems than their relatively older classmates within the same school year. This population-based cross-sectional study included all 10th-grade pupils enrolled in 2000 and 2001 in the city of Oslo. The participation rate was 88%. Of the 6,752 pupils in the study sample, 25% had a non-Norwegian background. Mental health problems were quantified using the abbreviated versions of Symptom Check List-25 (SCL-10) and the Strength and Difficulties Questionnaire (SDQ). Information on school performances and mental health problems were self-reported. We controlled for confounding factors including parental educational level, social support, gender, and ethnicity. The youngest one-third of pupils had significantly lower average school grades than the middle one-third and oldest one-third of their classmates (p < 0.001). Of the mental health problems identified in the questionnaires, the groups differed only on peer problems; the youngest one-third reported significantly more problems than the middle and oldest groups (p < 0.05). Age within a school year and gender showed significant interactions with total SDQ score, SDQ peer problems score, SDQ pro social score, and SCL-10 score. After stratifying for gender, the peer problem scores differed significantly between age groups only among boys. The SCL-10 score was significant, but only in girls and in the opposite direction to that expected, with the oldest pupils having significantly higher scores than the other two groups (p < 0.05). In adolescents from a multicultural city in Norway, relative age within a school year significantly influenced academic performance. In contrast to data from Great Britain, relative age within a school year was not an important risk factor for mental health problems in adolescents in Oslo.

  4. [Parenting stress and the reliability of parental information in the diagnostics of children and adolescents with symptoms of psychiatric and behavioral disorders].

    PubMed

    Irlbauer-Müller, Viktoria; Eichler, Anna; Stemmler, Mark; Moll, Gunther H; Kratz, Oliver

    2017-07-01

    Information from parents is regularly used in the diagnostic process of children and adolescents with psychiatric symptoms. But the reliability of this information is debatable, because the parents’ own stress can distort their perceptions of the child’s symptoms. For each of N = 68 children and adolescents (11–18 years) who were using mental health services for the first time, we evaluated the ratings of a parent and a professional clinician (internalizing, externalizing symptoms, total-problem score). In addition, parenting stress was scored on the Eltern-Belastungs-Inventars (EBI, Tröster, 2011), which measures both child-related stress and parent-related stress as well as total stress. Highly stressed parent ratings differed more from the clinicians’ ratings than the ratings of less stressed parents. Additionally, correlations showed that higher parenting stress resulted in larger differences between the parent’s and the clinician’s assessments. Multiple regressions proved the predictive value of child-caused parenting stress for these differences. These results apply for internalizing symptoms, externalizing symptoms, and total-problem score. Parenting stress should be evaluated systematically in order to carefully assess the value of the information from parents and to determine how it should be included in diagnostic and therapeutical decisions.

  5. The relation between child feeding problems as measured by parental report and mealtime behavior observation: A pilot study.

    PubMed

    van Dijk, Marijn; Bruinsma, Eke; Hauser, M Paulina

    2016-04-01

    Because feeding problems have clear negative consequences for both child and caretakers, early diagnosis and intervention are important. Parent-report questionnaires can contribute to early identification, because they are efficient and typically offer a 'holistic' perspective of the child's eating in different contexts. In this pilot study, we aim to explore the concurrent validity of a short screening instrument (the SEP, which is the Dutch MCH-FS) in one of its target populations (a group of premature children) by comparing the total score with the observed behavior of the child and caretaker during a regular home meal. 28 toddlers (aged 9-18 months) and their caretakers participated in the study. Video-observations of the meals were coded for categories of eating behavior and parent-child interaction. The results show that the total SEP-score correlates with food refusal, feeding efficiency, and self-feeding, but not with negative affect and parental instructions. This confirms that the SEP has a certain degree of concurrent validity in the sense that its total score is associated with specific 'benchmark' feeding behaviors: food refusal, feeding efficiency and autonomy. Future studies with larger samples are needed to generalize the findings from this pilot to a broader context. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Normative Data of the Self-Report Version of the German Strengths and Difficulties Questionnaire in an Epidemiological Setting.

    PubMed

    Becker, Andreas; Wang, Biyao; Kunze, Barbara; Otto, Christiane; Schlack, Robert; Hölling, Heike; Ravens-Sieberer, Ulrike; Klasen, Fionna; Rogge, Jana; Isensee, Corinna; Rothenberger, Aribert; Bella Study Group, The

    2018-05-30

    This study served to establish German norms for the Strengths and Difficulties Questionnaire self-report (SDQ-S) by using data from a representative epidemiological sample from the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS study). Although the German version of the SDQ has been widely used and normative data for the parent version (SDQ-P) exist, no German norms for the self-report version have been reported, so that practitioners had to rely on the available British norms. In addition, we investigated whether sex- and age-specific norms are necessary. At the baseline of the KiGGS study, SDQ-S ratings were collected from n = 6,726 children and adolescents between 11 and 17 years (n = 3,440 boys und n = 3,286 girls). We assessed the internal consistency and age/sex effects of the SDQ-S. Confirmatory factor analysis was conducted to assess the factor structure of the SDQ-S. Banding scores were developed to differentiate children and adolescents with levels of difficulties and categorized them as "normal," "borderline," and "abnormal." General as well as age- and sex-specific bandings were created for both total score and subscales of SDQ-S. In addition, the German norms of the SDQ-S were compared with those of the UK, Norway, and Thailand. The five-factor solution of the SDQ-S (including Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer problems, and Prosocial behavior) provided a satisfactory fit to the data. Moderate internal consistencies (Cronbach's α) were observed for the scales Emotional symptoms, Hyperactivity/Inattention, and Total difficulties score, whereas insufficient internal consistency was found for the scales Peer problems and Conduct problems. However, using McDonald's ω as a more appropriate measure of homogeneity, internal consistencies were found to be satisfactory for all subscales and for Total difficulties. Normative banding scores were established conservatively to avoid producing too many false positives in the category "abnormal." In line with previous research, girls showed more emotional problems but fewer Peer problems than boys. German normative bandings of SDQ-S were similar to the original British bandings and those of other countries. This study of the German SDQ-S in a large representative epidemiological sample presents evidence of partly moderate to good psychometric properties. It also supports the usefulness of SDQ-S as an effective and efficient instrument for child and adolescent mental health problems in Germany. German normative banding scores of SDQ-S established in this study were comparable with the original British norms as well as with those of other countries, so that SDQ-S can be recommended as a psychopathological broadband-screening tool.

  7. Predictive value of general movements' quality in low-risk infants for minor neurological dysfunction and behavioural problems at preschool age.

    PubMed

    Bennema, Anne N; Schendelaar, Pamela; Seggers, Jorien; Haadsma, Maaike L; Heineman, Maas Jan; Hadders-Algra, Mijna

    2016-03-01

    General movement (GM) assessment is a well-established tool to predict cerebral palsy in high-risk infants. Little is known on the predictive value of GM assessment in low-risk populations. To assess the predictive value of GM quality in early infancy for the development of the clinically relevant form of minor neurological dysfunction (complex MND) and behavioral problems at preschool age. Prospective cohort study. A total of 216 members of the prospective Groningen Assisted Reproductive Techniques (ART) cohort study were included in this study. ART did not affect neurodevelopmental outcome of these relatively low-risk infants born to subfertile parents. GM quality was determined at 2 weeks and 3 months. At 18 months and 4 years, the Hempel neurological examination was used to assess MND. At 4 years, parents completed the Child Behavior Checklist; this resulted in the total problem score (TPS), internalizing problem score (IPS), and externalizing problem score (EPS). Predictive values of definitely (DA) and mildly (MA) abnormal GMs were calculated. DA GMs at 2 weeks were associated with complex MND at 18 months and atypical TPS and IPS at 4 years (all p<0.05). Sensitivity and positive predictive value of DA GMs at 2 weeks were rather low (13%-60%); specificity and negative predictive value were excellent (92%-99%). DA GMs at 3 months occurred too infrequently to calculate prediction. MA GMs were not associated with outcome. GM quality as a single predictor for complex MND and behavioral problems at preschool age has limited clinical value in children at low risk for developmental disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Epidemiological survey of mental health in adolescent school children of Gujarat, India.

    PubMed

    Nair, Sandhya; Ganjiwale, Jaishree; Kharod, Nikhil; Varma, Jagdish; Nimbalkar, Somashekhar Marutirao

    2017-01-01

    Mental health problems in adolescents are inadequately researched in low-resource settings. We aimed in this study to assess the prevalence of mental health problems and correlates in school children aged 13-17 years and compare differences between urban and rural schools in Anand District, Gujarat. A cross-sectional study was conducted in five Gujarati medium higher secondary schools in Anand, Gujarat. Six hundred and ninety-three students with equal distribution of boys and girls belonging to 9th to 12th grades were included in the study. Strengths and Difficulties Questionnaire (SDQ) was used to assess the mental health status of the students, and total difficulties scoring was used to categorise participants into normal (0-15) and high (borderline (16-19) and abnormal (20-40)). Socio-demographic data and Teenage Screening Questionnaire-Trivandrum (TSQ) were used to assess associated medical and psychosocial factors. Clearance was obtained from the institutional ethics committee before conducting the study. 15% participants had a high SDQ score. Girls had more emotional problems, while the rest of the mental health problems were more prevalent in boys. Rural children were found to have more mental health issues. Having an eye problem, scoring <50% in last annual examinations, failure in examinations, difficulties in studying at home and difficulties in relationships were associated with high SDQ score. Keeping physically fit and having friends were associated with normal SDQ score. Logistic regression model revealed that age, receiving punishment in form of more homework and difficulty discussing friends with parents increased odds of high SDQ score, while having friends and after-school entertainment like watching movies decreased odds of high SDQ score. At least one in eight adolescents in this study was at risk of mental health problems. SDQ self-report questionnaire and TSQ survey may be used as a screening modality to identify at-risk students.

  9. A comparative assessment of generalized anxiety, conduct and peer relationship problems among AIDS and other orphaned children in India.

    PubMed

    Sg, Prem Kumar; G, Anil Kumar; Sp, Ramgopal; V, Venkata Srinivas; Dandona, Rakhi

    2016-09-21

    Data on mental health among orphaned children in India are scanty. We compared the generalized anxiety, conduct and peer relationship problems and their associated risk factors among children orphaned by HIV/AIDS and those due to other reasons in the Indian city of Hyderabad. Four hundred orphaned children aged 12 to 16 years residing in orphanages in Hyderabad were sampled, half being AIDS orphans (COA) and the rest orphaned due to other reasons (COO). Interviews were done using standardized scales to assess generalized anxiety, conduct and peer relationship problems. A score >8, >4, and >5 was considered as indicator of generalized anxiety, conduct problem and peer relationship problem, respectively. Variations in the intensity of these three conditions due to possible factors including co-existing depression were assessed using multiple classification analysis (MCA). A total of 396 (99.3 %) orphans participated of whom 199 (50.3 %) were COA. The mean generalized anxiety, conduct and peer relationship problem scores were 11.1 (SD 5.2), 3.8 (SD 2.5) and 3.8 (SD 2.5) for COA; and 7.6 (SD 4), 2.6 (SD 2) and 2.3 (SD 1.8) for COO, respectively. Among COA, the prevalence of generalized anxiety score of >8 was 74.4 % (95 % CI 67.8-80.0 %), of conduct problem score of >4 was 33.2 % (95 % CI 26.9-40.1 %), and of peer relationship problem score of >5 was 27.6 %, (95 % CI 21.8-34.3 %), with these being significantly lower in COO. In MCA, a higher mean depression score had the highest effect on the intensity of generalized anxiety, conduct and peer relationship problem (Beta 0.477; 0.379 and 0.453 respectively); being COA and a girl had the most impact on generalized anxiety (0.100 and 0.115, respectively). A significantly high proportion of AIDS orphans deal with generalized anxiety, conduct and peer relationship problem as compared with other orphans highlighting the need to address the poor mental health of orphans in India.

  10. Protective Role of Parenting Attitude on the Behavioral and Neurocognitive Development of the Children from Economically Disadvantaged Families.

    PubMed

    Jung, Da-Eun; Bhang, Soo-Young; Lee, Won-Hye; Yoon, Hae-Joo; Jung, Hee-Yeon; Kim, Yeni

    2018-06-01

    Association between home environment and the behavioral and neurocognitive development of children from a community childcare center for low-income families was examined (aged 6 to 12 years, n=155). The parents performed a questionnaire on home environment (K-HOME-Q) to assess home environment including parenting attitude and the Child Behavior Checklist (K-CBCL). The children performed the Wechsler Intelligence (IQ) Scale, Stroop interference test (Stroop), word fluency test (WF), and design fluency test (DF) to assess their neurocognitive development. 'Nurturing of Development' and 'Variety of Language Interaction' scores from the K-HOME-Q, were inversely associated with total behavior problems, externalization, rule-breaking, and aggressive behavior subscales of K-CBCL, and 'Emotional atmosphere' and 'Tolerance toward the child' scores showed inverse associations with the total behavior problems, rule-breaking, aggressive behavior, and withdrawn/depressed subscales. Despite economic hardship, the mean scores of the neurocognitive tests were comparable to the average level of Korean children's normative sample. However, 'Nurturing of Development' and 'Tolerance toward the Child' score of K-HOME-Q were associated with better executive function (IQ, WF, DF). These results suggest that parental stimulation of development and tolerant parenting attitude may offer protection against the negative effects of suboptimal economic environment on children's behavior and neurocognitive development.

  11. The role of attachment relationship in adolescents' problem behavior development: a cross-sectional study of Kenyan adolescents in Nairobi city.

    PubMed

    Wambua, Grace Nduku; Obondo, Anne; Bifulco, Antonia; Kumar, Manasi

    2018-01-01

    There is a significant link between insecure attachment and the development of psychopathology in adolescence. We investigated the relationship between adolescent attachment styles and the development of emotional and behavioral problems among adolescents in Kenya. We also examined the modifying influence of socio-economic-status (SES). One hundred and thirty-seven adolescents who were attending two schools participated in the study. One school (low SES school) catered for children from predominantly low-income households, while the second school (middle SES school) catered for children from predominantly middle-income households. The data were collected using three instruments: researcher designed questionnaire to obtain socio-demographic information, the Strength and Difficulties Questionnaire (SDQ) that is designed to assess symptoms of disorder, and the Vulnerable Attachment Scale Questionnaire (VASQ) that is designed to measure attachment style. Adolescents from the low SES school had higher vulnerable attachment scores than those from the middle SES school ( t (135) = - 2.5, P  =  0.02 ). Male students had higher vulnerable attachment scores than females ( P  =  0.03 ). Adolescents who had experienced adversity in childhood had higher vulnerable attachment scores than those who had not ( P  <  0.00 ). Results from Pearson's correlation showed moderate to strong positive correlations between attachment insecurity and emotional and behavioral problems with participants who had higher emotional symptoms (r = 0.47, P  < 0.01), conduct problem score (r = 0.33, P  < 0.01), hyperactivity (r = 0.26, P  < 0.01) and total difficulty scores (r = 0.47, P  < 0.01), experiencing significantly higher levels of attachment insecurity than those with lower scores. This study supports the notion that attachment insecurity increases the adolescents' susceptibility to develop psychological problems.

  12. Sleep habits and disturbances in Malaysian children with epilepsy.

    PubMed

    Ong, Lai Choo; Yang, Wai Wai; Wong, Sau Wei; alSiddiq, Feizel; Khu, Yi Soon

    2010-03-01

    To compare sleep habits and disturbances between Malaysian children with epilepsy and their siblings (age range 4-18 years) and to determine the factors associated with greater sleep disturbance. The Sleep Disturbance Scale for Children (SDSC) questionnaire was completed by the primary caregiver for 92 epileptic children (mean age 11.1 years, 50 male, 42 females) and their healthy siblings (mean age 11.1 years, 47 males, 45 females). Details of sleep arrangements and illness severity were obtained. Multiple regression analysis was used to determine factors associated with high Total SDSC scores in epileptic patients. Compared with their siblings, epileptic children had significantly higher total SDSC score (difference between means 8.7, 95% confidence interval (CI) 6.4-11.1) and subscale scores in disorders of initiating and maintaining sleep (3.9, 95% CI 2.8-5.2), sleep-wake transition disorders (2.1, 95% CI 1.3-2.9), sleep-disordered breathing (0.7, 95% CI 0.3-1.1) and disorders of excessive sleepiness (1.5, 95% CI 0.6-2.4). Epileptic children had a higher prevalence of co-sleeping (73.7% vs 31.5%) and on more nights per week (difference between means 3, 95% CI 2.0-3.9) than their siblings. Higher Epilepsy Illness Severity scores were associated with higher total SDSC scores (P= 0.02). Co-sleeping was highly prevalent in children with epilepsy, who also had more sleep disturbances (especially problems with initiating and maintaining sleep and sleep-wake transition disorders) than their siblings. Epilepsy severity contributed to the sleep disturbances. Evaluation of sleep problems should form part of the comprehensive care of children with severe epilepsy.

  13. Addiction-Like Mobile Phone Behavior – Validation and Association With Problem Gambling

    PubMed Central

    Fransson, Andreas; Chóliz, Mariano; Håkansson, Anders

    2018-01-01

    Mobile phone use and its potential addiction has become a point of interest within the research community. The aim of the study was to translate and validate the Test of Mobile Dependence (TMD), and to investigate if there are any associations between mobile phone use and problem gambling. This was a cross-sectional study on a Swedish general population. A questionnaire consisting of a translated version of the TMD, three problem gambling questions (NODS-CLiP) together with two questions concerning previous addiction treatment was published online. Exploratory factor analysis based on polychoric correlations was performed on the TMD. Independent samples T-tests, Mann-Whitney test, logistic regression analyses and ANOVA were performed to examine mean differences between subjects based on TMD test score, gambling and previous addiction treatment. A total of 1,515 people (38.3% men) answered the questionnaire. The TMD showed acceptable internal consistency (Cronbach's alpha: 0.905), and significant correlation with subjective dependence on one's mobile phone. Women scored higher on the TMD and 15-18 year olds had the highest mean test score. The TMD test score was significantly associated with problem gambling, but only when controlling for age and sex. Various separated items related to mobile phone use were associated with problem gambling. The TMD had acceptable internal consistency and correlates with subjective dependence, while future confirmatory factor analysis is recommended. An association between mobile phone use and problem gambling may be possible, but requires further research. PMID:29780345

  14. Addiction-Like Mobile Phone Behavior - Validation and Association With Problem Gambling.

    PubMed

    Fransson, Andreas; Chóliz, Mariano; Håkansson, Anders

    2018-01-01

    Mobile phone use and its potential addiction has become a point of interest within the research community. The aim of the study was to translate and validate the Test of Mobile Dependence (TMD), and to investigate if there are any associations between mobile phone use and problem gambling. This was a cross-sectional study on a Swedish general population. A questionnaire consisting of a translated version of the TMD, three problem gambling questions (NODS-CLiP) together with two questions concerning previous addiction treatment was published online. Exploratory factor analysis based on polychoric correlations was performed on the TMD. Independent samples T -tests, Mann-Whitney test, logistic regression analyses and ANOVA were performed to examine mean differences between subjects based on TMD test score, gambling and previous addiction treatment. A total of 1,515 people (38.3% men) answered the questionnaire. The TMD showed acceptable internal consistency (Cronbach's alpha: 0.905), and significant correlation with subjective dependence on one's mobile phone. Women scored higher on the TMD and 15-18 year olds had the highest mean test score. The TMD test score was significantly associated with problem gambling, but only when controlling for age and sex. Various separated items related to mobile phone use were associated with problem gambling. The TMD had acceptable internal consistency and correlates with subjective dependence, while future confirmatory factor analysis is recommended. An association between mobile phone use and problem gambling may be possible, but requires further research.

  15. Long-term follow-up of mental health, health-related quality of life and associations with motor skills in young adults born preterm with very low birth weight.

    PubMed

    Husby, Ingrid Marie; Stray, Kaia Mølbach-Thellefsen; Olsen, Alexander; Lydersen, Stian; Indredavik, Marit Sæbø; Brubakk, Ann-Mari; Skranes, Jon; Evensen, Kari Anne I

    2016-04-07

    Being born with very low birth weight (VLBW: ≤ 1,500 g) is related to long-term disability and neurodevelopmental problems, possibly affecting mental health and health-related quality of life (HRQoL). However, studies in young adulthood yield mixed findings. The aim of this study was to examine mental health and HRQoL at 23 years, including changes from 20 to 23 years and associations with motor skills in VLBW young adults compared with controls. In a geographically based follow-up study, 35 VLBW and 37 term-born young adults were assessed at 23 years by using Achenbach Adult Self-Report (ASR), Short Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI) and various motor tests. The ASR and SF-36 were also used at 20 years. Longitudinal changes in ASR and SF-36 from 20 to 23 years were analysed by linear mixed models and associations with motor skills at 23 years by linear regression. At 23 years, total ASR score was 38.6 (SD: 21.7) in the VLBW group compared with 29.0 (SD: 18.6) in the control group (p = 0.048). VLBW participants had higher scores for attention problems, internalizing problems and critical items, and they reported to drink less alcohol than controls. BDI total score did not differ between groups. On SF-36, VLBW participants reported significantly poorer physical and social functioning, more role-limitations due to physical and emotional problems, more bodily pain and lower physical and mental component summaries than controls. In the VLBW group, total ASR score increased by 9.0 (95 % CI: 3.3 to 14.7) points from 20 to 23 years (p = 0.009 vs controls), physical and mental component summaries of SF-36 decreased by 2.9 (95 % CI: -4.8 to -1.1) and 4.4 (95 % CI: -7.1 to -1.7) points, respectively (p = 0.012 and p = 0.022 vs controls). Among VLBW participants, more mental health problems and lower physical and mental HRQoL were associated with poorer motor skills at 23 years. VLBW young adults reported poorer and declining mental health and HRQoL in the transitional phase into adulthood. They seemed to have a cautious lifestyle with more internalizing problems and less alcohol use. The associations of mental health problems and HRQoL with motor skills are likely to reflect a shared aetiology.

  16. Age- and sex-related emotional and behavioral problems in children with autism spectrum disorders: comparison with control children.

    PubMed

    Horiuchi, Fumie; Oka, Yasunori; Uno, Hiroyuki; Kawabe, Kentaro; Okada, Fumi; Saito, Isao; Tanigawa, Takeshi; Ueno, Shu-ichi

    2014-07-01

    Children with autism spectrum disorders (ASD) often present with emotional and behavioral problems, which could change the clinical course, especially during childhood, and affect future quality of life. The aim of this study was to clarify the age- and sex-related differences of these problems in ASD. The study subjects were 173 patients with ASD (age: 4-16 years) and 173 age- and sex-matched community children (control group). The parent version of the Strengths and Difficulties Questionnaire was used for comparison of the emotional and behavioral problems between the two groups. The Strengths and Difficulties Questionnaire scores were significantly higher in children with ASD than controls at all ages. The score of total difficulties was significantly higher in girls with ASD than in boys, while the score in male controls was significantly higher than in female controls. Age-related differences in emotional and behavioral problems were observed both in children with ASD and controls, but the characteristics were different: in children with ASD, emotional symptoms and peer problems in both sexes and conduct problems in girls increased significantly with age, while none of the problems in the controls changed with age except for a decrease in the score of hyperactivity/inattention developmentally in both sexes. Prosocial behaviors of children with ASD and controls showed small changes with age. Emotional and behavioral problems are common in children with ASD and showed age- and sex-related differences. Our study emphasizes the importance of recognizing those differences among children with ASD for early intervention. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  17. Emotional development in children with tics: a longitudinal population-based study.

    PubMed

    Hoekstra, P J; Lundervold, A J; Lie, S A; Gillberg, C; Plessen, Kerstin J

    2013-03-01

    Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the developmental trajectory of children with and without tics when they were 7-9 years old. Parents and teachers completed the strengths and difficulties questionnaire (SDQ) when the children were 7-9 years (wave 1) and 4 years later (wave 2). Using strict criteria, we identified 38 children with tics in the cohort of 4,025 children (0.94% of the total cohort) with a preponderance of boys (78.9%). 22 children (57.9%) in the group with tics had only motor tics, and 16 (42.1%) had both motor and vocal tics. Children with tics had significantly higher parent- and teacher-rated SDQ total difficulty scores and subscale scores in both waves. Children with tics experienced an increase in emotional problems and in peer problems between the first and the second wave. This study in a general population indicates that the presence of tics is associated with a range of internalizing and externalizing difficulties, as well as problems in peer relationships. Moreover, our study indicates that emotional and peer problems tend to increase over time in the group of children with tics.

  18. Physiological and psychological symptoms of grief in widows.

    PubMed

    Kowalski, Susan D; Bondmass, Mary D

    2008-02-01

    In this cross-sectional descriptive survey of 173 widows, we describe their grief symptoms using an open-ended questionnaire and the Revised Grief Experience Inventory. Self-reported physical symptoms included pain, gastro-intestinal problems, medical/surgical conditions, sleep disturbances, and neurological/circulatory issues. Psychological symptoms were reported as depression, anxiety, and loneliness. The mean total grief score was 71.4 +/- 30.2 (possible range 22-132). Physical symptoms were significantly correlated with the total mean grief score, and subscales of physical distress, depression, existential tension, and guilt. When the subjects were grouped by years since loss, (range 1-5 years), there was no significant decrease found in overall grief scores, suggesting symptoms of grief experienced by widows may continue up to at least 5 years. (c) 2007 Wiley Periodicals, Inc.

  19. Validation of Toolkit After-Death Bereaved Family Member Interview.

    PubMed

    Teno, J M; Clarridge, B; Casey, V; Edgman-Levitan, S; Fowler, J

    2001-09-01

    The purpose of this study was to examine the reliability and validity of the Toolkit After-Death Bereaved Family Member Interview to measure quality of care at the end of life from the unique perspective of family members. The survey included proposed problem scores (a count of the opportunity to improve the quality of care) and scales. Data were collected through a retrospective telephone survey with a family member who was interviewed between 3 and 6 months after the death of the patient. The setting was an outpatient hospice service, a consortium of nursing homes, and a hospital in New England. One hundred fifty-six family members from across these settings participated. The 8 proposed domains of care, as represented by problem scores or scales, were based on a conceptual model of patient-focused, family-centered medical care. The survey design emphasized face validity in order to provide actionable information to health care providers. A correlational and factor analysis was undertaken of the 8 proposed problem scores or scales. Cronbach's alpha scores varied from 0.58 to 0.87, with two problem scores (each of which had only 3 survey items) having a low alpha of 0.58. The mean item-to-total correlations for the other problem scores varied from 0.36 to 0.69, and the mean item-to-item correlations were between 0.32 and 0.70. The proposed problem scores or scales, with the exception of closure and advance care planning, demonstrated a moderate correlation (i.e., from 0.44 to 0.52) with the overall rating of satisfaction (as measured by a five-point, "excellent" to "poor" scale). Family members of persons who died with hospice service reported fewer problems in each of the six domains of medical care, gave a higher rating of the quality of care, and reported higher self-efficacy in caring for their loved ones. These results indicate that 7 of the 8 proposed problem scores or scales demonstrated psychometric properties that warrant further testing. The domain of closure demonstrated a poor correlation with overall satisfaction and requires further work. This survey could provide information to help guide quality improvement efforts to enhance the care of the dying.

  20. Parental Post-Traumatic Stress Symptoms as Predictors of Psychosocial Problems in Children Treated for Cancer

    PubMed Central

    Nakajima-Yamaguchi, Ryoko; Morita, Nobuaki; Nakao, Tomohei; Shimizu, Takashi; Ogai, Yasukazu; Takahashi, Hideto; Saito, Tamaki; Nakatani, Yoji; Fukushima, Takashi

    2016-01-01

    The purpose of this study was to explore the association between psychosocial functioning of children treated for cancer and that of their parents. Factors associated with psychosocial functioning were also examined. The present study was a cross-sectional survey of 33 mothers and one father (mean age: 37.9), each of whom had a child that had been treated for cancer. The participants answered a package of questionnaires consisting of the Impact of Event Scale-Revised (IES-R), the Parent Experience of Child Illness (PECI), and the Child Behavior Checklist (CBCL). Information about the children’s illnesses was collected from medical records. The CBCL total problems T score was correlated with the parental IES-R total scores. Intensity of treatment independently predicted the variance of parental long-term uncertainty. In conclusion, psychosocial problems of children with cancer were associated with parental post-traumatic stress symptoms (PTSS). Provision of early, adequate support to parents who are vulnerable to PTSS will help not only the parents, but also their children with cancer. PMID:27529259

  1. [Analysis of correlative factors of sterility in males undergoing routine sperm inspection by masturbation].

    PubMed

    Zhou, Liyuan; Shi, Xiaobo; Wang, Xin; Liu, Dan

    2012-07-01

    To investigate the factors influencing sterility in males undergoing routine sperm inspection by masturbation. Scales for demographic data, self-compiled infertility questionnaire, Symptom Checklist-90 (SCL-90) , and sexual life subscale of Olson Marital Quality Questionnaire (ENRICH) were assessed in 220 cases of sterility in males who had undergone sperm examination after ejaculation. The total SCL-90 scores and the factor scores of anxiety, phobia, somatization, obsessive compulsive behavior, interpersonal-sensitivity, hostility, and depression were significantly higher than the norm (P<0.05). The total SCL-90 score of 69 males was higher than 160, implying that 31.36% of the sterile males had negative emotions. The total score was related to wife's attitude, semen collecting room, ejaculation situation, and the general state of sexual life. The ejaculation situation was subjected to a multivariate linear regression model. About 1/3 of males with sterility problems undergoing routine semen examination by masturbation have negative emotions such as anxiety, phobia, somatization, and interpersonal sensitivities. The defective ejaculation may be the influential factor at the stage.

  2. Spanish normative studies in young adults (NEURONORMA young adults project): norms for Stroop Color-Word Interference and Tower of London-Drexel University tests.

    PubMed

    Rognoni, T; Casals-Coll, M; Sánchez-Benavides, G; Quintana, M; Manero, R M; Calvo, L; Palomo, R; Aranciva, F; Tamayo, F; Peña-Casanova, J

    2013-03-01

    The Stroop Color-Word Interference Test (Stroop) measures cognitive flexibility, selective attention, cognitive inhibition and information processing speed. The Tower of London-Drexel University version test (TOL) assesses higher-order problem solving and executive planning abilities. In this study, as part of the Spanish normative studies project in young adults (NEURONORMA young adults), we present normative data for the Stroop and young adults TOL tests. The sample consisted of 179 participants who are cognitively normal and range in age from 18 to 49 years. Tables are provided to convert raw scores to scaled scores. Scores adjusted for sociodemographic factors were obtained by applying linear regression techniques. No effects were found for age and sex in either test. Educational level impacted most of the Stroop test variables and some of the TOL scores (Total Moves score and Total Initiation Time score). The norms obtained will be extremely useful in the clinical evaluation of young Spanish adults. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  3. Consumption of Soft Drinks and Hyperactivity, Mental Distress, and Conduct Problems Among Adolescents in Oslo, Norway

    PubMed Central

    Lien, Lars; Lien, Nanna; Heyerdahl, Sonja; Thoresen, Magne; Bjertness, Espen

    2006-01-01

    Objectives. We examined whether high levels of consumption of sugar-containing soft drinks were associated with mental distress, hyperactivity, and conduct problems among adolescents. Methods. A cross-sectional population-based survey was conducted with 10th-grade students in Oslo, Norway (n = 5498). We used the Hopkins Symptom Checklist and the Strengths and Difficulties Questionnaire to assess mental health outcomes. Results. There was a J-shaped dose–response relationship between soft drink consumption and mental distress, conduct problems, and total mental health difficulties score; that is, adolescents who did not consume soft drinks had higher scores (indicating worse symptoms) than those who consumed soft drinks at moderate levels but lower scores than those with high consumption levels. The relationship was linear for hyperactivity. In a logistic regression model, the association between soft drink consumption and mental health problems remained significant after adjustment for behavioral, social, and food-related variables. The highest adjusted odds ratios were observed for conduct problems among boys and girls who consumed 4 or more glasses of sugar-containing soft drinks per day. Conclusions. High consumption levels of sugar-containing soft drinks were associated with mental health problems among adolescents even after adjustment for possible confounders. PMID:17008578

  4. Bisphenol A, phthalates and lead and learning and behavioral problems in Canadian children 6-11 years of age: CHMS 2007-2009.

    PubMed

    Arbuckle, Tye E; Davis, Karelyn; Boylan, Khrista; Fisher, Mandy; Fu, Jingshan

    2016-05-01

    Childhood developmental disorders and related problems such as learning disabilities and attention deficit hyperactivity disorder (ADHD) account for a growing burden on the family, education and health care systems. Exposure to environmental chemicals such as bisphenol A (BPA) and phthalates may play a role in the development of child behavioral problems. Using cross-sectional data from Cycle 1 of the Canadian Health Measures Survey (CHMS), we examined the potential association between urinary concentrations of BPA and various phthalate metabolites and child learning and behavioral problems, considering important covariates such as gender, blood lead and environmental tobacco smoke (ETS). The Strengths and Difficulties Questionnaire (SDQ) outcomes of interest were emotional symptoms, hyperactivity/inattention, and a total difficulties score with borderline and abnormal scores grouped together and compared with children with normal scores. Other outcomes studied included any reported learning disability, a subset of learning disabilities reported as ADD/ADHD (attention deficit disorder) and use of psychotropic medications in the past month. Among children ages 6-11 years, the prevalences of any learning disability, ADD, and ADHD were 8.7%, 1.5% and 2.8%, respectively. Estimated prevalences for SDQ hyperactivity/inattention, emotional symptoms and total difficulties scores were 16.9%, 15.0%, and 13.0%, respectively. Child's urinary BPA was associated with taking psychotropic medications (OR 1.59; 95% CI 1.05-2.40). Urinary MBzP concentration was significantly associated with emotional symptoms in girls (OR 1.38 95% CI 1.09-1.75) but not in boys (OR 1.05 95% CI 0.82-1.36).) Blood lead was significantly associated with several of the outcomes examined, with a significant interaction observed between prenatal smoking and blood lead for the total difficulties score (OR=10.57; 95% CI 2.81-39.69 vs. OR=1.98; 95% CI 1.41-2.79 if mother did not smoke during pregnancy). Although limited by the cross-sectional nature of the study which precludes examining causation, the results suggest that although some indicators of child behavior were significantly associated with their urinary BPA and phthalate concentrations, the major chemical associated with adverse behavioral indicators was lead. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  5. Neighborhood disadvantage as a moderator of the association between harsh parenting and toddler-aged children’s internalizing and externalizing problems

    PubMed Central

    Callahan, Kristin L.; Scaramella, Laura V.; Laird, Robert D.; Sohr-Preston, Sara L.

    2011-01-01

    Neighborhood dangerousness and belongingness were expected to moderate associations between harsh parenting and toddler-aged children’s problem behaviors. Fifty-five predominantly African American mothers participated with their 2-year old children. Neighborhood danger, neighborhood belongingness, and children’s problem behaviors were measured with mothers’ reports. Harsh parenting was measured with observer ratings. Analyses considered variance common to externalizing and internalizing problems, using a total problems score, and unique variance, by controlling for internalizing behavior when predicting externalizing behavior, and vice-versa. Regarding the common variance, only the main effects of neighborhood danger and harsh parenting were significantly associated with total problem behavior. In contrast, after controlling for externalizing problems, the positive association between harsh parenting and unique variance in internalizing problems became stronger as neighborhood danger increased. No statistically significant associations emerged for the models predicting the unique variance in externalizing problems or models considering neighborhood belongingness. PMID:21355648

  6. Neighborhood disadvantage as a moderator of the association between harsh parenting and toddler-aged children's internalizing and externalizing problems.

    PubMed

    Callahan, Kristin L; Scaramella, Laura V; Laird, Robert D; Sohr-Preston, Sara L

    2011-02-01

    Neighborhood dangerousness and belongingness were expected to moderate associations between harsh parenting and toddler-age children's problem behaviors. Fifty-five predominantly African American mothers participated with their 2-year old children. Neighborhood danger, neighborhood belongingness, and children's problem behaviors were measured with mothers' reports. Harsh parenting was measured with observer ratings. Analyses considered variance common to externalizing and internalizing problems, using a total problems score, and unique variance, by controlling for internalizing behavior when predicting externalizing behavior, and vice versa. Regarding the common variance, only the main effects of neighborhood danger and harsh parenting were significantly associated with total problem behavior. In contrast, after controlling for externalizing problems, the positive association between harsh parenting and unique variance in internalizing problems became stronger as neighborhood danger increased. No statistically significant associations emerged for the models predicting the unique variance in externalizing problems or models considering neighborhood belongingness. PsycINFO Database Record (c) 2011 APA, all rights reserved.

  7. Concurrence of the strengths and difficulties questionnaire and developmental behaviour checklist among children with an intellectual disability.

    PubMed

    Rice, L J; Emerson, E; Gray, K M; Howlin, P; Tonge, B J; Warner, G L; Einfeld, S L

    2018-02-01

    The Strengths and Difficulties Questionnaire (SDQ) is widely used to measure emotional and behavioural problems in typically developing young people, although there is some evidence that it may also be suitable for children with intellectual disability (ID). The Developmental Behaviour Checklist - Parent version (DBC-P) is a measure of emotional and behavioural problems that was specifically designed for children and adolescents with an ID. The DBC-P cut-off has high agreement with clinical diagnosis. The aim of this study was to estimate the relationship between DBC-P and SDQ scores in a sample of children with ID. Parents of 83 young people with ID aged 4-17 years completed the parent versions of the SDQ and the DBC-P. We evaluated the concurrent validity of the SDQ and DBC-P total scores, and the agreement between the DBC-P cut-off and the SDQ cut-offs for 'borderline' and 'abnormal' behaviour. The SDQ total difficulties score correlated well with the DBC-P total behaviour problem score. Agreement between the SDQ borderline cut-off and the DBC-P cut-off for abnormality was high (83%), but was lower for the SDQ abnormal cut-off (75%). Positive agreement between the DBC-P and the SDQ borderline cut-off was also high, with the SDQ borderline cut-off identifying 86% of those who met the DBC-P criterion. Negative agreement was weaker, with the SDQ borderline cut-off identifying only 79% of the participants who did not meet the DBC-P cut-off. The SDQ borderline cut-off has some validity as a measure of overall levels of behavioural and emotional problems in young people with ID, and may be useful in epidemiological studies that include participants with and without ID. However, where it is important to focus on behavioural profiles in children with ID, a specialised ID instrument with established psychometric properties, such as the DBC-P, may provide more reliable and valid information. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  8. Caregiver Burden in Frontotemporal Degeneration and Corticobasal Syndrome

    PubMed Central

    Armstrong, Nicole; Schupf, Nicole; Grafman, Jordan; Huey, Edward D.

    2015-01-01

    Background and Aims Caregiver stress is often a serious problem when caring for a patient with frontal lobe dysfunction. Methods A total of 102 caregivers of both patients with frontotemporal degeneration and corticobasal syndrome completed the Frontal Systems Behavior Scale (FrSBe) and the Zarit Burden Interview (ZBI). To analyze the association between apathy or disinhibition (or both) and caregiver burden, the effects of the total FrSBe and the apathy and disinhibition subscales of the FrSBE on the total ZBI score were assessed with logistic regressions and t tests. Results Total FrSBE score and the apathy FrSBE subscore predicted caregiver burden. Apathy occurred without disinhibition, and the two occurred together, but disinhibition without apathy was very rare. Conclusions Disinhibition without apathy occurred very rarely. Apathy was more associated with caregiver burden than disinhibition. PMID:24022248

  9. Burn Injuries and Their Impact on Cognitive-Communication Skills in the Inpatient Rehabilitation Setting.

    PubMed

    Hendricks, Carla Tierney; Camara, Kristin; Violick Boole, Kathryn; Napoli, Maureen F; Goldstein, Richard; Ryan, Colleen M; Schneider, Jeffrey C

    The prevalence and extent of cognitive-communication disorders and factors that have impact on outcomes are examined in the burn population within an inpatient rehabilitation facility. A retrospective data analysis was conducted on adults diagnosed with burn injury (n = 144). Descriptive statistics were used to identify the prevalence of cognitive-communication deficits on admission and discharge. The main outcomes were cognitive-communication ratings on discharge from inpatient rehabilitation as measured by the memory and problem-solving domains of the Functional Independence Measure (FIM) and composite score of the Functional Communication Measure (FCM). Medical, demographic and rehabilitation predictors of the main outcomes were assessed using regression analyses. On admission to inpatient rehabilitation, 79% of the total population presented with cognitive-communication impairments, and of them, 27% presented with persistent deficits on discharge. Admission FIM memory score, marital status, and age were significant predictors of discharge FIM memory score. Admission FIM problem-solving score, age, marital status, and prehospital living-with were significant predictors of discharge FIM problem-solving score. Admission FCM score and age were significant predictors of discharge FCM cognitive score. Persons with burn injuries are at risk for cognitive-communication impairments, which may persist after inpatient rehabilitation. FIM data obtained on admission can be used as a screening tool to identify these at-risk patients. Future work is needed to assess the efficacy of speech-language pathologist intervention for cognitive-communication deficits within the burn injury population.

  10. Effects of internal displacement and resettlement on the mental health of Turkish children and adolescents

    PubMed Central

    Erol, Neşe; Şimşek, Zeynep; Öner, Özgür; Munir, Kerim

    2011-01-01

    Aims To evaluate the effects of internal displacement and resettlement within Turkey on the emotional and behavioral profile of children, age 5–18 after controlling for possible confounding and demographic variables. Method We conducted a national population survey using a self-weighted, equal probability sample. We compared the CBCL, TRF and YSR responses regarding children with (n = 1644) and without (n = 1855) experience of internal displacement. We examined the effects of gender, age, paternal employment, resettlement, urban residence and physical illness. Results The children and adolescents with internal displacement had significantly higher internalizing, externalizing and total problem scores on the CBCL and YSR, and higher internalizing scores on the TRF. The effect of displacement was related to higher internalizing problems when factors like physical illness, child age, child gender and urban residence were accounted. The overall effect was small explaining only 0.1–1.5% of the total variance by parent reports, and not evident by teacher reports. Discussion To our knowledge the present study is the first to examine Turkish children and adolescents with and without experience of internal displacement. The results are consistent with previous immigration studies: child age, gender, presence of physical illness and urban residence were more important predictors of internalization and externalization problem scores irrespective of informant source. PMID:15797700

  11. Screening for suicidal ideation in children with epilepsy.

    PubMed

    Jones, Jana E; Siddarth, Prabha; Gurbani, Suresh; Shields, W Donald; Caplan, Rochelle

    2013-12-01

    Given the FDA's warning regarding the potential connection between suicidal behavior and antiepileptic drugs, this study examined methods by which to detect suicidal ideation in children with epilepsy. It compared the sensitivity, specificity, and area under the curve for identifying children with suicidal behavior using the Child Behavior Checklist (CBCL) and a structured psychiatric interview. Parent-completed CBCLs provided behavioral problem scores on 177 children with epilepsy, aged 5-16years. Psychiatric diagnoses were made based on separate child and parent structured psychiatric interviews about the child. The children answered questions on suicidal behaviors during the interview. A clinically elevated score in the CBCL Total Problems scale and having more than one psychiatric diagnosis, irrespective of the type of diagnosis, were significant predictors and correctly classified children with suicidal ideation in 79% of the cases based on the CBCL and 80% of the cases with more than one psychiatric diagnosis. These findings indicate that elevated CBCL Total Problems scores, a commonly used instrument, can screen and identify risk for suicidal behavior in children with epilepsy. Additionally, irrespective of diagnosis, if a child with epilepsy has more than one psychiatric diagnosis, further assessment of suicidal behavior is warranted. Importantly, the results underscore the utility of having parents complete a questionnaire in the waiting room in order to identify children with epilepsy at risk for suicidal behavior. © 2013.

  12. The relationship of sleep problems to life quality and depression

    PubMed Central

    Sarıarslan, Hacı A.; Gulhan, Yıldırım B.; Unalan, Demet; Basturk, Mustafa; Delibas, Senol

    2015-01-01

    Objective: To identify the level of depression, the level of life quality, and the relationship between these, in patients applying to sleep centers for various sleep problems. Methods: This cross-sectional study included 229 patients who applied for polysomnography at sleeping centers under supervision of the Neurology and Chest Diseases Clinics of Kayseri Education and Research Hospital, Kayseri, Turkey between June and August 2013. The data collection tools were a socio-demographical data form, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life Scale (WHOQOL-BREF). For statistical analyses, the Student t-test, Kruskal-Wallis-variant analysis, and chi-square tests were used. Significance level was considered as p<0.05. Results: In our study, patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom were observed to have significantly poorer sleep quality. While patients with any chronic disease had significantly higher scores for total PSQI and depression, their physical, mental, and social WHOQOL-BREF scores were significantly lower. The PSQI total scores, and depression scores of the smoking patients were significantly higher for physical, mental, and social WHOQOL-BREF fields. There was a positive correlation between PSQI scores and BDI scores while there was a negative correlation among BDI, PSQI, and WHOQOL-BREF life quality sub-scale scores. Conclusions: Sleep quality was significantly poorer in patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom. There was a significantly negative correlation among depression, sleep quality, and life quality, while there was a significantly positive correlation between life quality and depression. PMID:26166591

  13. A magnetic resonance spectroscopy study of antisocial behaviour disorder, psychopathy and violent crime among military conscripts.

    PubMed

    Basoglu, Cengiz; Semiz, Umit; Oner, Ozgur; Gunay, Huseyin; Ebrinc, Servet; Cetin, Mesut; Sildiroglu, Onur; Algul, Ayhan; Ates, Alpay; Sonmez, Guner

    2008-04-01

    Prefrontal and/or temporo-limbic abnormalities associated with antisocial personality disorder (APD), high psychopathy scores and violent behaviours can readily be evaluated by neuroimaging methods. In this study, we compared the brain metabolites in adult male military conscripts with APD, high psychopathy scores and serious violent crimes (n = 15) with age- and educational-level-matched healthy controls (n = 15) by means of magnetic resonance spectroscopy. All cases were diagnosed by means of the Diagnostic Statistical Manual-IV APD module of the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II) semistructured questionnaire in Turkish. The psychopathy scores were evaluated by means of the Hare Psychopathy Checklist-Revised translated into Turkish (PCL-R). PCL-R is a 20-item, reliable and valid instrument for assessment of psychopathy, both in categorical and dimensional natures. All patients had a total score of 29 (of possible 40) or higher from PCL-R, indicating a high degree of psychopathy. Our results showed no significant differences in ratio of N-acetyl aspartate (NAA), creatine (Cr) and choline-related compounds in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC) and amygdala-hippocampus regions of cases compared with controls. ACC NAA/Cr was significantly negatively correlated with both the PCL-R total score and the PCL-R factor I score (interpersonal/affective problems) among the cases. As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.

  14. Is Trait Rumination Associated with the Ability to Generate Effective Problem Solving Strategies? Utilizing Two Versions of the Means-Ends Problem-Solving Test.

    PubMed

    Hasegawa, Akira; Nishimura, Haruki; Mastuda, Yuko; Kunisato, Yoshihiko; Morimoto, Hiroshi; Adachi, Masaki

    This study examined the relationship between trait rumination and the effectiveness of problem solving strategies as assessed by the Means-Ends Problem-Solving Test (MEPS) in a nonclinical population. The present study extended previous studies in terms of using two instructions in the MEPS: the second-person, actual strategy instructions, which has been utilized in previous studies on rumination, and the third-person, ideal-strategy instructions, which is considered more suitable for assessing the effectiveness of problem solving strategies. We also replicated the association between rumination and each dimension of the Social Problem-Solving Inventory-Revised Short Version (SPSI-R:S). Japanese undergraduate students ( N  = 223) completed the Beck Depression Inventory-Second Edition, Ruminative Responses Scale (RRS), MEPS, and SPSI-R:S. One half of the sample completed the MEPS with the second-person, actual strategy instructions. The other participants completed the MEPS with the third-person, ideal-strategy instructions. The results showed that neither total RRS score, nor its subscale scores were significantly correlated with MEPS scores under either of the two instructions. These findings taken together with previous findings indicate that in nonclinical populations, trait rumination is not related to the effectiveness of problem solving strategies, but that state rumination while responding to the MEPS deteriorates the quality of strategies. The correlations between RRS and SPSI-R:S scores indicated that trait rumination in general, and its brooding subcomponent in particular are parts of cognitive and behavioral responses that attempt to avoid negative environmental and negative private events. Results also showed that reflection is a part of active problem solving.

  15. Reliability and validity of a brief sleep questionnaire for children in Japan.

    PubMed

    Okada, Masakazu; Kitamura, Shingo; Iwadare, Yoshitaka; Tachimori, Hisateru; Kamei, Yuichi; Higuchi, Shigekazu; Mishima, Kazuo

    2017-09-15

    There is a dearth of sleep questionnaires with few items and confirmed reliability and validity that can be used for the early detection of sleep problems in children. The aim of this study was to develop a questionnaire with few items and assess its reliability and validity in both children at high risk of sleep disorders and a community population. Data for analysis were derived from two populations targeted by the Children's Sleep Habits Questionnaire (CSHQ): 178 children attending elementary school and 432 children who visited a pediatric psychiatric hospital (aged 6-12 years). The new questionnaire was constructed as a subset of the CSHQ. The newly developed short version of the sleep questionnaire for children (19 items) had an acceptable internal consistency (0.65). Using the cutoff value of the CSHQ, the total score of the new questionnaire was confirmed to have discriminant validity (27.2 ± 3.9 vs. 22.0 ± 2.1, p < 0.001) and yielded a sensitivity of 0.83 and specificity of 0.78 by receiver operator characteristic curve analysis. Total score of the new questionnaire was significantly correlated with total score (r = 0.81, p < 0.001) and each subscale score (r = 0.29-0.65, p < 0.001) of the CSHQ. The new questionnaire demonstrated an adequate reliability and validity in both high-risk children and a community population, as well as similar screening ability to the CSHQ. It could thus be a convenient instrument to detect sleep problems in children.

  16. More reasons to be straightforward: findings and norms for two scales relevant to social anxiety.

    PubMed

    Rodebaugh, Thomas L; Heimberg, Richard G; Brown, Patrick J; Fernandez, Katya C; Blanco, Carlos; Schneier, Franklin R; Liebowitz, Michael R

    2011-06-01

    The validity of both the Social Interaction Anxiety Scale and Brief Fear of Negative Evaluation scale has been well-supported, yet the scales have a small number of reverse-scored items that may detract from the validity of their total scores. The current study investigates two characteristics of participants that may be associated with compromised validity of these items: higher age and lower levels of education. In community and clinical samples, the validity of each scale's reverse-scored items was moderated by age, years of education, or both. The straightforward items did not show this pattern. To encourage the use of the straightforward items of these scales, we provide normative data from the same samples as well as two large student samples. We contend that although response bias can be a substantial problem, the reverse-scored questions of these scales do not solve that problem and instead decrease overall validity. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Evaluation of Patients With Voice Disorders.

    PubMed

    Lopes, Leonardo Wanderley; de Oliveira Florencio, Vanessa; Silva, Priscila Oliveira Costa; da Nóbrega E Ugulino, Ana Celiane; Almeida, Anna Alice

    2018-01-04

    We aimed to correlate the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for evaluation of patients with dysphonia. In addition, we aimed to compare vocal tract discomfort symptoms in patients with and without self-reported voice problem. This is a descriptive, cross-sectional, and retrospective study. We analyzed 143 women and 62 men with voice disorders, as confirmed by endoscopic larynx examination. All patients completed the VTDS and VoiSS at vocal evaluation. Descriptive statistics and the Spearman correlation test were applied to all variables. The degree of covariance of variables was noted. The Mann-Whitney U test was used to compare the average number of discomfort symptoms among patients with and without self-reported voice problems. A weak to moderate positive correlation was observed between the average number, frequency, and intensity of comfort symptom and the total score, physical domain score, and limitation domain score of the VoiSS. The vocal tract discomfort symptoms and the emotional domain score of the VoiSS were weakly correlated. Patients with self-reported voice problems had a higher number, frequency, and intensity of vocal tract discomfort symptoms. There is correlation between the VTDS and VoiSS scales, with greater references to vocal tract discomfort symptom in patients with self-reported voice problems. Therefore, the discomfort symptoms seem to influence the perception of the impact of a voice problem. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Function in job seekers with mental illness and drug and alcohol problems who access community based disability employment services.

    PubMed

    Matthews, Lynda R; Harris, Lynne M; Jaworski, Alison; Alam, Ashraful; Bozdag, Gokcen

    2013-03-01

    This study identified functioning, health, and social needs in jobseekers with mental disorders independently assessed as having capacity to work and referred to disability employment services. Differences in function between jobseekers with mental illness alone and with additional drug and alcohol problems were examined with view to identifying interventions for vocational rehabilitation. A convenience sample of 116 jobseekers completed BASIS-32, CANSAS, AUDIT, DAST-10 and 6 items from the EXIT interview and were divided into two groups: mental illness only, and additional drug and alcohol issues (AUDIT total score >8 and/or DAST total score >3). Analysis of variance was used to determine group differences. Jobseekers reported low-moderate problems with function. Over 40% of the sample reported unresolved psychological distress, physical health needs, and social/daytime activity needs. Thirty-five jobseekers (30%) had additional drug and alcohol problems and reported significantly greater difficulty with impulsive/addictive behavior and poorer memory and executive function than the mental illness only group. No significant differences were identified in past work functioning. Screening all job seekers for psychological, physical, and social needs to identify suitable treatment and rehabilitation strategies and providing interventions that improve emotional regulation and executive function for job seekers with additional drug and alcohol problems may improve employability of job seekers accessing disability employment services.

  19. Household Food Insecurity and Mental Health Problems Among Adolescents: What Do Parents Report?

    PubMed

    Poole-Di Salvo, Elizabeth; Silver, Ellen J; Stein, Ruth E K

    2016-01-01

    To investigate whether adolescents living in households with food insecurity have poorer parent-reported mental health (MH) than peers. We analyzed cross-sectional data from ∼8600 adolescents who participated in the 2007 (8th grade) wave of the Early Childhood Longitudinal Study-Kindergarten. Household food insecurity (HFI) was assessed by parental report on the 18-item US Household Food Security Scale. Total Difficulties score >13 on the parent-reported Strengths and Difficulties Questionnaire (SDQ) indicated problems with adolescent MH. SDQ subscale scores (Emotional, Conduct, Hyperactivity, Peer Problems) were also calculated. Associations between HFI and MH were explored in bivariate and multivariable analyses. Interactions of HFI and gender and HFI and receipt of free/reduced-price school lunch were analyzed with regard to problems with MH. A total of 10.2% of adolescents lived with HFI; 11.2% had SDQ >13. Adolescents with HFI had higher rates of overall MH problems (28.7% vs 9.2%), emotional problems (21.6% vs 6.6%), conduct problems (26.5% vs 11.6%), hyperactivity (22.4% vs 11.3%), and peer problems (19.8% vs 8.6%) (all P < .01). After adjustment for confounders, the association between HFI and overall MH problems (odds ratio 2.3; 95% confidence interval 1.6-3.3) remained. Interactions of HFI and gender and HFI and free/reduced-price school lunch were not significant. HFI was associated with increased risk of parent-reported MH problems among both male and female adolescents. Free/reduced-price school lunch did not significantly alter this relationship. Effective interventions to promote MH and reduce HFI among adolescents are necessary. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  20. Familial transient financial difficulties during infancy and long-term developmental concerns.

    PubMed

    Ramanathan, S; Balasubramanian, N; Faraone, S V

    2017-09-01

    Socioeconomic difficulties affect the cognitive and emotional development of children. However, the focus of prior studies has largely been on poverty and material hardship. This study expands on the existing literature by examining the impact of familial transient financial difficulties during infancy on long-term cognitive and behavioral outcomes. The National Longitudinal Surveys of Youth (79) were used to assess the association between a transient drop in family income by 50% or more (called transient income decline or TID) during the first 3 years of life and later-life Peabody Individual Achievement Math and Reading scores and behavior problem index (BPI) scores (N = 8272-17 348; median assessment age = 9 years). A subsample of matched siblings (N = 2049-4238) was examined to tease out maternal and intra-familial effects. Exposure to TID predicted increased total and externalizing BPI scores (std. coefficients of 0.10 and 0.09, respectively, p < 0.01) in the overall sample. Among matched siblings, exposure to TID predicted increased total, externalizing, and internalizing BPI scores (std. coefficients of 0.27, 0.25, and 0.23, respectively, p < 0.01). Familial transient financial difficulties can have long-lasting behavioral effects for infants. The study identifies an early risk factor and at-risk children, thus providing insight into developing early intervention measures for infants to avoid long-term behavioral problems.

  1. Nursing students' knowledge and attitude on pressure ulcer prevention evidence-based guidelines: a multicenter cross-sectional study.

    PubMed

    Simonetti, Valentina; Comparcini, Dania; Flacco, Maria Elena; Di Giovanni, Pamela; Cicolini, Giancarlo

    2015-04-01

    Pressure ulcers still remain a significant problem in many healthcare settings. Poor knowledge and negative attitudes toward pressure ulcer prevention could undesirably affect preventive care strategies. To assess both knowledge and attitudes among nursing students on Pressure Ulcer Prevention Evidence-Based Guidelines. A multicenter cross-sectional survey was carried out from December 2012 to August 2013. The study was carried out in seven Italian nursing schools. We involved a convenience sample of nursing students (n=742) METHODS: Data were collected using two validated questionnaires to assess students' knowledge and attitudes on pressure ulcer prevention. The overall Knowledge and Attitude scores were 51.1% (13.3/26) and 76.7% (39.9/52), respectively. We found a weak correlation between total Knowledge scores and total Attitude scores (rho=0.13, p<0.001). We also observed that nursing students' year of education, training experience and number of department frequented during their clinical placement were significantly related to both the Knowledge and the Attitude total scores (p<0.05). Nursing students' knowledge on pressure ulcer prevention was relatively low. However, we observed an association between a high level of education/training experience and higher knowledge scores. Most of the participants showed high attitude scores. These results suggest that positive attitudes toward pressure ulcer prevention may contribute to the compliance with the guidelines in clinical practice. Published by Elsevier Ltd.

  2. Children who witness violence, and parent report of children's behavior.

    PubMed

    Augustyn, Marilyn; Frank, Deborah A; Posner, Michael; Zuckerman, Barry

    2002-08-01

    To examine how much distress children report in response to violence that they have witnessed and how this is associated with parental reports of children's behavior. As part of a study of in utero exposure to cocaine, children completed the Levonn interview for assessing children's symptoms of distress in response to witnessing violence. The children's caregivers completed the Exposure to Violence Interview (EVI), a caretaker-report measure of the child's exposure to violent events during the last 12 months. The EVI was analyzed as a 3-level variable: no exposure, low exposure, and high exposure. The caregivers also completed the Children's Behavior Checklist (CBCL). Of 94 six-year-old children, 58% had no exposure to violence, 36% had low exposure to violence, and 6% had high exposure to violence, according to caretaker reports. The children's median+/-SD Levonn score was 64 (SD +/- 19.3). The mean SD +/- CBCL total T-score was 53 (SD +/- 10.2). In multiple regression analyses with gender, low and high exposure on EVI, Levonn, and prenatal cocaine exposure status as predictors, the Levonn score explained 4.8% of total variance in children's CBCL internalizing scores, 9.1% of the total variance in CBCL externalizing score, and 12.2% of the total variance in CBCL total score (P =.04, P =.004, and P<.001, respectively). After accounting for the caretaker's report of the level of the child's exposure to violence, the child's own report significantly increased the amount of variance in predicting child behavior problems with the CBCL. These findings indicate that clinicians and researchers should elicit children's own accounts of exposure to violence in addition to the caretakers' when attempting to understand children's behavior.

  3. Decreased health-related quality of life in patients with diabetic foot problems

    PubMed Central

    Sothornwit, Jin; Srisawasdi, Gulapar; Suwannakin, Atchara; Sriwijitkamol, Apiradee

    2018-01-01

    Purpose The aim of this study was to investigate health-related quality of life (HRQoL) in patients with diabetic foot problems and compare the HRQoL between diabetic patients with: 1) diabetic foot problems (DF), including diabetic foot ulcer (DFU) or amputation (AMPU); 2) other diabetic complications (COM), such as diabetic retinopathy (DR), end-stage renal disease (ESRD), or coronary artery disease (CAD); and 3) no diabetic complication (CON). Patients and methods A total of 254 diabetic patients were studied in a cross-sectional setting. HRQoL was evaluated using Thai version of the Euro Quality of Life Questionnaire (EuroQoL), with five dimensions and five-level scale (EQ-5D-5L). Utility scores were calculated using time trade-off methods. Results A total of 141 patients in the DF group (98 DFU and 43 AMPU groups), 82 in the COM group (27 DR, 28 ESRD, and 27 CAD groups), and 31 in the CON group were interviewed. The mean age was 63.2±12.1 years, body mass index was 24.9±4.7 kg/m2, mean hemoglobin A1c was 7.7±2.1%, duration of diabetes was 13.1±9.9 years, and the mean utility scores were 0.799±0.25. After having DF, 21% of patients had lost their jobs. The COM group had lower utility scores than the CON group. Among the diabetic complications, the DF group had the lowest mean utility scores as compared to the COM and CON groups (0.703±0.28 in the DF group, 0.903±0.15 in the COM group, and 0.961±0.06 in the CON group, P<0.01). There was no difference in the mean utility scores between DFU and AMPU groups. Patients in the DF group reported moderate-to-severe problem in all dimensions more than the other groups. Conclusion DF have the greatest negative impact on HRQoL. Therefore, diabetic foot care should be emphasized in clinical practice to prevent foot complications. PMID:29563821

  4. Decreased health-related quality of life in patients with diabetic foot problems.

    PubMed

    Sothornwit, Jin; Srisawasdi, Gulapar; Suwannakin, Atchara; Sriwijitkamol, Apiradee

    2018-01-01

    The aim of this study was to investigate health-related quality of life (HRQoL) in patients with diabetic foot problems and compare the HRQoL between diabetic patients with: 1) diabetic foot problems (DF), including diabetic foot ulcer (DFU) or amputation (AMPU); 2) other diabetic complications (COM), such as diabetic retinopathy (DR), end-stage renal disease (ESRD), or coronary artery disease (CAD); and 3) no diabetic complication (CON). A total of 254 diabetic patients were studied in a cross-sectional setting. HRQoL was evaluated using Thai version of the Euro Quality of Life Questionnaire (EuroQoL), with five dimensions and five-level scale (EQ-5D-5L). Utility scores were calculated using time trade-off methods. A total of 141 patients in the DF group (98 DFU and 43 AMPU groups), 82 in the COM group (27 DR, 28 ESRD, and 27 CAD groups), and 31 in the CON group were interviewed. The mean age was 63.2±12.1 years, body mass index was 24.9±4.7 kg/m 2 , mean hemoglobin A1c was 7.7±2.1%, duration of diabetes was 13.1±9.9 years, and the mean utility scores were 0.799±0.25. After having DF, 21% of patients had lost their jobs. The COM group had lower utility scores than the CON group. Among the diabetic complications, the DF group had the lowest mean utility scores as compared to the COM and CON groups (0.703±0.28 in the DF group, 0.903±0.15 in the COM group, and 0.961±0.06 in the CON group, P <0.01). There was no difference in the mean utility scores between DFU and AMPU groups. Patients in the DF group reported moderate-to-severe problem in all dimensions more than the other groups. DF have the greatest negative impact on HRQoL. Therefore, diabetic foot care should be emphasized in clinical practice to prevent foot complications.

  5. Interpersonal Functioning Among Treatment-Seeking Trans Individuals.

    PubMed

    Davey, Amanda; Bouman, Walter Pierre; Meyer, Caroline; Arcelus, Jon

    2015-12-01

    Trans people have been found to have high levels of depression. In view of the association between interpersonal problems and depression and the importance of interpersonal skills to navigate the transition of trans people, this study aims to investigate the levels of interpersonal problems among treatment-seeking trans men and women and the role of depression in this association. A total of 104 patients from a UK gender identity clinic and 104 age- and gender-matched control participants completed self-report measures of interpersonal problems and general psychopathology, including depression. Trans people reported significantly higher scores on global interpersonal problems and on the Inventory of Interpersonal Problems-32 (IIP-32) Hard to be Sociable, Hard to be Supportive, and Hard to be Involved subscales and lower scores on the Too Open subscale. Depression accounted for significant differences on IIP-32 global and the Too Open subscale but not on Hard to be Sociable, Hard to be Supportive, and Hard to be Involved subscales. Trans individuals present with interpersonal problems, which could potentially increase their vulnerability to mental health problems. Therefore, addressing interpersonal problems may help to prevent the development of depressive symptomatology and facilitate transition. © 2015 Wiley Periodicals, Inc.

  6. Knee arthrodesis with an intramedullary nail: a retrospective study.

    PubMed

    De Vil, Jeroen; Almqvist, Karl Fredrik; Vanheeren, Philippe; Boone, Barbara; Verdonk, René

    2008-07-01

    A group of 19 patients who underwent knee arthrodesis with use of an intramedullary nail between 1996 and 2005, was studied. In the majority of patients knee arthrodesis was performed as a salvage procedure for the limb following an infected total knee arthroplasty. The outcome of the procedure was evaluated with radiographs, the SF-36 score and the Oxford 12-item knee score. The functional result of a successful arthrodesis was found to be comparable with that of a revised hinged total knee arthroplasty. Knee arthrodesis with an intramedullary nail allows weightbearing within 1 week and is accompanied by a high rate of pain relief. However, recurrence of infection is the most challenging problem.

  7. Development and Validation of the Actionable Bladder Symptom Screening Tool for Multiple Sclerosis Patients

    PubMed Central

    Chancellor, Michael; Bates, David; Denys, Pierre; MacDiarmid, Scott; Nitti, Victor; Globe, Denise; Signori, Manuel; Hudgens, Stacie; Odderson, Ib; Panicker, Jalesh; Ross, Amy Perrin

    2013-01-01

    Bladder symptoms such as urinary urgency, frequency, and incontinence are common in people with multiple sclerosis (MS). These symptoms, which often result from neurogenic detrusor overactivity (NDO), can have a major impact on patients' day-to-day lives. However, in many cases they are over-looked in the clinical management of MS. The objective of this study was to develop and validate a reliable, sensitive, and specific screening tool for patients with bladder problems related to MS. We performed a literature review and then conducted a content validation study followed by a multisite observational study of a new screening tool, the Actionable Bladder Symptom Screening Tool (ABSST). All ABSST domains as well as the total score met the threshold for good internal consistency (Cronbach α ≥ 0.70), with a Cronbach α value of 0.95 for the total score and values ranging from 0.85 to 0.90 for the three domains. The validity of the ABSST was demonstrated by high correlation of the domains and total score with the Overactive Bladder Questionnaire Short Form (OAB-q SF) Symptom Severity and Total Health-Related Quality of Life (HRQOL) scores (Spearman correlation coefficient ≥ 0.782). The predictive validity of the ABSST total score to identify patients who might receive a recommendation to see a urologist was strong. This new instrument, which was developed with input from clinicians as well as MS patients, meets the current content validity and psychometric testing thresholds established by the US Food and Drug Administration, with high sensitivity and specificity. PMID:24453782

  8. Psychosocial distress of part-time occlusion in children with intermittent exotropia.

    PubMed

    Kim, Ungsoo Samuel; Park, Subin; Yoo, Hee Jeong; Hwang, Jeong-Min

    2013-01-01

    To evaluate the psychosocial distress of part-time occlusion therapy in intermittent exotropia. A total of 25 children (15 males and 10 females, aged 3 to 7 years, mean age 4.7 years) with intermittent exotropia were enrolled. Behavioral and psychosocial problems were assessed by the Korean Child Behavior Checklist (K-CBCL), which consists of eight categories of withdrawal, somatic problems, depression/anxiety, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior, and the Amblyopia Treatment Index (ATI). The ATI was designed to evaluate the three factors of compliance, adverse effect, and social stigma. The Parenting Stress Index (PSI) is a parent self-report designed to identify potentially dysfunctional parent-child systems. The K-CBCL was obtained before and after occlusion therapy, and the ATI and PSI were taken from parents only after occlusion therapy. We evaluated the change on the K-CBCL and the correlation between the K-CBCL and ATI. The attention problem assessed by the K-CBCL significantly decreased after occlusion therapy. On the ATI, the social stigma was relatively lower than compliance and adverse effect factors (Likert scale 2.64, 3.11, and 3.11, respectively). The somatic problem assessed by the K-CBCL and compliance on the ATI were significantly correlated (p = 0.014). There was no significant change in percentile scores of each subscale (parental dominant scale and child dominant scale) of the PSI. Total stress index before and after occlusion therapy was 97.16 ± 8.38 and 97.00 ± 8.16 respectively (p = 0.382). Occlusion therapy may influence the psychosocial impact on intermittent exotropia patients. Part-time occlusion significantly decreased the attention problem in children with intermittent strabismus. Children with a high somatic problem score on the KCBCL showed poor compliance to the part-time occlusion.

  9. The psychological well-being of children orphaned by AIDS in Cape Town, South Africa.

    PubMed

    Cluver, Lucie; Gardner, Frances

    2006-07-19

    An estimated 2 million children are parentally bereaved by AIDS in South Africa. Little is known about mental health outcomes for this group. This study aimed to investigate mental health outcomes for urban children living in deprived settlements in Cape Town. 30 orphaned children and 30 matched controls were compared using standardised questionnaires (SDQ) on emotional and behavioural problems, peer and attention difficulties, and prosocial behaviour. The orphan group completed a modified version of a standardised questionnaire (IES-8), measuring Post-Traumatic Stress symptoms. Group differences were tested using t-tests and Pearson's chi-square. Both groups scored highly for peer problems, emotional problems and total scores. However, orphans were more likely to view themselves as having no good friends (p = .002), to have marked concentration difficulties (p = .03), and to report frequent somatic symptoms (p = .05), but were less likely to display anger through loss of temper (p = .03). Orphans were more likely to have constant nightmares (p = .01), and 73% scored above the cut-off for Post-Traumatic Stress Disorder. Findings suggest important areas for larger-scale research for parentally-bereaved children.

  10. Plasma homovanillic acid correlates inversely with history of learning problems in healthy volunteer and personality disordered subjects.

    PubMed

    Coccaro, Emil F; Hirsch, Sharon L; Stein, Mark A

    2007-01-15

    Central dopaminergic activity is critical to the functioning of both motor and cognitive systems. Based on the therapeutic action of dopaminergic agents in treating attention deficit hyperactivity disorder (ADHD), ADHD symptoms may be related to a reduction in central dopaminergic activity. We tested the hypothesis that dopaminergic activity, as reflected by plasma homovanillic acid (pHVA), may be related to dimensional aspects of ADHD in adults. Subjects were 30 healthy volunteer and 39 personality disordered subjects, in whom morning basal pHVA concentration and a dimensional measure of childhood ADHD symptoms (Wender Utah Rating Scale: WURS) were obtained. A significant inverse correlation was found between WURS Total score and pHVA concentration in the total sample. Among WURS factor scores, a significant inverse relationship was noted between pHVA and history of "childhood learning problems". Consistent with the dopaminergic dysfunction hypothesis of ADHD and of cognitive function, pHVA concentrations were correlated with childhood history of ADHD symptoms in general and with history of "learning problems" in non-ADHD psychiatric patients and controls. Replication is needed in treated and untreated ADHD samples to confirm these initial results.

  11. Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

    PubMed

    Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

    2016-09-01

    Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome.

    PubMed

    Kajiwara, Mitsuru; Inoue, Shougo; Kobayashi, Kanao; Ohara, Shinya; Teishima, Jun; Matsubara, Akio

    2014-04-01

    Narrow band imaging cystoscopy can increase the visualization and detection of Hunner's lesions. A single-center, prospective clinical trial was carried out aiming to show the effectiveness of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome. A total of 23 patients (19 women and 4 men) diagnosed as having ulcer-type interstitial cystitis/painful bladder syndrome were included. All typical Hunner's lesions and suspected areas identified by narrow band imaging were electrocoagulated endoscopically after the biopsy of those lesions. Therapeutic efficacy was assessed prospectively by using visual analog scale score of pain, O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score. The mean follow-up period was 22 months. All patients (100%) experienced a substantial improvement in pain. The average visual analog scale pain scores significantly decreased from 7.3 preoperatively to 1.2 1 month postoperatively. A total of 21 patients (91.3%) who reported improvement had at least a 50% reduction in bladder pain, and five reported complete resolution. Daytime frequency was significantly decreased postoperatively. O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score were significantly decreased postoperatively. However, during the follow-up period, a total of six patients had recurrence, and repeat narrow band imaging-assisted transurethral electrocoagulation of the recurrent lesions was carried out for five of the six patients, with good response in relieving bladder pain. Our results showed that narrow band imaging-assisted transurethral electrocoagulation could be a valuable therapeutic alternative in patients with ulcer-type interstitial cystitis/painful bladder syndrome, with good efficacy and reduction of recurrence rate. © 2014 The Japanese Urological Association.

  13. Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis

    PubMed Central

    Parker, Kathy P; Kutner, Nancy G; Bliwise, Donald L; Bailey, James L; Rye, David B

    2003-01-01

    Background Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD). However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life remains to be well characterized. Thus, we studied a sample of stable HD patients to explore relationships between quality of life and both subjective and objective measures of nocturnal sleep and daytime sleepiness Methods The sample included forty-six HD patients, 24 men and 22 women, with a mean age of 51.6 (10.8) years. Subjects underwent one night of polysomnography followed the next morning by a Multiple Sleep Latency Test (MSLT), an objective measure of daytime sleepiness. Subjects also completed: 1) a brief nocturnal sleep questionnaire; 2) the Epworth Sleepiness Scale; and, 3) the Quality of Life Index (QLI, Dialysis Version) which provides an overall QLI score and four subscale scores for Health & Functioning (H&F), Social & Economic (S&E), Psychological & Spiritual (P&S), and Family (F). (The range of scores is 0 to 30 with higher scores indicating better quality of life.) Results The mean (standard deviation; SD) of the overall QLI was 22.8 (4.0). The mean (SD) of the four subscales were as follows: H&F – 21.1 (4.7); S&E – 22.0 (4.8); P&S – 24.5 (4.4); and, F – 26.8 (3.5). H&F (rs = -0.326, p = 0.013) and F (rs = -0.248, p = 0.048) subscale scores were negatively correlated with periodic limb movement index but not other polysomnographic measures. The H&F subscale score were positively correlated with nocturnal sleep latency (rs = 0.248, p = 0.048) while the H&F (rs = 0.278, p = 0.030) and total QLI (rs = 0.263, p = 0.038) scores were positively associated with MSLT scores. Both of these latter findings indicate that higher life quality is associated with lower sleepiness levels. ESS scores were unrelated to overall QLI scores or the subscale scores. Subjective reports of difficulty falling asleep and waking up too early were significantly correlated with all four subscale scores and overall QLI. Feeling rested in the morning was positively associated with S&E, P&S, and Total QLI scores. Conclusion Selected measures of both poor nocturnal sleep and increased daytime sleepiness are associated with decreased quality of life in HD patients, underscoring the importance of recognizing and treating these patients' sleep problems. PMID:14633280

  14. The development of a new questionnaire for cognitive complaints in vertigo: the Neuropsychological Vertigo Inventory (NVI).

    PubMed

    Lacroix, Emilie; Deggouj, Naima; Salvaggio, Samuel; Wiener, Valérie; Debue, Michel; Edwards, Martin Gareth

    2016-12-01

    Vertigo patients frequently complain of emotional and associated cognitive problems, yet currently, there is no satisfactory questionnaire to measure these associated problems. In the present paper, we propose a new internet-based Neuropsychological Vertigo Inventory (NVI; French) that evaluates attention, memory, emotion, space perception, time perception, vision, and motor abilities. The questionnaire was created using four steps: (1) open interviews with patients suffering from vertigo; (2) semi-structured interviews with an analysis grid to quantify and define the various cognitive and emotional problems reported by the patients; (3) a first version of an internet questionnaire tested on 108 vertigo participants; and (4) the selection of subscale items using principal component analyses (PCA). From the development phase, the revised NVI was composed of seven subscales, each with four items (28 items). In the validation phase, Cronbach's alphas were performed on the revised NVI for total and each subscale score, and to test extreme groups validity, the analyses of covariance (ANCOVAs) taking into account age were performed between 108 vertigo and 104 non-vertigo participants. The Cronbach's alphas showed good to satisfactory coefficients for the total and for all subscale scores, demonstrating acceptable reliability. The extreme groups validity analyses (ANCOVAs) were reliable for the total scale and for four subscales. Supplementary analyses showed no effect of hearing difficulties and an inverse age effect for attention and emotion subscales, with reduced problems with increased age in the vertigo participants. The NVI provides a useful new questionnaire to determine cognitive and emotional neuropsychological complaints that are associated with vertigo.

  15. A comparison of three developmental stage scoring systems.

    PubMed

    Dawson, Theo Linda

    2002-01-01

    In social psychological research the stage metaphor has fallen into disfavor due to concerns about bias, reliability, and validity. To address some of these issues, I employ a multidimensional partial credit analysis comparing moral judgment interviews scored with the Standard Issue Scoring System (SISS) (Colby and Kohlberg, 1987b), evaluative reasoning interviews scored with the Good Life Scoring System (GLSS) (Armon, 1984b), and Good Education interviews scored with the Hierarchical Complexity Scoring System (HCSS) (Commons, Danaher, Miller, and Dawson, 2000). A total of 209 participants between the ages of 5 and 86 were interviewed. The multidimensional model reveals that even though the scoring systems rely upon different criteria and the data were collected using different methods and scored by different teams of raters, the SISS, GLSS, and HCSS all appear to measure the same latent variable. The HCSS exhibits more internal consistency than the SISS and GLSS, and solves some methodological problems introduced by the content dependency of the SISS and GLSS. These results and their implications are elaborated.

  16. Psychosis risk screening: Validation of the youth psychosis at-risk questionnaire - brief in a community-derived sample of adolescents.

    PubMed

    Fonseca-Pedrero, Eduardo; Ortuño-Sierra, Javier; Chocarro, Edurne; Inchausti, Felix; Debbané, Martin; Bobes, Julio

    2017-12-01

    There have been several attempts to identify individuals potentially at high risk for psychotic-spectrum disorders using brief screening measures. However, relatively few studies have tested the psychometric properties of the psychosis screening measures in representative samples of adolescents. The main purpose of the present study was to analyse the prevalence, factorial structure, measurement invariance across gender, and reliability of the Youth Psychosis At-Risk Questionnaire - Brief (YPARQ-B) in a community-derived sample of adolescents. Additionally, the relationship between YPARQ-B, depressive symptoms, psychopathology, stress manifestations, and prosocial skills was analysed. One thousand and twenty students from high schools participated in a cross-sectional survey. The YPARQ-B, the Reynolds Adolescent Depression Scale, the Strengths and Difficulties Questionnaire, and the Student Stress Inventory - Stress Manifestations were used. A total of 85.1% of the total sample self-reported at least one subclinical psychotic experience. We observed a total of 10.9% of adolescents with a cutoff score of ≥11 or 6.8% with a cutoff score of ≥13. The analysis of internal structure of the YPARQ-B yielded an essentially unidimensional structure. The YPARQ-B scores showed measurement invariance across gender. The internal consistency of the YPARQ-B total score was 0.94. Furthermore, self-reported subclinical psychotic experiences were associated with depressive symptoms, emotional and behavioural problems, poor prosocial skills, and stress manifestations. These results would appear to indicate that YPARQ-B is a brief and easy tool to assess self-reported subclinical psychotic experiences in adolescents from the general population. The assessment of these experiences in community settings, and its associations with psychopathology, may help us to enhance the possibility of an early identification of adolescents potentially at risk for psychosis and mental health problems. Copyright © 2016 John Wiley & Sons, Ltd.

  17. Problem solving strategies integrated into nursing process to promote clinical problem solving abilities of RN-BSN students.

    PubMed

    Wang, Jing-Jy; Lo, Chi-Hui Kao; Ku, Ya-Lie

    2004-11-01

    A set of problem solving strategies integrated into nursing process in nursing core courses (PSNP) was developed for students enrolled in a post-RN baccalaureate nursing program (RN-BSN) in a university in Taiwan. The purpose of this study, therefore, was to evaluate the effectiveness of PSNP on students' clinical problem solving abilities. The one-group post-test design with repeated measures was used. In total 114 nursing students with 47 full-time students and 67 part-time students participated in this study. The nursing core courses were undertaken separately in three semesters. After each semester's learning, students would start their clinical practice, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. The overall score of problem solving indicated that score on the post-test III was significantly better than that on post-test I and II, meaning both full-time and part-time students' clinical problem solving abilities improved at the last semester. In conclusion, problem-solving strategies integrated into nursing process designed for future RN-BSN students are recommendable.

  18. The Relationship Between Total Neuropathy Score-reduced, Neuropathy Symptoms and Function

    NASA Astrophysics Data System (ADS)

    Abulhaija, Ashraf

    Chemotherapy Induced Peripheral Neuropathy (CIPN) is a common problem among cancer patients who receive a wide range of chemotherapy. This problem causes a decline in quality of life and increased disabilities. CIPN assessment instruments are either subjective, objective, or a combination of both. So far, there is no agreement on the best way for assessment. The goal of this study was to explore the relationships among subjective and objective CIPN assessment instruments. Specifically, this study aimed to 1) evaluate the relationship between the Total Neuropathy Score-reduced (mainly objective) and patients' function, as measured by the interference scale of the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (subjective); and 2) evaluate the relationship between the Total Neuropathy Score-reduced and neuropathy symptom experience, as measured by the symptom experience scale of the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (Subjective). To achieve those aims, a secondary data analysis for 56 participants who participated in a study entitled: Group Acupuncture for Treatment of Neuropathy from Chemotherapy was done. After Pearson correlations were calculated, the study found that there is a positive, weak relationship between the TNSr and the symptom experience scale of the CIPNAT(r=0.34). A positive, week relationship was found between the TNSr and the interference with activity scale of the CIPNAT(r=0.28). These results suggest that objective and subjective assessment are not highly correlated, and likely measure different aspects of CIPN. A comprehensive assessment approach is needed for decision making in the clinical oncology setting.

  19. Association of screen time with self-perceived attention problems and hyperactivity levels in French students: a cross-sectional study

    PubMed Central

    Guichard, Elie; Kurth, Tobias

    2016-01-01

    Objective To investigate whether high levels of screen time exposure are associated with self-perceived levels of attention problems and hyperactivity in higher education students. Design Cross-sectional study among participants of the i-Share cohort. Setting French-speaking students of universities and higher education institutions. Participants 4816 graduate students who were at least 18 years old. Exposure Screen time was assessed by self-report of the average time spent on five different screen activities on smartphone, television, computer and tablet and categorised into quartiles. Main outcome measure We used the Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v1.1) concerning students’ behaviour over the past 6 months to measure self-perceived levels of attention problems and hyperactivity. Responses were summarised into a global score as well as scores for attention problems and hyperactivity. Results The 4816 participants of this study had a mean age of 20.8 years and 75.5% were female. Multivariable ordinary regression models showed significant associations of screen time exposure with quintiles of the total score of self-perceived attention problems and hyperactivity levels as well as the individual domains. Compared to the lowest screen time exposure category, the ORs (95% CI) were 1.58 (1.37 to 1.82) for each increasing level of quintiles of the global score, 1.57 (1.36 to 1.81) for increasing quintiles of attention levels and 1.25 (1.09 to 1.44) for increasing quartiles of hyperactivity. Conclusions Results of this large cross-sectional study among French university and higher education students show dose-dependent associations between screen time and self-perceived levels of attention problems and hyperactivity. Further studies are warranted to evaluate whether interventions could positively influence these associations. PMID:26920440

  20. Behavioural problems in children with enuresis

    PubMed Central

    Birdal, Seval; Doğangün, Burak

    2016-01-01

    Aim: Enuresis is defined as involuntary or intentional repeated voiding of urine into clothes or bed at least twice a week for a period of three consecutive months in children older than five years old. It is one of the most frequent chronic childhood disorders. The aim of this study was to investigate the frequency of behavioural problems in children with enuresis. Material and Methods: The research compared 30 children aged between 7 and 11 years who had consulted to Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Training and Research Hospital, Child and Adolescent Psychiatry Clinics and diagnosed with enuresis with their 30 peers who were randomly selected from a state elementary school. The Child Behaviour Checklist was applied to both groups. Results: The subdimension scores of both groups were compared, it was observed that children with enuresis had higher scores compared to their peers in all sub-tests except for the Sluggish Cognitive Tempo, Anxiety Disorders, and Obsessive Compulsive Disorder sub-tests. Enuretic children had higher scores in externalizing (p<0.001), internalizing (p=0.001) and total problem (p<0.001) scales. Conclusion: The results of this study indicate that children with enuresis exhibit behavioral problems with a higher rate compared to their healthy peers. The results are in line with the literature. Moreover, compered to the results of the studies conducted in different countries, significantly higher scores in internalizing problems were obtained. It was thought is possible that this might be related with cultural factors. However, these findings need to be verified with data from larger scale studies. PMID:27738398

  1. Vision and academic performance of learning disabled children.

    PubMed

    Wharry, R E; Kirkpatrick, S W

    1986-02-01

    The purpose of this study was to assess difference in academic performance among myopic, hyperopic, and emmetropic children who were learning disabled. More specifically, myopic children were expected to perform better on mathematical and spatial tasks than would hyperopic ones and that hyperopic and emmetropic children would perform better on verbal measures than would myopic ones. For 439 learning disabled students visual anomalies were determined via a Generated Retinal Reflex Image Screening System. Test data were obtained from school files. Partial support for the hypothesis was obtained. Myopic learning disabled children outperformed hyperopic and emmetropic children on the Key Math test. Myopic children scored better than hyperopic children on the WRAT Reading subtest and on the Durrell Analysis of Reading Difficulty Oral Reading Comprehension, Oral Rate, Flashword, and Spelling subtests, and on the Key Math Measurement and Total Scores. Severity of refractive error significantly affected the Wechsler Intelligence Scale for Children--Revised Full Scale, Performance Scale, Verbal Scale, and Digit Span scores but did not affect any academic test scores. Several other findings were also reported. Those with nonametropic problems scored higher than those without problems on the Key Math Time subtest. Implications supportive of the theories of Benbow and Benbow and Geschwind and Behan were stated.

  2. Psychometric characteristics of the chronic Otitis media questionnaire 12 (COMQ - 12): stability of factor structure and replicability shown by the Serbian version.

    PubMed

    Bukurov, Bojana; Arsovic, Nenad; Grujicic, Sandra Sipetic; Haggard, Mark; Spencer, Helen; Marinkovic, Jelena Eric

    2017-10-23

    Recently, demand for and supply of short-form patient-reported outcome measures (PROMs) have risen throughout the world healthcare. Our contribution to meeting that demand has been translating and culturally adapting the Chronic Otitis Media Questionnaire-12 (COMQ-12) for adults into Serbian and enhancing its psychometric base on the relatively large Serbian COM caseload. Chronic otitis media can seriously affect quality of life progressively and in long-term, and it remains the major source of hearing problems in the developing world. The translated questionnaire was given twice to 60 adult patients with chronic otitis media of three types (inactive, active mucosal and active squamous disease) and to 60 healthy volunteers. Both patients and volunteers also filled the generic Short-Form 36 questionnaire (SF-36). Conventional statistical procedures were used in strategically driven development of scoring. Additionally, item responses were scaled by linear mapping against the provisional total score. Generalizability, detailed factor interpretation and supportability of scores were criteria, for the best compromise factor solution. Test-retest reliability was very high (0.924 to 0.989, depending on score). The a priori content dimensions of the questionnaire were strongly supported by 3-factor exploratory and confirmatory factor analyses for content validity, separating (i) ear symptoms from (ii) hearing problems, from (iii) daily activity restriction plus healthcare uptake. The 3-factor structure was furthermore highly stable on replication. The very large effect sizes when contrasting patients with healthy volunteers, and active with inactive disease established construct validity for the total score. A strong association with disease activity and a moderate one with generic health-related quality of life (HRQoL), the SF-36, supported construct validity for two of three factors extracted (ear symptoms, and impact on daily activities plus healthcare uptake). Given the minimal psychometric work to date on COMQ-12, this interim sample with 120 data points adds materially to knowledge of its reliability, several forms of validity and the feasibility of profile sub-scores to supplement total scores. The good psychometric properties shown for COMQ-12 justify both its routine clinical use and acquisition of the necessarily larger sample for generality, score optimisation and the evaluation of responsiveness.

  3. Association between speech-language, general cognitive functioning and behaviour problems in individuals with Williams syndrome.

    PubMed

    Rossi, N F; Giacheti, C M

    2017-07-01

    Williams syndrome (WS) phenotype is described as unique and intriguing. The aim of this study was to investigate the associations between speech-language abilities, general cognitive functioning and behavioural problems in individuals with WS, considering age effects and speech-language characteristics of WS sub-groups. The study's participants were 26 individuals with WS and their parents. General cognitive functioning was assessed with the Wechsler Intelligence Scale. Peabody Picture Vocabulary Test, Token Test and the Cookie Theft Picture test were used as speech-language measures. Five speech-language characteristics were evaluated from a 30-min conversation (clichés, echolalia, perseverative speech, exaggerated prosody and monotone intonation). The Child Behaviour Checklist (CBCL 6-18) was used to assess behavioural problems. Higher single-word receptive vocabulary and narrative vocabulary were negatively associated with CBCL T-scores for Social Problems, Aggressive Behaviour and Total Problems. Speech rate was negatively associated with the CBCL Withdrawn/Depressed T-score. Monotone intonation was associated with shy behaviour, as well as exaggerated prosody with talkative behaviour. WS with perseverative speech and exaggerated prosody presented higher scores on Thought Problems. Echolalia was significantly associated with lower Verbal IQ. No significant association was found between IQ and behaviour problems. Age-associated effects were observed only for the Aggressive Behaviour scale. Associations reported in the present study may represent an insightful background for future predictive studies of speech-language, cognition and behaviour problems in WS. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  4. Assessment of sleep in pediatric cancer patients.

    PubMed

    İnce, Dilek; Demirağ, Bengü; Karapınar, Tuba Hilkay; Oymak, Yeşim; Ay, Yılmaz; Kaygusuz, Arife; Töret, Ersin; Vergin, Canan

    2017-01-01

    İnce D, Demirağ B, Karapınar TH, Oymak Y, Ay Y, Kaygusuz A, Töret E, Vergin C. Assessment of sleep in pediatric cancer patients. Turk J Pediatr 2017; 59: 379-386. The purpose of the study is to describe sleep habits, assess the prevalence of sleep disturbances in pediatric cancer patients and healthy controls, and to compare sleep patterns, sleep problems. One hundred-thirty-five patients and 190 healthy controls were evaluated. Healthy children matched for age, sex, economic status, parental education and family structure constituted the control group. Sleep was evaluated by using the Children`s Sleep Habits Questionnaire (CSHQ). Sleep problems were detected in half of patients. There were no significant differences in total sleep score and subscale scores between patients and controls. Solely the wake-time was found significantly different between patients and controls. Although our results indicated that neither childhood cancer survivors nor patients with cancer during treatment period had more sleep problems than their healthy peers, sleep problems were not uncommon in whole study group. This study underlines the need to screen, assess and manage sleep problems in children with diagnosis of cancer.

  5. [Behaviour problems of children with Down syndrome in preschool-age - Results from the Heidelberg Down syndrome study].

    PubMed

    Sarimski, Klaus

    2018-05-01

    We report on the frequency and the correlations of behaviour problems among children with Down syndrome in preschool-age. As part of a longitudinal study 48 mothers of children with Down syndrome completed the German version of the “Strengths and Difficulties Questionnaire” (SDQ-D) and the Parenting Stress Inventory (PSI). The mothers were asked to fill out the questionnaires when the children had a mean age of five years. The results were compared to norms from children with typical development. Thirty per cent of the children with Down syndrome were rated as abnormal. Specifically, mean scores indicating problems with children of the same age and hyperactivity were elevated. A regression analysis predicting the total problem score of the SDQ-D revealed maternal educational level, optimistic attitude, and subjective parental stress at the age of one year and the degree of behavioural abnormalities at the age of three years as significant influential factors. Early intervention for Down syndrome children should include supporting parenting competence and coping skills in order to prevent behaviour problems.

  6. Why Johnny Can Be Average Today.

    ERIC Educational Resources Information Center

    Sturrock, Alan

    1997-01-01

    During a (hypothetical) phone interview with a university researcher, an elementary principal reminisced about a lifetime of reading groups with unmemorable names, medium-paced math problems, patchworked social studies/science lessons, and totally "average" IQ and batting scores. The researcher hung up at the mention of bell-curved assembly lines…

  7. Walker use, but not falls, is associated with lower physical functioning and health of residents in an assisted-living environment.

    PubMed

    Andersen, Daniel A; Roos, Bernard A; Stanziano, Damian C; Gonzalez, Natasha M; Signorile, Joseph F

    2007-01-01

    The relationship between perceived health and walker use has seldom been addressed. Concerns over falls and falls risk are precursors to walker use. We compared the SF-36 scores of 26 women and 14 men, mean age 86.8 +/- 6.0 years based on walker use and faller status. An analysis of covariance (ANCOVA) with age as the covariate, compared groups for the SF-36 constructs and totals score. Significant differences were noted between walker users and nonusers in physical functioning, role limitations due to physical problems, general health, and the total SF-36 score. Pairwise comparisons favored nonusers, while no differences were seen due to faller status. Walker use is associated with lower self-perceptions of physical functioning, role limitations due to physical problems, and general health in assisted-living residents. Faller status is not associated with self-perceived health status. Although walker use aids mobility and lowers the probability of falls, further research is needed to determine if the prescription of assistive devices has a more negative impact on self-perceived health than does falling. This possibility could be explained, in part, by the greater activity levels of those individuals who do not depend on walkers.

  8. Aggression in Teachers is Related to Role Conflict and Role Ambiguity as Occupational Stress.

    PubMed

    Kanchika, Masaru; Iwasaki, Shinichi; Konish, Akihito; Deguchi, Yasuhiko; Kobayashi, Yumi; Nakada, Akihiro; Inoue, Koki

    2015-12-01

    Aggression in the workplace is increasingly recognized as a serious problem, but there are few studies about worker aggression toward outsiders in the workplace. We investigated the association between aggression and occupational stress among teachers. This was a cross-sectional study of 1583 teachers, principals, and vice-principals. Aggression was measured using the Japanese version of the Buss-Perry Aggression Questionnaire (BAQ). The survey respondents were classified into tertiles according to the BAQ score. The high BAQ group was defined as the upper tertile for the BAQ total score (BAQ total score 625). Occupational stress was measured using the Japanese version of the Generic Job Stress Questionnaire. Comparisons among the groups were performed using multiple logistic regression analysis. Of the 1583 respondents, 488 were included in the high BAQ group. After adjusting for demographic and occupational variables, high role conflict and role ambiguity were significantly associated with belonging to the high BAQ group. In subscales of the BAQ, high role conflict and role ambiguity related to high levels of hostility, and physical aggression. Occupational stress such as role conflict and role ambiguity was associated with aggression among teachers. It is necessary to reduce problems which relates to role conflict and role ambiguity for preventing teachers' aggression.

  9. The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism.

    PubMed

    Mazefsky, Carla A; Schreiber, Dana R; Olino, Thomas M; Minshew, Nancy J

    2014-07-01

    This study investigated the association between gastrointestinal symptoms and a broad set of emotional and behavioral concerns in 95 children with high-functioning autism and IQ scores ≥ 80. Gastrointestinal symptoms were assessed via the Autism Treatment Network's Gastrointestinal Symptom Inventory, and data were gathered on autism symptom severity, adaptive behavior, and multiple internalizing and externalizing problems. The majority (61%) of children had at least one reported gastrointestinal symptom. Emotional and behavioral problems were also common but with a high degree of variability. Children with and without gastrointestinal problems did not differ in autism symptom severity, adaptive behavior, or total internalizing or externalizing problem scores. However, participants with gastrointestinal problems had significantly higher levels of affective problems. This finding is consistent with a small body of research noting a relationship between gastrointestinal problems, irritability, and mood problems in autism spectrum disorder. More research to identify the mechanisms underlying this relationship in autism spectrum disorder is warranted. Future research should include a medical assessment of gastrointestinal concerns, longitudinal design, and participants with a range of autism spectrum disorder severity in order to clarify the directionality of this relationship and to identify factors that may impact heterogeneity in the behavioral manifestation of gastrointestinal concerns. © The Author(s) 2013.

  10. Reliability and Validity of the Alcohol Short Index of Problems and a Newly Constructed Drug Short Index of Problems*

    PubMed Central

    Alterman, Arthur I.; Cacciola, John S.; Ivey, Megan A.; Lynch, Kevin G.

    2009-01-01

    Objective: This study evaluated the psychometric properties of the 15-item alcohol Short Index of Problems (SIP) instrument and those of a newly constructed 15-item drug Short Index of Problems (SIP-D) instrument in 277 newly entered substance-abuse patients. Method: The SIP is derived from the longer, 50-item Drinker Inventory of Consequences (DrInC), which was designed to assess adverse consequences of alcohol use. The SIP-D was constructed by substituting the term “drug use” for the term “drinking” in each SIP item. A 3-month recall interval was employed. Results: Factor analyses of each of the instruments revealed similar solutions, with only one main factor accounting for the majority of variance. Nonparametric item response theory methods produced the same finding. Internal consistency reliability estimates for the SIP and SIP-D total scores were .98 and .97, respectively. Concurrent validity was demonstrated by examining the correlations of the total scores for each of the instruments with the recent summary indexes of the newly revised Addiction Severity Index (ASI-Version 6): alcohol, drug, medical, economic, legal, family/social, and psychiatric problems. Conclusions: This study is the first to confirm the psychometric validity of the SIP when used as an independent instrument unembedded within the DrInC. The study also supports the use of the SIP-D as a brief measure of adverse consequences of drug use. The findings strongly support the unidimensional structure of both measures. PMID:19261243

  11. Reliability and validity of the alcohol short index of problems and a newly constructed drug short index of problems.

    PubMed

    Alterman, Arthur I; Cacciola, John S; Ivey, Megan A; Habing, Brian; Lynch, Kevin G

    2009-03-01

    This study evaluated the psychometric properties of the 15-item alcohol Short Index of Problems (SIP) instrument and those of a newly constructed 15-item drug Short Index of Problems (SIP-D) instrument in 277 newly entered substance-abuse patients. The SIP is derived from the longer, 50-item Drinker Inventory of Consequences (DrInC), which was designed to assess adverse consequences of alcohol use. The SIP-D was constructed by substituting the term "drug use" for the term "drinking" in each SIP item. A 3-month recall interval was employed. Factor analyses of each of the instruments revealed similar solutions, with only one main factor accounting for the majority of variance. Nonparametric item response theory methods produced the same finding. Internal consistency reliability estimates for the SIP and SIP-D total scores were .98 and .97, respectively. Concurrent validity was demonstrated by examining the correlations of the total scores for each of the instruments with the recent summary indexes of the newly revised Addiction Severity Index (ASI-Version 6): alcohol, drug, medical, economic, legal, family/social, and psychiatric problems. This study is the first to confirm the psychometric validity of the SIP when used as an independent instrument unembedded within the DrInC. The study also supports the use of the SIP-D as a brief measure of adverse consequences of drug use. The findings strongly support the unidimensional structure of both measures.

  12. An iterated local search algorithm for the team orienteering problem with variable profits

    NASA Astrophysics Data System (ADS)

    Gunawan, Aldy; Ng, Kien Ming; Kendall, Graham; Lai, Junhan

    2018-07-01

    The orienteering problem (OP) is a routing problem that has numerous applications in various domains such as logistics and tourism. The objective is to determine a subset of vertices to visit for a vehicle so that the total collected score is maximized and a given time budget is not exceeded. The extensive application of the OP has led to many different variants, including the team orienteering problem (TOP) and the team orienteering problem with time windows. The TOP extends the OP by considering multiple vehicles. In this article, the team orienteering problem with variable profits (TOPVP) is studied. The main characteristic of the TOPVP is that the amount of score collected from a visited vertex depends on the duration of stay on that vertex. A mathematical programming model for the TOPVP is first presented and an algorithm based on iterated local search (ILS) that is able to solve modified benchmark instances is then proposed. It is concluded that ILS produces solutions which are comparable to those obtained by the commercial solver CPLEX for smaller instances. For the larger instances, ILS obtains good-quality solutions that have significantly better objective value than those found by CPLEX under reasonable computational times.

  13. Prenatal and Childhood Traffic-Related Air Pollution Exposure and Childhood Executive Function and Behavior

    PubMed Central

    Harris, Maria H.; Gold, Diane R.; Rifas-Shiman, Sheryl L.; Melly, Steven J.; Zanobetti, Antonella; Coull, Brent A.; Schwartz, Joel D.; Gryparis, Alexandros; Kloog, Itai; Koutrakis, Petros; Bellinger, David C.; Belfort, Mandy B.; Webster, Thomas F.; White, Roberta F.; Sagiv, Sharon K.; Oken, Emily

    2016-01-01

    Background Traffic-related air pollution exposure may influence brain development and function and thus be related to neurobehavioral problems in children, but little is known about windows of susceptibility. Aims Examine associations of gestational and childhood exposure to traffic-related pollution with executive function and behavior problems in children. Methods We studied associations of pre- and postnatal pollution exposures with neurobehavioral outcomes in 1,212 children in the Project Viva pre-birth cohort followed to mid-childhood (median age 7.7 years). Parents and classroom teachers completed the Behavior Rating Inventory of Executive Function (BRIEF), and the Strengths and Difficulties Questionnaire (SDQ). Using validated spatiotemporal models, we estimated exposure to black carbon (BC) and fine particulate matter (PM2.5) in the third trimester of pregnancy, from birth to 3 years, from birth to 6 years, and in the year before behavioral ratings. We also measured residential distance to major roadways and near-residence traffic density at birth and in mid-childhood. We estimated associations of BC, PM2.5, and other traffic exposure measures with BRIEF and SDQ scores, adjusted for potential confounders. Results Higher childhood BC exposure was associated with higher teacher-rated BRIEF Behavioral Regulation Index (BRI) scores, indicating greater problems: 1.0 points (95% confidence interval (CI): 0.0, 2.1) per interquartile range (IQR) increase in birth-age 6 BC, and 1.7 points (95% CI: 0.6, 2.8) for BC in the year prior to behavioral ratings. Mid-childhood residential traffic density was also associated with BRI score (0.6, 95% CI: 0.1, 1.1). Birth-age 3 BC was not associated with BRIEF or SDQ scores. Third trimester BC exposure was not associated with teacher-rated BRI scores (−0.2, 95% CI: −1.1, 0.8), and predicted lower scores (fewer problems) on the BRIEF Metacognition Index (−1.2, 95% CI: −2.2, −0.2) and SDQ total difficulties (−0.9, 95% CI: −1.4, −0.4). PM2.5 exposure was associated with teacher-rated BRIEF and SDQ scores in minimally adjusted models but associations attenuated with covariate adjustment. None of the parent-rated outcomes suggested adverse effects of greater pollution exposure at any time point. Conclusions Children with higher mid-childhood exposure to BC and greater near-residence traffic density in mid-childhood had greater problems with behavioral regulation as assessed by classroom teachers, but not as assessed by parents. Prenatal and early childhood exposure to traffic-related pollution did not predict greater executive function or behavior problems; third trimester BC was associated with lower scores (representing fewer problems) on measures of metacognition and behavioral problems. PMID:27350569

  14. Prenatal and childhood traffic-related air pollution exposure and childhood executive function and behavior.

    PubMed

    Harris, Maria H; Gold, Diane R; Rifas-Shiman, Sheryl L; Melly, Steven J; Zanobetti, Antonella; Coull, Brent A; Schwartz, Joel D; Gryparis, Alexandros; Kloog, Itai; Koutrakis, Petros; Bellinger, David C; Belfort, Mandy B; Webster, Thomas F; White, Roberta F; Sagiv, Sharon K; Oken, Emily

    Traffic-related air pollution exposure may influence brain development and function and thus be related to neurobehavioral problems in children, but little is known about windows of susceptibility. Examine associations of gestational and childhood exposure to traffic-related pollution with executive function and behavior problems in children. We studied associations of pre- and postnatal pollution exposures with neurobehavioral outcomes in 1212 children in the Project Viva pre-birth cohort followed to mid-childhood (median age 7.7years). Parents and classroom teachers completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Strengths and Difficulties Questionnaire (SDQ). Using validated spatiotemporal models, we estimated exposure to black carbon (BC) and fine particulate matter (PM 2.5 ) in the third trimester of pregnancy, from birth to 3years, from birth to 6years, and in the year before behavioral ratings. We also measured residential distance to major roadways and near-residence traffic density at birth and in mid-childhood. We estimated associations of BC, PM 2.5 , and other traffic exposure measures with BRIEF and SDQ scores, adjusted for potential confounders. Higher childhood BC exposure was associated with higher teacher-rated BRIEF Behavioral Regulation Index (BRI) scores, indicating greater problems: 1.0 points (95% confidence interval (CI): 0.0, 2.1) per interquartile range (IQR) increase in birth-age 6BC, and 1.7 points (95% CI: 0.6, 2.8) for BC in the year prior to behavioral ratings. Mid-childhood residential traffic density was also associated with BRI score (0.6, 95% CI: 0.1, 1.1). Birth-age 3BC was not associated with BRIEF or SDQ scores. Third trimester BC exposure was not associated with teacher-rated BRI scores (-0.2, 95% CI: -1.1, 0.8), and predicted lower scores (fewer problems) on the BRIEF Metacognition Index (-1.2, 95% CI: -2.2, -0.2) and SDQ total difficulties (-0.9, 95% CI: -1.4, -0.4). PM 2.5 exposure was associated with teacher-rated BRIEF and SDQ scores in minimally adjusted models but associations attenuated with covariate adjustment. None of the parent-rated outcomes suggested adverse effects of greater pollution exposure at any time point. Children with higher mid-childhood exposure to BC and greater near-residence traffic density in mid-childhood had greater problems with behavioral regulation as assessed by classroom teachers, but not as assessed by parents. Prenatal and early childhood exposure to traffic-related pollution did not predict greater executive function or behavior problems; third trimester BC was associated with lower scores (representing fewer problems) on measures of metacognition and behavioral problems. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Predictors of child functioning and problem behaviors for children diagnosed with posttraumatic stress disorder and externalizing problems.

    PubMed

    Nabors, Laura; Baker-Phibbs, Christina; Burbage, Michelle

    2016-01-01

    Posttraumatic stress disorder and behavioral disorders are related to problems in emotional functioning for young children. Factors related to child functioning are important to understand in order to develop interventions and assess their impact. This study examined clinician and parent reports of child functioning and behavior problems and factors related to each of these outcome variables. Results indicated that parental acceptance was inversely related to child behavior problems. Increased parental supervision of the child was related to high total problems scores. Parental acceptance was positively related to child functioning. Future research is needed to examine relations among interventions to improve parental supervision and interactions with the child and child functioning, in terms of both positive and negative behaviors.

  16. Measurement error in the Liebowitz Social Anxiety Scale: results from a general adult population in Japan.

    PubMed

    Takada, Koki; Takahashi, Kana; Hirao, Kazuki

    2018-01-17

    Although the self-report version of Liebowitz Social Anxiety Scale (LSAS) is frequently used to measure social anxiety, data is lacking on the smallest detectable change (SDC), an important index of measurement error. We therefore aimed to determine the SDC of LSAS. Japanese adults aged 20-69 years were invited from a panel managed by a nationwide internet research agency. We then conducted a test-retest internet survey with a two-week interval to estimate the SDC at the individual (SDC ind ) and group (SDC group ) levels. The analysis included 1300 participants. The SDC ind and SDC group for the total fear subscale (scoring range: 0-72) were 23.52 points (32.7%) and 0.65 points (0.9%), respectively. The SDC ind and SDC group for the total avoidance subscale (scoring range: 0-72) were 32.43 points (45.0%) and 0.90 points (1.2%), respectively. The SDC ind and SDC group for the overall total score (scoring range: 0-144) were 45.90 points (31.9%) and 1.27 points (0.9%), respectively. Measurement error is large and indicate the potential for major problems when attempting to use the LSAS to detect changes at the individual level. These results should be considered when using the LSAS as measures of treatment change.

  17. [Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis].

    PubMed

    Medenica, Ivica; Luković, Milan; Radoicić, Dragan

    2010-02-01

    The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score--7.1). We performed total rearthroplasty by a custom-made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score--87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specificaly for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

  18. The relationship between sexual functioning and depressive symptomatology in postpartum women: a pilot study.

    PubMed

    Chivers, Meredith L; Pittini, Richard; Grigoriadis, Sophie; Villegas, Laura; Ross, Lori E

    2011-03-01

    Previous research on postpartum sexuality has primarily focused on the impact of physical factors on the resumption and frequency of sexual intercourse; fewer studies have focused on the impact of psychological factors on women's sexual functioning. The aim of this study is to assess current sexual functioning and sexual behavior in women with and without symptoms of postpartum depression using validated measures of postpartum depression and sexual functioning. Women attending postpartum appointments were consecutively recruited over a 12-month period and completed questionnaires assessing sexual functioning, current sexual behavior, and mental health. The Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and items assessing current sexual behaviors. A total of 77 women returned completed questionnaire packages (mean postpartum weeks: 13, range 3-24). Of these, 57 women (74%) had engaged in sexual activity with a partner in the 4 weeks prior to completing the questionnaire. The mean FSFI score was 23.0 (range 6-34), with 37 women (65%) scoring in the range associated with clinical sexual dysfunction. Women with elevated EPDS scores had significantly lower total FSFI, arousal, orgasm, and satisfaction FSFI subscale scores (all P values <0.005) than nondepressed women, suggesting more problematic sexual functioning. Desire, lubrication, and pain FSFI subscale scores were not significantly associated with depression status. A substantial proportion of women experience sexual problems in the postpartum period; these problems are particularly pronounced among women with symptoms of postpartum depression. Longitudinal research is needed to better understand the relationship between sexual dysfunction and depression among postpartum women, and to identify implications for prevention and treatment of both conditions. © 2010 International Society for Sexual Medicine.

  19. Impact of nutritional status on the quality of life of advanced cancer patients in hospice home care.

    PubMed

    Shahmoradi, Negar; Kandiah, Mirnalini; Peng, Loh Su

    2009-01-01

    Cancer patients frequently experience malnutrition and this is an important factor in impaired quality of life. This cross-sectional study examined the association between global quality of life and its various subscales with nutritional status among 61 (33 females and 28 males) advanced cancer patients cared for by selected hospices in peninsular Malaysia. The Patient Generated-Subjective Global Assessment (PG-SGA) and the Hospice Quality of Life Index (HQLI) were used to assess nutritional status and quality of life, respectively. Nine (14.7%) patients were well-nourished, 32 (52.5%) were moderately or suspected of being malnourished while 20 (32.8%) of them were severely malnourished. The total HQLI mean score for these patients was 189.9-/+51.7, with possible scores ranging from 0 to 280. The most problem areas in these patients were in the domain of functional well-being and the least problems were found in the social/spiritual domain. PG-SGA scores significantly correlated with total quality of life scores (r2= 0.38, p<0.05), psychophysiological well-being (r2= 0.37, p<0.05), functional well-being (r2= 0.42, p<0.05) and social/ spiritual well-being (r2= 0.07, p<0.05). Thus, patients with a higher PG-SGA score or poorer nutritional status exhibited a lower quality of life. Advanced cancer patients with poor nutritional status have a diminished quality of life. These findings suggest that there is a need for a comprehensive nutritional intervention for improving nutritional status and quality of life in terminally ill cancer patients under hospice care.

  20. Psychometric properties and Dutch norm values of the Children's Sleep Habits Questionnaire in toddlers.

    PubMed

    Steur, Lindsay Martina Helena; Visser, Eva Henriëtte; Grootenhuis, Martha Alexandra; Terwee, Caroline Barbara; Kaspers, Gerardus Johannes Laurentius; van Litsenburg, Raphaële Reine Lydie

    2017-06-01

    The Children's Sleep Habits Questionnaire (CSHQ) was developed in the USA for children aged 4-10 years. The Dutch CSHQ has been validated for this age group, but not yet for toddlers. Furthermore, Dutch norm values for toddlers are unavailable. This study aimed to investigate the psychometric properties and collect norm values of the Dutch CSHQ in toddlers. Data collection was conducted by Taylor Nelson Sofres Netherlands Institute for Public Opinion (TNS-NIPO), a Dutch market research agency. The TNS-NIPO provided access to the TNS-NIPO base, which comprises a panel of respondents who have indicated that they are willing to regularly participate in research. Parents of children aged 2-3 years were invited to complete the CSHQ. The CSHQ is a multidimensional questionnaire to detect sleep problems in children. It is a 33-item, one-week retrospective (parent-)proxy survey. A higher score indicates more sleep problems. The response rate was 61% (n = 201). The original eight-factor structure did not fit well in this population and a more appropriate structure could not be achieved with explorative factor analyses. The mean total score was 41.9 (SD 5.6), and was higher (indicating more sleep problems) compared to Dutch school-aged children. The one-dimensionality of the subscales of the CSHQ could not be confirmed in Dutch toddlers. Clinicians and researcher should be aware of the difficulty of reliably measuring sleep in this age group when using the CSHQ. For research purposes, it is therefore recommended to only use the total score. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. The Behavior Problems Inventory-Short Form for individuals with intellectual disabilities: part II: reliability and validity.

    PubMed

    Rojahn, J; Rowe, E W; Sharber, A C; Hastings, R; Matson, J L; Didden, R; Kroes, D B H; Dumont, E L M

    2012-05-01

    The Behavior Problems Inventory-01 (BPI-01) is an informant-based behaviour rating instrument for intellectual disabilities (ID) with 49 items and three sub-scales: Self-injurious Behavior, Stereotyped Behavior and Aggressive/Destructive Behavior. The Behavior Problems Inventory-Short Form (BPI-S) is a BPI-01 spin-off with 30 items. The psychometric properties of these two versions of the scale were computed using aggregated archival data from nine different sites in the USA, Wales, England, the Netherlands and Romania with a total of 1122 cases with a BPI-01 total score >0. The internal consistency of the BPI-01 and the BPI-S ranged from fair to excellent with the BPI-01 showing slightly stronger reliability. Construct validity (confirmatory and discriminant) was computed by comparing BPI sub-scale scores with the scores of four other behaviour rating scales (the Aberrant Behavior Checklist, the Diagnostic Assessment for the Severely Handicapped-II, the Nisonger Child Behavior Rating Form and the Inventory for Client and Agency Planning). Strong evidence for confirmatory and discriminant validity was found for both the BPI-01 and the BPI-S. Confirmatory fit indices for the BPI and the BPI-S were comparable and suggesting that the factor structures fit the data well. In summary, both BPI versions were found to be equally sound psychometrically and can be endorsed for future use. However, independent future studies are needed to replicate the psychometrics of the BPI-S with new data. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

  2. The psychological well-being of children orphaned by AIDS in Cape Town, South Africa

    PubMed Central

    Cluver, Lucie; Gardner, Frances

    2006-01-01

    Background An estimated 2 million children are parentally bereaved by AIDS in South Africa. Little is known about mental health outcomes for this group. Methods This study aimed to investigate mental health outcomes for urban children living in deprived settlements in Cape Town. 30 orphaned children and 30 matched controls were compared using standardised questionnaires (SDQ) on emotional and behavioural problems, peer and attention difficulties, and prosocial behaviour. The orphan group completed a modified version of a standardised questionnaire (IES-8), measuring Post-Traumatic Stress symptoms. Group differences were tested using t-tests and Pearson's chi-square. Results Both groups scored highly for peer problems, emotional problems and total scores. However, orphans were more likely to view themselves as having no good friends (p = .002), to have marked concentration difficulties (p = .03), and to report frequent somatic symptoms (p = .05), but were less likely to display anger through loss of temper (p = .03). Orphans were more likely to have constant nightmares (p = .01), and 73% scored above the cut-off for Post-Traumatic Stress Disorder. Conclusion Findings suggest important areas for larger-scale research for parentally-bereaved children. PMID:16848910

  3. Musculoskeletal Health of 40-65 Year Old Males and Females in Kosova and the Impact of N05B, A02B (PPI, H2RA), H02AB and Lifestyle Factors on It

    PubMed Central

    Krasniqi, Ermira; Koni, Mynyr; Tschan, Harald; Krasniqi, Blerim; Kabashi, Antigona; Boshnjaku, Arben

    2016-01-01

    Background: This observational, cross-sectional study investigates the impact of medication usage, physical activity (PA) and nutritional status on musculoskeletal health (MSH) in males and females aged 40-65 in the population of a post conflict, developing country. Methods: Bone Mineral Density (BMD), T-score and Z-score at distal forearm regions (measured by DEXA scan), together with isometric hand grip strength (dynamometer) were evaluated in a total of 162 subjects (53 Males, average age 55.15±7.12 and 109 Females, 54.27±5.1). Additionally, bio-anthropometric assessments, medication usage, PA level and nutritional status were assessed. Results: Significant differences (p<0.05) were found in total subjects Body Mass Index (BMI), PA, BMD, T-score and Hand grip between genders. 42% of total participants met the diagnostic criteria of, out of which 6.8% with T-score below -2, while no cases of Osteoporosis was recorded. N05B Anxiolytics and A02B Drugs for peptic ulcer and gastro-oesophageal reflux disease medication groups consumption turned to have no significant differences (p>0.05) in BMD, T-score, and hand grip in total population, except for A02B where p<0.05 were found in Hand grip, as well as between female consumers and no consumers in all variables. Meanwhile, in total subjects consuming H02AB Glucocorticoids p<0.05 were observed in BMD and T-score, but not on hand grip. Conclusions: This study shows a low risk for MSH problems amongst the studied population in Kosova, while the consumption of H02AB medication group in both genders and A02B in females only for extended periods might effect MSH, therefore appropriate benefit/risk assessment should be made before prescribing these medications, notwithstanding age, gender, PA or nutritional status. PMID:27994297

  4. Musculoskeletal Health of 40-65 Year Old Males and Females in Kosova and the Impact of N05B, A02B (PPI, H2RA), H02AB and Lifestyle Factors on It.

    PubMed

    Krasniqi, Ermira; Koni, Mynyr; Tschan, Harald; Krasniqi, Blerim; Kabashi, Antigona; Boshnjaku, Arben

    2016-10-01

    This observational, cross-sectional study investigates the impact of medication usage, physical activity (PA) and nutritional status on musculoskeletal health (MSH) in males and females aged 40-65 in the population of a post conflict, developing country. Bone Mineral Density (BMD), T-score and Z-score at distal forearm regions (measured by DEXA scan), together with isometric hand grip strength (dynamometer) were evaluated in a total of 162 subjects (53 Males, average age 55.15±7.12 and 109 Females, 54.27±5.1). Additionally, bio-anthropometric assessments, medication usage, PA level and nutritional status were assessed. Significant differences (p<0.05) were found in total subjects Body Mass Index (BMI), PA, BMD, T-score and Hand grip between genders. 42% of total participants met the diagnostic criteria of, out of which 6.8% with T-score below -2, while no cases of Osteoporosis was recorded. N05B Anxiolytics and A02B Drugs for peptic ulcer and gastro-oesophageal reflux disease medication groups consumption turned to have no significant differences (p>0.05) in BMD, T-score, and hand grip in total population, except for A02B where p<0.05 were found in Hand grip, as well as between female consumers and no consumers in all variables. Meanwhile, in total subjects consuming H02AB Glucocorticoids p<0.05 were observed in BMD and T-score, but not on hand grip. This study shows a low risk for MSH problems amongst the studied population in Kosova, while the consumption of H02AB medication group in both genders and A02B in females only for extended periods might effect MSH, therefore appropriate benefit/risk assessment should be made before prescribing these medications, notwithstanding age, gender, PA or nutritional status.

  5. Medication regimen complexity in ambulatory older adults with heart failure.

    PubMed

    Cobretti, Michael R; Page, Robert L; Linnebur, Sunny A; Deininger, Kimberly M; Ambardekar, Amrut V; Lindenfeld, JoAnn; Aquilante, Christina L

    2017-01-01

    Heart failure prevalence is increasing in older adults, and polypharmacy is a major problem in this population. We compared medication regimen complexity using the validated patient-level Medication Regimen Complexity Index (pMRCI) tool in "young-old" (60-74 years) versus "old-old" (75-89 years) patients with heart failure. We also compared pMRCI between patients with ischemic cardiomyopathy (ISCM) versus nonischemic cardiomyopathy (NISCM). Medication lists were retrospectively abstracted from the electronic medical records of ambulatory patients aged 60-89 years with heart failure. Medications were categorized into three types - heart failure prescription medications, other prescription medications, and over-the-counter (OTC) medications - and scored using the pMRCI tool. The study evaluated 145 patients (n=80 young-old, n=65 old-old, n=85 ISCM, n=60 NISCM, mean age 73±7 years, 64% men, 81% Caucasian). Mean total pMRCI scores (32.1±14.4, range 3-84) and total medication counts (13.3±4.8, range 2-30) were high for the entire cohort, of which 72% of patients were taking eleven or more total medications. Total and subtype pMRCI scores and medication counts did not differ significantly between the young-old and old-old groups, with the exception of OTC medication pMRCI score (6.2±4 young-old versus 7.8±5.8 old-old, P =0.04). With regard to heart failure etiology, total pMRCI scores and medication counts were significantly higher in patients with ISCM versus NISCM (pMRCI score 34.5±15.2 versus 28.8±12.7, P =0.009; medication count 14.1±4.9 versus 12.2±4.5, P =0.008), which was largely driven by other prescription medications. Medication regimen complexity is high in older adults with heart failure, and differs based on heart failure etiology. Additional work is needed to address polypharmacy and to determine if medication regimen complexity influences adherence and clinical outcomes in this population.

  6. Some psychometric properties of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL™) in the general Serbian population.

    PubMed

    Stevanović, Dejan; Lakić, Aneta; Damnjanović, Maja

    2011-08-01

    The aim of this study was to evaluate the general measurement properties of the Serbian version of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL™) self-report versions for children and adolescents (8-18 years). The PedsQL™ was completed by 238 children and adolescents. The version was descriptively analyzed first. Afterward, internal consistency and construct and convergent validity were analyzed using the classic test theory psychometrical procedures. The PedsQL™ scale score means ranged 70.65-88.34, with the total score was 80.74. Scale internal consistency reliability determined by Cronbach's coefficient was above 0.7 for all except the School, 0.65, and Emotional Functioning Scale, 0.69. The statistics assessing the adequacy of the model in confirmatory factor analysis revealed poor model fit for the current structure of the PedsQL™. Finally, the PedsQL™ total and psychosocial health showed convincing negative correlations with emotional and conduct problems, hyperactivity/inattention, and peer relationship problems. The Serbian PedsQL™ scales have appropriate internal consistency reliability, sufficient for group evaluations, and good convergent validity against psychological constructs. However, there are problems regarding its current construct validity (factorial validity).

  7. Rationale and Use of Content-Relevant Achievement Tests for the Evaluation of Instructional Programs.

    ERIC Educational Resources Information Center

    Patalino, Marianne

    Problems in current course evaluation methods are discussed and an alternative method is described for the construction, analysis, and interpretation of a test to evaluate instructional programs. The method presented represents a different approach to the traditional overreliance on standardized achievement tests and the total scores they provide.…

  8. Reasoning Ability and Academic Achievement among Secondary School Students in Trivandrum

    ERIC Educational Resources Information Center

    Rani, K. V.

    2017-01-01

    Reasoning ability is the 'problem solving skills' or 'analytical ability' or 'deductive and inductive reasoning'. Academic achievement is the total score one achieved at school, college, or university from class, laboratory, library, or field work. The objectives of the study were to explore the relationship between reasoning ability and academic…

  9. Sexual problems in a sample of the Turkish psychiatric population.

    PubMed

    Hariri, Aytul Gursu; Karadag, Figen; Gurol, Defne Tamar; Aksoy, Umut Mert; Tezcan, Ahmet Ertan

    2009-01-01

    Sexual functioning has received little attention as an important aspect of patient care for those who have severe mental disorders. The aim of this study is to compare sexual difficulties seen in Turkish psychiatric patients and healthy control subjects. Study group consisted of outpatients in remission with schizophrenia (n = 84), bipolar affective disorders (n = 90), heroin addiction (n = 88), and healthy control group (n = 98). A sociodemographical data form and the Golombok Rust Inventory of Sexual Satisfaction were applied to all groups (N = 360). Half of the patient groups and 72.8% of control subjects reported that they had regular sexual life. The patients with heroin addiction complained about more problems in their sexual life than in the other groups. Controls (86.2%) felt more satisfied with their sexual life. Female patients with heroin addiction had statistically significant higher scores in nonsensuality subscale of Golombok Rust Inventory of Sexual Satisfaction. Female patients with schizophrenia and bipolar disorder had statistically significant higher scores in vaginismus subscale than in control group. Between the groups, male patients with bipolar disorder had higher score in most of the items except noncommunication and erectile dysfunction and also had higher total score than in the controls. More men (especially with heroin addiction) thought that their illness and drugs were responsible for their sexual problems, knew the effect of the illness and drugs on their sexual life, and asked questions to their psychiatrists about the problems more than women. Patients with bipolar disorders and schizophrenia were unaware of effects of their medication on their sexual life. Finally, it was also found that clinicians in our country do not pay sufficient attention to the sexual problems of psychiatric patients.

  10. Swallowing disorders in nursing home residents: how can the problem be explained?

    PubMed Central

    Nogueira, Dália; Reis, Elizabeth

    2013-01-01

    Background The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes. Methods The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST). For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test. Results The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age, education, the Geriatric Depression Scale score, 3 ounce Water Swallow Test, and diagnosed conditions (such as neurological disorder, dementia, and cardiorespiratory problems) as explaining variables. Conclusion Results showed a high prevalence of dysphagia signs amongst a nursing home population. For the purpose of the present study, both a subjective and an objective assessment were applied. Results pointed to a significant statistical relation between objective and subjective measures, thus indicating that a self-perception test should be included in the assessment of swallowing disorders in a nursing home population. Notwithstanding, it should not be used as a single or principal measure as it is influenced by the individuals’ cognitive condition. PMID:23449951

  11. Diabetes quality of life perception in a multiethnic population.

    PubMed

    Goh, S G K; Rusli, B N; Khalid, B A K

    2015-07-01

    The aim of this study was to determine ethnic differences and predictors of the perception of quality of life (QOL) in a multiethnic Malaysian population with type 2 diabetes. A population-based cross-sectional study was done in three different states in Malaysia. The Asian Diabetes Quality of Life (AsianDQOL) tool specific for type 2 diabetes is the primary outcome tool. One-way analysis of covariance was undertaken to examine ethnic differences on the total and component AsianDQOL scores controlling for important covariates. Stepwise multiple linear regression models were used for selecting predictors for the AsianDQOL score with stratification for ethnicity and language. A total of 647 subjects (338 Malays, 160 Chinese and 149 Indians) were recruited. Chinese scored significantly lower (78.1 ± 11.6) on the AsianDQOL (total) score compared to Malays (81.4 ± 9.0) and Indians (81.5 ± 9.2) (F = 3.060, p = 0.049, η (2) = 0.02). Likewise, Chinese scored significantly lower (21.0 ± 4.3) on the AsianDQOL (diet) score compared to Malays (22.8 ± 3.6) and Indians (22.5 ± 3.7) (F = 4.96, p = 0.008, η (2) = 0.04). The main predictors of AsianDQOL (total) score for the English language group of different ethnicities were sexual dysfunction (-4.5), having visual problems (-3.7), female (-2.8) and glycemic control (-1.6). Sexual dysfunction was negatively correlated with QOL in Malay, Chinese ethnic group and Indian ethnic groups. The perception of AsianDQOL is different across ethnic groups and languages spoken. Significant differences in the English-speaking group and the non-English-speaking group are detected within the same ethnicity. Sexual dysfunction severely impacts AsianDQOL in a multiethnic Asian population and remains an important determinant regardless of ethnicity and language.

  12. Written Language Ability in Mandarin-Speaking Children with Cochlear Implants.

    PubMed

    Wu, Che-Ming; Ko, Hui-Chen; Chen, Yen-An; Tsou, Yung-Ting; Chao, Wei-Chieh

    2015-01-01

    Objectives. To examine narrative writing in cochlear implant (CI) children and understand the factors associated with unfavorable outcomes. Materials and Methods. Forty-five CI children in grades 2-6 participated in this study. They received CIs at 4.1 ± 2.1 years of age and had used them for 6.5 ± 2.7 years. A story-writing test was conducted and scored on 4 subscales: Total Number of Words, Words per Sentence, Morphosyntax, and Semantics. Scores more than 1.5 SD lower than the mean of the normal-hearing normative sample were considered problematic. Language and speech skills were examined. Results. Significantly more implanted students were problematic on "Total Number of Words" (p < 0.001), "Words per Sentence" (p = 0.049), and "Semantics" (p < 0.001). Poorer receptive language and auditory performance were independently associated with problematic "Total Number of Words" (R (2) = 0.489) and "Semantics" (R (2) = 0.213), respectively. "Semantics" problem was more common in lower graders (grades 2-4) than in higher graders (grades 5-6; p = 0.016). Conclusion. Implanted children tend to write stories that are shorter, worse-organized, and without a plot, while formulating morphosyntactically correct sentences. Special attention is required on their auditory and language performances, which could lead to written language problems.

  13. Behavioral difficulties in 7-year old children in relation to developmental exposure to perfluorinated alkyl substances.

    PubMed

    Oulhote, Youssef; Steuerwald, Ulrike; Debes, Frodi; Weihe, Pal; Grandjean, Philippe

    2016-12-01

    Perfluorinated alkyl substances (PFAS) are suspected endocrine disruptors that are highly persistent and neurotoxic in animals. Human epidemiological studies of exposure-related deviations of children's behaviors are sparse. We assessed the associations between prenatal, 5- and 7-year PFAS exposures and behavioral problem scores in 7-year Faroese children. Concentrations of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), perfluorooctane sulfonate (PFOS), and perfluorohexane sulfonic acid (PFHxS) were measured in maternal serum and in serum from children at ages 5 and 7years (n=539, 508, and 491, respectively). We used multivariable regressions and structural equations models to estimate the covariate-adjusted associations between serum-PFAS concentrations and behavioral difficulties, as assessed by the strengths and difficulties questionnaire (SDQ) at age 7. Serum-PFOS and PFHxS concentrations declined over time, whereas PFOA, PFNA, and PFDA tended to increase. No associations were observed between prenatal PFAS concentrations and SDQ scores. However, a two-fold increase in 5-year serum-PFOA, PFNA, and PFDA concentrations was associated with increases in total SDQ scores by 1.03 (95% CI: 0.11, 1.95), 0.72 (95% CI: 0.07, 1.38) and 0.78 points (95% CI: 0.01, 1.55), respectively. For SDQ subscales, significant associations were found in regard to hyperactivity, peer relationship, and conduct problems, as well as internalizing and externalizing problems and autism screening composite scores. Cross-sectional analyses at age 7years showed possible sex-dimorphic associations between PFAS concentrations and SDQ scores, where girls had consistently positive associations with SDQ scores whereas boys exhibited a pattern of negative or null associations. Higher serum PFAS concentrations at ages 5- and 7-years, but not prenatally, were associated with parent-reported behavioral problems at age 7. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Behavioral difficulties in 7-year old children in relation to developmental exposure to perfluorinated alkyl substances

    PubMed Central

    Oulhote, Youssef; Steuerwald, Ulrike; Debes, Frodi; Weihe, Pal; Grandjean, Philippe

    2016-01-01

    Background Perfluorinated alkyl substances (PFAS) are suspected endocrine disruptors that are highly persistent and neurotoxic in animals. Human epidemiological studies of exposure-related deviations of children’s behaviors are sparse. We assessed the associations between prenatal, 5- and 7-year PFAS exposures and behavioral problem scores in 7-year Faroese children. Methods Concentrations of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), perfluorooctane sulfonate (PFOS), and perfluorohexane sulfonic acid (PFHxS) were measured in maternal serum and in serum from children at ages 5 and 7 years (n=539, 508, and 491, respectively). We used multivariable regressions and structural equations models to estimate the covariate-adjusted associations between serum-PFAS concentrations and behavioral difficulties, as assessed by the strengths and difficulties questionnaire (SDQ) at age 7. Results Serum-PFOS and PFHxS concentrations declined over time, whereas PFOA, PFNA, and PFDA tended to increase. No associations were observed between prenatal PFAS concentrations and SDQ scores. However, a two-fold increase in 5-year serum-PFOA, PFNA, and PFDA concentrations was associated with increases in total SDQ scores by 1.03 (95% CI: 0.11, 1.95), 0.72 (95% CI: 0.07, 1.38) and 0.78 points (95% CI: 0.01, 1.55), respectively. For SDQ subscales, significant associations were found in regard to hyperactivity, peer relationship, and conduct problems, as well as internalizing and externalizing problems and autism screening composite scores. Cross-sectional analyses at age 7 years showed possible sex-dimorphic associations between PFAS concentrations and SDQ scores, where girls had consistently positive associations with SDQ scores whereas boys exhibited a pattern of negative or null associations. Conclusions Higher serum PFAS concentrations at ages 5- and 7-years, but not prenatally, were associated with parent-reported behavioral problems at age 7. PMID:27692925

  15. Need for education on footcare in diabetic patients in India.

    PubMed

    Viswanathan, V; Shobhana, R; Snehalatha, C; Seena, R; Ramachandran, A

    1999-11-01

    The patient himself plays the crucial role in the prevention of diabetic foot disease and therefore education on foot care is important. In this study, we have evaluated the knowledge of the diabetic subjects regarding the foot problems and the care of feet in order to identify areas that require stress in the education programme. Two hundred and fifty, consecutive cases of Type 2 diabetes (M:F, 176:74, age 57.2 +/- 9.7 yrs, duration 12.9 +/- 7.9 yrs) were selected for this study from the out-patient department of our hospital. A questionnaire was filled up for each patient by personal interview. The total score was 100 and a score of < 50 was considered as a low score for foot care knowledge. A score of < 50 was obtained in 67.2%. Low score was more common in women (78.5%) than in men (62.5%) (chi 2 = 5.26, P = 0.022). Low scores (< 50) were more common among those with lower level of formal education (chi 2 = 70.0, P < 0.0001), there were more women with low educational status. Significant foot problems like gangrene, foot ulcers were present in 27.2% and low scores were more common among those with these complications (82% vs 62%) (chi 2 = 8.3, P = 0.004). In general the scores on awareness of general foot care principles and basic facts about the foot complications were poor. Most of them (72%) had good knowledge about the right usage of foot wear. There was a trend to have lower scores with poor formal education (chi 2 = 51.1, P < 0.0001) and also with increasing age. There was no correlation between the scores and the number of hospital visits. Multiple linear regression analyses showed that 31.2% of the variations in the scores were explained by the level of education. This study underscores the importance of patient education on foot care principles, especially so, considering the magnitude of the problem of diabetes and the lower levels of literacy and poor socio economic status of many patients in this country.

  16. Mental health of Automobile Transportation Troop personnel stationed in the Western Sichuan Plateau of China.

    PubMed

    Tan, Yan; Li, Yunming; Wu, Juan; Chen, Fuqin; Lu, Hao; Lu, Shijun; Yang, Xianjun; Ma, Xiao

    2018-03-01

    This study investigated the mental health of military transport personnel in the Western Sichuan Plateau of China, and factors that correlate with their mental health.The Symptom Checklist 90 (SCL-90) was used to investigate the mental health status of the subjects. Their scores were compared with the national and military norm in China. Demographic factors were analyzed for associations with SCL-90 scores.Psychological problems were detected in 28.90% of total 1076 male officers and soldiers surveyed. The SCL-90 scale somatization score of these servicemen was higher than the national and military norms in China, while other scores were comparable. The reported physical health symptoms and being an only child were strongly associated with the SCL-90 scores.The mental health of military transport personnel in the China Western Sichuan Plateau should receive more attention.

  17. Mental health of Automobile Transportation Troop personnel stationed in the Western Sichuan Plateau of China

    PubMed Central

    Tan, Yan; Li, Yunming; Wu, Juan; Chen, Fuqin; Lu, Hao; Lu, Shijun; Yang, Xianjun; Ma, Xiao

    2018-01-01

    Abstract This study investigated the mental health of military transport personnel in the Western Sichuan Plateau of China, and factors that correlate with their mental health. The Symptom Checklist 90 (SCL-90) was used to investigate the mental health status of the subjects. Their scores were compared with the national and military norm in China. Demographic factors were analyzed for associations with SCL-90 scores. Psychological problems were detected in 28.90% of total 1076 male officers and soldiers surveyed. The SCL-90 scale somatization score of these servicemen was higher than the national and military norms in China, while other scores were comparable. The reported physical health symptoms and being an only child were strongly associated with the SCL-90 scores. The mental health of military transport personnel in the China Western Sichuan Plateau should receive more attention. PMID:29561449

  18. Factors related to presenteeism among employees of the private sector.

    PubMed

    Mandiracioglu, Aliye; Bolukbas, Osman; Demirel, Mehmet; Gumeli, Filiz

    2015-01-01

    The objective was to explore the relationship between person-based variables and work-related variables of presenteeism in four different private sector workplaces. Employees (N=413) filled in a questionnaire related to demographic and socio-economic characteristics, social networks, work-related factors, lifestyle factors and state of health. Presenteeism was assessed using the Stanford Presenteeism Scale 6 (SPS-6). The majority of respondents were male (77.2%), and mean age was 34.7±8.1 years. The prevalence of chronic conditions was 15.9%. The mean score for the SPS-6 was 19.9 (SD, 3.3). The female score was higher than the male score on the SPS-6 in this study. Total score was higher among workers who reported working at high speed. SPS-6 score was higher among individuals with a chronic health problem. Understanding of the workplace and personal factors related to presenteeism may support the health and well-being of workers.

  19. Factors affecting oral health-related quality of life among pregnant women.

    PubMed

    Acharya, S; Bhat, P V; Acharya, S

    2009-05-01

    To assess oral health status and to describe the possible factors that could affect the oral health-related quality of life (OHRQoL) among a group of pregnant rural women in South India. A total of 259 pregnant women (mean age 26 +/- 5.5 years) who participated in the cross-sectional study were administered the Oral Health Impact Profile (OHIP-14) questionnaire and were clinically examined for caries and periodontal status. The highest oral impact on quality of life was reported for 'painful mouth' (mean: 1.7) and 'difficulty in eating' (mean: 1.1). On comparing the mean OHIP-14 scores against the various self-reported oral problems, it was seen that the mean OHIP-14 scores were significantly higher among those who reported various oral problems than those who did not. Those with previous history of pregnancies had more severe levels of gingivitis than those who were pregnant for the first time. Also gingival index scores, community periodontal index of treatment needs scores and previous pregnancies was associated with poorer OHRQoL scores. Increased health promotion interventions and simple educational preventive programmes on oral self-care and disease prevention during pregnancy can go a long way in improving oral health and lessening its impact on the quality of life in this important population.

  20. Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy.

    PubMed

    Barlow, Karen M; Thomson, Elaine; Johnson, David; Minns, Robert A

    2005-08-01

    There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population. A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort. Two global outcome measures were used: Glasgow Outcome Score (GOS) and Seshia's outcome score. Cognitive outcome was assessed using the Bayley Scales of Infant Development, British Ability Scales, and the Vineland Adaptive Behavior Scales. The mean length of follow-up was 59 months. A total of 68% of survivors were abnormal on follow-up, 36% had severe difficulties and were totally dependant, 16% had moderate difficulties, and 16% had mild difficulties on follow-up. A wide range of neurologic sequelae were seen, including motor deficits (60%), visual deficits (48%), epilepsy (20%), speech and language abnormalities (64%), and behavioral problems (52%). There was a wide range of cognitive abilities: the mean psychomotor index, 69.9 (SD: +/-25.73); and mean mental development index, 74.53 (SD: +/-28.55). Adaptive functioning showed a wide range of difficulties across all domains: communication domain (mean: 76.1; SD: +/-25.4), Daily living skills domain (mean: 76.9; SD: +/-24.3), and socialization domain (mean: 79.1; SD: +/-23.1). Outcome was found to correlate with the Pediatric Trauma Score and the Glasgow Coma Score but did not correlate with age at injury or mechanism of injury. Inflicted TBI has a very poor prognosis and correlates with severity of injury. Extended follow-up is necessary so as not to underestimate problems such as specific learning difficulties and attentional and memory problems that may become apparent only once the child is in school. Behavioral problems are present in 52% and begin to manifest clinically between the second and third years of life, although the consequences of frontal lobe injury may be underestimated unless follow-up is extended into adolescence and early adulthood.

  1. Assessment of Reduced Tolerance to Sound (Hyperacusis) in University Students.

    PubMed

    Yilmaz, Sule; Taş, Memduha; Bulut, Erdoğan; Nurçin, Elçin

    2017-01-01

    Hyperacusis is defined as a reduction in tolerance to ordinary environmental sounds. Hyperacusis can occur in individuals of all age groups, making daily life difficult for the sufferers. Although there is no objective test to accurately diagnose hyperacusis, questionnaires are useful for the assessment of hyperacusis. The aim of this study was to explore the reduced sound tolerance in university students using a hyperacusis questionnaire (HQ). A total of 536 university students (300 females and 236 males) aged between 18 and 25 years, with a mean age of 21.34 ± 1.87 years, were assessed using an HQ developed by Khalfa. The mean total score of all the participants was 16.34 ± 7.91, and 5.78% of the participants had total scores indicating hyperacusis, where a majority of them were females. Females had significantly higher scores than men in terms of both the total and the attentional and emotional dimensions. The scores of the participants who reported noise exposure or a decrease in their tolerance to noise were significantly higher than those of the other participants. Even among young adults, there was a group of participants suffering from some problems related to decreased tolerance to everyday sounds. Although the Turkish translation of the HQ seems to be a reliable tool for evaluating hyperacusis in young adults, further work with various populations of different age groups is required to establish validity and to assess the psychometric qualities of the Turkish form.

  2. Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials

    PubMed Central

    Doyle, Orla; McGlanaghy, Edel; O’Farrelly, Christine; Tremblay, Richard E.

    2016-01-01

    This study examined the impact of a targeted Irish early intervention program on children’s emotional and behavioral development using multiple methods to test the robustness of the results. Data on 164 Preparing for Life participants who were randomly assigned into an intervention group, involving home visits from pregnancy onwards, or a control group, was used to test the impact of the intervention on Child Behavior Checklist scores at 24-months. Using inverse probability weighting to account for differential attrition, permutation testing to address small sample size, and quantile regression to characterize the distributional impact of the intervention, we found that the few treatment effects were largely concentrated among boys most at risk of developing emotional and behavioral problems. The average treatment effect identified a 13% reduction in the likelihood of falling into the borderline clinical threshold for Total Problems. The interaction and subgroup analysis found that this main effect was driven by boys. The distributional analysis identified a 10-point reduction in the Externalizing Problems score for boys at the 90th percentile. No effects were observed for girls or for the continuous measures of Total, Internalizing, and Externalizing problems. These findings suggest that the impact of this prenatally commencing home visiting program may be limited to boys experiencing the most difficulties. Further adoption of the statistical methods applied here may help to improve the internal validity of randomized controlled trials and contribute to the field of evaluation science more generally. Trial Registration: ISRCTN Registry ISRCTN04631728 PMID:27253184

  3. [A project to provide instruction in the nursing of elderly patients with total hip replacement (T.H.R.)].

    PubMed

    Ting, Chao-Fong; Chou, Hsiu-Ling; Chen, Ming-Mie

    2006-02-01

    This project was aimed at improving the nursing of patients who have undergone total hip replacements. Investigation showed the following problems with existing nursing instruction in this area: lack of standard instruction, outdated educational materials, a 33.75% rate of completion of instruction lack of familiarity with instruction materials, and an average satisfaction score of 2.56 among nurses who have undergone instruction; The reading for patient's satisfaction with the guidance of nurses was 2.04. After site investigation, status analysis and reference check, we proposed the following program. (1) Establish standards and monitor tools for instruction for nursing total hip replacement patients, including "Caring standard", "Guidance for nursing instruction", "Nursing instruction sheet", "Notes at nursing instruction", "Satisfaction scoring system for nursing instruction"; (2) Carry out a training course to enhance nursing staff's knowledge about caring for patients with total hip replacement. After program had been implemented, a completion rate of 88.56% was achieved, and the satisfaction scores among nursing staff and patients were 4.3 and 4.36 respectively. This result shows that when we undertake reform at various different levels--including systemic structure, processing and monitoring--this can radically improve the quality of nursing instruction.

  4. [Validation of the German version of the Singing Voice Handicap Index].

    PubMed

    Lorenz, A; Kleber, B; Büttner, M; Fuchs, M; Mürbe, D; Richter, B; Sandel, M; Nawka, T

    2013-08-01

    The Singing Voice Handicap Index (SVHI) was developed in the United States for the self-assessment of patients with singing problems. It has been translated into German and its reliability and validity have been assessed. In total, 54 (35 female, 19 male) dysphonic singers and 130 (74 female, 56 male) non-dysphonic professional singers were included in the study. Reliability rested on high test-retest reliability (r = 0.960, p ≤ 0.001, Pearson correlation) and a Cronbach's α of 0.975. A principal component analysis using the Varimax method and the results of the screeplot suggest the SVHI scored as a single scale. Validity rested on a highly significant correlation between the severity of the self-rated voice impairment by the patient and the total SVHI score. Dysphonic singers have significantly higher SVHI scores than healthy singers. The SVHI is thus suited to implementation as a diagnostic tool in German-speaking countries.

  5. Sleep problems and suicide attempts among adolescents: a case-control study.

    PubMed

    Koyawala, Neel; Stevens, Jack; McBee-Strayer, Sandra M; Cannon, Elizabeth A; Bridge, Jeffrey A

    2015-01-01

    This study used a case-control design to compare sleep disturbances in 40 adolescents who attempted suicide with 40 never-suicidal adolescents. Using hierarchical logistic regression analyses, we found that self-reported nighttime awakenings were significantly associated with attempted suicide, after controlling for antidepressant use, antipsychotic use, affective problems, and being bullied. In a separate regression analysis, the parent-reported total sleep problems score also predicted suicide attempt status, controlling for key covariates. No associations were found between suicide attempts and other distinct sleep problems, including falling asleep at bedtime, sleeping a lot during the day, trouble waking up in the morning, sleep duration, and parent-reported nightmares. Clinicians should be aware of sleep problems as potential risk factors for suicide attempts for adolescents.

  6. Distress levels in patients with oropharyngeal vs. non-oropharyngeal squamous cell carcinomas of the head and neck over 1 year after diagnosis: a retrospective cohort study.

    PubMed

    Schorr, Melissa; Carlson, Linda E; Lau, Harold Y; Zhong, Lihong; Bultz, Barry D; Waller, Amy; Groff, Shannon L; Hao, Desiree

    2017-10-01

    Human papillomavirus (HPV)-related cancers have been associated with different demographic profiles and disease characteristics than HPV-unrelated cancers in head and neck patients, but distress and other symptoms have not been compared. The aim of this study was to assess whether distress levels, fatigue, pain, anxiety, depression, and common psychological and practical problems differ between head and neck cancer patients with HPV-related vs. HPV-unrelated carcinomas (using oropharyngeal carcinoma (OPC) and non-OPC cancers as surrogates for HPV status). Distress, depression, anxiety, fatigue, pain, and common problems were examined in 56 OPC and 90 non-OPC patients at 4 timepoints during the first year following diagnosis. Two-level hierarchical linear modeling was used to examine effects. The HPV-related OPC group was more likely to be younger (p = 0.05), Caucasian (p = 0.001), non-smokers (p = 0.01), earn more (p = 0.04), and present with more advanced stage (p < 0.0001). At baseline, OPC patients reported only higher pain scores (p = 0.01) than non-OPC patients. Total problems decreased more in the OPC group (p = 0.08) than the non-OPC group from baseline to 12-month follow-up. In both groups, scores on distress, depression, psychosocial problems, and practical problems decreased similarly over time. Despite a difference in the clinico-demographic characteristics of HPV-related vs. HPV-unrelated patients, only baseline pain levels and total problems over time differed between the two groups.

  7. How do voice restoration methods affect the psychological status of patients after total laryngectomy?

    PubMed

    Saltürk, Z; Arslanoğlu, A; Özdemir, E; Yıldırım, G; Aydoğdu, İ; Kumral, T L; Berkiten, G; Atar, Y; Uyar, Y

    2016-03-01

    This study investigated the relationship between psychological well-being and different voice rehabilitation methods in total laryngectomy patients. The study enrolled 96 patients who underwent total laryngectomy. The patients were divided into three groups according to the voice rehabilitation method used: esophageal speech (24 patients); a tracheoesophageal fistula and Provox 2 voice prosthesis (57 patients); or an electrolarynx (15 patients). The participants were asked to complete the Turkish version of the Voice Handicap Index-10 (VHI-10) to assess voice problems. They were also asked to complete the Turkish version of the Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). The test scores of the three groups were compared statistically. Patients who used esophageal speech had a mean VHI-10 score of 10.25 ± 3.22 versus 19.42 ± 5.56 and 17.60 ± 1.92 for the tracheoesophageal fistula and Provox 2 and electrolarynx groups respectively, reflecting better perception of their voice. They also had a PSS score of 11.38 ± 3.92, indicating that they felt less stressed in comparison with the tracheoesophageal fistula and Provox 2 and electrolarynx groups, which scored 18.84 ± 5.50 and 16.20 ± 3.49 respectively. The HADS scores of the groups were not different, indicating that the patients' anxiety and depression status did not vary. Patients who used esophageal speech perceived less stress and were less handicapped by their voice.

  8. Problem behaviour and traumatic dental injuries in adolescents.

    PubMed

    Ramchandani, Damini; Marcenes, Wagner; Stansfeld, Stephen A; Bernabé, Eduardo

    2016-02-01

    To explore the relationship between problem behaviour and traumatic dental injuries (TDI) among 15- to 16-year-old schoolchildren from East London. This cross-sectional study used data from 794 adolescents who participated in phase III of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based prospective study of a representative sample of adolescents. Participants completed a questionnaire and were clinically examined for TDI, overjet and lip coverage. The Strength and Difficulties Questionnaire (SDQ) was used to assess problem behaviour, which provided a total score and five domain scores (emotional symptoms, conduct problems, hyperactivity, peer problems and pro-social behaviour). The association between problem behaviour and TDI was assessed in unadjusted and adjusted logistic regression models. Adjusted models controlled for demographic (sex, age and ethnicity), socio-economic (parental employment) and clinical factors (overjet and lip coverage). The prevalence of TDI was 17% and the prevalence of problem behaviour, according to the SDQ, was 10%. In the adjusted model, adolescents with problem behaviour were 1.87 (95% confidence interval: 1.03-3.37) times more likely to have TDI than those without problem behaviour. In subsequent analysis by SDQ domains, it was found that only peer problems were associated with TDI (OR = 1.78, 95% CI: 1.01-3.14), even after adjustment for confounders. This study found evidence for a relationship between problem behaviour and TDI among adolescents, which was mainly due to peer relationship problems. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Circadian typology and sensation seeking in adolescents.

    PubMed

    Muro, Anna; Gomà-i-Freixanet, Montserrat; Adan, Ana

    2012-12-01

    The relationship of circadian typology with personality has been largely studied in adults, but there are few studies exploring such relationship in adolescents. Adolescence has been associated with a greater tendency to eveningness preference, sleeping problems, poorer academic achievement, earlier substance use, or risky behaviors, and it is suggested that this association might be mediated by personality factors. Given the relevance of identifying the behavioral outcomes of young evening types to detect and prevent health problems, the present study aimed to explore, for the first time, the relationship between sensation seeking and circadian typology in an adolescent sample of 688 students (51.45% boys) from 12 to 16 yrs old. They answered the Spanish versions of the Morningness-Eveningness Scale for Children (MESC) and the Junior Sensation Seeking Scale (J-SSS), which includes four subscales measuring Thrill and Adventure Seeking, Experience Seeking, Disinhibition, and Boredom Susceptibility. Analyses showed that boys obtained significantly higher scores than girls on J-SSS total score and all subscales except Boredom Susceptibility, whereas evening-type adolescents of both sexes scored significantly higher than neither types and than morning types on J-SSS total score. These results indicate that evening-type adolescents show a greater desire for varied, new, complex, and intense sensations, and they are ready for experiencing more risks than morning types. The implications of this study suggest the need of being aware of individual differences in the SS trait in evening-type adolescents, as well as taking into account the wide variety of behaviors associated with it, either prosocial or antisocial, to design better preventive health and academic programs.

  10. Parental reports of behavioural outcome among paediatric leukaemia survivors in Malaysia: a single institution experience.

    PubMed

    Hamidah, Alias; Sham Marina, Mohd; Tamil, Azmi M; Loh, C-Khai; Zarina, Latiff A; Jamal, Rahman; Tuti Iryani, Mohd Daud; Ratnam, Vijayalakshmi C

    2014-10-01

    To determine the behavioural impact of chemotherapy in survivors of acute lymphoblastic leukaemia (ALL) treated with chemotherapy only and to identify treatment-related or sociodemography-related factors that might be associated with behavioural outcome. We examined 57 survivors of childhood ALL, who were off treatment for at least 2 years and were in remission, aged 4-18 years, and 221 unrelated healthy controls. The Child Behaviour Checklist (CBCL) parent report was used either in English or in Bahasa Malaysia (the national language of Malaysia) to assess the behavioural outcome. Childhood ALL survivors had significantly higher scores on externalising behaviour on the CBCL parent report than did controls. Higher problem scores were found in ALL survivors with single parents on 'total problems' (P = 0.03) and subscales 'withdrawn' (P = 0.03), 'social problems' (P < 0.01) and 'delinquent behaviour' (P = 0.03) than in survivors with married parents. Significant associations were seen between a lower education level of the father and the variables representing internalising (withdrawn, anxious/depressed) and externalising (aggressive behaviour). We observed trends on higher scores in all scales in ALL survivors with single parents than in controls with single parents or with fathers with low education level, especially primary education only. Malaysian childhood ALL survivors had a significantly increased risk for externalising behavioural problems, and there was a trend towards increased risk of problems in many other behavioural scales. Understanding the sociocultural dimension of patients' health is important to be able to design the most appropriate remedy for problem behaviours detected in this multi-ethnic population. © 2014 John Wiley & Sons Ltd.

  11. Integrating Problem-Based Learning and Simulation: Effects on Student Motivation and Life Skills.

    PubMed

    Roh, Young Sook; Kim, Sang Suk

    2015-07-01

    Previous research has suggested that a teaching strategy integrating problem-based learning and simulation may be superior to traditional lecture. The purpose of this study was to assess learner motivation and life skills before and after taking a course involving problem-based learning and simulation. The design used repeated measures with a convenience sample of 83 second-year nursing students who completed the integrated course. Data from a self-administered questionnaire measuring learner motivation and life skills were collected at pretest, post-problem-based learning, and post-simulation time points. Repeated-measures analysis of variance determined that the mean scores for total learner motivation (F=6.62, P=.003), communication (F=8.27, P<.001), problem solving (F=6.91, P=.001), and self-directed learning (F=4.45, P=.016) differed significantly between time points. Post hoc tests using the Bonferroni correction revealed that total learner motivation and total life skills significantly increased both from pretest to postsimulation and from post-problem-based learning test to postsimulation test. Subscales of learner motivation and life skills, intrinsic goal orientation, self-efficacy for learning and performance, problem-solving skills, and self-directed learning skills significantly increased both from pretest to postsimulation test and from post-problem-based learning test to post-simulation test. The results demonstrate that an integrating problem-based learning and simulation course elicits significant improvement in learner motivation and life skills. Simulation plus problem-based learning is more effective than problem-based learning alone at increasing intrinsic goal orientation, task value, self-efficacy for learning and performance, problem solving, and self-directed learning.

  12. Obesity, overweight, and eating problems in children with incontinence.

    PubMed

    Wagner, Catharina; Equit, Monika; Niemczyk, Justine; von Gontard, Alexander

    2015-08-01

    The aim was to analyze the prevalence of eating problems and specific associations between overweight, obesity, and eating behavior in children with incontinence. Forty-three consecutively presented children with incontinence, diagnosed to International Children's Continence Society standards, and 44 matched continent controls were examined prospectively. All children received a physical examination, sonography, and a one-dimensional intelligence test. Child psychopathology was measured with the Child Behavior Checklist (CBCL/4-18). Eating problems were assessed with the German version of the Dutch Eating Behaviour Questionnaire for Children (DEBQ-C) and a 40-item-parental questionnaire referring to atypical eating problems. Of the 43 children with incontinence, 23.3% had nocturnal enuresis (NE) only, 37.2% had any form of daytime urinary incontinence (DUI) (isolated or combined with NE) and 39.5% had fecal incontinence (FI) (isolated or combined with NE and/or DUI). Incontinent children showed significantly more CBCL externalizing symptoms (35.7% vs. 6.8%) and total problems (46.3% vs. 6.8%) in the clinical range (>90th percentile), as well as significantly lower mean IQ (105.5 vs. 120.6) than continent controls. Of the children with incontinence, 16.9% were affected by obesity (≥95th body mass index [BMI] percentile) compared with none of the continent controls. Especially in children with FI, the rate of obesity was significantly increased (23.5%). In addition, 46.5% of incontinent children, but none of the controls, had constipation. Again, children with FI (82.4%) had the highest rate of constipation (>DUI: 25% > NE only: 20%). "Food refusal" (FR) and "intense fear of gaining weight" (GW), but not other eating problems, were significantly more common among incontinent children (FR mean score 7.3; GW mean score 1.4) than in controls (FR mean score 5.6; GW mean score 0.7). After controlling for BMI percentiles, FR still was significantly higher in incontinent children. Children with FI had the highest score of FR among all subgroups of incontinence (mean score 9.1). This study shows that overweight, obesity, behavioral and eating problems are especially associated with disorders of the gastrointestinal tract (FI and constipation), and only to a lesser degree with those of the urinary tract (DUI and NE). These problems should be addressed routinely in the clinical care of children with incontinence. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  13. [Evaluating work-personality insufficiency of schizophrenic patients; an assessment of employability in psychiatric rehabilitation].

    PubMed

    Nozu, M

    1995-01-01

    Work-Personality means a person's motivation, values and attitude toward labor, general abilities which make his/her work performance efficient, which can be grasped through observation of behavior patterns in working situations. Problems connected with Work-Personality may cause schizophrenics some vocational difficulties. The author made out a "Work-Personality Insufficiency (WPI) Rating Scale" with 15 items, in order to estimate the employability of schizophrenics, and examined its inter-rater reliability by means of ANOVA-ICC and the results were sufficient enough. Then, WPI was applied to 71 schizophrenic outpatients of Tokyo Metropolitan Chubu Comprehensive Mental Health Center (Occupational Training Unit). Also positive and negative symptoms were estimated at admission, and some indicies of historical data were collected. These data were examined statistically as shown below. (1) Construct validity was verified through factor analysis of scores at admission. (2) By comparison of admission scores between two groups of employed and unemployed at discharge, the average score of employed was significantly low (p < 0.01), and the correlation between the discharge state and the total WPI score was significantly high (r = 0.472, p < 0.01), which proved predict validity. (3) The total score of negative symptoms correlated to WPI scores. Also the total score of positive symptoms correlated to some components of WPI scores. (4) By comparison of WPI scores between at admission and at discharge, reduction of disability was seen mainly in interpersonal area, which meant the improvement of patients' adaptability to work situation. Work performance in the narrow sense, however, seemed to make little development, which meant the limited effect of prevocational training with limited time. (5) Indicies of historical data had no relations to outcome and WPI, which showed the difficulty of predicting vocational prognosis from these variables directly. From above, the author concluded that WPI could be utilized to the vocational issues of prolonged schizophrenic patients, and discussed the predictors of vocational prognosis.

  14. Factors related to self-reported social anxiety symptoms among incoming university students.

    PubMed

    Cheng, Shu Hui; Sun, Zih-Jie; Lee, I Hui; Lee, Chih-Ting; Chen, Kao Chin; Tsai, Chung Hung; Yang, Yen Kuang; Yang, Yi Ching

    2017-08-01

    The aim of this study was to explore the lifestyle/social, personality trait and mental factors among incoming university students with higher self-reported social anxiety symptoms (SAS). A total of 5126 incoming university students were recruited. The test battery included a self-administered questionnaire that examined personal lifestyle, the Measurement of Support Functions, the Chinese Internet Addiction Scale-Revision, the Organizational Citizenship Behaviour Scale, the Social Phobia Inventory, the suicide ideation from the Brief Symptoms Rating Scale and the Pittsburgh Sleep Questionnaire. SAS (23.7%) were prevalent. Using logistic regression analysis, we found that the significant predictors of higher levels of SAS were being an undergraduate student and a non-smoker, having lower Measurement of Support Functions score (poorer social support), having higher Chinese Internet Addiction Scale-Revision score (Internet addiction), having lower Organizational Citizenship Behaviour Scale score (less altruistic behaviour), having suicide ideation and having higher Pittsburgh Sleep Questionnaire score (poorer sleeper). Given the high prevalence of SAS among university students, it is necessary to build a better strategy to detect students with potential social anxiety-related problems/disorders or other mental problems early on. © 2015 Wiley Publishing Asia Pty Ltd.

  15. Motor performance and correlates of mental health in children who are deaf or hard of hearing.

    PubMed

    Fellinger, Matthäus J; Holzinger, Daniel; Aigner, Martin; Beitel, Christoph; Fellinger, Johannes

    2015-10-01

    This cross-sectional study investigates the relationship between motor performance and mental health in a representative population of children with hearing impairment. Ninety-three pupils (45 males, 48 females) aged 6 years to 16 years (mean 11 y 3 mo, SD 2 y 9 mo) with hearing impairment of at least 40 dB and a Nonverbal IQ greater than 70 were assessed for motor performance with the Zürich Neuromotor Assessment (ZNA) and for mental health with the parent version of the Strengths and Difficulties Questionnaire (SDQ). Children with hearing impairment had lower motor performance scores in all four ZNA subscales compared with ZNA norms (z-scores -1.42 to -2.67). After controlling for Nonverbal IQ, ZNA pure motor performance correlated negatively with the SDQ total difficulties score. Pure motor, pegboard, and dynamic balance subscales correlated negatively with peer-relationship problems. Dynamic balance correlated negatively with emotional problems. Performance in pure motor and dynamic balance skills correlated negatively with age. Except for static balance, no correlation was found between motor performance and the degree of hearing impairment. Results confirm that a high percentage of children with hearing impairment have poor motor performance. These problems are associated with difficulties in social relationships. Early recognition of these problems may lead to interventions to assist children with hearing impairment with their peer relationships. © 2015 Mac Keith Press.

  16. Do pneumonia readmissions flagged as potentially preventable by the 3M PPR software have more process of care problems? A cross-sectional observational study.

    PubMed

    Borzecki, Ann M; Chen, Qi; Restuccia, Joseph; Mull, Hillary J; Shwartz, Michael; Gupta, Kalpana; Hanchate, Amresh; Strymish, Judith; Rosen, Amy

    2015-12-01

    In the USA, administrative data-based readmission rates such as the Centers for Medicare and Medicaid Services' all-cause readmission measures are used for public reporting and hospital payment penalties. To improve this measure and identify better quality improvement targets, 3M developed the Potentially Preventable Readmissions (PPRs) measure. It matches clinically related index admission and readmission diagnoses that may indicate readmissions resulting from admission- or post-discharge-related quality problems. To examine whether PPR software-flagged pneumonia readmissions are associated with poorer quality of care. Using a retrospective observational study design and Veterans Health Administration (VA) data, we identified pneumonia discharges associated with 30-day readmissions, and then flagged cases as PPR-yes or PPR-no using the PPR software. To assess quality of care, we abstracted electronic medical records of 100 random readmissions using a tool containing explicit care processes organised into admission work-up, in-hospital evaluation/treatment, discharge readiness and post-discharge period. We derived quality scores, scaled to a maximum of 25 per section (maximum total score=100) and compared cases by total and section-specific mean scores using t tests and effect size (ES) to characterise the clinical significance of findings. Our abstraction sample was selected from 11,278 pneumonia readmissions (readmission rate=16.5%) during 1 October 2005-30 September 2010; 77% were flagged as PPR-yes. Contrary to expectations, total and section mean quality scores were slightly higher, although non-significantly, among PPR-yes (N=77) versus PPR-no (N=23) cases (respective total scores, 71.2±8.7 vs 65.8±11.5, p=0.14); differences demonstrated ES >0.30 overall and for admission work-up and post-discharge period sections. Among VA pneumonia readmissions, PPR categorisation did not produce the expected quality of care findings. Either PPR-yes cases are not more preventable, or preventability assessment requires other data collection methods to capture poorly documented processes (eg, direct observation). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Relationships among circadian typology, psychological symptoms, and sensation seeking.

    PubMed

    Prat, Gemma; Adan, Ana

    2013-08-01

    Recently, attention has been focused on the relationship among circadian typology, psychiatric symptoms, and personality traits. This study analyzes the influence of circadian typology on psychological distress, and the sensation-seeking personality trait. Five hundred seventeen college students (173 males), aged 17 to 30, answered the Composite Scale of Morningness (CSM), the General Health Questionnaire 28-item version (GHQ-28), and the Sensation Seeking Scale-V (SSS-V). The evening-type subjects in our sample scored higher than the neither- and morning- type in the GHQ-28 total score, as well as in the four subscales that composed it (Psychosomatic Symptoms, Anxiety and Insomnia, Social Dysfunction, and Severe Depression) (p<0.02 in all cases). The evening-type subjects also had a larger proportion of psychiatric cases than the other two circadian typologies (p<0.0001 in all cases). Moreover, the evening-type subjects obtained higher scores in the SSS-V total score and in the subscales of Disinhibition and Boredom Susceptibility (p<0.001 in all cases). A positive correlation was observed between the GHQ-28 and the SSS-V total scores in the total sample, but only for the evening-type group (r=0.217; p<0.027). In the evening group, several relations were also found between the subscales of the GHQ-28 and the subscales of the SSS-V (r>0.206; p<0.036). All these data point to a relationship between evening-type subjects and the level of psychological distress and the sensation-seeking personality trait. They also suggest that eveningness could be related to developing psychological distress and personality traits that could, in turn, be related to developing other problems, such as drug consumption.

  18. Fatigue and health related quality of life in children and adolescents with cancer.

    PubMed

    Nunes, Michelle Darezzo Rodrigues; Jacob, Eufemia; Bomfim, Emiliana Omena; Lopes-Junior, Luis Carlos; de Lima, Regina Aparecida Garcia; Floria-Santos, Milena; Nascimento, Lucila Castanheira

    2017-08-01

    The study examined the different dimensions of fatigue (general, sleep/rest, cognitive), health related quality of life (HRQL) (physical, emotional, cognitive, social), and the relationships between fatigue and HRQL in hospitalized children and adolescents with cancer in Brazil. Participants were recruited from a pediatric oncology inpatient unit in a comprehensive cancer care hospital in southeast Brazil. They completed the PedsQL Multidimensional Fatigue Scale and the PedsQL Inventory of Quality of Life (Generic and Cancer module) once during hospitalization. The majority (66.7%) of the participants (n = 38; mean age 12.1 ± 2.9 years) had total fatigue scores < 75 on 0 to 100 scale; with the mean total fatigue score of 63.8 ± 18.5. The majority (72.2% generic; 83.3% cancer modules) had total PedsQL scores < 75 on 0 to 100 scale. The mean PedsQL score on generic module (61.1 ± 17.0) was similar to the mean PedsQL score cancer module (59.1 ± 16.7). Significant correlations were found between total fatigue and quality of life generic (r = 0.63, p = 0.000) and cancer module (r = 0.74, p = 0.000). The study is the first to report fatigue and health related quality of life in hospitalized children and adolescents with cancer in Brazil. Similar to experiences of other children in the world, our findings indicate that children and adolescents with cancer had problems with fatigue that were associated with low HRQL. Future studies are recommended to examine interventions (exercise, leisurely activities) that may alleviate fatigue and improve HRQL in pediatric patients with cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

    PubMed Central

    Lindelow, M; Hardy, R; Rodgers, B

    1997-01-01

    OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity. PMID:9425466

  20. Short Form of the Developmental Behaviour Checklist

    ERIC Educational Resources Information Center

    Taffe, John R.; Gray, Kylie M.; Einfeld, Stewart L.; Dekker, Marielle C.; Koot, Hans M.; Emerson, Eric; Koskentausta, Terhi; Tonge, Bruce J.

    2007-01-01

    A 24-item short form of the 96-item Developmental Behaviour Checklist was developed to provide a brief measure of Total Behaviour Problem Score for research purposes. The short form Developmental Behaviour Checklist (DBC-P24) was chosen for low bias and high precision from among 100 randomly selected item sets. The DBC-P24 was developed from…

  1. Sleep Patterns, Sleep Disturbances, and Associated Factors Among Chinese Urban Kindergarten Children.

    PubMed

    Liu, Zhijun; Wang, Guanghai; Geng, Li; Luo, Junna; Li, Ningxiu; Owens, Judith

    2016-01-01

    This study aimed to characterize sleep patterns and disturbances among Chinese urban kindergarten children and examine potentially associated factors. Caregivers of 513 children (47.96% male) aged 3-6 years (mean age = 4.46, SD = 0.9) completed the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). Almost 80% (78.8%) of the children scored above the original CSHQ cutoff point for global sleep disturbance. Regression analysis indicated that child's age, and the presence of emotional problems, hyperactivity and peer problems, cosleeping, and interparental inconsistency of attitudes toward child rearing accounted for significant variance in the CSHQ total score (R(2) = 22%). These findings indicate that there is an apparently high prevalence of sleep disturbances in Chinese urban kindergarten children; and sleep disturbances are associated with both child-related and parenting practice variables.

  2. Sleep Problems and Their Relationship to Maladaptive Behavior Severity in Psychiatrically Hospitalized Children with Autism Spectrum Disorder (ASD).

    PubMed

    Sannar, Elise M; Palka, Tamara; Beresford, Carol; Peura, Christine; Kaplan, Desmond; Verdi, Mary; Siegel, Matthew; Kaplan, Shir; Grados, Marco

    2017-10-30

    We examined the relationship between sleep duration and awakenings to Aberrant Behavior Checklist-Community (ABC-C) and Autism Diagnostic Observation Schedule (ADOS-2) scores in hospitalized youth with ASD and behavioral disturbance. Participants included 106 patients with a stay of at least 10 nights. Sleep in the hospital was recorded by staff observation. Higher scores on the ABC-C (irritability, stereotypy, and hyperactivity subscales) at admission were significantly associated with fewer minutes slept during the last five nights of hospitalization. There was no association between total awakenings and ABC-C scores or ADOS-2 comparison scores. Improved understanding of the relationship between sleep quality and maladaptive behavior in this challenging cohort of patients with ASD is vital to the definition and design of future effective interventions.

  3. [The Status, Change and Health Issues of Inpatients' Sixth Vital Sign in a Medical Center].

    PubMed

    Lin, Li-Ying; Huang, Ya-Hui; Hung, Chung-Lung; Chen, Ya-Mei; Kuo, Ching-Ju; Ku, Yan-Chiou

    2017-04-01

    Hospitalized patients generally have elevated levels of emotional distress. Gaining a better under-standing of the problem of emotional distress among hospitalized patients is conducive to providing appropriate emotional care and promoting their recovery. To analyze the scores for the "sixth vital sign" (i.e., emotional distress), diversification, and the health-related problems of hospitalized patients at a medical center in Taiwan. The results may offer an important reference for providing effective emotional care to hospitalized patients. A retrospective descriptive research design was used. Data were collected from all of the 27,885 inpatients that were registered at the target hospital in 2013. Further, a total of 245,814 attendance records were assessed to extract the data that were relevant to emotional distress. The findings revealed that 58.3% of hospitalized patients had earned a sixth vital sign score ≥ 1 and that 0.8% of these patients had earned a score ≥ 4. On the whole, the sixth vital sign scores of hospitalized patients were found to decrease progressively with the number of hospitalization days except for hematology and oncology, neurosurgery, and plastic surgery patients. The highest emotional distress scores were found among family medicine, dermatology, and plastic surgery patients. Moreover, emotional distress scores were significantly higher in patients who had health problems that involved pain, anxiety, or sleep disorder. The present study suggests that improving the emotional care of hematology, oncology, neurosurgery, family medicine, dermatology, and plastic surgery patients and of patients with health problems involving pain, anxiety, or sleep disorder may significantly improve the quality of inpatient holistic healthcare. Only 0.8% of the subjects in the present study had an emotional distress score ≥ 4, which is significantly lower than the level reported in other similar studies. Our findings suggest that related education and training for nursing staffs may improve their assessment and care practices in caring for patients with emotional distress. Furthermore, using more appropriate words, methods, and environments to evaluate the emotional distress of patients holds the potential to improve assessment and care for these patients.

  4. Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt.

    PubMed

    Hoytema van Konijnenburg, E M M; van der Lee, J H; Teeuw, A H; Lindeboom, R; Brilleslijper-Kater, S N; Sieswerda-Hoogendoorn, T; van Goudoever, J B; Lindauer, R J L

    2017-05-01

    High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. A cross-sectional study was conducted in six hospitals. All consecutive families of which a parent visited the emergency department due to partner violence, substance abuse or suicide attempt between 1 July 2012 and 1 March 2014 with children aged 1.5-17 years were approached for participation. Parents and children aged 8 years and older filled out questionnaires measuring post-traumatic stress [13-item version of Children's Revised Impact of Event Scale (CRIES-13)], anxiety, depression (Revised Child Anxiety and Depression Scale), behavioural problems [Child Behavior Checklist (CBCL) and Youth Self-Report (YSR)] and health-related quality of life (PedsQL). Scores of participants were compared with reference data obtained in children in similar age ranges from representative Dutch community samples (CRIES-13, Revised Child Anxiety and Depression Scale, PedsQL and CBCL) and to a normed cutoff score (CRIES-13). Of 195 eligible families, 89 (46%) participated in the study. Participating children did not score different from community children, both on child-reported and parent-reported instruments. Standardized mean differences of total sum scores were 0 (CRIES-13 and CBCL 1.5-5), 0.1 (YSR), 0.2 (CBCL 6-18) and -0.3 (PedsQL) and not statistically different from community children. Thirty-five percent of the participating children scored above the cutoff score on the CRIES-13, indicating post-traumatic stress disorder, but this difference was not statistically significant from community children (mean difference 8%; 95% CI -4-22%). We found no differences in psychosocial problems between children whose parents visited the emergency department due to partner violence, substance abuse or suicide attempt and children from community samples. Because 35% of the children scored in the range of post-traumatic stress disorder, we advise healthcare providers to pay attention to post-traumatic stress symptoms. © 2016 John Wiley & Sons Ltd.

  5. Influence of timing and dose of thyroid hormone replacement on mental, psychomotor, and behavioral development in children with congenital hypothyroidism.

    PubMed

    Bongers-Schokking, Jacoba J; de Muinck Keizer-Schrama, Sabine M P F

    2005-12-01

    To evaluate the influence of initial and postinitial treatment factors on cognitive, psychomotor, and psychological outcome in schoolchildren with congenital hypothyroidism (CH). We studied 45 patients (19 with severe CH and 26 with mild CH) and 37 control children by correlating initial and postinitial treatment factors (free thyroxine and thyroid-stimulating hormone [TSH] concentrations, and the percentage of overtreatment and undertreatment periods) with the results of neuropsychological tests and behavior (as reported on the Teacher Report Form [TRF]). The global IQ of the children with CH was comparable to that of the controls; visuomotor and verbal scores were lower, and total TRF scores were higher. Ethnic group, previous development, and overtreatment predicted IQ and verbal scores, with higher scores seen for the overtreated patients than for the control children and those patients who had not been overtreated. As initial treatment was less satisfactory, total TRF scores were higher. Our study suggests that initial and postinitial suboptimal treatment of CH leads to abnormalities in IQ and specific fields. Overtreatment may advance cognitive development in 5-1/2- to 7-year-olds. Suboptimal initial treatment may lead to behavioral problems. We recommend that TSH concentrations be maintained within the normal range in patients with CH.

  6. Factors Influencing Burnout Syndrome in Obstetrics and Gynecology Physicians

    PubMed Central

    Muraru, Diana; Dirtu, Catalin; Soponaru, Camelia; Ilea, Ciprian; Socolov, Demetra-Gabriela

    2017-01-01

    Aim To identify the influence of environmental, personality, and alexithymia factors on burnout syndrome among obstetrics and gynecology physicians. Material and Methods A total of 116 physicians (35 men and 81 women) completed questionnaires and sociodemographic data sheets. The Maslach Burnout Inventory, the Big Five Inventory, and the Toronto Alexithymia Scale were used to measure burnout, innate personality traits, and alexithymia, respectively. The t-test and Pearson correlations were used for other measurements. Results Of the 116 study physicians, 12.9% have suffered or still suffer from depression and 35.3% have had or still have problems related to insomnia. Regarding emotional exhaustion and depersonalization factors, men obtained lower scores than women (18.73 ± 13.48 versus 24.14 ± 11.71 for emotional exhaustion; 5.97 ± 5.45 versus 7.70 ± 5.29 for depersonalization). Self-reported depression was related to higher scores for all 3 domains, to higher total scores for alexithymia and neuroticism, and to lower scores for extraversion, conscientiousness, and openness. Residents and consultants had markedly different scores. Conclusion The results of this study will help obstetrics and gynecology physicians cope with professional burnout and to consider personality traits, alexithymia domains, and environmental factors when finding strategies to cope with their professional stress. PMID:29359161

  7. The shoulder pain and disability index: the construct validity and responsiveness of a region-specific disability measure.

    PubMed

    Heald, S L; Riddle, D L; Lamb, R L

    1997-10-01

    The purposes of this study were (1) to assess the construct validity of the Shoulder Pain and Disability Index (SPADI) and (2) to determine whether the SPADI is more responsive than the Sickness Impact Profile (SIP), a generic health status measure. The sample consisted of 94 patients who were diagnosed with a shoulder problem and referred to six outpatient physical therapy clinics. Clinically meaningful change was determined by use of an ordinal rating scale designed to determine whether the patient's shoulder function was improved, the same, or worse following treatment. Spearman rho correlations were calculated for the initial visit SPADI and SIP scores. The standardized response mean (SRM) was used to measure responsiveness for the patients who were judged to be improved. One-tailed paired t tests (alpha = .01) were used to determine whether differences existed among SRM values. Correlations between the SPADI and SIP scores ranged from r = .01 to r = .57. The SRM value was higher for the SPADI total score (SRM = 1.38) than for the SIP total score (SRM = 0.79). Most correlations between SPADI and SIP scores provided support for the construct validity of the SPADI. The SPADI does not appear to strongly reflect occupational and recreational disability and is more responsive than the SIP.

  8. Psychometric characteristics of Clinical Reasoning Problems (CRPs) and its correlation with routine multiple choice question (MCQ) in Cardiology department.

    PubMed

    Derakhshandeh, Zahra; Amini, Mitra; Kojuri, Javad; Dehbozorgian, Marziyeh

    2018-01-01

    Clinical reasoning is one of the most important skills in the process of training a medical student to become an efficient physician. Assessment of the reasoning skills in a medical school program is important to direct students' learning. One of the tests for measuring the clinical reasoning ability is Clinical Reasoning Problems (CRPs). The major aim of this study is to measure psychometric qualities of CRPs and define correlation between this test and routine MCQ in cardiology department of Shiraz medical school. This study was a descriptive study conducted on total cardiology residents of Shiraz Medical School. The study population consists of 40 residents in 2014. The routine CRPs and the MCQ tests was designed based on similar objectives and were carried out simultaneously. Reliability, item difficulty, item discrimination, and correlation between each item and the total score of CRPs were all measured by Excel and SPSS software for checking psycometeric CRPs test. Furthermore, we calculated the correlation between CRPs test and MCQ test. The mean differences of CRPs test score between residents' academic year [second, third and fourth year] were also evaluated by Analysis of variances test (One Way ANOVA) using SPSS software (version 20)(α=0.05). The mean and standard deviation of score in CRPs was 10.19 ±3.39 out of 20; in MCQ, it was 13.15±3.81 out of 20. Item difficulty was in the range of 0.27-0.72; item discrimination was 0.30-0.75 with question No.3 being the exception (that was 0.24). The correlation between each item and the total score of CRP was 0.26-0.87; the correlation between CRPs test and MCQ test was 0.68 (p<0.001). The reliability of the CRPs was 0.72 as calculated by using Cronbach's alpha. The mean score of CRPs was different among residents based on their academic year and this difference was statistically significant (p<0.001). The results of this present investigation revealed that CRPs could be reliable test for measuring clinical reasoning in residents. It can be included in cardiology residency assessment programs.

  9. Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: a correlational study.

    PubMed

    Mecagni, C; Smith, J P; Roberts, K E; O'Sullivan, S B

    2000-10-01

    This study investigated the relationship between balance measures and ankle range of motion (ROM) in community-dwelling elderly women with no health problems. Identification of modifiable factors associated with balance may enable clinicians to design treatments to help reduce the risk of falls in elderly people. The sample consisted of 34 women between the ages of 64 and 87 years (mean=74.7, SD=6.0). Goniometry was used to determine bilateral ankle active-assistive range of motion (AAROM) and passive range of motion. Balance capabilities were measured with the Functional Reach Test (FRT) and the Tinetti Performance-Oriented Mobility Assessment (POMA). Balance data for the FRT, POMA balance subtest, POMA gait subtest, and POMA total score were correlated with ankle ROM using the Pearson product moment correlation coefficient (PCC). Correlations between ROM and balance scores were found, ranging from.29 to.63. The POMA gait subtest and FRT resulted in higher correlations with ROM than did the POMA balance subtest (left total AAROM PCC=.63,.51, and.31). Correlations using composite ankle ROM scores were higher than individual motions. The strongest correlation existed between bilateral, total ankle AAROM and the POMA gait subtest scores (PCC=. 63) Correlations exist between ankle ROM and balance in community-dwelling elderly women. Additional research is needed to determine whether treatment directed at increasing ankle ROM can improve balance.

  10. Sexual dysfunction among married couples living in Kumasi metropolis, Ghana

    PubMed Central

    2011-01-01

    Background Sexuality and its manifestation constitute some of the most complex of human behaviour and its disorders are encountered in community. Sexual dysfunction is more prevalent in women than in men. While studies examining sexual dysfunction among males and females in Ghana exist, there are no studies relating sexual problems in males and females as dyadic units. This study therefore investigated the prevalence and type of sexual disorders among married couples. Method The study participants consisted of married couples between the ages of 19 and 66 living in the province of Kumasi, Ghana. Socio-demographic information and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) questionnaires were administered to 200 couples who consented to take part in the study. All 28 questions of the GRISS are answered on a five-point (Likert type) scale from "always", through "usually', "sometimes", and "hardly ever", to "never". Responses are summed up to give a total raw score ranging from 28-140. The total score and subscale scores are transformed using a standard nine point scale, with high scores indicating greater problems. Scores of five or more are considered to indicate SD. The study was conducted between July and September 2010. Results Out of a total of 200 married couples, 179 completed their questionnaires resulting in a response rate of 89.5%. The mean age of the participating couples as well as the mean duration of marriage was 34.8 ± 8.6 years and 7.8 ± 7.6 years respectively. The husbands (37.1 ± 8.6) were significantly older (p < 0.0001) than their corresponding wives (32.5 ± 7.9). After adjusting for age, 13-18 years of marriage life poses about 10 times significant risk of developing SD compared to 1-6 years of married life among the wives (OR: 10.8; CI: 1.1 - 49.1; p = 0.04). The total scores (6.0) as well as the percentage above the cut-off (59.2) obtained by the husbands compared to the total score (6.2) and the percentage above cut-off (61.5) obtained by the wives, indicates the likely presence of sexual dysfunction. The prevalence of impotence and premature ejaculation were 60.9% and 65.4% respectively from this study and the prevalence of vaginismus and anorgasmia were 69.3% and 74.9% respectively. The highest prevalence of SD subscales among the men was dissatisfaction with sexual act followed by infrequency, whereas the highest among the women was infrequency followed by anorgasmia. Dissatisfaction with sexual intercourse among men correlated positively with anorgasmia and wife's non-sensuality and infrequency of sex. Conclusion The prevalence of sexual dysfunction in married couples is comparable to prevalence rates in the general male and female population and is further worsened by duration of marriage. This could impact significantly on a couple's self-esteem and overall quality of life. PMID:21366917

  11. Construct validity of the individual work performance questionnaire.

    PubMed

    Koopmans, Linda; Bernaards, Claire M; Hildebrandt, Vincent H; de Vet, Henrica C W; van der Beek, Allard J

    2014-03-01

    To examine the construct validity of the Individual Work Performance Questionnaire (IWPQ). A total of 1424 Dutch workers from three occupational sectors (blue, pink, and white collar) participated in the study. First, IWPQ scores were correlated with related constructs (convergent validity). Second, differences between known groups were tested (discriminative validity). First, IWPQ scores correlated weakly to moderately with absolute and relative presenteeism, and work engagement. Second, significant differences in IWPQ scores were observed for workers differing in job satisfaction, and workers differing in health. Overall, the results indicate acceptable construct validity of the IWPQ. Researchers are provided with a reliable and valid instrument to measure individual work performance comprehensively and generically, among workers from different occupational sectors, with and without health problems.

  12. [Review and analysis of the review results of Taiwan nurses association nursing projects (2011~2013)].

    PubMed

    Chang, Li-Yin; Chen, Yu-Chih; Huang, Kuang-Chi; Huang, Jui-Lan; Lee, Tso-Ying

    2015-04-01

    Nursing projects are a key part of N4 professional competency training for nursing personnel. Low passage rates for these projects have been shown to negatively affect the intent of nursing personnel to advance further in the nursing ladder system. This study analyzes the scores for nursing projects between 2011 and 2013, the passage rate for these projects, and the differences in passage rates between different types of projects. This retrospective and descriptive study collected data on nursing projects conducted under the auspices of the Taiwan Nurses Association between 2011 and 2013. Furthermore, the comments of reviewers on 100 nursing projects were randomly selected and subjected to content analysis. A total of 3,359 nursing projects were examined. Eliminating unqualified nursing projects left a total of 3,246 projects for the dataset. A total of 1,099 projects were scored with passing grades, giving a passing rate of 33.9%. The authors of these passing projects worked primarily in northern Taiwan, worked in medical centers, and worked in intensive care departments. The projects submitted by authors in central Taiwan had the highest average score and passing rate, while those living in offshore islands had the lowest average score and passing rate. Most of the project topics belonged to the category: "improvement of nursing service skills or quality" (77.3%). Items with the lowest scores were: validation of questions, analysis of the current situation, and evaluation of results. The topics of nursing projects did not relate significantly to passing rate. However, years of experience, geographic location of hospital, level of institution, and department each had a statistically significant impact on the passage rate. A content analysis of reviewer comments was used to extract common problems. Most of the positive comments were related to the category of "literature review and reference", while most of the negative comments were related to the categories of "literature review and reference", "analysis of current situation", "problem result and process", "evaluation of results", and "validation of questions". This study analyzed the types of nursing projects, the trends in submission, and the comments of project reviewers. The results indicate that the validation of problems in project writing and current situation analysis and the evaluation of results should be improved. These findings may be referenced by nursing personnel for executing projects in the future and for developing improved criteria / methodologies for the clinical ladder system for nursing personnel.

  13. Clinical research of comprehensive rehabilitation in treating brachial plexus injury patients.

    PubMed

    Zhou, Jun-Ming; Gu, Yu-Dong; Xu, Xiao-Jun; Zhang, Shen-Yu; Zhao, Xin

    2012-07-01

    Brachial plexus injury is one of the difficult medical problems in the world. The aim of this study was to observe the clinical therapeutic effect of comprehensive rehabilitation in treating dysfunction after brachial plexus injury. Forty-three cases of dysfunction after brachial plexus injury were divided into two groups randomly. The treatment group, which totaled 21 patients (including 14 cases of total brachial plexus injury and seven cases of branch brachial plexus injury), was treated with comprehensive rehabilitation including transcutaneous electrical nerve stimulation, mid-frequency electrotherapy, Tuina therapy, and occupational therapy. The control group, which totaled 22 patients (including 16 cases of total brachial plexus injury and six cases of branch brachial plexus injury), was treated with home-based electrical nerve stimulation and occupational therapy. Each course was of 30 days duration and the patients received four courses totally. After four courses, the rehabilitation effect was evaluated according to the brachial plexus function evaluation standard and electromyogram (EMG) assessment. In the treatment group, there was significant difference in the scores of brachial plexus function pre- and post-treatment (P < 0.01) in both "total" and "branch" injury. The scores of two "total injury" groups had statistical differences (P < 0.01), while the scores of two "branch injury" groups had statistical differences (P < 0.05) after four courses. EMG suggested that the appearance of regeneration potentials of the recipient nerves in the treatment group was earlier than the control group and had significant differences (P < 0.05). Comprehensive rehabilitation was more effective in treating dysfunction after brachial plexus injury than nonintegrated rehabilitation.

  14. Teaching ergonomics to nursing facility managers using computer-based instruction.

    PubMed

    Harrington, Susan S; Walker, Bonnie L

    2006-01-01

    This study offers evidence that computer-based training is an effective tool for teaching nursing facility managers about ergonomics and increasing their awareness of potential problems. Study participants (N = 45) were randomly assigned into a treatment or control group. The treatment group completed the ergonomics training and a pre- and posttest. The control group completed the pre- and posttests without training. Treatment group participants improved significantly from 67% on the pretest to 91% on the posttest, a gain of 24%. Differences between mean scores for the control group were not significant for the total score or for any of the subtests.

  15. HoNOSCA-D As a Measure of the Severity of Diagnosed Mental Disorders in Children and Adolescents-Psychometric Properties of the German Translation.

    PubMed

    von Wyl, Agnes; Toggweiler, Stephan; Zollinger, Ruedi

    2017-01-01

    The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), in use worldwide, is a 13-item measure assessing the biopsychosocial severity of mental health problems in children and adolescents. This article introduces the authorized German-language version of HoNOSCA, the HoNOSCA-D, and examines and discusses its psychometric properties based on a clinical sample of 1,533 children and adolescents aged 4;0 to 17;11 years. For the HoNOSCA-D total score (severity of mental health problems), internal consistency (Cronbach's alpha) was 0.63. The discriminative power of the items ranged from 0.07 to 0.44; the average interitem correlation was 0.11. Due to this stochastic independence, calculation of a total severity index is acceptable. Using factor analysis, the principal axis factoring and varimax rotation resulted in a four-factor structure, which with a Kaiser-Meyer-Olkin measure of sampling adequacy of 0.684 explained 30.62% of total variance. The convergent correlations with the German-language parent report version of the Strengths and Difficulties Questionnaire were as expected and showed a medium effect size. Gender and age differences in the HoNOSCA-D total score were small. Regarding the 13 items gender and age differences were negligible to medium. The highest severity was found for schizophrenia and psychotic disorders, followed by affective disorders and social behavior disorders. Overall, validity of HoNOSCA-D was clearly supported.

  16. [Validation and reliability of Turkish Singing Voice Handicap index].

    PubMed

    Denizoğlu, İsmail İlter; Şahin, Mustafa; Kazancıoğlu, Alper; Dağdelen, Zibelhan; Akdeniz, Serap; Oğuz, Haldun; Kılıç, Mehmet Akif; Yücedağ, Aslı; Öğüt, Mehmet Fatih

    2016-01-01

    This study aims to constitute a valid and reliable Turkish version of the original Singing Voice Handicap Index. An authorized committee assessed the reliability and validity of the content, scope, and language of the original Singing Voice Handicap Index which underwent a back translation process. The Turkish version of the questionnaire was answered twice with a 7 to 10-day interval by two singing voice groups with or without singing voice problems. The reliability and validity analyses were performed based on these answers. Of a total of 123 individuals (64 females, 59 males; mean age 26.2±7.3 years), 81 were without a voice pathology and 42 were with a voice pathology. The total Cronbach's alpha coefficient was 0.917. The item-total correlations ranged between 0.51 and 0.89. The weighted kappa values of test-retest correlation values of the items were 0.82-0.91. The Cronbach's alpha values of two part of the questionnaire based on the split-half method were 0.89 and 0.84. The mean total scale scores were 21.8±18.5 and 53.6±28.9 in normal and pathology groups, respectively and there was a statistically significant difference in scores between these two groups (p=0.000). The Turkish version of the Singing Voice Handicap Index is a valid and reliable scale which can be used in the evaluation of voice problems of Turkish-speaking singing voice users.

  17. Problem-solving by traumatically brain injured and neurologically intact subjects on an adaptation of the twenty questions test.

    PubMed

    Marshall, Robert C; Karow, Colleen M; Morelli, Claudia A; Iden, Kristin K; Dixon, Judith

    2003-07-01

    RAPS (Rapid Assessment of Problem-Solving) is a clinical measure for assessing verbal problem-solving in hard-to-test patients or those that may not be able to tolerate a longer, more detailed assessment. The design of the test is based on Mosher and Hornsby's Twenty Question test, but RAPS contains several modifications to facilitate its use with brain-injured individuals. This study used RAPS to compare the verbal problem-solving ability of subjects that were neurologically intact and subjects that had chronic traumatic brain injuries. Twenty-one adults that were neurologically intact (NI) and 21 adults that had incurred a traumatic brain injury (TBI) matched for age, gender and education took part in the study. Before being tested with RAPS, participants signed an IRB-approved consent form and completed a battery of neurocognitive measures. RAPS entailed the solving of three verbal problems. Each problem involved an array of 32 pictures of common objects (e.g. football) arranged in a 4x 8 grid. The subjects were instructed to ask yes/no questions to determine which picture the examiner was 'thinking of '. Three scores were computed for each problem solved: number of questions asked, percentage of constraint-seeking questions, and question-asking efficiency scores for the first four questions. No learning effects across the problems were found for any of the RAPS measures. Scores were averaged across the three problems to determine group effects. Groups of TBI and NI subjects did not differ significantly in the number of questions asked in solving RAPS problems. Members of the NI group asked significantly more constraint-seeking questions (e.g. Is it an animal?) than those in the TBI group, and the subjects that had incurred brain injuries did more guessing than the NI group. Over 70% of the time, guessing took place after the semantic category containing the target picture was known to the subject. Guesses took the form of pseudo-constraint questions (e.g. Is it the animal with a long neck?) rather than frank guesses (e.g. Is it the giraffe?). These trends were seen for both groups. Question-asking efficiency scores, computed for the first four questions of each problem, reflected the amount of information gained by the subjects' questions. It was anticipated that subjects' questioning strategies would target larger rather than smaller number of pictures and systematically reduce the number of total pictures under consideration. Question-asking efficiency scores were significantly higher for the group of NI subjects. Both groups increased question-asking efficiency scores across the first four questions, and there was no significant group x question interaction. Further analysis of the question-asking efficiency scores revealed that questions from the group of NI subjects tended to target multiple categories of pictures and larger single semantic categories of pictures on the 32-item problem-solving board, whereas those from the group of TBI subjects often targeted smaller categories or portions of categories. Two meta-cognitive functions, planning and strategy shifting, appeared to explain most of the differences in the verbal problem-solving performance between the groups. Both groups, however, demonstrated a range of abilities on RAPS. Until a larger normative database for RAPS is available, it behooves clinicians using the test to analyse results on an individual basis, to consider the subject's pre-morbid problem-solving ability and to weigh those factors associated with brain injury that could affect RAPS performance.

  18. Cancer-specific health-related quality of life in children with brain tumors.

    PubMed

    Sato, Iori; Higuchi, Akiko; Yanagisawa, Takaaki; Mukasa, Akitake; Ida, Kohmei; Sawamura, Yutaka; Sugiyama, Kazuhiko; Saito, Nobuhito; Kumabe, Toshihiro; Terasaki, Mizuhiko; Nishikawa, Ryo; Ishida, Yasushi; Kamibeppu, Kiyoko

    2014-05-01

    To understand the influence of disease and treatment on the health-related quality of life (HRQOL) of children with brain tumors, compared to the HRQOL of children with other cancers, from the viewpoints of children and parents. A total of 133 children aged 5-18 years and 165 parents of children aged 2-18 completed questionnaires of the Pediatric Quality of Life Inventory Cancer Module (Pain and Hurt, Nausea, Procedural Anxiety, Treatment Anxiety, Worry, Cognitive Problems, Perceived Physical Appearance, and Communication scales); higher scores indicate a better HRQOL. The Cancer Module scores, weighted by age and treatment status, were compared to those obtained in a previous study of children with other cancers (mostly leukemia). The weighted mean scores for Pain and Hurt (effect size d = 0.26) and Nausea (d = 0.23) from child reports and the scores for Nausea (d = 0.28) from parent reports were higher for children with brain tumors than scores for children with other cancers. The scores for Procedural Anxiety (d = -0.22) and Treatment Anxiety (d = -0.32) from parent reports were lower for parents of children with brain tumors than the scores for parents of children with other cancers. The child-reported Pain and Hurt score of the Cancer Module was higher (d = 0.29) and in less agreement (intraclass correlation coefficient = 0.43) with scores from the Brain Tumor Module, indicating that assessments completed with the Cancer Module misesteem pain and hurt problems in children with brain tumors. The profiles of cancer-specific HRQOL in children with brain tumors differ from those of children with other cancers; we therefore suggest that these children receive specific psychological support.

  19. Symptoms of depression as reported by Norwegian adolescents on the Short Mood and Feelings Questionnaire

    PubMed Central

    Lundervold, Astri J.; Breivik, Kyrre; Posserud, Maj-Britt; Stormark, Kjell Morten; Hysing, Mari

    2013-01-01

    The present study investigated sex-differences in reports of depressive symptoms on a Norwegian translation of the short version of the Mood and Feelings Questionnaire (SMFQ). The sample comprised 9702 Norwegian adolescents (born 1993–1995, 54.9% girls), mainly attending highschool. A set of statistical analyses were run to investigate the dimensionality of the SMFQ. Girls scored significantly higher than boys on the SMFQ and used the most severe response-category far more frequently. Overall, the statistical analyses supported the essential unidimensionality of SMFQ. However, the items with the highest loadings according to the bifactor analysis, reflecting problems related to tiredness, restlessness and concentration difficulties, indicated that some of the symptoms may both be independent of and part of the symptomatology of depression. Measurement invariance analysis showed that girls scored slightly higher on some items when taking the latent variable into account; girls had a lower threshold for reporting mood problems and problems related to tiredness than boys, who showed a marginally lower threshold for reporting that no-one loved them. However, the effect on the total SMFQ score was marginal, supporting the use of the Norwegian translation of SMFQ as a continuous variable in further studies of adolescents. PMID:24062708

  20. Human performance on visually presented Traveling Salesman problems.

    PubMed

    Vickers, D; Butavicius, M; Lee, M; Medvedev, A

    2001-01-01

    Little research has been carried out on human performance in optimization problems, such as the Traveling Salesman problem (TSP). Studies by Polivanova (1974, Voprosy Psikhologii, 4, 41-51) and by MacGregor and Ormerod (1996, Perception & Psychophysics, 58, 527-539) suggest that: (1) the complexity of solutions to visually presented TSPs depends on the number of points on the convex hull; and (2) the perception of optimal structure is an innate tendency of the visual system, not subject to individual differences. Results are reported from two experiments. In the first, measures of the total length and completion speed of pathways, and a measure of path uncertainty were compared with optimal solutions produced by an elastic net algorithm and by several heuristic methods. Performance was also compared under instructions to draw the shortest or the most attractive pathway. In the second, various measures of performance were compared with scores on Raven's advanced progressive matrices (APM). The number of points on the convex hull did not determine the relative optimality of solutions, although both this factor and the total number of points influenced solution speed and path uncertainty. Subjects' solutions showed appreciable individual differences, which had a strong correlation with APM scores. The relation between perceptual organization and the process of solving visually presented TSPs is briefly discussed, as is the potential of optimization for providing a conceptual framework for the study of intelligence.

  1. The Alcohol Use Disorders Identification Test (AUDIT): reliability and validity of the Greek version.

    PubMed

    Moussas, George; Dadouti, Georgia; Douzenis, Athanassios; Poulis, Evangelos; Tzelembis, Athanassios; Bratis, Dimitris; Christodoulou, Christos; Lykouras, Lefteris

    2009-05-14

    Problems associated with alcohol abuse are recognised by the World Health Organization as a major health issue, which according to most recent estimations is responsible for 1.4% of the total world burden of morbidity and has been proven to increase mortality risk by 50%. Because of the size and severity of the problem, early detection is very important. This requires easy to use and specific tools. One of these is the Alcohol Use Disorders Identification Test (AUDIT). This study aims to standardise the questionnaire in a Greek population. AUDIT was translated and back-translated from its original language by two English-speaking psychiatrists. The tool contains 10 questions. A score >or= 11 is an indication of serious abuse/dependence. In the study, 218 subjects took part: 128 were males and 90 females. The average age was 40.71 years (+/- 11.34). From the 218 individuals, 109 (75 male, 34 female) fulfilled the criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), and presented requesting admission; 109 subjects (53 male, 56 female) were healthy controls. Internal reliability (Cronbach alpha) was 0.80 for the controls and 0.80 for the alcohol-dependent individuals. Controls had significantly lower average scores (t test P < 0.001) when compared to the alcoholics. The questionnaire's sensitivity for scores >8 was 0.98 and its specificity was 0.94 for the same score. For the alcohol-dependent sample 3% scored as false negatives and from the control group 1.8% scored false positives. In the alcohol-dependent sample there was no difference between males and females in their average scores (t test P > 0.05). The Greek version of AUDIT has increased internal reliability and validity. It detects 97% of the alcohol-dependent individuals and has a high sensitivity and specificity. AUDIT is easy to use, quick and reliable and can be very useful in detection alcohol problems in sensitive populations.

  2. Identifying at-risk children at school entry: the usefulness of multibehavioral problem profiles.

    PubMed

    Flanagan, Kelly S; Bierman, Karen L; Kam, Chi-Ming

    2003-09-01

    Found that 1st-grade teacher ratings of aggressive, hyperactive-inattentive, and low levels of prosocial behaviors made unique contributions to the prediction of school outcomes (measured 2 years later) for 755 children. Person-oriented analyses compared the predictive utility of 5 screening strategies based on child problem profiles to identify children at risk for school problems. A broad screening strategy, in which children with elevations in any 1 of the 3 behavior problem dimensions were identified as "at-risk," showed lower specificity but superior sensitivity, odds ratios, and overall accuracy in the prediction of school outcomes than the other screening strategies that were more narrowly focused or were based on a total problem score. Results are discussed in terms of implications for the screening and design of preventive interventions.

  3. Self-perceptions of young adults who survived severe childhood burn injury.

    PubMed

    Russell, William; Robert, Rhonda S; Thomas, Christopher R; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2013-01-01

    The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report [YASR]), and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID I]). This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 subscale scores of physical function, appearance, and sexuality, moral conduct, personal values, academics and work, and identity, than did the reference population. Pearson correlation coefficients showed that as moral, personal, family, and social aspects of self-concept decreased, clinical problems endorsed on the YASR subscales increased, including anxiety, somatic, attention, intrusive, and aggressive. Persons with lower self-concept scores on the TSCS2 personal, family, and social scales were more withdrawn on the YASR. Similarly, those with lower TSCS2 scores on the personal and family scales endorsed significantly more thought problems on the YASR. TSCS2 total self-concept, personal, and all of the supplementary scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 total self-concept and personal. Lower self-concept was associated with endorsement of SCID symptoms. In summary, the significantly lower self-concept scores on the TSCS2 physical scale are consistent with the physical disfigurement and handicaps common with major burn injuries, and a strong indication of this group's perception of the first impression made when interacting with others. The survivors seem to feel worthwhile within the contexts of family and friends. Although the major limitation of this study using the TSCS2 is the lack of a matched reference population to compare the burn survivors, the TSCS2 does help in gaining insight into the self-esteem issues of the burn survivor population.

  4. Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy.

    PubMed

    Pittman, Joyce; Rawl, Susan M; Schmidt, C Max; Grant, Marcia; Ko, Clifford Y; Wendel, Christopher; Krouse, Robert S

    2008-01-01

    The purpose of this study is to describe demographic, clinical, and quality-of-life variables related to ostomy complications (skin irritation, leakage, and difficulty adjusting to an ostomy) in a veteran population in the United States. The original study employed a descriptive crosssectional study using a mixed method design. This secondary analysis used the quantitative data collected. Two hundred thirty-nine veterans with intestinal ostomies from 3 Veteran's Administration hospitals participated in the study. Instruments used for this investigation included the City of Hope Quality of Life: Ostomy Instrument. Demographic and medical history data were collected from the survey, the Veteran's Administration health information system, and the Tumor Registry database. A self-administered survey questionnaire (mCOH-QOL-Ostomy) was mailed to each participant. The severity of skin irritation, problems with leakage, and difficulty adjusting were significantly related to demographic, clinical, and quality-of-life domains. Univariate analyses showed that age, income, employment, preoperative care (stoma site marking and education), having a partner, ostomy type, reason for ostomy, time since surgery, total quality-of-life scores and scores on all 4 domains of quality of life were related to the severity of these ostomy complications. Age was inversely related to severity of all 3 ostomy complications (skin irritation, leakage, and difficulty adjusting). Having an ileostomy, rather than a colostomy, was associated with higher severity of skin irritation. Having had the stoma site marked preoperatively was associated with less difficulty adjusting to an ostomy, and having had preoperative ostomy education was associated with less severe problems with skin irritation and leakage. Severity of each ostomy complication predicted total quality-of-life scores. Difficulty adjusting to the ostomy was related to all 4 quality-of-life domains (physical, psychological, social, and spiritual). This study found important relationships between demographic and clinical factors and ostomy complications. Skin problems, leakage, and difficulty adjusting predicted total quality of life scores and domains. Establishing relationships among ostomy complications and demographic, clinical factors, and quality of life can enhance identification of patients at risk for the development of complications and is an important first step in identifying the development of effective interventions to reduce the negative impact of complications for people with ostomies. Further study of predictors and outcomes of ostomy complications is needed to improve care.

  5. Latent class analysis of gambling subtypes and impulsive/compulsive associations: Time to rethink diagnostic boundaries for gambling disorder?

    PubMed

    Chamberlain, Samuel R; Stochl, Jan; Redden, Sarah A; Odlaug, Brian L; Grant, Jon E

    2017-09-01

    Gambling disorder has been associated with cognitive dysfunction and impaired quality of life. The current definition of non-pathological, problem, and pathological types of gambling is based on total symptom scores, which may overlook nuanced underlying presentations of gambling symptoms. The aims of the current study were (i) to identify subtypes of gambling in young adults, using latent class analysis, based on individual responses from the Structured Clinical Interview for Gambling Disorder (SCI-GD); and (ii) to explore relationships between these gambling subtypes, and clinical/cognitive measures. Total 582 non-treatment seeking young adults were recruited from two US cities, on the basis of gambling five or more times per year. Participants undertook clinical and neurocognitive assessment, including stop-signal, decision-making, and set-shifting tasks. Data from individual items of the Structured Clinical Interview for Gambling Disorder (SCI-GD) were entered into latent class analysis. Optimal number of classes representing gambling subtypes was identified using Bayesian Information Criterion and differences between them were explored using multivariate analysis of variance. Three subtypes of gambling were identified, termed recreational gamblers (60.2% of the sample; reference group), problem gamblers (29.2%), and pathological gamblers (10.5%). Common quality of life impairment, elevated Barratt Impulsivity scores, occurrence of mainstream mental disorders, having a first degree relative with an addiction, and impaired decision-making were evident in both problem and pathological gambling groups. The diagnostic item 'chasing losses' most discriminated recreational from problem gamblers, while endorsement of 'social, financial, or occupational losses due to gambling' most discriminated pathological gambling from both other groups. Significantly higher rates of impulse control disorders occurred in the pathological group, versus the problem group, who in turn showed significantly higher rates than the reference group. The pathological group also had higher set-shifting errors and nicotine consumption. Even problem gamblers who had a relatively low total SCI-PG scores (mean endorsement of two items) exhibited impaired quality of life, objective cognitive impairment on decision-making, and occurrence of other mental disorders that did not differ significantly from those seen in the pathological gamblers. Furthermore, problem/pathological gambling was associated with other impulse control disorders, but not increased alcohol use. Groups differed on quality of life when classified using the data-driven approach, but not when classified using DSM cut-offs. Thus, the current DSM-5 approach will fail to discriminate a significant fraction of patients with biologically plausible, functionally impairing illness, and may not be ideal in terms of diagnostic classification. Cognitive distortions related to 'chasing losses' represent a particularly important candidate treatment target for early intervention. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Colonic transit times and behaviour profiles in children with defecation disorders

    PubMed Central

    Benninga, M; Voskuijl, W; Akkerhuis, G; Taminiau, J; Buller, H

    2004-01-01

    Aims: To evaluate children referred for defecation disorders using the child behavioural checklist (CBCL). Methods: A total of 215 patients were divided into three groups: 135 (5–14 years of age) with paediatric constipation (PC), 56 (5–17 years) with functional non-retentive faecal soiling (FNRFS), and 24 (5–16 years) with recurrent abdominal pain (RAP). Behavioural scores were correlated with colonic transit time (CTT) and anorectal function parameters (manometry and EMG). Results: No significant differences in the mean CBCL scores were found among the three patient groups. However, children with PC and FNRFS had significantly more behavioural problems than the Dutch normative sample, while children with RAP had scores within the normal range. No significant differences were found between CTT in the patient groups, with respect to the CBCL. Similarly, no significant difference existed between children able or unable to relax their pelvic floor muscles during defecation attempts and their behaviour profiles. Conclusion: There seems to be no relation between colonic/anorectal function and specific behavioural profiles. On the other hand, children with defecation disorders show more behavioural problems than do controls. PMID:14709493

  7. [Teaching Bioethics to Students of Medicine with Problem-Based Learning (PBL)].

    PubMed

    Bosch-Barrera, Joaquim; Briceño García, Hugo C; Capella, Dolors; De Castro Vila, Carmen; Farrés, Ramón; Quintanas, Anna; Ramis, Josep; Roca, Rosa; Brunet, Joan

    2015-01-01

    We present the experience of the introduction of the subject of bioethics in a medical school in order to give to the 73 students of 5th degree skills to handle ethical conflicts in their practice. The main teaching method used was problem-based learning (PBL). Skills objectives are described. The course was structured with a theoretical seminar (2 hours of duration), a workshop (2 hours of duration), 4 cases of PBL (24 hours of duration in total) and a role playing workshop (2 hours of duration). The seminar was aimed at the acquisition of theoretical knowledge. The PBL cases provided critical appraisal, obtaining knowledge, and application. The Role Playing set out for the practical demonstration of skills acquired in a simulated environment. A continuous assessment of students was performed throughout their practice on the PBL cases (40% of the final score) and also a final evaluation of the course was carried out via exam (60% of the final score). Students completed a course and faculty evaluation anonymously, which came out with positive results (median score of 8.5/10).

  8. The effects of psychotherapy on behavior problems of sexually abused deaf children.

    PubMed

    Sullivan, P M; Scanlan, J M; Brookhouser, P E; Schulte, L E; Knutson, J F

    1992-01-01

    This study assessed the effectiveness of a broad based psychotherapeutic intervention with a sample of 72 children sexually abused at a residential school for the deaf. An untreated comparison group emerged when about half of their parents refused the offer for psychotherapy provided by the school. Treated and untreated children were randomly assigned to two assessment groups: those who participated in a pretreatment assessment and those who did not. Houseparents at the residential school used the Child Behavior Checklist (CBC) to rate the pretreatment assessment children before treatment and all 72 children one year after the implementation of psychotherapy. Children receiving therapy had significantly fewer behavior problems than children not receiving therapy. There was a differential response to therapy on the basis of sex. Boys receiving therapy had significantly lower scores on the following CBC scales than the no treatment group: Total, Internal, External, Somatic, Uncommunicative, Immature, Hostile, Delinquent, Aggressive, and Hyperactive. There were no differences on the Schizoid and Obsessive scales. Girls receiving therapy had significantly lower scores than the no treatment group on the following CBC scales: Total, External, Depressed, Aggressive, and Cruel. There were no differences on the Internal, Anxious, Schizoid, Immature, Somatic, and Delinquent scales.

  9. Pain, functional disability, and psychologic status in tennis elbow.

    PubMed

    Alizadehkhaiyat, Omid; Fisher, Anthony C; Kemp, Graham J; Frostick, Simon P

    2007-01-01

    First to compare pain and functional disability in tennis elbow (TE) patients with healthy controls. Second, to evaluate the relationship between the 2 major psychologic factors (anxiety and depression) and TE. Sixteen TE patients were recruited from 46 consecutive attendees at an upper limb clinic: inclusion criteria were lateral epicondyle tenderness, pain with resisted wrist and middle finger extension and at least 3 months localized lateral elbow pain. Sixteen healthy controls with no upper limb problem were recruited from students and staff. Participants were given 4 questionnaires, together with instructions for completion: Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Forearm Evaluation Questionnaire, Patient-Rated Wrist Evaluation Questionnaire, and Hospital Anxiety and Depression Scale. The independent t test was used to compare the total and subscale scores between the groups. Significantly higher scores were found in TE for pain and function subscales and also total score for Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Forearm Evaluation Questionnaire, and Patient-Rated Wrist Evaluation Questionnaire. For Hospital Anxiety and Depression Scale, both anxiety and depression subscales (P<0.001) and the total score (P<0.01) were significantly higher in TE. According to the anxiety and depression subscales, 55% and 36% of patients, respectively, were classified as probable cases (score >11). TE patients showed markedly increased pain and functional disability. Significantly elevated levels of depression and anxiety pointed out the importance of psychologic assessment in TE patients. In the development of supportive and treatment strategies, we suggest the combination of "upper limb" and "psychologic" assessment tools.

  10. A Psychoneuroimmunologic Examination of Cumulative Perinatal Steroid Exposures and Preterm Infant Behavioral Follow-Up

    PubMed Central

    Purdy, Isabell B.; Smith, Lynne; Wiley, Dorothy; Badr, Lina

    2014-01-01

    Purpose This study’s aim was to explore relationships between preterm infant behavioral outcomes and maternal/infant glucocorticoid (dexamethasone [DEX]) treatments using a psychoneuroimmunologic approach. Research questions were (a) do relationships exist between infant cumulative perinatal steroid (PNS) exposure and child behavioral problems? and (b) do maternal/infant characteristics (e.g., immune markers and biophysiologic stressors) influence these relationships? Methods The convenience sample comprised 45 mother–child dyads in which the children (mean age 8 years ± 2.3) had been born at a mean postconceptional age of 28 weeks (± 4.2). We used the Child Behavior Checklist (CBCL) to assess behavior, the Clinical Risk Index for Babies (CRIB) to score stress at birth, and retrospective record review to identify additional perinatal factors (PNS dosage, sepsis, and maternal and infant complete blood counts near delivery). Results Children were dichotomized into high (> 0.2mg/kg; n = 20) versus low–no (≤ 0.2 mg/kg; n = 25) PNS exposure groups. Significant relationships existed between CBCL Total Problems score and sepsis, PNS exposure, timing of initial PNS, and infant length percentile at discharge. Competence problems were significantly associated with PNS, neonatal intensive care unit (NICU) infant length percentile, CRIB score, sepsis, retinopathy of prematurity, hearing deficit, and immunity markers (i.e., maternal lymphocyte percentage and infant band/seg ratio). Children in the higher PNS group exhibited more behavioral problems (e.g., withdrawn, attention, conduct, social, and rule breaking problems), but there were no significant differences. The findings are reassuring regarding long-term effects of this PNS dose on preterm infant behavioral outcomes. PMID:21900308

  11. Psychological problems in children with hemiplegia: a European multicentre survey.

    PubMed

    Parkes, J; White-Koning, M; McCullough, N; Colver, A

    2009-06-01

    To describe the prevalence and determinants of psychological problems in European children with hemiplegia. Cross-sectional survey. Home visits in nine European regions by research associates who administered standard questionnaires to parents. 279 children with hemiplegia aged 8-12 years were recruited from population-based case registers. Strengths and Difficulties Questionnaire comprising emotion, conduct, hyperactivity, peer problems and prosocial domains. An "impact score" (IS) measures the social and psychological impact of the child's difficulties. Children with hemiplegia had higher mean scores on the total difficulties score (TDS) compared with a normative sample (p<0.001). 48% and 57% of children, respectively, had borderline-abnormal TDS and IS. Significant, independent associations were observed between intellectual impairment and an increased risk for hyperactivity (odds ratio; OR 8.4, 95% CI 3.4 to 20.8), peer problems (OR 3.1, 95% CI 1.7 to 5.5), psychological and social impact (OR 3.0, 95% CI 1.6 to 5.6) when children with an intellectual quotient (IQ) <50 were compared with those with an IQ >70. Boys had an increased risk for conduct (OR 2.1, 95% CI 1.2 to 3.7) and hyperactivity disorders (OR 2.5, 95% CI 1.4 to 4.6). Poor self-esteem was associated with an increased risk for peer problems (OR 5.8, 95% CI 2.5 to 13.4) and poor prosocial skills (OR 7.5, 95% CI 2.4 to 23.2) compared with those with high self-esteem. Other determinants of psychological adjustment were impaired communication, severe pain and living with a single parent. Many of the psychological problems identified are amenable to treatment. Special attention should be given to those at highest risk of developing psychological difficulties.

  12. Maternal fat intake during pregnancy and behavioral problems in 5-y-old Japanese children.

    PubMed

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Arakawa, Masashi

    2018-06-01

    The aim of this cohort study was to investigate the relationship between maternal fat consumption during pregnancy and behavioral problems in 1199 Japanese children at age 5 y. Dietary intake of mothers during pregnancy was assessed using a diet history questionnaire. Emotional, conduct, hyperactivity, and peer problems in children were assessed using the Strengths and Difficulties Questionnaire; the four scale scores were dichotomized, comparing children with borderline and abnormal scores to children with normal scores. Logistic regression analysis was applied to estimate adjusted odds ratios and 95% confidence intervals for each behavioral problem according to the quartile of dietary factors under study, adjusting for potential confounding factors. Higher maternal intake of monounsaturated fatty acids, α-linolenic acid, ω-6 polyunsaturated fatty acids, and linoleic acid during pregnancy was independently associated with an increased risk for childhood emotional problems. The adjusted odds ratios between extreme quartiles (95% confidence intervals, P trend ) were 1.85 (1.11 - 3.17, 0.04), 1.60 (0.99 - 2.60, 0.03), 2.06 (1.24 - 3.46, 0.002), and 2.09 (1.26 - 3.51, 0.002), respectively. No such positive associations were observed for the other outcomes. No relationships were found between maternal intake of total fat, saturated fatty acids, ω-3 polyunsaturated fatty acids, eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, or cholesterol, or the ratio of ω-3 to ω-6 polyunsaturated fatty acid intake during pregnancy and any of the outcomes. Maternal consumption of monounsaturated fatty acids, α-linolenic acid, ω-6 polyunsaturated fatty acids, and linoleic acid during pregnancy may increase the risk for childhood emotional problems. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. An examination of the symptoms of anxiety and parental attitude in children with hemophilia.

    PubMed

    Abali, Osman; Zülfikar, Osman Bülent; Karakoç Demirkaya, Sevcan; Ayaydin, Hamza; Kircelli, Fuat; Duman, Mehtap

    2014-01-01

    Hemophilia is an inherited disease with serious repercussions. Psychiatric symptoms are frequently seen in children and adolescents with hemophilia. The aim of this study was to assess symptoms of anxiety in children with hemophilia and parental attitude towards children with hemophilia. 42 boys were assessed according to child and adolescent psychiatry. Anxiety symptoms and parental attitude were obtained by the State-Trait Anxiety Scale, the Self-Report for Childhood Anxiety Related Disorders (SCARED) and the Parent Attitude Research Instrument (PARI). The mean age was 11.6 ± 2.5 (range; 7-16). State anxiety scores (44.02 ± 6.9) were higher than trait anxiety scores (32.7 + 7.5). The most interesting results were high scores related to overprotective mothering (47.9 ± 9.7) and the application of strict discipline (39.4 ± 9.1). The total SCARED scores obtained were (23.25 ± 11.3). Assuring a high quality of life is important for children and adolescents with chronic illness. Quality of life is negatively affected by psychiatric symptoms (e.g. anxiety symptoms, depression, intra-familial stress symptoms) in children with hemophilia. This study suggests that high anxiety scores and problems related to parental attitude can be seen in children and adolescents with hemophilia. These problems caused by parental attitude and anxiety symptoms should be considered in the treatment of hemophilia.

  14. A disease specific questionnaire for assessing behavior in individuals with Prader-Willi syndrome.

    PubMed

    Avrahamy, Hamutal; Pollak, Yehuda; Shriki-Tal, Liron; Genstil, Larry; Hirsch, Harry J; Gross-Tsur, Varda; Benarroch, Fortu

    2015-04-01

    Prader-Willi syndrome (PWS) is a genetic multisystem disorder with various medical, cognitive, behavioral and psychiatric problems. PWS is caused by the lack of expression of paternal genes on chromosome 15q2-q13 due to a deletion (70-75%), uniparental disomy (25-30%) or imprinting center defect (<5%). The common PWS behavioral and psychiatric characteristics are very typical in all ethnicities and were reported worldwide. Still, each individual has a specific profile of these common traits and the severity of his or her symptoms varies over time. Behavioral problems are the most important factor affecting the quality of life of both the individuals and their families. There is a need for a standardized tool to assess the specific behavioral profile of each individual and its present severity, in order to enable physicians to tailor the specific treatment needed and assist in a more accurate clinical follow up. To the best of our knowledge no such a tool has been standardized and published. We developed, based on the literature (mainly Forster and Gourash's paradigm) and our clinical experience, a 37 item disease specific questionnaire, the "PWS Behavioral Questionnaire" (PWSBQ) for assessing behavior in PWS patients. The purpose of the present study was to validate this tool in the entire adolescent and adult PWS population in Israel. The PWSBQ focuses on five major domains-abnormal emotional regulation, food-seeking related behavior, lack of flexibility, oppositional behavior and interpersonal problems and lastly body related behaviors. Caregivers of all Hebrew speaking individuals with PWS over the age of 12 years attending the Israeli national multidisciplinary PWS clinic were recruited. Of the 54 eligible individuals, 53 participated. They were interviewed with the PWSBQ and in addition filled the "Hyperphagia Questionnaire" and the "Child Behavioral Checklist" (CBCL). After verifying the questionnaire's content validity, all items on the PWSBQ were analyzed for internal reliability by calculating Cronbach's α. Criterion validity was evaluated by correlation testing with regard to the Hyperphagia Questionnaire and CBCL. In order to assess the questionnaire's interpretability, the correlation between the PWSBQ and the "Clinical Global Impression" (CGI) scores was evaluated. The PWSBQ total score was positively correlated with both the CBCL total score and the CGI score (0.662 and 0.549, p<0.001 respectively). Of the five domains, four had acceptable internal reliability (excluding the body related behaviors domain, which was thus removed from the total score). Criterion validity was established for the four domains remaining in the statistical analysis (abnormal emotional regulation, food seeking related behavior, lack of flexibility and oppositional behavior and interpersonal problems). Our findings suggest that the PWSBQ is a valid and reliable tool for the assessment of current behavioral problems among individuals with PWS. Although further research is needed in order to verify PWSBQ's ability to identify changes in the behavioral status of a given individual, it can now be used both in research and in a clinical setting, enabling the physician to plan the most suitable treatment based on the current behavioral status. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Factor Structure and Item Level Psychometrics of the Social Problem Solving Inventory Revised-Short Form in Traumatic Brain Injury

    PubMed Central

    Li, Chih-Ying; Waid-Ebbs, Julia; Velozo, Craig A.; Heaton, Shelley C.

    2016-01-01

    Primary Objective Social problem solving deficits characterize individuals with traumatic brain injury (TBI). Poor social problem solving interferes with daily functioning and productive lifestyles. Therefore, it is of vital importance to use the appropriate instrument to identify deficits in social problem solving for individuals with TBI. This study investigates factor structure and item-level psychometrics of the Social Problem Solving Inventory-Revised Short Form (SPSI-R:S), for adults with moderate and severe TBI. Research Design Secondary analysis of 90 adults with moderate and severe TBI who completed the SPSI-R:S. Methods and Procedures An exploratory factor analysis (EFA), principal components analysis (PCA) and Rasch analysis examined the factor structure and item-level psychometrics of the SPSI-R:S. Main Outcomes and Results The EFA showed three dominant factors, with positively worded items represented as the most definite factor. The other two factors are negative problem solving orientation and skills; and negative problem solving emotion. Rasch analyses confirmed the three factors are each unidimensional constructs. Conclusions The total score interpretability of the SPSI-R:S may be challenging due to the multidimensional structure of the total measure. Instead, we propose using three separate SPSI-R:S subscores to measure social problem solving for the TBI population. PMID:26052731

  16. Factor structure and item level psychometrics of the Social Problem Solving Inventory-Revised: Short Form in traumatic brain injury.

    PubMed

    Li, Chih-Ying; Waid-Ebbs, Julia; Velozo, Craig A; Heaton, Shelley C

    2016-01-01

    Social problem-solving deficits characterise individuals with traumatic brain injury (TBI), and poor social problem solving interferes with daily functioning and productive lifestyles. Therefore, it is of vital importance to use the appropriate instrument to identify deficits in social problem solving for individuals with TBI. This study investigates factor structure and item-level psychometrics of the Social Problem Solving Inventory-Revised: Short Form (SPSI-R:S), for adults with moderate and severe TBI. Secondary analysis of 90 adults with moderate and severe TBI who completed the SPSI-R:S was performed. An exploratory factor analysis (EFA), principal components analysis (PCA) and Rasch analysis examined the factor structure and item-level psychometrics of the SPSI-R:S. The EFA showed three dominant factors, with positively worded items represented as the most definite factor. The other two factors are negative problem-solving orientation and skills; and negative problem-solving emotion. Rasch analyses confirmed the three factors are each unidimensional constructs. It was concluded that the total score interpretability of the SPSI-R:S may be challenging due to the multidimensional structure of the total measure. Instead, we propose using three separate SPSI-R:S subscores to measure social problem solving for the TBI population.

  17. Minimal clinically important difference in the fibromyalgia impact questionnaire.

    PubMed

    Bennett, Robert M; Bushmakin, Andrew G; Cappelleri, Joseph C; Zlateva, Gergana; Sadosky, Alesia B

    2009-06-01

    The Fibromyalgia Impact Questionnaire (FIQ) is a disease-specific composite instrument that measures the effect of problems experienced by patients with fibromyalgia (FM). Utilization of the FIQ in measuring changes due to interventions in FM requires derivation of a clinically meaningful change for that instrument. Analyses were conducted to estimate the minimal clinically important difference (MCID), and to propose FIQ severity categories. Data from 3 similarly designed, 3-month placebo-controlled, clinical treatment trials of pregabalin 300, 450, and 600 mg/day in patients with FM were modeled to estimate the change in the mean FIQ total and stiffness items corresponding to each category on the Patient Global Impression of Change. FIQ severity categories were modeled and determined using established pain severity cutpoints as an anchor. A total of 2228 patients, mean age 49 years, 93% women, with a mean baseline FIQ total score of 62 were treated in the 3 studies. Estimated MCID on a given measure were similar across the studies. In a pooled analysis the estimated MCID (95% confidence interval) was 14% (13; 15) and for FIQ stiffness it was 13% (12; 14). In the severity analysis a FIQ total score from 0 to <39 was found to represent a mild effect, >or= 39 to <59 a moderate effect, and >or=59 to 100 a severe effect. The analysis indicates that a 14% change in the FIQ total score is clinically relevant, and results of these analyses should enhance the clinical utility of the FIQ in research and practice.

  18. Efficacy and Safety of a Chewable Methylphenidate Extended-Release Tablet in Children with Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Childress, Ann; Berry, Sally A.; Belden, Heidi; Walters, Faith; Chappell, Phillip; Sherman, Nancy; Orazem, John; Palumbo, Donna

    2017-01-01

    Abstract Objective: This phase 3, laboratory classroom study assessed the efficacy and safety of methylphenidate hydrochloride extended-release chewable tablets (MPH ERCT) compared with placebo in children with attention-deficit/hyperactivity disorder (ADHD). Methods: Following a 6-week, open-label, dose-optimization period, children 6–12 years of age (n = 90) with ADHD were randomly assigned to double-blind MPH ERCT at the final optimized dose (20–60 mg/day) or placebo. After 1 week of double-blind treatment, efficacy was assessed predose and 0.75, 2, 4, 8, 10, 12, and 13 hours postdose in a laboratory classroom setting. The primary efficacy measure was the average of postdose Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) Rating Scale-Combined scores, analyzed using a mixed-model, repeated-measures analysis. Secondary efficacy measures included Permanent Product Measure of Performance (PERMP) total number of problems attempted and total number of problems correct. Safety assessments included adverse event (AE) monitoring and the Columbia-Suicide Severity Rating Scale (C-SSRS). Results: MPH ERCT treatment statistically significantly reduced the average of all postdose SKAMP-Combined scores versus placebo (least-squares mean difference [95% confidence interval], −7.0 [−10.9, −3.1]; p < 0.001). Statistically significant treatment differences in SKAMP-Combined scores were observed at 2 hours postdose through 8 hours postdose (p-values <0.001). Statistically significant differences between MPH ERCT and placebo in PERMP total number of problems attempted and total number of problems correct were observed at 0.75 hours postdose through 8 hours postdose (p-values ≤0.049). Common AEs in the open-label period (≥5%) were decreased appetite, upper abdominal pain, mood swings, irritability, insomnia, upper respiratory tract infection (URTI), dysgeusia, and headache; URTI was the only AE reported by >1 subject receiving MPH ERCT in the double-blind period (placebo: URTI, contusion, wound, and initial insomnia). No suicidal ideation or behavior was reported on the C-SSRS at baseline or at any postbaseline assessment. Conclusions: MPH ERCT 20–60 mg significantly improved ADHD symptoms compared with placebo at 2 hours postdose through at least 8 hours postdose. MPH ERCT was generally safe and well tolerated, with a safety profile consistent with other MPH ER formulations. ClinicalTrials.gov Identifier: NCT01654250. www.clinicaltrials.gov/ct2/show/NCT01654250. PMID:28557548

  19. Knowledge of diabetes mellitus among pregnant women in three districts of Nepal.

    PubMed

    Shrestha, S; Thapa, P; Saleh, F; Thapa, N; Stray, B Pedersen; Khanom, K

    2013-09-01

    Diabetes mellitus is an emerging health problem in developing world with the consumption of energy dense diet and inactive lifestyle. The problem of diabetes is further expanded due to ignorance and lack of knowledge. The aim of the study was to assess the knowledge of diabetes among pregnant women in three districts of Nepal. A community based cross-sectional study was conducted in three districts in mountain, hilly and plain areas of Nepal. A total of 590 pregnant women were interviewed during the period of July 2009 to June 2010. A knowledge score system was applied. Poor score was <40%, average (40-60%) and good (>60%) of the total score. Statistical software SPSS 11.5 was used for data entry, data management and analysis. Out of 590 pregnant women, only 41% had heard about diabetes mellitus. Majority of the participants (75%) from age group >30 years had not heard about diabetes. Among the 241 with some knowledge, the knowledge score median percent(range) on the meaning, symptoms, risk factors, treatment, prevention, complications and overall knowledge were 50%(0-100), 25% (0-75), 20% (0-60), 20% (0-100), 25% (0-100), 20% (0-60) and 26% (0- 58) respectively. According to defined category, majority of those who ever heard about diabetes had poor knowledge (95%). Knowledge among literate women (p=.001), women residing in Kailali district (plain region) (p=.003) and those with positive family history of diabetes (p=.003) was found to be significant. As large proportions of Nepalese pregnant women do not have any knowledge or have poor knowledge regarding diabetes, extensive health education and health promotion programs are urgently recommended to prevent diabetes in Nepal.

  20. Validation of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Sleep

    PubMed Central

    2017-01-01

    Background Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. Methods In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10–14 days. Results The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. Conclusion The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD. PMID:29215823

  1. Validation of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Sleep.

    PubMed

    Sung, Young Hee; Kim, Hee Jin; Koh, Seong Beom; Kim, Joong Seok; Kim, Sang Jin; Cheon, Sang Myung; Cho, Jin Whan; Kim, Yoon Joong; Ma, Hyeo Il; Park, Mee Young; Baik, Jong Sam; Lee, Phil Hyu; Chung, Sun Ju; Kim, Jong Min; Song, In Uk; Kim, Han Joon; Kim, Ji Young; Kwon, Do Young; Lee, Jae Hyeok; Lee, Jee Young; Kim, Ji Seon; Yun, Ji Young; Hong, Jin Yong; Kim, Mi Jung; Youn, Jinyoung; Kim, Ji Sun; Oh, Eung Seok; Yang, Hui Jun; Yoon, Won Tae; You, Sooyeoun; Kwon, Kyum Yil; Park, Hyung Eun; Lee, Su Yun; Kim, Younsoo; Kim, Hee Tae; Ahn, Tae Beom

    2018-01-08

    Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10-14 days. The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD. © 2018 The Korean Academy of Medical Sciences.

  2. A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries.

    PubMed

    Humeniuk, Rachel; Ali, Robert; Babor, Thomas; Souza-Formigoni, Maria Lucia O; de Lacerda, Roseli Boerngen; Ling, Walter; McRee, Bonnie; Newcombe, David; Pal, Hemraj; Poznyak, Vladimir; Simon, Sara; Vendetti, Janice

    2012-05-01

    This study evaluated the effectiveness of a brief intervention (BI) for illicit drugs (cannabis, cocaine, amphetamine-type stimulants and opioids) linked to the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST screens for problem or risky use of 10 psychoactive substances, producing a score for each substance that falls into either a low-, moderate- or high-risk category. Prospective, randomized controlled trial in which participants were either assigned to a 3-month waiting-list control condition or received brief motivational counselling lasting an average of 13.8 minutes for the drug receiving the highest ASSIST score. Primary health-care settings in four countries: Australia, Brazil, India and the United States. A total of 731 males and females scoring within the moderate-risk range of the ASSIST for cannabis, cocaine, amphetamine-type stimulants or opioids. ASSIST-specific substance involvement scores for cannabis, stimulants or opioids and ASSIST total illicit substance involvement score at baseline and 3 months post-randomization. Omnibus analyses indicated that those receiving the BI had significantly reduced scores for all measures, compared with control participants. Country-specific analyses showed that, with the exception of the site in the United States, BI participants had significantly lower ASSIST total illicit substance involvement scores at follow-up compared with the control participants. The sites in India and Brazil demonstrated a very strong brief intervention effect for cannabis scores (P < 0.005 for both sites), as did the sites in Australia (P < 0.005) and Brazil (P < 0.01) for stimulant scores and the Indian site for opioid scores (P < 0.01). The Alcohol, Smoking and Substance Involvement Screening Test-linked brief intervention aimed at reducing illicit substance use and related risks is effective, at least in the short term, and the effect generalizes across countries. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  3. Improvement of Visuo-spatial Function Assessed by Raven’s Colored Progressive Matrices in Dementia with Lewy Bodies by Donepezil Treatment

    PubMed Central

    Yoshino, Yuta; Mori, Takaaki; Yoshida, Taku; Toyota, Yasutaka; Shimizu, Hideaki; Iga, Jun-ichi; Nishitani, Shusaku; Ueno, Shu-ichi

    2017-01-01

    Objective Donepezil is used to improve cognitive impairment of dementia with Lewy bodies (DLB). Visuo-spatial dysfunction is a well-known symptom of DLB. Non-verbal Raven’s Colored Progressive Matrices (RCPM) were used to assess both visual perception and reasoning ability in DLB subjects treated with donepezil. Methods Twenty-one DLB patients (mean age, 78.7±4.5 years) were enrolled. RCPM assessment was performed at the time of starting donepezil and within one year after starting donepezil. Results There were significant improvements of RCPM in the total scores between one year donepezil treatment (p=0.013), in both Set A score (p=0.002) and Set AB score (p=0.015), but trend in the Set B score (p=0.083). Conclusion Donepezil is useful for improving visuo-spatial impairment in DLB, but not for problem-solving impairment. PMID:28783933

  4. Decreased shoulder function and pain common in recreational badminton players.

    PubMed

    Fahlström, M; Söderman, K

    2007-06-01

    The aim of this study was to describe the prevalence and consequences of painful conditions in the shoulder region in recreational badminton players. A questionnaire study was performed on 99 players, of whom 57 were also assessed with Constant score. Previous or present pain in the dominant shoulder was reported by 52% of the players. Sixteen percent of the players had on-going shoulder pain associated with badminton play. A majority of these players reported that their training habits were affected by the pain. Total Constant score was lower in the painful shoulders. Furthermore, range of active pain-free shoulder abduction was decreased. However, isometric shoulder strength test showed no differences when compared with pain-free shoulders. Even though the pain caused functional problems, the players were still playing with on-going symptoms. The diagnoses were mostly unknown, although history and clinical tests indicate problems resembling subacromial impingement.

  5. Impact of Early Intervention on Psychopathology, Crime, and Weil-Being at Age 25

    PubMed Central

    2015-01-01

    Objective This randomized controlled trial tested the efficacy of early intervention to prevent adult psychopathology and improve well-being in early-starting conduct-problem children. Method Kindergarteners (N=9,594) in three cohorts (1991–1993) at 55 schools in four communities were screened for conduct problems, yielding 979 early starters. A total of 891 (91%) consented (51% African American, 47% European American; 69% boys). Children were randomly assigned by school cluster to a 10-year intervention or control. The intervention goal was to develop social competencies in children that would carry them throughout life, through social skills training, parent behavior-management training with home visiting, peer coaching, reading tutoring, and classroom social-emotional curricula. Manualization and supervision ensured program fidelity. Ninety-eight percent participated during grade 1, and 80% continued through grade 10. At age 25, arrest records were reviewed (N=817,92%), and condition-blinded adults psychiatrically interviewed participants (N=702; 81% of living participants) and a peer (N=535) knowledgeable about the participant. Results Intent-to-treat logistic regression analyses indicated that 69% of participants in the control arm displayed at least one externalizing, internalizing, or substance abuse psychiatric problem (based on self- or peer interview) at age 25, in contrast with 59% of those assigned to intervention (odds ratio=0.59, CI=0.43–0.81; number needed to treat=8). This pattern also held for self-interviews, peer interviews, scores using an “and” rule for self- and peer reports, and separate tests for externalizing problems, internalizing problems, and substance abuse problems, as well as for each of three cohorts, four sites, male participants, female participants, African Americans, European Americans, moderate-risk, and high-risk subgroups. Intervention participants also received lower severity-weighted violent (standardized estimate=-0.37) and drug (standardized estimate=-0.43) crime conviction scores, lower risky sexual behavior scores (standardized estimate=-0.24), and higher well-being scores (standardized estimate=0.19). Conclusions This study provides evidence for the efficacy of early intervention in preventing adult psychopathology among high-risk early-starting conduct-problem children. PMID:25219348

  6. Adaptation and Validation of the Kannada Version of the Singing Voice Handicap Index.

    PubMed

    Gunjawate, Dhanshree R; Aithal, Venkataraja U; Guddattu, Vasudeva; Bellur, Rajashekhar

    2017-07-01

    The present study aimed to adapt and validate the Singing Voice Handicap Index (SVHI) into Kannada language using standard procedures. This is a cross-sectional study. The original English version of SVHI was translated into Kannada. It was administered on 106 Indian classical singers, of whom 22 complained of voice problems. Its internal consistency was determined using Cronbach's alpha coefficient (α), test-retest reliability using Pearson's product moment correlation and paired t test, and the difference in mean scores by independent sample t test. The results revealed that the Kannada SVHI exhibited an excellent internal consistency (α = 0.96) with a high item-to-total correlation. Further, excellent test-retest reliability (r = 0.99) and significant differences in SVHI scores were also obtained by singers with and without a voice problem (t = 12.93, df = 104, P = 0.005). The Kannada SVHI is a valid and reliable tool for self-reported assessment of singers with voice problems. It will provide a valuable insight into the singing-related voice problems as perceived by the singers themselves. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. Exploring the Pareto frontier using multisexual evolutionary algorithms: an application to a flexible manufacturing problem

    NASA Astrophysics Data System (ADS)

    Bonissone, Stefano R.; Subbu, Raj

    2002-12-01

    In multi-objective optimization (MOO) problems we need to optimize many possibly conflicting objectives. For instance, in manufacturing planning we might want to minimize the cost and production time while maximizing the product's quality. We propose the use of evolutionary algorithms (EAs) to solve these problems. Solutions are represented as individuals in a population and are assigned scores according to a fitness function that determines their relative quality. Strong solutions are selected for reproduction, and pass their genetic material to the next generation. Weak solutions are removed from the population. The fitness function evaluates each solution and returns a related score. In MOO problems, this fitness function is vector-valued, i.e. it returns a value for each objective. Therefore, instead of a global optimum, we try to find the Pareto-optimal or non-dominated frontier. We use multi-sexual EAs with as many genders as optimization criteria. We have created new crossover and gender assignment functions, and experimented with various parameters to determine the best setting (yielding the highest number of non-dominated solutions.) These experiments are conducted using a variety of fitness functions, and the algorithms are later evaluated on a flexible manufacturing problem with total cost and time minimization objectives.

  8. Randomized controlled trial of web-based alcohol screening and brief intervention in primary care.

    PubMed

    Kypri, Kypros; Langley, John D; Saunders, John B; Cashell-Smith, Martine L; Herbison, Peter

    2008-03-10

    There is compelling evidence supporting screening and brief intervention (SBI) for hazardous drinking, yet it remains underused in primary health care. Electronic (computer or Web-based) SBI (e-SBI) offers the prospects of ease and economy of access. We sought to determine whether e-SBI reduces hazardous drinking. We conducted a randomized controlled trial in a university primary health care service. Participants were 975 students (age range, 17-29 years) screened using the Alcohol Use Disorders Identification Test (AUDIT). Of 599 students who scored in the hazardous or harmful range, 576 (300 of whom were women) consented to the trial and were randomized to receive an information pamphlet (control group), a Web-based motivational intervention (single-dose e-SBI group), or a Web-based motivational intervention with further interventions 1 and 6 months later (multidose e-SBI group). Relative to the control group, the single-dose e-SBI group at 6 months reported a lower frequency of drinking (rate ratio [RR], 0.79; 95% confidence interval [CI], 0.68-0.94), less total consumption (RR, 0.77; 95% CI, 0.63-0.95), and fewer academic problems (RR, 0.76; 95% CI, 0.64-0.91). At 12 months, statistically significant differences in total consumption (RR, 0.77; 95% CI, 0.63-0.95 [equivalent to 3.5 standard drinks per week]) and in academic problems (RR, 0.80; 95% CI, 0.66-0.97) remained, and the AUDIT scores were 2.17 (95% CI, -1.10 to -3.24) points lower. Relative to the control group, the multidose e-SBI group at 6 months reported a lower frequency of drinking (RR, 0.85; 95% CI, 0.73-0.98), less total consumption (RR, 0.79; 95% CI, 0.64-0.97 [equivalent to 3.0 standard drinks per week]), reduced episodic heavy drinking (RR, 0.65; 95% CI, 0.45-0.93), and fewer academic problems (RR, 0.78; 95% CI, 0.65-0.93). At 12 months, statistically significant differences in academic problems remained (RR, 0.75; 95% CI, 0.62-0.90), while the AUDIT scores were 2.02 (95% CI, -0.97 to -3.10) points lower. Single-dose e-SBI reduces hazardous drinking, and the effect lasts 12 months. Additional sessions seem not to enhance the effect. Trial Registration www.anzctr.org.au Identifier:ACTRN012607000103460.

  9. Robust LOD scores for variance component-based linkage analysis.

    PubMed

    Blangero, J; Williams, J T; Almasy, L

    2000-01-01

    The variance component method is now widely used for linkage analysis of quantitative traits. Although this approach offers many advantages, the importance of the underlying assumption of multivariate normality of the trait distribution within pedigrees has not been studied extensively. Simulation studies have shown that traits with leptokurtic distributions yield linkage test statistics that exhibit excessive Type I error when analyzed naively. We derive analytical formulae relating the deviation from the expected asymptotic distribution of the lod score to the kurtosis and total heritability of the quantitative trait. A simple correction constant yields a robust lod score for any deviation from normality and for any pedigree structure, and effectively eliminates the problem of inflated Type I error due to misspecification of the underlying probability model in variance component-based linkage analysis.

  10. Urinary Metabolites of Organophosphate and Pyrethroid Pesticides and Behavioral Problems in Canadian Children

    PubMed Central

    Oulhote, Youssef

    2013-01-01

    Background: Exposure to organophosphate pesticides has been associated with neurobehavioral deficits in children, although data on low levels of exposure experienced by the general population are sparse. Pyrethroids are insecticides rapidly gaining popularity, and epidemiological evidence on their potential effects is lacking. Objective: We examined the association between exposure to organophosphate and pyrethroid pesticides, indicated by urinary metabolites, and parentally reported behavioral problems in children. Methods: We used data on children 6–11 years of age from the Canadian Health Measures Survey (2007–2009). We used logistic regressions to estimate odds ratios (ORs) for high scores on the Strengths and Difficulties Questionnaire (SDQ), which may indicate behavioral problems, in association with concentrations of pyrethroid and organophosphate metabolites in the urine of 779 children, adjusting for covariates (sex, age, race/ethnicity, income, parental education, blood lead levels, maternal smoking during pregnancy, and others). Results: At least one urinary metabolite for organophosphates was detected in 91% of children, and for pyrethroids in 97% of children. Organophosphate metabolites were not significantly associated with high SDQ scores. The pyrethroid metabolite cis-DCCA [3-(2,2-dichlorovinyl)-2,2-dimethylycyclopropane carboxylic acid] was significantly associated with high scores for total difficulties on the SDQ (OR for a 10-fold increase = 2.0; 95% CI: 1.1, 3.6), and there was a nonsignificant association with trans-DCCA (OR = 1.6; 95% CI: 0.9, 3.0). Conclusion: In contrast with previous studies, we did not observe an association between exposure to organophosphate pesticides and behavioral scores in children. However, some pyrethroid urinary metabolites were associated with a high level of parent-reported behavioral problems. Longitudinal studies should be conducted on the potential risks of pyrethroids. Citation: Oulhote Y, Bouchard MF. 2013. Urinary metabolites of organophosphate and pyrethroid pesticides and behavioral problems in Canadian children. Environ Health Perspect 121:1378–1384; http://dx.doi.org/10.1289/ehp.1306667 PMID:24149046

  11. Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran.

    PubMed

    Namavar Jahromi, Bahia; Mansouri, Mahsa; Forouhari, Sedighe; Poordast, Tahere; Salehi, Alireza

    2018-01-01

    Infertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associated factors among infertile couples. In this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measure QoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran. We used an additional questionnaire to assess participants' demographic and clinical characteristics. The relationship between the scores of QoL to the sociodemographic and treatment data was analysed. The subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Female participants without academic education had lower scores in the emotional subscale, while the male participants showed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergone any type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperm injection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participants with lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, and environmental domains were significantly more desirable when the infertility problem was related to a male factor. Infertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academic education, lower income levels, or prior unsuccessful treatments are associated with lower QoL. Copyright© by Royan Institute. All rights reserved.

  12. Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran

    PubMed Central

    Namavar Jahromi, Bahia; Mansouri, Mahsa; Forouhari, Sedighe; Poordast, Tahere; Salehi, Alireza

    2018-01-01

    Background Infertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associated factors among infertile couples. Materials and Methods In this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measure QoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran. We used an additional questionnaire to assess participants’ demographic and clinical characteristics. The relationship between the scores of QoL to the sociodemographic and treatment data was analysed. Results The subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Female participants without academic education had lower scores in the emotional subscale, while the male participants showed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergone any type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperm injection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participants with lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, and environmental domains were significantly more desirable when the infertility problem was related to a male factor. Conclusion Infertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academic education, lower income levels, or prior unsuccessful treatments are associated with lower QoL. PMID:29043705

  13. Severity of psychosis syndrome and change of metabolic abnormality in chronic schizophrenia patients: severe negative syndrome may be related to a distinct lipid pathophysiology.

    PubMed

    Chen, S-F; Hu, T-M; Lan, T-H; Chiu, H-J; Sheen, L-Y; Loh, E-W

    2014-03-01

    Metabolic abnormality is common among schizophrenia patients. Some metabolic traits were found associated with subgroups of schizophrenia patients. We examined a possible relationship between metabolic abnormality and psychosis profile in schizophrenia patients. Three hundred and seventy-two chronic schizophrenia patients treated with antipsychotics for more than 2 years were assessed with the Positive and Negative Syndrome Scale. A set of metabolic traits was measured at scheduled checkpoints between October 2004 and September 2006. Multiple regressions adjusted for sex showed negative correlations between body mass index (BMI) and total score and all subscales; triglycerides (TG) was negatively correlated with total score and negative syndrome, while HDLC was positively correlated with negative syndrome. When sex interaction was concerned, total score was negatively correlated with BMI but not with others; negative syndrome was negatively correlated with BMI and positively with HDLC. No metabolic traits were correlated with positive syndrome or general psychopathology. Loss of body weight is a serious health problem in schizophrenia patients with severe psychosis syndrome, especially the negative syndrome. Schizophrenia patients with severe negative syndrome may have a distinct lipid pathophysiology in comparison with those who were less severe in the domain. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Canadian dental students' perceptions of stress.

    PubMed

    Muirhead, Vanessa; Locker, David

    2007-05-01

    In this paper, we report the results of a survey on dental student stress carried out in April 2005. A questionnaire was used to collect data from 171 students (62% response rate). Identified stressors were academic, clinic-related, social and financial. "Examination and grades" produced the most academic stress, and inconsistent feedback from instructors created the most clinic-related stress. Students found that having a dual role--wife or husband and dental student--was the most burdensome social stressor. Approximately 60% of students reported marital problems and stress associated with "relations with members of the opposite sex." Survey results showed that students who expected a high graduating debt had higher total and academic stress scores. Total stress was not related to age, gender or marital status. Students living with parents during term time had significantly higher total stress scores than students living in other arrangements. Students residing with parents also had significantly higher debts on entry to dental school. Students with more predental education had (non-significantly) lower stress scores but also had higher student debts. Undergraduate subject major (biological science or non-science) had no bearing on reported stress. This study highlights the negative effects of student debt, the necessity for staff training and the need for further studies exploring relations among stress, psychological well-being and academic performance.

  15. Total knee arthroplasty: good agreement of clinical severity scores between patients and consultants.

    PubMed

    Ebinesan, Ananthan D; Sarai, Bhupinder S; Walley, Gayle; Bridgman, Stephen; Maffulli, Nicola

    2006-07-31

    Nearly 20,000 patients per year in the UK receive total knee arthroplasty (TKA). One of the problems faced by the health services of many developed countries is the length of time patients spend waiting for elective treatment. We therefore report the results of a study in which the Salisbury Priority Scoring System (SPSS) was used by both the surgeon and their patients to ascertain whether there were differences between the surgeon generated and patient generated Salisbury Priority Scores. The Salisbury Priority Scoring System (SPSS) was used to assign relative priority to patients with knee osteoarthritis as part of a randomised controlled trial comparing the standard medial parapatellar approach versus the sub-vastus approach in TKA. The operating surgeons and each patient completed the SPSS at the same pre-assessment clinic. The SPSS assesses four criteria, namely progression of disease, pain or distress, disability or dependence on others, and loss of usual occupation. Crosstabs and agreement measures (Cohen's kappa) were performed. Overall, the four SPSS criteria showed a kappa value of 0.526, 0.796, 0.813, and 0.820, respectively, showing moderate to very good agreement between the patient and the operating consultant. Male patients showed better agreement than female patients. The Salisbury Priority Scoring System is a good means of assessing patients' needs in relation to elective surgery, with high agreement between the patient and the operating surgeon.

  16. Self Perceptions of Young Adults who Survived Severe Childhood Burn Injury

    PubMed Central

    Russell, W; Robert, RS; Thomas, CR; Holzer, CE; Blakeney, P; Meyer, WJ

    2012-01-01

    Objective The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self concept. In order to anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Method 82 young adult burn survivors (45 males, 37 females) were assessed using the Tennessee Self-Concept, 2nd Edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report, YASR) and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders, SCID I). Results This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 sub-scale scores of Physical function, appearance, and sexuality, Moral conduct, Personal values, Academics and work, and Identity than did the reference population. Pearson correlation coefficients showed that as Moral, Personal, Family and Social aspects of self concept decreased, clinical problems endorsed on the YASR sub-scales increased, including Anxiety Somatic, Attention, Intrusive and Aggressive. Persons with lower self-concept scores on the TSCS2 Personal, Family, and Social Scales, were more withdrawn on the YASR. Similarly those with lower TSCS2 scores on the Personal and Family Scales endorsed significantly more Thought Problems on the YASR. Affective distress on the SCID I was associated with significantly lower self concept. TSCS2 Total Self Concept, Personal, and all of the Supplementary Scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 Total Self Concept and Personal. Lower self-concept was associated with endorsement of SCID I symptoms (Identity, p= .0018, Satisfaction, p=.0018, and Behavior, p= .0004). Although the major limitation of this study using the TSCS2 is the lack of a matched reference population to compare with the burn survivors, the TSCS2 does help in gaining insight into the self esteem issues of this population. PMID:23202876

  17. Monitoring Hip and Elbow Dysplasia achieved modest genetic improvement of 74 dog breeds over 40 years in USA.

    PubMed

    Hou, Yali; Wang, Yachun; Lu, Xuemei; Zhang, Xu; Zhao, Qian; Todhunter, Rory J; Zhang, Zhiwu

    2013-01-01

    Hip (HD) and Elbow Dysplasia (ED) are two common complex developmental disorders of dogs. In order to decrease their prevalence and severity, the Orthopedic Foundation for Animals (OFA) has a voluntary registry of canine hip and elbow conformation certified by boarded radiologists. However, the voluntarily reports have been severely biased against exposing dogs with problems, especially at beginning period. Fluctuated by additional influential factors such as age, the published raw scores barely showed trends of improvement. In this study, we used multiple-trait mixed model to simultaneously adjust these factors and incorporate pedigree to derive Estimated Breeding Values (EBV). A total of 1,264,422 dogs from 74 breeds were evaluated for EBVs from 760,455 hip scores and 135,409 elbow scores. These EBVs have substantially recovered the reporting bias and the other influences. Clear and steady trends of genetic improvement were observed over the 40 years since 1970. The total genetic improvements were 16.4% and 1.1% of the phenotypic standard deviation for HD and ED, respectively. The incidences of dysplasia were 0.83% and 2.08%, and the heritabilities were estimated as 0.22 and 0.17 for hip and elbow scores, respectively. The genetic correlation between them was 0.12. We conclude that EBV is more effective than reporting raw phenotype. The weak genetic correlation suggested that selection based on hip scores would also slightly improve elbow scores but it is necessary to allocate effort toward improvement of elbow scores alone.

  18. Monitoring Hip and Elbow Dysplasia Achieved Modest Genetic Improvement of 74 Dog Breeds over 40 Years in USA

    PubMed Central

    Zhang, Xu; Zhao, Qian; Todhunter, Rory J.; Zhang, Zhiwu

    2013-01-01

    Hip (HD) and Elbow Dysplasia (ED) are two common complex developmental disorders of dogs. In order to decrease their prevalence and severity, the Orthopedic Foundation for Animals (OFA) has a voluntary registry of canine hip and elbow conformation certified by boarded radiologists. However, the voluntarily reports have been severely biased against exposing dogs with problems, especially at beginning period. Fluctuated by additional influential factors such as age, the published raw scores barely showed trends of improvement. In this study, we used multiple-trait mixed model to simultaneously adjust these factors and incorporate pedigree to derive Estimated Breeding Values (EBV). A total of 1,264,422 dogs from 74 breeds were evaluated for EBVs from 760,455 hip scores and 135,409 elbow scores. These EBVs have substantially recovered the reporting bias and the other influences. Clear and steady trends of genetic improvement were observed over the 40 years since 1970. The total genetic improvements were 16.4% and 1.1% of the phenotypic standard deviation for HD and ED, respectively. The incidences of dysplasia were 0.83% and 2.08%, and the heritabilities were estimated as 0.22 and 0.17 for hip and elbow scores, respectively. The genetic correlation between them was 0.12. We conclude that EBV is more effective than reporting raw phenotype. The weak genetic correlation suggested that selection based on hip scores would also slightly improve elbow scores but it is necessary to allocate effort toward improvement of elbow scores alone. PMID:24124555

  19. [Mental health problems among female staff in a provincial maternal and child health hospital: an investigation of 647 individuals].

    PubMed

    He, W J; Xia, J H; Lv, X; Li, L M

    2018-02-20

    Objective: To investigate the current status of depression and anxiety among female staff in a maternal and child health hospital, and to provide a basis for developing related prevention and intervention measures and promoting the mental health of female staff. Methods: The female staff from a provincial maternal and child health hospital completed a psycho-health questionnaire survey on Internet from June to October, 2016. The questionnaires used in the survey consisted of Patient Health Questionnaire (PHQ-9) , Generalized Anxiety Disorder Scale (GAD-7) , and Symptom Checklist-90 (SCL-90) . The distribution features of mental health problems such as depression and anxiety were analyzed according to the results: of the questionnaire survey. Results Of all female staff surveyed, 42.04% showed depression symptoms, 28.90% showed anxiety symptoms, and 26.12% showed comorbid symptoms of depression and anxiety. Moderate or severe depression (anxiety) was mainly distributed among the female staff with comorbid symptoms (90.63% and 97.01%, respectively) . There were significant differences in the distribution of moderate or severe anxiety symptoms between the medical staff and nursing staff (χ(2)= 5.81, P =0.05) and between those with intermediate and junior professional titles (χ(2)=7.99, P =0.018) . As for SCL-90 results, the total score, total average score, and scores on factors of somatization, compulsion, interpersonal sensitivity, depression, and anxiety in the female staff with comorbid symptoms, moderate or severe depression, and moderate or severe anxiety were significantly higher than the national norm ( P <0.01) , while the scores on paranoid and psychotic factors were significantly lower than the national norm ( P <0.01) . The numbers of cases of positive factors were significantly higher in the female staff with comorbid symptoms than in the female staff with a single symptom and asymptomatic female staff (both P <0.01) , and positive cases were mainly distributed in depression, interpersonal sensitivity, compulsion, anxiety, and somatic factors. Conclusion: The prevalence of depression and anxiety is high among female staff in the maternal and child health hospital, mainly characterized by comorbid symptoms of moderate or severe depression and anxiety. Comorbidity is accompanied by mental health problems such as interpersonal sensitivity, obsessive compulsion, and physical discomfort. Corresponding measures are needed for the prevention and intervention of mental health problems among female staff in the maternal and child health hospital.

  20. Joint Effects of Age, Period, and Cohort on Conduct Problems Among American Adolescents From 1991 Through 2015.

    PubMed

    Keyes, Katherine M; Gary, Dahsan S; Beardslee, Jordan; Prins, Seth J; O'Malley, Patrick M; Rutherford, Caroline; Schulenberg, John

    2018-03-01

    Although arrest rates among juveniles have substantially decreased since the 1990s, US national trends in conduct problems are unknown. Population variation in conduct problems would imply changes in the social environment, which would include emergent or receding risk factors. In the present study, we separated age, period, and cohort effects on conduct problems using nationally representative surveys of 375,879 US students conducted annually (1991-2015). The summed score of 7 items measuring the frequency of conduct problems was the outcome. Conduct problems have decreased during the past 25 years among boys; the total amount of the decrease was approximately 0.4 standard deviations (P < 0.01), and by item prevalence, the total amount of the decrease was 8%-11%. Declines are best explained by period effects beginning approximately in 2008, and a declining cohort effect beginning among those born after 1992, which suggests not only declines in population levels, but more rapid declines among younger cohorts of boys. Trends were also consistent with age-period-cohort effects on evenings spent out, which suggest a possible mechanism. Conduct problems among girls were lower than boys and did not demonstrate trends across time. These changes may reflect the changing nature of adolescence toward less unsupervised interaction.

  1. Development of a gambling addictive behavior scale for adolescents in Korea.

    PubMed

    Park, Hyun Sook; Jung, Sun Young

    2012-12-01

    This study was conducted to develop a gambling addictive behavior scale for adolescents. The process involved construction of a conceptual framework, initial item search, verification of content validity, selection of secondary items, and extraction of final items. The participants were 299 adolescents from two middle schools and four high schools. Item analysis, factor analysis, criterion validity, internal consistency, and ROC curve were used to analyze the data. For the final scale, 25 items were selected, and categorized into 4 factors which accounted for 54.9% of the total variance. The factors were labeled as loss of control, life dysfunction from gambling addiction, gambling experience, and social dysfunction from problem gambling. The scores for the scale were significantly correlated with addictive personality, irrational gambling belief, and adolescent's gambling addictive behavior. Cronbach's alpha coefficient for the 25 items was .94. Scale scores identified adolescents as being in a problem gambling group, a non-problem gambling group, and a non-gambling group by the ROC curve. The above findings indicate that the gambling addictive behavior scale has good validity and reliability and can be used with adolescents in Korea.

  2. Gender differences in addiction severity.

    PubMed

    Díaz-Mesa, Eva M; García-Portilla, Paz; Fernández-Artamendi, Sergio; Sáiz, Pilar A; Bobes Bascarán, Teresa; Casares, María José; Fonseca, Eduardo; Al-Halabí, Susana; Bobes, Julio

    2016-06-14

    Gender has been associated with substance use disorders (SUD). However, there are few studies that have evaluated gender differences in a global and a standardized way, and with a large sample of patients with SUD. Our goal is to analyze the role of gender in addiction severity throughout multiple life domains, using the Addiction Severity Index-6 (ASI-6). A naturalistic, multicenter and prospective study was conducted. A total of 221 patients with SUD (80.1% men) were interviewed with the ASI-6. Our results indicate that the Recent Summary Scores (RSSs) of men and women are similar, with the exception of Psychiatric and Partner- Problems, where women showed higher severity (p = .017 and p = .013, respectively). Statistically significant gender differences were found in certain aspects of the ASI-6 domains: men have more problems of physical health, legal issues, and alcohol and other substance use; and woman score higher in problems of mental health, social network, subjective evaluations of SUD consequences, and treatment needs. These results should be taken into account to improve the identification, prevention, and treatment of SUD.

  3. Modified perianal/pericapsular anesthesia for transrectal biopsy of prostate in patients with anal rectal problems.

    PubMed

    Kravchick, Sergey; Yoffe, Boris; Cytron, Shmuel

    2007-01-01

    To modify our technique of perianal anesthesia and use it in patients with painful conditions of the rectum and/or anus. A total of 31 consecutive patients with anal-rectal problems underwent prostate needle biopsy. Of these, 17 were referred to our hospital after vain attempts to insert a transrectal ultrasound probe. Patients received a perianal-pericapsular injection of 1% lidocaine. Pain perception was separately assessed for probe insertion and biopsies using a visual pain analog score. Only in 1 patient were we unable to insert the transrectal ultrasound probe. The mean patient age was 65.28 +/- 5.35 years. We performed a mean of 12.25 biopsies per case. At probe insertion, the mean pain score was 2.2 +/- 0.83. During the biopsy punctures, the mean pain level was 2.53 +/- 1.054. We did not find any increase in the complication rate related to the anesthesia method. Modified perianal anesthesia can be used for transrectal ultrasound-guided biopsy of the prostate in patients with anal-rectal problems, because it provides significant pain relief.

  4. Understanding planning ability measured by the Tower of London: an evaluation of its internal structure by latent variable modeling.

    PubMed

    Koppenol-Gonzalez, Gabriela V; Bouwmeester, Samantha; Boonstra, A Marije

    2010-12-01

    The Tower of London (TOL) is a widely used instrument for assessing planning ability. Inhibition and (spatial) working memory are assumed to contribute to performance on the TOL, but findings about the relationship between these cognitive processes are often inconsistent. Moreover, the influence of specific properties of TOL problems on cognitive processes and difficulty level is often not taken into account. Furthermore, it may be expected that several planning strategies can be distinguished that cannot be extracted from the total score. In this study, a factor analysis and a latent class regression analysis were performed to address these issues. The results showed that 4 strategy groups that differed with respect to preplanning time could be distinguished. The effect of problem properties also differed for the 4 groups. Additional analyses showed that the groups differed on average planning performance but that there were no significant differences between inhibition and spatial working memory performance. Finally, it seemed that multiple factors influence performance on the TOL, the most important ones being the score measurements, the problem properties, and strategy use.

  5. The development, validity, and reliability of the Addiction Profile Index (API).

    PubMed

    Ögel, Kültegin; Evren, Cüneyt; Karadağ, Figen; Gürol, Defne Tamar

    2012-01-01

    The objective of this study was to develop a practical questionnaire for multidimensional assessment of problems associated with alcohol and substance abuse that would also be useful for treatment planning. The Addiction Profile Index (API) is a self-report questionnaire consisting of 37 items and the following 5 subscales: characteristics of substance use; dependency diagnosis; the effects of subsance use on the user; craving; motivation to quit using substances. The study included 345 alcohol and/or substance abusers from 2 addiction treatment clinics and a prison addiction service. The validity of the questionnaire was assessed using the Michigan Alcoholism Screening Test (MAST), Readiness to Change Questionnaire (SOCRATES), Penn Alcohol Craving Scale (PACS), Drug Craving Scale (DCS), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and Addiction Severity Index (ASI). The Cronbach's alpha coefficient for the total API was 0.89 and for the subscales it ranged from 0.63 to 0.86. Item-total correlation coefficients ranged from 0.42 to 0.89. The Spearman Brown split-half method coefficient for the total API was 0.83. In all, 4 factors were obtained using explanatory factor analysis that represented 52.3% of the total variance. The API craving subscale was observed to be consistent with PACS and the API motivation subscale was consistent with SOCRATES. The API total score was strongly correlated with the mean MAST score, and the composite ASI medical status, substance use, legal status, and family social relations subscale scores. Based on ROC analyses, the area under curve was 0.90. With a total API cut-off score of 4, the scale's sensitivity and specificity 0.85 was 0.78, respectively. The findings show that the API is a valid and reliable questionnaire that can be used to measure the severity of different dimensions of substance dependency.

  6. Specific Reading Comprehension Disability: Major Problem, Myth, or Misnomer?

    PubMed Central

    Spencer, Mercedes; Quinn, Jamie M.; Wagner, Richard K.

    2013-01-01

    The goal of the present study was to test three competing hypotheses about the nature of comprehension problems of students who are poor in reading comprehension. Participants in the study were first, second, and third graders, totaling 9 cohorts and over 425,000 participants in all. The pattern of results was consistent across all cohorts: Less than one percent of first- through third-grade students who scored as poor in reading comprehension were adequate in both decoding and vocabulary. Although poor reading comprehension certainly qualifies as a major problem rather than a myth, the term specific reading comprehension disability is a misnomer: Individuals with problems in reading comprehension that are not attributable to poor word recognition have comprehension problems that are general to language comprehension rather than specific to reading. Implications for assessment and intervention are discussed. PMID:25143666

  7. Specific Reading Comprehension Disability: Major Problem, Myth, or Misnomer?

    PubMed

    Spencer, Mercedes; Quinn, Jamie M; Wagner, Richard K

    2014-02-01

    The goal of the present study was to test three competing hypotheses about the nature of comprehension problems of students who are poor in reading comprehension. Participants in the study were first, second, and third graders, totaling 9 cohorts and over 425,000 participants in all. The pattern of results was consistent across all cohorts: Less than one percent of first- through third-grade students who scored as poor in reading comprehension were adequate in both decoding and vocabulary. Although poor reading comprehension certainly qualifies as a major problem rather than a myth, the term specific reading comprehension disability is a misnomer: Individuals with problems in reading comprehension that are not attributable to poor word recognition have comprehension problems that are general to language comprehension rather than specific to reading. Implications for assessment and intervention are discussed.

  8. HoNOSCA-D As a Measure of the Severity of Diagnosed Mental Disorders in Children and Adolescents—Psychometric Properties of the German Translation

    PubMed Central

    von Wyl, Agnes; Toggweiler, Stephan; Zollinger, Ruedi

    2017-01-01

    The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), in use worldwide, is a 13-item measure assessing the biopsychosocial severity of mental health problems in children and adolescents. This article introduces the authorized German-language version of HoNOSCA, the HoNOSCA-D, and examines and discusses its psychometric properties based on a clinical sample of 1,533 children and adolescents aged 4;0 to 17;11 years. For the HoNOSCA-D total score (severity of mental health problems), internal consistency (Cronbach’s alpha) was 0.63. The discriminative power of the items ranged from 0.07 to 0.44; the average interitem correlation was 0.11. Due to this stochastic independence, calculation of a total severity index is acceptable. Using factor analysis, the principal axis factoring and varimax rotation resulted in a four-factor structure, which with a Kaiser–Meyer–Olkin measure of sampling adequacy of 0.684 explained 30.62% of total variance. The convergent correlations with the German-language parent report version of the Strengths and Difficulties Questionnaire were as expected and showed a medium effect size. Gender and age differences in the HoNOSCA-D total score were small. Regarding the 13 items gender and age differences were negligible to medium. The highest severity was found for schizophrenia and psychotic disorders, followed by affective disorders and social behavior disorders. Overall, validity of HoNOSCA-D was clearly supported. PMID:29033858

  9. The effect of fertility stress on endometrial and subendometrial blood flow among infertile women.

    PubMed

    Dong, Yuezhi; Cai, Yanna; Zhang, Yu; Xing, Yurong; Sun, Yingpu

    2017-03-04

    To investigate the effect of fertility stress on endometrial and subendometrial blood flow among infertile women. This case-control study was conducted in The First Affiliated Hospital of Zhengzhou University. The fertility problem inventory (FPI) was adopted to evaluate fertility stress. Three-dimensional power Doppler ultrasonography (3D PD-US) was performed during the proliferative phase of the menstrual cycle (days 5-11) to measure endometrial thickness, pattern, endometrial and subendometrial volume (V), the vascularization index (VI), the flow index (FI) and the vascularization-FI (VFI) index. Then, 300 infertile women were separated into two groups (high-score group and low-score group) based on total FPI scores and 80 healthy women were selected as controls. No differences were found among all three groups with regard to general characteristics, endometrial thickness, pattern, endometrial and subendometrial V, VI and VFI. The endometrial and subendometrial FIs associated with different stress levels significantly differed among the three groups (F = 33.95, P < 0.001; F = 44.79, P < 0.001, respectively). The endometrial and subendometrial FIs in the control group were significantly higher than those in the high-score group and low-score groups. The endometrial and subendometrial FIs in the low-score group were significantly higher than those in the high-score group. The total FPI score was closely related to the endometrial and subendometrial FIs (r = -0.304, P < 0.001; r = -0.407, P < 0.001, respectively). Fertility stress was associated with endometrial and subendometrial flow index. Whether fertility stress might affect pregnancy outcome by reducing endometrial and subendometrial blood flow requires further research.

  10. Reduced ventral cingulum integrity and increased behavioral problems in children with isolated optic nerve hypoplasia and mild to moderate or no visual impairment.

    PubMed

    Webb, Emma A; O'Reilly, Michelle A; Clayden, Jonathan D; Seunarine, Kiran K; Dale, Naomi; Salt, Alison; Clark, Chris A; Dattani, Mehul T

    2013-01-01

    To assess the prevalence of behavioral problems in children with isolated optic nerve hypoplasia, mild to moderate or no visual impairment, and no developmental delay. To identify white matter abnormalities that may provide neural correlates for any behavioral abnormalities identified. Eleven children with isolated optic nerve hypoplasia (mean age 5.9 years) underwent behavioral assessment and brain diffusion tensor imaging, Twenty four controls with isolated short stature (mean age 6.4 years) underwent MRI, 11 of whom also completed behavioral assessments. Fractional anisotropy images were processed using tract-based spatial statistics. Partial correlation between ventral cingulum, corpus callosum and optic radiation fractional anisotropy, and child behavioral checklist scores (controlled for age at scan and sex) was performed. Children with optic nerve hypoplasia had significantly higher scores on the child behavioral checklist (p<0.05) than controls (4 had scores in the clinically significant range). Ventral cingulum, corpus callosum and optic radiation fractional anisotropy were significantly reduced in children with optic nerve hypoplasia. Right ventral cingulum fractional anisotropy correlated with total and externalising child behavioral checklist scores (r = -0.52, p<0.02, r = -0.46, p<0.049 respectively). There were no significant correlations between left ventral cingulum, corpus callosum or optic radiation fractional anisotropy and behavioral scores. Our findings suggest that children with optic nerve hypoplasia and mild to moderate or no visual impairment require behavioral assessment to determine the presence of clinically significant behavioral problems. Reduced structural integrity of the ventral cingulum correlated with behavioral scores, suggesting that these white matter abnormalities may be clinically significant. The presence of reduced fractional anisotropy in the optic radiations of children with mild to moderate or no visual impairment raises questions as to the pathogenesis of these changes which will need to be addressed by future studies.

  11. Evaluation of long term health-related quality of life in extensive burns: a 12-year experience in a burn center.

    PubMed

    Xie, Bing; Xiao, Shi-chu; Zhu, Shi-hui; Xia, Zhao-fan

    2012-05-01

    We sought to evaluate the long term health-related quality of life (HRQOL) in patients survived severely extensive burn and identify their clinical predicting factors correlated with HRQOL. A cross-sectional study was conducted in 20 patients survived more than 2 years with extensive burn involving ≥70% total body surface area (TBSA) between 1997 and 2009 in a burn center in Shanghai. Short Form-36 Medical Outcomes Survey (SF-36), Brief Version of Burn Specific Health Scale (BSHS-B) and Michigan Hand Outcome Questionnaire (MHQ) were used for the present evaluation. SF-36 scores were compared with a healthy Chinese population, and linear correlation analysis was performed to screen the clinical relating factors predicting physical and mental component summary (PCS and MCS) scores from SF-36. HRQOL scores from SF-36 were significantly lower in the domains of physical functioning, role limitations due to physical problems, pain, social functioning and role limitations due to emotional problems compared with population norms. Multiple linear regression analysis demonstrated that only return to work (RTW) predicted improved PCS. While age at injury, facial burns, skin grafting and length of hospital stay were correlated with MCS. Work, body image and heat sensitivity obtained the lowest BSHS-B scores in all 9 domains. Improvements of HRQOL could still be seen in BSHS-B scores in domains of simple abilities, hand function, work and affect even after a quite long interval between burns and testing. Hand function of extensive burn patients obtained relatively poor MHQ scores, especially in those without RTW. Patients with extensive burns have a poorer quality of life compared with that of general population. Relatively poor physical and psychological problems still exist even after a long period. Meanwhile, a trend of gradual improvements was noted. This information will aid clinicians in decision-making of comprehensive systematic regimens for long term rehabilitation and psychosocial treatment. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  12. Sociotropic or autonomous personality and problem solving in peritoneal dialysis patients.

    PubMed

    Demir, S; Tufan, G; Erem, O

    2010-01-01

    This study investigated the sociotropic and autonomous personality characteristics and perceived problem solving ability of continuous ambulatory peritoneal dialysis (CAPD) patients, and their relationship with quality of life. The study included 14 CAPD patients and 54 healthy volunteers. Sociotropy and autonomy scores were significantly higher in CAPD patients than in the healthy control group. Among CAPD patients, there was a significant correlation between problem solving and serum phosphate, parathormone levels and erythrocyte sedimentation rate. There was a negative correlation between total dialysis time and sociotropy in CAPD patients, and a positive correlation between general health/pain perception and autonomy. Appropriate medical management, time on dialysis and positive self-perception of health were correlated with better problem solving ability and higher autonomous but lower sociotropic personality styles.

  13. Psychometric properties and relations with coping and family strain of the Health Services and Caregiver Experience questionnaire (HSCE): an outcome measure of informal caregivers' experience for inpatient care in Italy.

    PubMed

    Coluccia, Anna; Ferretti, Fabio; Fagiolini, Andrea; Pozza, Andrea

    2017-07-17

    In the last decade, the number of patients supported by informal caregivers has substantially increased. In the Italian healthcare context, informal caregivers' experience of care is a new under-recognized construct, and no assessment tool is available. Measuring caregivers' experience is important since in Italy the relationship between doctors and patients/relatives is still considered asymmetrical. The current study presented development and initial psychometric properties of the Health Services and Caregiver Experience questionnaire (HSCE), a self-report tool of caregivers' global experience for inpatient clinical care, including factor structure, reliability and its relations with measures of coping strategies and family strain. The HSCE was administered to a total of 503 informal caregivers of inpatients admitted at an Italian University Hospital (mean age = 48.08 years, SD = 14.82, females = 61.40%). Family Strain Questionnaire-Short Form (FSQ-SF) and Coping Orientations to Problems Experience-New Italian Version (COPE-NVI) were administered to a subgroup of participants. First-grade relatives were 73.10%, whereas 13.20% were second-grade relatives and 13.70% were home-watch caregivers. Exploratory and confirmatory factor analyses showed a structure with a single factor, which explained 64.80% of the total variance. All the items had salient loadings. In the two subsamples, HSCE had excellent internal consistency (Cronbach's alpha = 0.95-0.97). Positive moderate correlations were found between HSCE and FSQ-SF scores (r = 0.45, p < .05), between HSCE and COPE-NVI scale scores, including COPE-NVI positive attitude and COPE-NVI problem solving scores (rs' range = 0.51-0.57, p < .05). Moreover, a positive large correlation between HSCE and COPE-NVI social support scores emerged (r = 0.72, p < .05). Correlations were not significant between HSCE scores and COPE-NVI turning to religion and avoidance strategies. The HSCE resulted to have good psychometric properties. Better caregivers' experience correlated with stronger family strain but also with better problem solving and social support. The study expanded knowledge on caregiver's experience in Italy and indicated that HSCE is a valid and reliable tool to measure this under-recognized construct in Italy.

  14. Brazilian version of the Functional Status Score for the ICU: translation and cross-cultural adaptation

    PubMed Central

    da Silva, Vinicius Zacarias Maldaner; de Araújo Neto, Jose Aires; Cipriano Jr., Gerson; Pinedo, Mariela; Needham, Dale M.; Zanni, Jennifer M.; Guimarães, Fernando Silva

    2017-01-01

    Objective The aim of the present study was to translate and cross-culturally adapt the Functional Status Score for the intensive care unit (FSS-ICU) into Brazilian Portuguese. Methods This study consisted of the following steps: translation (performed by two independent translators), synthesis of the initial translation, back-translation (by two independent translators who were unaware of the original FSS-ICU), and testing to evaluate the target audience's understanding. An Expert Committee supervised all steps and was responsible for the modifications made throughout the process and the final translated version. Results The testing phase included two experienced physiotherapists who assessed a total of 30 critical care patients (mean FSS-ICU score = 25 ± 6). As the physiotherapists did not report any uncertainties or problems with interpretation affecting their performance, no additional adjustments were made to the Brazilian Portuguese version after the testing phase. Good interobserver reliability between the two assessors was obtained for each of the 5 FSS-ICU tasks and for the total FSS-ICU score (intraclass correlation coefficients ranged from 0.88 to 0.91). Conclusion The adapted version of the FSS-ICU in Brazilian Portuguese was easy to understand and apply in an intensive care unit environment. PMID:28444070

  15. Examining relations between psychopathology and psychopathy dimensions among adolescent female and male offenders.

    PubMed

    Sevecke, Kathrin; Lehmkuhl, Gerd; Krischer, Maya K

    2009-02-01

    This study was performed to investigate relations between psychopathology and psychopathy in adolescent female and male detainees. We examined 91 male and 123 female adolescent detainees (aged 14-19) for psychopathology -using the Youth Self Report, the Overt Aggression Scale-Modified and a Conduct Disorder Self Report Scale- and for psychopathic dimensions using the psychopathy checklist youth version (PCL:YV). Based on a linear regression analysis we compared the specific associations between psychopathology and psychopathy in both male and female delinquent juveniles. Our results revealed higher scores for externalizing behavior and psychopathic dimensions in delinquent males, and higher internalizing problem scores in delinquent females. Furthermore, we found a positive relationship between suicidal behavior and the psychopathy total score as well as the affective, the lifestyle and the antisocial dimension only in girls. No association was found for suicidal behavior in boys. Regarding anxious-depressive behavior, we found a negative relation to the psychopathy total score and to the affective psychopathy factor for the boys. Expectedly, the population of incarcerated adolescents exhibited a high prevalence of psychopathology. At the same time our results referred to meaningful gender-related differences with respect to associations with psychopathy. The gender-related differences in psychopathological symptoms could indicate varied subtypes of psychopathy in boys and girls.

  16. Ambiguities and conflicting results: the limitations of the kappa statistic in establishing the interrater reliability of the Irish nursing minimum data set for mental health: a discussion paper.

    PubMed

    Morris, Roisin; MacNeela, Padraig; Scott, Anne; Treacy, Pearl; Hyde, Abbey; O'Brien, Julian; Lehwaldt, Daniella; Byrne, Anne; Drennan, Jonathan

    2008-04-01

    In a study to establish the interrater reliability of the Irish Nursing Minimum Data Set (I-NMDS) for mental health difficulties relating to the choice of reliability test statistic were encountered. The objective of this paper is to highlight the difficulties associated with testing interrater reliability for an ordinal scale using a relatively homogenous sample and the recommended kw statistic. One pair of mental health nurses completed the I-NMDS for mental health for a total of 30 clients attending a mental health day centre over a two-week period. Data was analysed using the kw and percentage agreement statistics. A total of 34 of the 38 I-NMDS for mental health variables with lower than acceptable levels of kw reliability scores achieved acceptable levels of reliability according to their percentage agreement scores. The study findings implied that, due to the homogeneity of the sample, low variability within the data resulted in the 'base rate problem' associated with the use of kw statistic. Conclusions point to the interpretation of kw in tandem with percentage agreement scores. Suggestions that kw scores were low due to chance agreement and that one should strive to use a study sample with known variability are queried.

  17. Optimizing the Use of the AUDIT for Alcohol Screening in College Students

    PubMed Central

    DeMartini, Kelly S.; Carey, Kate B.

    2013-01-01

    The screening and brief intervention (SBI) modality of treatment for at-risk college drinking is becoming increasingly popular. A key to effective implementation is use of validated screening tools. While the Alcohol Use Disorder Identification Test (AUDIT) has been validated in adult samples and is often used with college students, research has not yet established optimal cut-off scores to screen for at-risk drinking. A total of 401 current drinkers completed computerized assessments of demographics, family history of alcohol use disorders, alcohol use history, alcohol-related problems, and general health. Of the 401 drinkers, 207 met criteria for at-risk drinking. Receiver-operating characteristic (ROC) curve analysis revealed that the AUROC of the AUDIT was 0.86 (95% CI = 0.83-0.90). The AUDIT-C (AUROC = 0.89, 95% CI = 0.86--.92) performed significantly better than the AUDIT in the detection of at-risk drinking in the whole sample, and specifically for females. Gender differences emerged in the optimal cut-off scores for the AUDIT-C. A total score of 7 should be used for males and a score of 5 should be used for females. These empirical guidelines may enhance identification of at-risk drinkers in college settings. PMID:22612646

  18. Domestic elder abuse in Yazd, Iran: a cross-sectional study.

    PubMed

    Morowatisharifabad, Mohammad Ali; Rezaeipandari, Hassan; Dehghani, Ali; Zeinali, Ahmad

    2016-01-01

    Social changes due to urbanism, acculturation, and fading of values have led to some challenges in family relationships, including domestic elder abuse. This study was conducted to determine elder abuse status in Yazd, Iran. This cross-sectional study was conducted on 250 elderly people over 60 years in Yazd in 2014-2015. Clustered random sampling was used to recruit the participants from 10 clusters in Yazd (25 individuals from each cluster). The data were gathered by the 49-item,Iranian Domestic Elder Abuse Questionnaire which was filled out through private interviews with the participants. Mean score of elder abuse was 11.84 (SD: 12.70) of total 100. Of the participants,79.6% (95% CI: 74.5-84.6) experienced at least one type of abuse. Emotional neglect was the most reported abuse and physical abuse was the least reported. Abuse score was associated with age, education level, living status, and insurance status of elders. Further, those who reported history of gastrointestinal problems, dyslipidemia, respiratory diseases, sleep disorders, audiovisual problems, joints pain, hypertension, dental/oral problems, cardiovascular disease,urinary incontinence and disability, reported a statistically significant higher abuse score. Despite overall low rate of domestic elder abuse, its high prevalence indicates that some interventions are necessary to decrease domestic elder abuse. Emotional neglect of elders should be addressed more than other abuse types.

  19. Self-reported oral health and xerostomia in adult patients with celiac disease versus a comparison group.

    PubMed

    van Gils, Tom; Bouma, Gerd; Bontkes, Hetty J; Mulder, Chris J J; Brand, Henk S

    2017-08-01

    This study aimed to assess the impact of celiac disease (CD) on oral health and xerostomia. Members of the Dutch Celiac Society (n = 5522) were invited to complete an online questionnaire based on the Oral Health Impact Profile 14 (OHIP-14) and Xerostomia Inventory (XI). Acquaintances and partners of the CD respondents served as the comparison group. In total, data of 740 patients with CD and 270 comparison participants were evaluated. The median age of the responding patients with CD (55 years) was similar to the median age in the comparison group (53 years). Oral health problems, including aphthous stomatitis, painful mouth, and gingival problems, were more frequently reported by patients with CD. Mean OHIP-14 score (4.9 vs 2.6; P < .001) and the mean XI score (22.2 vs 17.2; P < .001) were higher in the CD group than in the comparison group. No significant effects of gender, age at CD diagnosis, or time on a gluten-free diet in mean OHIP-14 and XI scores were observed. This study showed that oral health problems are more commonly experienced in adult patients with CD than in the comparison group. Collaboration between dentists and gastroenterologists is recommended to increase detection of undiagnosed CD. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Domestic elder abuse in Yazd, Iran: a cross-sectional study

    PubMed Central

    Morowatisharifabad, Mohammad Ali; Rezaeipandari, Hassan; Dehghani, Ali; Zeinali, Ahmad

    2016-01-01

    Background: Social changes due to urbanism, acculturation, and fading of values have led to some challenges in family relationships, including domestic elder abuse. This study was conducted to determine elder abuse status in Yazd, Iran. Methods: This cross-sectional study was conducted on 250 elderly people over 60 years in Yazd in 2014-2015. Clustered random sampling was used to recruit the participants from 10 clusters in Yazd (25 individuals from each cluster). The data were gathered by the 49-item,Iranian Domestic Elder Abuse Questionnaire which was filled out through private interviews with the participants. Results: Mean score of elder abuse was 11.84 (SD: 12.70) of total 100. Of the participants,79.6% (95% CI: 74.5-84.6) experienced at least one type of abuse. Emotional neglect was the most reported abuse and physical abuse was the least reported. Abuse score was associated with age, education level, living status, and insurance status of elders. Further, those who reported history of gastrointestinal problems, dyslipidemia, respiratory diseases, sleep disorders, audiovisual problems, joints pain, hypertension, dental/oral problems, cardiovascular disease,urinary incontinence and disability, reported a statistically significant higher abuse score. Conclusion: Despite overall low rate of domestic elder abuse, its high prevalence indicates that some interventions are necessary to decrease domestic elder abuse. Emotional neglect of elders should be addressed more than other abuse types. PMID:27386426

  1. State and trait anxiety levels of adolescents in a changing society, Kirikkale city, Turkey.

    PubMed

    Oğuztürk, Ömer; Bülbül, Selda Hızel; Özen, Nurper Erberk; Ekici, Mehmet; Örnek, Kemal; Ünlü, Erdal; Yüksel, Serhat

    2012-06-01

    Adolescents face rapidly changing challenges. Psychosocial health problems during adolescence are relatively common in all cultures. This study was designed to evaluate the state and trait anxiety status and influencing sociodemographic and other factors, thought to pertain to youth, on anxiety among school children in Kirikkale. It was carried out at three public primary and two high schools representative of two different socioeconomic statuses. 430 Turkish school children (246 girls, 184 boys) were asked voluntarily to answer a set of questionnaires in their classrooms at the beginning of a training programme. Then the State and Trait Anxiety Inventory for Children was administered. Mean age of the students was 14.16 ± 1.87 years. The mean total STAI-CS and STAI-CT scores were 40.24 ± 11.64, and 44.71 ± 9.64, respectively. There were no differences in STAI-CS and STAI-CT scores between boys and girls in both schools and in all age groups. Among girls, a positive body image had a significant effect on state anxiety scores. There was a positive correlation between age and anxiety scores (r = .17, F:12.176, p < .001). Students identifying their families SES as bad and/or moderate scored significantly higher in comparison to the other groups (p < .05). STAI-CS scores were higher for lower educational grade, higher body weight and sleep problems. In Kirikkale, a city faced with substantial changes in cultural and traditional norms, adolescents could be expected to be under stress and appear to be responding to stress with anxiety.

  2. Maternal mental quality of life mediates the associations between intimate partner abuse against mothers and their children's behaviours and quality of life in low-income Chinese families.

    PubMed

    Guo, Vivian Yawei; Yu, Esther Yee Tak; Wong, Rosa Sze Man; Ip, Patrick; Tiwari, Agnes Fung Yee; Wong, Carlos King Ho; Fung, Colman Siu Cheung; Wong, Wilfred Hing Sang; Lam, Cindy Lo Kuen

    2017-12-01

    To explore the association between maternal intimate partner abuse (IPA) and their children's health-related quality of life (HRQOL) and behavioural problem, and to establish a mediation model and investigate the mediating role of mothers' HRQOL on this association. A cross-sectional study was conducted on 197 mothers of 227 children (112 boys and 115 girls) from low-income Chinese families. The mothers were asked to complete the 5-item abuse assessment screen questionnaire for the presence of IPA, the Chinese (Hong Kong) version of 12-item Short-Form Health Survey (SF-12) for their HRQOL and a structured socio-demographics questionnaire. One of the parents completed the Child Health Questionnaire-Parent Form-50 (CHQ-PF50) and the strengths and difficulties questionnaire (SDQ) to report on their children's HRQOL and behavioural problems, respectively. The mediating effect of the maternal HRQOL on the relationship between maternal IPA status and their children's behavioural problems and HRQOL was tested using Baron and Kenney's multistage regression approach and bootstrapping method. Thirty-five of the 197 mothers reported IPA (17.8%). Children whose mothers had experienced IPA had lower scores in the CHQ-PF50 mental health, parental impact-emotional, family activities and family cohesion subscales, and the psychosocial summary score compared to children of mothers who reported no IPA; they also had more emotional, conduct and hyperactivity/inattention problems and higher total difficulties scores measured by the SDQ. Maternal mental HRQOL was a mediator on the relationship between maternal IPA status and their children's behavioural problems and psychosocial HRQOL. IPA experienced by mothers had significant negative impacts on their children's HRQOL and behaviours, which was mediated by maternal mental HRQOL.

  3. Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study.

    PubMed Central

    Piccinelli, M.; Tessari, E.; Bortolomasi, M.; Piasere, O.; Semenzin, M.; Garzotto, N.; Tansella, M.

    1997-01-01

    OBJECTIVE: To determine the properties of the alcohol use disorders identification test in screening primary care attenders for alcohol problems. DESIGN: A validity study among consecutive primary care attenders aged 18-65 years. Every third subject completed the alcohol use disorders identification test (a 10 item self report questionnaire on alcohol intake and related problems) and was interviewed by an investigator with the composite international diagnostic interview alcohol use module (a standardised interview for the independent assessment of alcohol intake and related disorders). SETTING: 10 primary care clinics in Verona, north eastern Italy. PATIENTS: 500 subjects were approached and 482 (96.4%) completed evaluation. RESULTS: When the alcohol use disorders identification test was used to detect subjects with alcohol problems the area under the receiver operating characteristic curve was 0.95. The cut off score of 5 was associated with a sensitivity of 0.84, a specificity of 0.90, and a positive predictive value of 0.60. The screening ability of the total score derived from summing the responses to the five items minimising the probability of misclassification between subjects with and without alcohol problems provided an area under the receiver operating characteristic curve of 0.93. A score of 5 or more on the five items was associated with a sensitivity of 0.79, a specificity of 0.95, and a positive predictive value of 0.73. CONCLUSIONS: The alcohol use disorders identification test performs well in detecting subjects with formal alcohol disorders and those with hazardous alcohol intake. Using five of the 10 items on the questionnaire gives reasonable accuracy, and these are recommended as questions of choice to screen patients for alcohol problems. PMID:9040389

  4. Learning style preferences and their influence on students' problem solving in kinematics observed by eye-tracking method

    NASA Astrophysics Data System (ADS)

    Kekule, Martina

    2017-01-01

    The article presents eye-tracking method and its using for observing students when they solve problems from kinematics. Particularly, multiple-choice items in TUG-K test by Robert Beichner. Moreover, student's preference for visual way of learning as a possible influential aspect is proofed and discussed. Learning Style Inventory by Dunn, Dunn&Price was administered to students in order to find out their preferences. More than 20 high school and college students about 20 years old took part in the research. Preferred visual way of learning in contrast to the other ways of learning (audio, tactile, kinesthetic) shows very slight correlation with the total score of the test, none correlation with the average fixation duration and slight correlation with average fixation count on a task and average total visit duration on a task.

  5. Psychometric characteristics of Clinical Reasoning Problems (CRPs) and its correlation with routine multiple choice question (MCQ) in Cardiology department

    PubMed Central

    DERAKHSHANDEH, ZAHRA; AMINI, MITRA; KOJURI, JAVAD; DEHBOZORGIAN, MARZIYEH

    2018-01-01

    Introduction: Clinical reasoning is one of the most important skills in the process of training a medical student to become an efficient physician. Assessment of the reasoning skills in a medical school program is important to direct students’ learning. One of the tests for measuring the clinical reasoning ability is Clinical Reasoning Problems (CRPs). The major aim of this study is to measure psychometric qualities of CRPs and define correlation between this test and routine MCQ in cardiology department of Shiraz medical school. Methods: This study was a descriptive study conducted on total cardiology residents of Shiraz Medical School. The study population consists of 40 residents in 2014. The routine CRPs and the MCQ tests was designed based on similar objectives and were carried out simultaneously. Reliability, item difficulty, item discrimination, and correlation between each item and the total score of CRPs were all measured by Excel and SPSS software for checking psycometeric CRPs test. Furthermore, we calculated the correlation between CRPs test and MCQ test. The mean differences of CRPs test score between residents’ academic year [second, third and fourth year] were also evaluated by Analysis of variances test (One Way ANOVA) using SPSS software (version 20)(α=0.05). Results: The mean and standard deviation of score in CRPs was 10.19 ±3.39 out of 20; in MCQ, it was 13.15±3.81 out of 20. Item difficulty was in the range of 0.27-0.72; item discrimination was 0.30-0.75 with question No.3 being the exception (that was 0.24). The correlation between each item and the total score of CRP was 0.26-0.87; the correlation between CRPs test and MCQ test was 0.68 (p<0.001). The reliability of the CRPs was 0.72 as calculated by using Cronbach's alpha. The mean score of CRPs was different among residents based on their academic year and this difference was statistically significant (p<0.001). Conclusion: The results of this present investigation revealed that CRPs could be reliable test for measuring clinical reasoning in residents. It can be included in cardiology residency assessment programs. PMID:29344528

  6. Measuring change in critical thinking skills of dental students educated in a PBL curriculum.

    PubMed

    Pardamean, Bens

    2012-04-01

    This study measured the change in critical thinking skills of dental students educated in a problem-based learning (PBL) pedagogical method. The quantitative analysis was focused on measuring students' critical thinking skills achievement from their first through third years of dental education at the University of Southern California. This non-experimental evaluation was based on a volunteer sample of ninety-eight dental students who completed a demographics/academic questionnaire and a psychometric assessment known as the Health Sciences Reasoning Test (HSRT). The HSRT produced the overall critical thinking skills score. Additionally, the HSRT generated five subscale scores: analysis, inference, evaluation, deductive reasoning, and inductive reasoning. The results of this study concluded that the students showed no continuous and significant incremental improvement in their overall critical thinking skills score achievement during their PBL-based dental education. Except for the inductive reasoning score, this result was very consistent with the four subscale scores. Moreover, after performing the statistical adjustment on total score and subscale scores, no significant statistical differences were found among the three student groups. However, the results of this study found some aspects of critical thinking achievements that differed by categories of gender, race, English as first language, and education level.

  7. Generalizability Theory Research on Developing a Scoring Rubric to Assess Primary School Students' Problem Posing Skills

    ERIC Educational Resources Information Center

    Cankoy, Osman; Özder, Hasan

    2017-01-01

    The aim of this study is to develop a scoring rubric to assess primary school students' problem posing skills. The rubric including five dimensions namely solvability, reasonability, mathematical structure, context and language was used. The raters scored the students' problem posing skills both with and without the scoring rubric to test the…

  8. Borderline pathology and the Personality Assessment Inventory (PAI): an evaluation of criterion and concurrent validity.

    PubMed

    Stein, Michelle B; Pinsker-Aspen, Janet H; Hilsenroth, Mark J

    2007-02-01

    In this study, we examined how patients diagnosed with borderline pathology (BP) would respond on the Personality Assessment Inventory (PAI; Morey, 1991) Borderline (BOR) scales in relation to patients without BP pathology. In addition, we examined whether the PAI BOR scales would be related to variables on the Social Cognition and Object Relations Scale (SCORS; Hilsenroth, Stein, & Pinsker, 2004; Westen, 1995) derived from early memory narratives. Results indicate that outpatients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnosis of BP scored significantly higher on the PAI BOR Total (BOR-Total) score, Identity Problems, and Self- Harm scales in comparison to a Non-BP clinical sample. The overall correct classification rate for the presence or absence of BP using the BOR Total scale (T >or= 70) was 73%. In addition, there were several significant relationships between dimensional PAI BOR scales and the presence versus absence of DSM-IV BP. Moreover, both the BOR-Total and Affect Instability scales were significantly related to the SCORS variable Complexity of Representations. We provide clinical examples to illustrate these research findings in an applied manner.

  9. Results of a multimodal analgesic trial involving patients with total hip or total knee arthroplasty.

    PubMed

    Skinner, Harry B; Shintani, Ellen Y

    2004-02-01

    The mainstays for pain relief after total hip arthroplasty (THA) and total knee arthroplasty (TKA) have been the opioids, but these medications, though excellent analgesics, have problems limiting their effectiveness. Alternative analgesics have been considered too mild for the pain caused by THA and TKA. These medications have been used in combination, but only in pairs and not in a "stacked modality." Here we report a trial of around-the-clock acetaminophen, rofecoxib, tramadol, and dexamethasone combined with bupivicaine pain pumps and on-demand opioid use (patient-controlled analgesia with morphine). Patients (48 with THA, 54 with TKA) were divided into pain protocol (PP) groups and conventional pain-therapy groups. Important variables were recorded from a chart review. In the PP groups, reductions in opioid use, length of hospital stay (TKA, P=.012), and time on patient-controlled analgesia were significant, as were improvements in pain scores for TKA. In addition, there was a trend in improved pain scores for the PP group with THA. Minor adverse events were similar for the groups, but major medical complications were fewer in the PP group. Preemptive analgesia with multiple non-narcotic medications used in a stacked modality can significantly reduce postoperative pain.

  10. Evaluation of Relationship between Obsessive-compulsive Disorder and Dissociative Experiences.

    PubMed

    Tatlı, Mustafa; Cetinkaya, Ozlem; Maner, Fulya

    2018-05-31

    The aim of the study is to evaluate the relationship between obsessive-compulsive disorder (OCD) symptoms and dissociative experiences and the effect of childhood traumatic experiences on this relationship in OCD patients. Fifty consecutive OCD patients and 50 healthy controls are enrolled for this study. Sociodemographic and Clinical Data Form, Dissociative Experiences Scale (DES), Padua Inventory (PI) and Childhood Trauma Questionnaire (CTQ) are applied to participants. Average DES total score in the patient group is 20.58 and in the control group it is 4.87. In the patient group, when we evaluate the relation strengths of DES total and subscale scores with PI total score, we found out that amnesia subscale has r=0.361 ( p <0.01), absorption subscale has r=0.611 ( p <0.01), depersonalization/derealization subscale has r=0.574 ( p <0.01), and DES total score has r=0.55 ( p <0.01) relation strengths with PI total score. In patient group both DES total score and CTQ total score have influence on PI total score independently from each other. In addition to this, the level of the influence of DES total scores on PI total scores is, R²=0.399 ( p <0.01) and the level of the influence of CTQ total scores on PI total scores is R²=0.343 ( p <0.01). Dissociative experiences are seen more frequently in OCD patients than healthy controls. Among dissociative experiences, absorption has stronger relation with OCD symptoms. The relation between OCD and dissociation is independent from and stronger than the relation between childhood traumatic experiences and OCD.

  11. [Association between behavioral problems and gastrointestinal disorders among children with autism spectrum disorder].

    PubMed

    Zhu, J; Guo, M; Yang, T; Lai, X; Lei, Y Y; He, M L; Chen, J; Li, T Y

    2017-12-02

    Objective: To investigate the relationship between gastrointestinal disorders (GID) and core symptoms or behavioral problems among the children with autism spectrum disorder (ASD) . Method: Totally 328 children with ASD and 202 normal controls were enrolled in this cross-sectional study from August 2013 to October 2016. The information about the gastrointestinal disorders, behavioral and emotional problems was collected by using questionnaires. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC) were used to assess the core symptoms of the children with ASD. Neurodevelopmental status was evaluated with Gesell Developmental Scale (GDS). These variables were analyzed by using student's t -test and chi-square test. Result: The prevalence of GID was significantly higher in the children with ASD than in the normally developing children (49.4% (162/328) vs .25.7% (52/202), χ(2)=29.039, P= 0.000), especially the symptoms of constipation (33.2% (109/328) vs . 13.9% (28/202)), diarrhea (9.5%(31/328) vs . 1.5% (3/202)), nausea and vomiting (9.5% (31/328) vs . 3.5% (7/202)), and foul defecation (16.5% (54/328) vs . 5.0% (10/202)) (all P< 0.05). Among the ASD children, the prevalence of GID was similar between male and female (46.7% (133/285) vs . 46.5%(20/43), χ(2)=0.006, P= 0.938), as well as among all age groups (χ(2)=1.907, P= 0.862). There was no significant difference in scores of GDS in the ASD children with or without GID (all P> 0.05). Compared with ASD children without GID ( n =166), the ASD children with GID ( n =162) got higher scores in the "Body and Object Use" of ABC scale ( (16.4±9.3) vs . (12.3±6.7) scores, t= 2.258, P= 0.028), and had more emotional problems (63.6% (103/162) vs . 49.4% (82/166), χ(2)=6.707, P= 0.010). Moreover, the score of behavior problems questionnaire was higher in the ASD children with GID ( (35.3±16.8) vs . (16.1±13.6) scores, t= 5.748, P= 0.000). Conclusion: Children with ASD have higher risk of GID than the normal developing children. While the stereotyped behaviors, problem behaviors and emotional problems are severer in the ASD children with GID. Hence, it is important to provide comprehensive treatment and management for these groups of children.

  12. [Influence of sociodemographic variables on coping styles, social stress, and sexual sensation seeking in adolescents].

    PubMed

    de la Paz Bermúdez, María; Teva, Inmaculada; Buela-Casal, Gualberto

    2009-05-01

    The aim of this study is to analyze the influence of gender, age, and type of high school (public/private) on coping styles solve the problem coping style, reference to others coping style and non-productive coping, social stress, and sexual sensation seeking in adolescents. A total of 4.456 adolescents participated. The following measures were used: Adolescent Coping Scale, Sexual Sensation Seeking Scale, and the Social Stress subscale of the Behavior Assessment System for Children. This is a cross-sectional study that used a stratified random sampling considering Spanish regions and type of high school (public/private) to select participants. The sample is representative of the national level at a 95.5% confidence interval. Results showed that males had higher scores in sexual sensation seeking and social stress compared to females. Female adolescents scored higher in reference to others coping style and non-productive coping. Compared to adolescents of public high schools, adolescents who attended to private high schools scored higher in solve the problem coping style and reference to others coping style. Associations among sexual sensation seeking, coping styles, social stress, and health risk behaviors in adolescents are discussed.

  13. A similarity score-based two-phase heuristic approach to solve the dynamic cellular facility layout for manufacturing systems

    NASA Astrophysics Data System (ADS)

    Kumar, Ravi; Singh, Surya Prakash

    2017-11-01

    The dynamic cellular facility layout problem (DCFLP) is a well-known NP-hard problem. It has been estimated that the efficient design of DCFLP reduces the manufacturing cost of products by maintaining the minimum material flow among all machines in all cells, as the material flow contributes around 10-30% of the total product cost. However, being NP hard, solving the DCFLP optimally is very difficult in reasonable time. Therefore, this article proposes a novel similarity score-based two-phase heuristic approach to solve the DCFLP optimally considering multiple products in multiple times to be manufactured in the manufacturing layout. In the first phase of the proposed heuristic, a machine-cell cluster is created based on similarity scores between machines. This is provided as an input to the second phase to minimize inter/intracell material handling costs and rearrangement costs over the entire planning period. The solution methodology of the proposed approach is demonstrated. To show the efficiency of the two-phase heuristic approach, 21 instances are generated and solved using the optimization software package LINGO. The results show that the proposed approach can optimally solve the DCFLP in reasonable time.

  14. Prenatal exposure to maternal smoking and childhood behavioural problems: a quasi-experimental approach.

    PubMed

    McCrory, Cathal; Layte, Richard

    2012-11-01

    This retrospective cross-sectional paper examines the relationship between maternal smoking during pregnancy and children's behavioural problems at 9 years of age independent of a wide range of possible confounders. The final sample comprised 7,505 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population. Information on maternal smoking during pregnancy was obtained retrospectively at 9 years of age via parental recall and children's behavioural problems were assessed using the Strengths and Difficulties Questionnaire across separate parent and teacher-report instruments. A quasi-experimental approach using propensity score matching was used to create treatment (smoking) and control (non-smoking) groups which did not differ significantly in their propensity to smoke in terms of 16 observed characteristics. After matching on the propensity score, children whose mothers smoked during pregnancy were 3.5 % (p < 0.001) and 3.4 % (p < 0.001) more likely to score in the problematic range on the SDQ total difficulties index according to parent and teacher-report respectively. Maternal smoking during pregnancy was more strongly associated with externalising than internalising behavioural problems. Analysis of the dose-response relationship showed that the differential between matched treatment and control groups increased with level of maternal smoking. Given that smoking is a modifiable risk factor, the promotion of successful cessation in pregnancy may prevent potentially adverse long-term consequences.

  15. Adverse Selection in Community Based Health Insurance among Informal Workers in Bangladesh: An EQ-5D Assessment

    PubMed Central

    Sarker, Abdur Razzaque; Sultana, Marufa; Chakrovorty, Sanchita; Khan, Jahangir A. M.

    2018-01-01

    Community-based Health Insurance (CBHI) schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured) respondents were surveyed using the Bengali version of the EuroQuol-5 dimensions (EQ-5D) questionnaire for assessing their health status. The EQ-5D scores were estimated using available regional tariffs. Multiple logistic regression was applied for predicting the association between health status and CBHI scheme enrolment. A higher number of insured reported problems in mobility (7.3%; p = 0.002); self-care (7.1%; p = 0.000) and pain and discomfort (7.7%; p = 0.005) than uninsured. The average EQ-5D score was significantly lower among the insured (0.704) compared to the uninsured (0.749). The regression analysis showed that those who had a problem in mobility (OR = 1.65; 95% CI: 1.25–2.17); self-care (OR = 2.29; 95% CI: 1.62–3.25) and pain and discomfort (OR = 1.43; 95% CI: 1.13–1.81) were more likely to join the scheme. Individuals with higher EQ-5D scores (OR = 0.46; 95% CI: 0.31–0.69) were less likely to enroll in the scheme. Given that adverse selection was evident in the pilot CBHI scheme, there should be consideration of this problem when planning scale-up of these kind of schemes. PMID:29385072

  16. Predictive value of callous-unemotional traits in a large community sample.

    PubMed

    Moran, Paul; Rowe, Richard; Flach, Clare; Briskman, Jacqueline; Ford, Tamsin; Maughan, Barbara; Scott, Stephen; Goodman, Robert

    2009-11-01

    Callous-unemotional (CU) traits in children and adolescents are increasingly recognized as a distinctive dimension of prognostic importance in clinical samples. Nevertheless, comparatively little is known about the longitudinal effects of these personality traits on the mental health of young people from the general population. Using a large representative sample of children and adolescents living in Great Britain, we set out to examine the effects of CU traits on a range of mental health outcomes measured 3 years after the initial assessment. Parents were interviewed to determine the presence of CU traits in a representative sample of 7,636 children and adolescents. The parents also completed the Strengths and Difficulties Questionnaire, a broad measure of childhood psychopathology. Three years later, parents repeated the Strengths and Difficulties Questionnaire. At 3-year follow-up, CU traits were associated with conduct, hyperactivity, emotional, and total symptom scores. After adjusting for the effects of all covariates, including baseline symptom score, CU traits remained robustly associated with the overall levels of conduct problems and emotional problems and with total psychiatric difficulties at 3-year follow-up. Callous-unemotional traits are independently associated with future psychiatric difficulties in children and adolescents. An assessment of CU traits adds small but significant improvements to the prediction of future psychopathology.

  17. A multidimensional assessment of the validity and utility of alcohol use disorder severity as determined by item response theory models.

    PubMed

    Dawson, Deborah A; Saha, Tulshi D; Grant, Bridget F

    2010-02-01

    The relative severity of the 11 DSM-IV alcohol use disorder (AUD) criteria are represented by their severity threshold scores, an item response theory (IRT) model parameter inversely proportional to their prevalence. These scores can be used to create a continuous severity measure comprising the total number of criteria endorsed, each weighted by its relative severity. This paper assesses the validity of the severity ranking of the 11 criteria and the overall severity score with respect to known AUD correlates, including alcohol consumption, psychological functioning, family history, antisociality, and early initiation of drinking, in a representative population sample of U.S. past-year drinkers (n=26,946). The unadjusted mean values for all validating measures increased steadily with the severity threshold score, except that legal problems, the criterion with the highest score, was associated with lower values than expected. After adjusting for the total number of criteria endorsed, this direct relationship was no longer evident. The overall severity score was no more highly correlated with the validating measures than a simple count of criteria endorsed, nor did the two measures yield different risk curves. This reflects both within-criterion variation in severity and the fact that the number of criteria endorsed and their severity are so highly correlated that severity is essentially redundant. Attempts to formulate a scalar measure of AUD will do as well by relying on simple counts of criteria or symptom items as by using scales weighted by IRT measures of severity. Published by Elsevier Ireland Ltd.

  18. Parental HIV/AIDS and psychological health of younger children in South Africa.

    PubMed

    Asanbe, Comfort; Moleko, Anne-Gloria; Visser, Maretha; Thomas, Angela; Makwakwa, Catherine; Salgado, Waleska; Tesnakis, Alexandra

    2016-07-01

    We examined several indicators of psychological health in a sample of orphans and vulnerable children (OVC) to determine if there were significant differences between those orphaned by AIDS and those orphaned by other causes, and if there were gender differences. Our sample consisted of 119 young children (ages 6-10 years) who participated in a non-governmental organisation (NGO)-supported social services programme in a low-resource, non-urban community in South Africa. We collected data on three groups: non-orphans (OVC1; n = 45); orphans due to AIDS (OVC2; n = 43); and other orphans (OVC3; n = 31). Parents of non-orphans and legal guardians of orphans rated their children on a 112-item, age appropriate Child Behaviour Checklist (CBCL), South Africa version. Children in the OVC2 group were significantly different from their peers on Internalising Problems and Somatic Complaints, while OVC3 group had a higher proportion of children in the at-risk range on Social Problems compared to OVC2. Females had elevated scores on the anxious/depressed, internalising problems, total problems, and sluggish cognitive tempo scales compared to males. There was an interaction between factors, such that boys in OVC2 had elevated mean scores on Somatic Complaints. These findings suggest increased vulnerability for girls on emotional issues and for boys on somatic problems.

  19. The Effect of Metacognitive Instruction on Problem Solving Skills in Iranian Students of Health Sciences

    PubMed Central

    Safari, Yahya; Meskini, Habibeh

    2016-01-01

    Background: Learning requires application of such processes as planning, supervision, monitoring and reflection that are included in the metacognition. Studies have shown that metacognition is associated with problem solving skills. The current research was conducted to investigate the impact of metacognitive instruction on students’ problem solving skills. Methods: The study sample included 40 students studying in the second semester at Kermanshah University of Medical Sciences, 2013-2014. They were selected through convenience sampling technique and were randomly assigned into two equal groups of experimental and control. For the experimental group, problem solving skills were taught through metacognitive instruction during ten two-hour sessions and for the control group, problem solving skills were taught via conventional teaching method. The instrument for data collection included problem solving inventory (Heppner, 1988), which was administered before and after instruction. The validity and reliability of the questionnaire had been previously confirmed. The collected data were analyzed by descriptive statistics, mean and standard deviation and the hypotheses were tested by t-test and ANCOVA. Results: The findings of the posttest showed that the total mean scores of problem solving skills in the experimental and control groups were 151.90 and 101.65, respectively, indicating a significant difference between them (p<0.001). This difference was also reported to be statistically significant between problem solving skills and its components, including problem solving confidence, orientation-avoidance coping style and personal control (p<0.001). No significant difference, however, was found between the students’ mean scores in terms of gender and major. Conclusion: Since metacognitive instruction has positive effects on students’ problem solving skills and is required to enhance academic achievement, metacognitive strategies are recommended to be taught to the students. PMID:26234970

  20. The Effect of Metacognitive Instruction on Problem Solving Skills in Iranian Students of Health Sciences.

    PubMed

    Safari, Yahya; Meskini, Habibeh

    2015-05-17

    Learning requires application of such processes as planning, supervision, monitoring and reflection that are included in the metacognition. Studies have shown that metacognition is associated with problem solving skills. The current research was conducted to investigate the impact of metacognitive instruction on students' problem solving skills. The study sample included 40 students studying in the second semester at Kermanshah University of Medical Sciences, 2013-2014. They were selected through convenience sampling technique and were randomly assigned into two equal groups of experimental and control. For the experimental group, problem solving skills were taught through metacognitive instruction during ten two-hour sessions and for the control group, problem solving skills were taught via conventional teaching method. The instrument for data collection included problem solving inventory (Heppner, 1988), which was administered before and after instruction. The validity and reliability of the questionnaire had been previously confirmed. The collected data were analyzed by descriptive statistics, mean and standard deviation and the hypotheses were tested by t-test and ANCOVA. The findings of the posttest showed that the total mean scores of problem solving skills in the experimental and control groups were 151.90 and 101.65, respectively, indicating a significant difference between them (p<0.001). This difference was also reported to be statistically significant between problem solving skills and its components, including problem solving confidence, orientation-avoidance coping style and personal control (p<0.001). No significant difference, however, was found between the students' mean scores in terms of gender and major. Since metacognitive instruction has positive effects on students' problem solving skills and is required to enhance academic achievement, metacognitive strategies are recommended to be taught to the students.

  1. Maternal-child dyads of functioning: the intergenerational impact of violence against women on children.

    PubMed

    McFarlane, Judith; Symes, Lene; Binder, Brenda K; Maddoux, John; Paulson, Rene

    2014-11-01

    Violence against women is a global epidemic with potential consequences of injury, illness, and death. Children exposed to the violence may also be impacted with functional impairments. Little is known of the inter-generational impact of violence experienced by the mother from an intimate partner on functioning of her children. No dyad analysis was found in the literature. To examine the inter-generational impact of violence against women on the behavioral functioning of children, 300 mothers reporting intimate partner abuse and one randomly chosen child, age 18 months to 16 years of age; were evaluated for borderline and clinical diagnostic levels of problem behaviors. Linear, Logistic, and Ordinal regression models were applied. Mothers' problem behavior scores were significantly related to children's problem behavior scores (internalizing r = 0.611, externalizing r = 0.494, total problems r = 0.662, all ps < 0.001). Mothers who reported clinical and borderline clinical internalized problems (i.e., depression, anxiety) were 7 times more likely to have children with the same problems and mothers with borderline clinical and clinical external problems (i.e., aggression, hostility) were 4.5 times more likely to have children with the same external problems. These dyadic analyses provide evidence of a direct relationship of maternal functioning on child behavioral functioning. Intervention strategies to decrease internalizing maternal behavioral problems, such as depression, anxiety, and post traumatic stress disorder, and/or externalizing problems, such as hostility and aggression, can be expected to have a pass through, secondary impact on the behavioral functioning of children. Awareness of the relationship between intimate partner violence against mothers and child behavioral function can support interventions that decrease the distress experienced by mothers and their children, interrupt intergenerational transmission of abusive behaviors, and promote better maternal child functioning.

  2. Evaluation of Relationship between Obsessive-compulsive Disorder and Dissociative Experiences

    PubMed Central

    Cetinkaya, Ozlem; Maner, Fulya

    2018-01-01

    Objective The aim of the study is to evaluate the relationship between obsessive-compulsive disorder (OCD) symptoms and dissociative experiences and the effect of childhood traumatic experiences on this relationship in OCD patients. Methods Fifty consecutive OCD patients and 50 healthy controls are enrolled for this study. Sociodemographic and Clinical Data Form, Dissociative Experiences Scale (DES), Padua Inventory (PI) and Childhood Trauma Questionnaire (CTQ) are applied to participants. Results Average DES total score in the patient group is 20.58 and in the control group it is 4.87. In the patient group, when we evaluate the relation strengths of DES total and subscale scores with PI total score, we found out that amnesia subscale has r=0.361 (p<0.01), absorption subscale has r=0.611 (p<0.01), depersonalization/derealization subscale has r=0.574 (p<0.01), and DES total score has r=0.55 (p<0.01) relation strengths with PI total score. In patient group both DES total score and CTQ total score have influence on PI total score independently from each other. In addition to this, the level of the influence of DES total scores on PI total scores is, R2=0.399 (p<0.01) and the level of the influence of CTQ total scores on PI total scores is R2=0.343 (p<0.01). Conclusion Dissociative experiences are seen more frequently in OCD patients than healthy controls. Among dissociative experiences, absorption has stronger relation with OCD symptoms. The relation between OCD and dissociation is independent from and stronger than the relation between childhood traumatic experiences and OCD. PMID:29739129

  3. Contribution of maternal smoking during pregnancy and lead exposure to early child behavior problems.

    PubMed

    Wasserman, G A; Liu, X; Pine, D S; Graziano, J H

    2001-01-01

    Maternal smoking during pregnancy elevates risk for later child behavior problems. Because prior studies considered only Western settings, where smoking co-occurs with social disadvantage, we examined this association in Yugoslavia, a different cultural setting. Mothers enrolled in pregnancy as the low-exposure group in a prospective study of lead exposure were interviewed about health, including smoking history. A total of 199 children were assessed on the Child Behavior Checklist (CBCL) at ages 4, 4 1/2, and 5 years. Average cumulative blood lead (BPb) was determined from serial samples taken biannually since delivery. Longitudinal analyses were derived from 191 children with available data on behavior and covariates. Smoking was unrelated to social adversity. Controlling for age, gender, birthweight, ethnicity, maternal education, and Home Observation for Measurement of the Environment (HOME) Acceptance, smoking was associated with worse scores on almost all subscales; BPb concentration was related to small increases in the Delinquency subscale. Daughters of smokers received significantly higher scores on Somatic Complaints compared to daughters of nonsmokers, consistent with other work relating biological factors and internalizing problems in young girls. Because the present smoking/child behavior associations persist after control for individual and social factors also related to behavior problems, possible biological mediators are considered.

  4. [Relationship Between Child Behavior and Emotional Problems and School Based Effort Avoidance].

    PubMed

    Weber, Hanna Maria; Büttner, Peter; Rücker, Stefan; Petermann, Franz

    2015-01-01

    The present study has examined the relationship between school based effort avoidance tendencies and problem behavior in children aged 9 to 16 years. Effort avoidance tendencies were assessed in 367 children with and without child care. Teachers and social workers rated children on behavioral and emotional problems with the Strengths and Difficulties Questionnaire (SDQ). Results confirmed significant but low correlations between teacher ratings of behavior and emotional problems in children and selected subscales of self-reported effort avoidance in school, especially for children in child care institutions. For them "conduct problems" were significantly correlated with three of the four subscales and the total sum score of effort avoidance whereas "hyperactivity" was the only scale which was significantly associated with the fourth subscale. In the school sample only "hyperactivity" and "peer problems" were significantly correlated with one subscale of school-based effort avoidance. The findings suggest that more problem behavior is in relation to more school based effort avoidance tendencies.

  5. A Confidant Support and Problem Solving Model of Divorced Fathers’ Parenting

    PubMed Central

    DeGarmo, David S.; Forgatch, Marion S.

    2011-01-01

    This study tested a hypothesized social interaction learning (SIL) model of confidant support and paternal parenting. The latent growth curve analysis employed 230 recently divorced fathers, of which 177 enrolled support confidants, to test confidant support as a predictor of problem solving outcomes and problem solving outcomes as predictors of change in fathers’ parenting. Fathers’ parenting was hypothesized to predict growth in child behavior. Observational measures of support behaviors and problem solving outcomes were obtained from structured discussions of personal and parenting issues faced by the fathers. Findings replicated and extended prior cross-sectional studies with divorced mothers and their confidants. Confidant support predicted better problem solving outcomes, problem solving predicted more effective parenting, and parenting in turn predicted growth in children’s reduced total problem behavior T scores over 18 months. Supporting a homophily perspective, fathers’ antisociality was associated with confidant antisociality but only fathers’ antisociality influenced the support process model. Intervention implications are discussed regarding SIL parent training and social support. PMID:21541814

  6. A confidant support and problem solving model of divorced fathers' parenting.

    PubMed

    Degarmo, David S; Forgatch, Marion S

    2012-03-01

    This study tested a hypothesized social interaction learning (SIL) model of confidant support and paternal parenting. The latent growth curve analysis employed 230 recently divorced fathers, of which 177 enrolled support confidants, to test confidant support as a predictor of problem solving outcomes and problem solving outcomes as predictors of change in fathers' parenting. Fathers' parenting was hypothesized to predict growth in child behavior. Observational measures of support behaviors and problem solving outcomes were obtained from structured discussions of personal and parenting issues faced by the fathers. Findings replicated and extended prior cross-sectional studies with divorced mothers and their confidants. Confidant support predicted better problem solving outcomes, problem solving predicted more effective parenting, and parenting in turn predicted growth in children's reduced total problem behavior T scores over 18 months. Supporting a homophily perspective, fathers' antisociality was associated with confidant antisociality but only fathers' antisociality influenced the support process model. Intervention implications are discussed regarding SIL parent training and social support.

  7. Beliefs towards mental illness in Turkish physiotherapy students.

    PubMed

    Yildirim, Meric; Demirbuken, Ilksan; Balci, Birgul; Yurdalan, Ufuk

    2015-01-01

    Mental health is a new area of specialization for physiotherapists. However, they usually meet patients with psychiatric co-morbidities secondary to other chronic diseases. It is important to explore the beliefs of future physiotherapists regarding mental illness in order to implement effective strategies to avoid possible stigmatizing attitudes that may interfere with the rehabilitation process. Moreover, the psychiatric field should be introduced to physiotherapists as a clinical and research area. Therefore, we aimed to question the beliefs of physiotherapy students regarding mental illness using the Beliefs towards Mental Illness Scale in two different universities in Turkey. The total score of 524 students was 46.5 ± 14.5 out of 105 while the Dangerousness Subscale score was 21.2 ± 5.8/40; Incurability and Poor Social and Interpersonal Skills Subscale score was 24.2 ± 9.3/55 and Shame Subscale score was 1.1 ± 1.9/10. Students who had a relationship with an individual having a mental problem and students who had consulted a psychiatrist/psychologist for any mental problem showed more positive beliefs. Future physiotherapists should be informed and trained regarding people with mental illness both to avoid stigma and to be aware of this area in physiotherapy settings. Therefore, it is important to implement new curricula for schools providing physiotherapy education including courses, lectures and clinical practices in the psychiatry field.

  8. Disordered Eating Behaviors in Emerging Adults With Type 1 Diabetes: A Common Problem for Both Men and Women.

    PubMed

    Doyle, Elizabeth A; Quinn, Sheila M; Ambrosino, Jodie M; Weyman, Kate; Tamborlane, William V; Jastreboff, Ania M

    Emerging adults (EA) with disordered eating behaviors (DEBs) and Type 1 diabetes (T1D) are at increased risk for severe complications of T1D, and these behaviors have been reported in EA women with T1D. Few studies, though, have included men. This study assessed the prevalence of DEB in both EA men and women with T1D. DEB was measured with the diabetes-specific Diabetes Eating Problem Survey-Revised (DEPS-R); scores of 20 or greater indicate need for further evaluation for DEB. A total of 27 women and 33 men (age range = 21 ± 2.5 years) completed the DEPS-R; 27% of women and 18% of men had scores of 20 or greater (p = .23). Hemoglobin A1c level was significantly higher in subjects with elevated DEPS-R scores (10.4 ± 2.1% vs. 7.8 ± 1.3%; p < .001), and DEPS-R scores correlated with increased body mass index values (r = 0.27, p < .05). Clinicians should assess for DEB in both male and female emerging adults with T1D, especially overweight patients with poor glycemic control. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  9. Cross-national replication of the gender identity interview for children.

    PubMed

    Wallien, Madeleine S C; Quilty, Lena C; Steensma, Thomas D; Singh, Devita; Lambert, Susan L; Leroux, Annie; Owen-Anderson, Allison; Kibblewhite, Sarah J; Bradley, Susan J; Cohen-Kettenis, Peggy T; Zucker, Kenneth J

    2009-11-01

    We administered the Gender Identity Interview for Children, a 12-item child-informant measure, to children referred clinically for gender identity problems in Toronto, Ontario, Canada (N = 329) and Amsterdam, The Netherlands (N = 228) and 173 control children. Confirmatory factor analysis identified a Cognitive Gender Confusion factor (4 items) and an Affective Gender Confusion factor (8 items). Patients from both clinics had a significantly higher deviant total score than the controls, and the Dutch patients had a significantly higher deviant score than the Toronto patients. In this cross-national study, we are the first to report on the validity of this measure to discriminate children with gender identity disorder from controls outside of North America.

  10. Gender Differences in Patterns of Association Between Prosocial Behavior, Personality, and Externalizing Problems

    PubMed Central

    Pursell, Gwen R.; Laursen, Brett; Rubin, Kenneth H.; Booth-LaForce, Cathryn; Rose-Krasnor, Linda

    2008-01-01

    This study examines whether prosocial behavior and personality have independent or overlapping associations with adolescent externalizing problems. A total of 128 female and 103 male early adolescents (M = 13.6 years old) completed personality inventories. Prosocial behavior was assessed by peer nominations (N = 663). Composite aggression and delinquency scores were derived from maternal and self-reports. Path analyses indicated gender differences in patterns of association. For girls, links between prosocial behavior and both aggression and delinquency were fully mediated by agreeableness and partially mediated by conscientiousness. For boys, prosocial behavior, agreeableness, and conscientiousness were independently and negatively associated with aggression and delinquency. The findings suggest that personality and prosocial behavior are uniquely related to boys’ behavior problems but cannot be readily disentangled when it comes to girls’ behavior problems. PMID:18836524

  11. The Lichen-GIS Project, Teaching Students How to Use Bioindicator Species to Assess Environmental Quality.

    PubMed

    Wagner, Stephen C; McDonald, Darrel; Watson, Trey; Taylor, Josephine; Sowards, Alan B

    2009-01-01

    A content-driven biology course for preservice K-8 teachers has been developed. This course uses the constructivist approach, where instructors engage students by organizing information around concept-based problems. To this end, a semester-long, inquiry-based project was introduced where students studied lichen populations on trees located on their campus to monitor air quality. Data were incorporated into a geographical information systems (GIS) database to demonstrate how it can be used to map communities. Student teams counted the number of each lichen type within a grid placed on each tree trunk sampled and entered this information into a GIS database. The students constructed maps of lichen populations at each sample site and wrote abstracts about their research. Student performance was assessed by the preparation of these abstracts as well as by scores on pre- and posttests of key content measures. Students also completed a survey to determine whether the project aided in their comprehension as well as their interest in incorporating this activity into their own curricula. The students' pre- and posttest results showed an eightfold improvement in the total score after the semester project. Additionally, correct responses to each individual content measure increased by at least 35%. Total scores for the abstract ranged from 12 to 20 points out of 20 total points possible (60% to 100%), with a mean score of 15.8 points (78%). These results indicate that this exercise provided an excellent vehicle to teach students about lichens and their use as bioindicators and the application of geospatial technologies to map environmental data.

  12. Breast feeding and child behaviour in the Millennium Cohort Study.

    PubMed

    Heikkilä, Katriina; Sacker, Amanda; Kelly, Yvonne; Renfrew, Mary J; Quigley, Maria A

    2011-07-01

    To examine whether breast feeding is associated with behavioural development in children aged 5 years. The authors used data from a large, prospective, nationally representative UK cohort, the Millennium Cohort Study. 10 037 mother-child pairs from white ethnic background (9525 term and 512 preterm children) were included in the analyses. Duration of breast feeding (at all or exclusively) was ascertained from parental interview at study baseline, when the children were aged 9 months. Child behaviour was assessed using a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ). The authors used logistic regression to investigate the associations of breastfeeding duration with abnormal parent-rated SDQ total and subscores at age 5 in term and preterm children separately. Abnormal SDQ scores were less common in term children (n=1129/9525, 12%) than pre-term (n=78/512, 15%) children. Term children breast fed for 4 months or longer (n=2741/9525, 29%) had lower odds of an abnormal total SDQ score (multivariable-adjusted OR compared with never breastfed children (n=3292/9525, 35%) 0.67, 95% CI: 0.54 to 0.83). This effect was similar for all the SDQ subscores. In preterm children, longer duration of breast feeding was generally associated with lower odds of abnormal SDQ total and subscores but the effect estimates were imprecise. The associations between exclusive breast feeding and abnormal SDQ scores were similar to those of any breast feeding and abnormal SDQ scores. The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years.

  13. A parent-report gender identity questionnaire for children.

    PubMed

    Johnson, Laurel L; Bradley, Susan J; Birkenfeld-Adams, Andrea S; Kuksis, Myra A Radzins; Maing, Dianne M; Mitchell, Janet N; Zucker, Kenneth J

    2004-04-01

    This paper reports on the psychometric properties of a 16-item parent-report Gender Identity Questionnaire, originally developed by P. H. Elizabeth and R. Green (1984), to aid in the assessment of children with potential problems in their gender identity development. The questionnaire, which covered aspects of the core phenomenology of gender identity disorder (GID), was completed by parents of gender-referred children (N = 325) and controls (siblings, clinic-referred, and nonreferred; N = 504), who ranged in age from 2.5-12 years (mean age, 7.6 years). Factor-analysis indicated that a one-factor solution, containing 14 of the 16 items with factor loadings > or =.30, best fit the data, accounting for 43.7% of the variance. The gender-referred children had a significantly more deviant total score than did the controls, with a large effect size of 3.70. The GIQ total score had negligible age effects, indicating that the questionnaire has utility for assessing change over time. The gender-referred children who met the complete DSM criteria for GID had a significantly more deviant total score than did the children who were subthreshold for GID, although the latter group had a mean score that was closer to the threshold cases than to the controls. With a specificity rate set at 95% for the controls, the sensitivity rate for the probands was 86.8%. It is concluded that this parent-report gender identity questionnaire has excellent psychometric properties and can serve as a useful screening device for front-line clinicians, for whom more extensive, expensive, and time-consuming assessment procedures may be precluded.

  14. Care plans using concept maps and their effects on the critical thinking dispositions of nursing students.

    PubMed

    Atay, Selma; Karabacak, Ukke

    2012-06-01

    It is expected that nursing education improves abilities of students in solving problems, decision making and critical thinking in different circumstances. This study was performed to analyse the effects of care plans prepared using concept maps on the critical thinking dispositions of students. An experimental group and a control group were made up of a total of 80 freshman and sophomore students from the nursing department of a health school. The study used a pre-test post-test control group design. The critical thinking dispositions of the groups were measured using the California Critical Thinking Disposition Inventory. In addition, the care plans prepared by the experimental group students were evaluated using the criteria for evaluating care plans with concept maps. T-test was used in analysing the data. The results showed that there were no statistically significant differences in the total and sub-scale pre-test scores between the experimental group and control group students. There were also significant differences in the total and sub-scale post-test scores between the experimental group and control group students. There were significant differences between concept map care plan evaluation criteria mean scores of the experimental students. In the light of these findings, it could be argued that the concept mapping strategy improves critical thinking skills of students. © 2012 Blackwell Publishing Asia Pty Ltd.

  15. Impact of oral conditions on the quality of life of secondary schoolchildren in Nigeria.

    PubMed

    Oziegbe, Elizabeth O; Esan, Temitope A; Adesina, Bola A

    2012-01-01

    Oral health problems have been increasingly recognized as important factors causing a negative impact on daily performance and quality of life. The purpose of this study was to assess the impact of tooth extraction with no replacement, untreated fractured anterior teeth, malocclusion, dental restorations, and orthodontic braces on the quality of life in Nigerian schoolchildren. A total of 197 9- to 17-year-old schoolchildren completed the Oral Health Impact Profile (OHIP) index/questionnaire. Students who had tooth extraction with no replacement and untreated fractured incisors had significantly higher mean OHIP scores for functional limitations, physical pain, psychological discomfort, physical, psychological, and social disabilities, and handicaps (P<.001) when compared to other groups and the control. The mean OHIP scores of students with features of malocclusion were significantly higher for functional limitations, psychological discomfort, and psychological disability compared to the control group (P<.001). Untreated dental problems had some negative impact on the quality of life on the 7 subscales of the OHIP.

  16. Conflict resolution abilities in children with Specific Language Impairment.

    PubMed

    Paula, Erica Macêdo de; Befi-Lopes, Debora Maria

    2013-01-01

    To investigate the conflict resolution abilities of children with Specific Language Impairment, and to verify whether the time of speech-language therapy correlates to the performance on the conflict resolution task. Participants included 20 children with Specific Language Impairment (Research Group) and 40 children with normal language development (Control Group), with ages ranging from 7 years to 8 years and 11 months. To assess the conflict resolution abilities, five hypothetical contexts of conflict were presented. The strategies used by the children were classified and scored by the following levels: level 0 (solutions that do not match the other levels), level 1 (physical solutions), level 2 (unilateral solutions), level 3 (cooperative solutions), and level 4 (mutual solutions). Statistical analysis showed group effect for the variable total score. There was a difference between the groups for modal development level, with higher level of modal development observed in the Control Group. There was no correlation between the period of speech-language therapy attendance and the total score. Children with Specific Language Impairment present difficulties in solving problems, in view of the fact that they mainly use physical and unilateral strategies. There was no correlation between the time of speech-language therapy and performance in the task.

  17. Increased menopausal symptoms among Afro-Colombian women as assessed with the Menopause Rating Scale.

    PubMed

    Monterrosa, Alvaro; Blumel, Juan E; Chedraui, Peter

    2008-02-20

    Increased frequency and severity of menopausal symptoms have been associated to black race. However, this situation has not been described in any Latin American population. Compare frequency and severity of menopausal symptoms among Afro and non-Afro Hispanic Colombian climacteric women. In this cross-sectional study, healthy Afro and non-Afro-Colombian women aged 40-59 years were asked to fill out the Menopause Rating Scale (MRS) questionnaire in order to compare symptom frequency and intensity. A total of 578 women were surveyed (201 Afro-Colombian and 377 non-Afro-Colombian). Mean age of the whole sample was 47.9+/-5.9 years (median 47), with no differences among studied groups in terms of age, parity, and hormone therapy (HT) use. Intensity of menopausal symptoms, assessed with the total MRS score, was found to be significantly higher among Afro-Colombian women (10.6+/-6.7 vs. 7.5+/-5.7, p=0.0001), which was due to higher somatic and psychological subscale scores. In this group, the frequency of somatic symptoms, heart discomfort and muscle and joint problems, was found to be higher than in non-Afro-Colombian women (38.8% vs. 26.8% and 77.1% vs. 43.5%, respectively, p<0.05); equally, all items of the psychological subscale (depressive mood, irritability, anxiety and physical exhaustion) were also found to be higher among black women. On the other hand, compared to black women non-Afro-Colombian ones presented more bladder problems (24.9% vs. 14.9%, p=0.005). After adjusting for confounding factors, logistic regression analysis determined that black race increased the risk for presenting higher total MRS scorings (OR: 2.31; CI 95%: 1.55-3.45, p=0.0001). Despite the limitations of this study, as determined with the MRS Afro-Colombian women exhibited more impaired quality of life (QoL) when compared to non-Afro-Colombian ones, due to a higher rate and severity of menopausal somatic and psychological symptoms.

  18. Prevalence and Factors Associated with Female Sexual Dysfunction in Beijing, China

    PubMed Central

    Lou, Wen-Jia; Chen, Bo; Zhu, Lan; Han, Shao-Mei; Xu, Tao; Lang, Jing-He; Zhang, Lei

    2017-01-01

    Background: Female sexual dysfunction (FSD) is a highly prevalent and often underestimated problem. However, large-scale, population-based epidemiological surveys of FSD are scarce in China. The present study was conducted to evaluate the prevalence and the potential risk factors of FSD across a selection of social groups in Beijing, China, based on the Female Sexual Function Index (FSFI). Methods: A cross-sectional study based on the multiple-stage cluster sampling was performed with adult women throughout the Dongcheng and Shunyi districts of Beijing. The Chinese version of FSFI was used, as well as questions on demographic characteristics, the disease-related context, and social relationships. Results: A total of 6000 consecutive women entered this study, with an actual response from 5024 women, corresponding to a response rate of 83.7%. A total of 4697 (78.3%) questionnaires were effective. The prevalence of adult FSD in Beijing was 2973 (63.3%) using a score of 26.55 as the boundary value, whereas the total mean FSFI score was 23.92 ± 6.37. However, 1423 (30.3%) women did not seek help. By multivariate logistic regression analysis, the possible potential risk factors included age (odds ratio [OR] = 1.051), dissatisfaction with the spouse's sexual ability (OR = 3.520), poor marital affection (OR = 2.087), spouse sexual difficulties (OR = 1.720), dissatisfaction with married life (OR = 1.476), living in a rural area (OR = 1.292), chronic pelvic pain (OR = 1.261), chronic disease (OR = 1.534), previous pelvic surgery (OR = 1.605), vaginal delivery (OR = 2.285), lower education (OR = 3.449) and postmenopausal (OR = 3.183). Conclusions: As suggested by the FSFI scores, female sexual problems are highly prevalent in Beijing. Dissatisfaction with the spouse's sexual ability, poor marital affection, sexual difficulties of the spouse, dissatisfaction with the marriage, rural life, CPP, and postmenopausal were conceivable risk factors for FSD in Beijing women. PMID:28584199

  19. International epidemiology of child and adolescent psychopathology ii: integration and applications of dimensional findings from 44 societies.

    PubMed

    Rescorla, Leslie; Ivanova, Masha Y; Achenbach, Thomas M; Begovac, Ivan; Chahed, Myriam; Drugli, May Britt; Emerich, Deisy Ribas; Fung, Daniel S S; Haider, Mariam; Hansson, Kjell; Hewitt, Nohelia; Jaimes, Stefanny; Larsson, Bo; Maggiolini, Alfio; Marković, Jasminka; Mitrović, Dragan; Moreira, Paulo; Oliveira, João Tiago; Olsson, Martin; Ooi, Yoon Phaik; Petot, Djaouida; Pisa, Cecilia; Pomalima, Rolando; da Rocha, Marina Monzani; Rudan, Vlasta; Sekulić, Slobodan; Shahini, Mimoza; de Mattos Silvares, Edwiges Ferreira; Szirovicza, Lajos; Valverde, José; Vera, Luis Anderssen; Villa, Maria Clara; Viola, Laura; Woo, Bernardine S C; Zhang, Eugene Yuqing

    2012-12-01

    To build on Achenbach, Rescorla, and Ivanova (2012) by (a) reporting new international findings for parent, teacher, and self-ratings on the Child Behavior Checklist, Youth Self-Report, and Teacher's Report Form; (b) testing the fit of syndrome models to new data from 17 societies, including previously underrepresented regions; (c) testing effects of society, gender, and age in 44 societies by integrating new and previous data; (d) testing cross-society correlations between mean item ratings; (e) describing the construction of multisociety norms; (f) illustrating clinical applications. Confirmatory factor analyses (CFAs) of parent, teacher, and self-ratings, performed separately for each society; tests of societal, gender, and age effects on dimensional syndrome scales, DSM-oriented scales, Internalizing, Externalizing, and Total Problems scales; tests of agreement between low, medium, and high ratings of problem items across societies. CFAs supported the tested syndrome models in all societies according to the primary fit index (Root Mean Square Error of Approximation [RMSEA]), but less consistently according to other indices; effect sizes were small-to-medium for societal differences in scale scores, but very small for gender, age, and interactions with society; items received similarly low, medium, or high ratings in different societies; problem scores from 44 societies fit three sets of multisociety norms. Statistically derived syndrome models fit parent, teacher, and self-ratings when tested individually in all 44 societies according to RMSEAs (but less consistently according to other indices). Small to medium differences in scale scores among societies supported the use of low-, medium-, and high-scoring norms in clinical assessment of individual children. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Subjective well-being among African-Americans with spinal cord injury: an exploratory study between men and women.

    PubMed

    Krause, James S; Broderick, Lynne E; Broyles, Joy

    2004-01-01

    The purpose of this study was to identify gender differences in subjective well-being among 309 African-American participants with spinal cord injury (SCI). Cross-sectional. A Southeastern specialty hospital. There were a total of 309 participants, all of whom were African-Americans. All participants had traumatic SCI, were at least 18 years or older at the time of the study, and a minimum of one year had passed since SCI onset. Measures of subjective well-being included the Life Situation Questionnaire--Revised, Purpose in Life scale, and the Older Adult Health and Mood Questionnaire. Multiple gender differences were observed, with women reporting higher scores on depressive symptoms and negative affect, but lower scores on purpose in life. Other significant findings were observed related to self-reported problems, with men reporting greater problems with pressure ulcers and sexual issues and women reporting greater problems in several areas related to coping and affect. The only gender difference in life satisfaction indicated greater satisfaction with sex life among women. It is clear from the findings that differences do exist among male and female African-Americans with spinal cord injuries. More research is needed to definitively outline differences.

  1. Voiding dysfunction in patients with nasal congestion treated with pseudoephedrine: a prospective study.

    PubMed

    Shao, I-Hung; Wu, Chia-Chen; Tseng, Hsiao-Jung; Lee, Ta-Jen; Lin, Yu-Hsiang; Tam, Yuan-Yun

    2016-01-01

    Pseudoephedrine is a sympathomimetic drug widely used as a nasal decongestant. However, it can cause adverse effects, such as voiding dysfunction. The risk of voiding dysfunction remains uncertain in patients without subjective voiding problems. We prospectively enrolled patients with nasal congestion who required treatment with pseudoephedrine from May to August 2015. All patients denied concomitant subjective voiding problem. The International Prostate Symptom Score (IPSS) questionnaire was used to evaluate voiding function before and 1 week after the pseudoephedrine treatment. The results of the IPSS questionnaire were analyzed as the total (IPSS-T), voiding (IPSS-V), storage (IPSS-S), and quality of life due to urinary symptom scores. We enrolled 131 males with a mean age of 42.0±14.3 years. The IPSS-T, IPSS-V, and IPSS-S scores slightly increased after the medication (IPSS-T increased from 6.49 to 6.77, IPSS-V from 3.33 to 3.53, and IPSS-S from 3.17 to 3.24). The quality of life due to urinary symptom score nonsignificantly decreased from 2.02 to 1.87. We observed that older age and a higher premedication IPSS-V score yielded significant differences (P<0.05) for subclinical voiding dysfunction and unchanged voiding function. In patients aged ≥50 years, the IPSS-T, IPSS-V, and IPSS-S scores significantly increased after the pseudoephedrine treatment (IPSS-T increased from 9.95 to 11.45, IPSS-V from 5.38 to 6.07, and IPSS-S 4.57 to 5.38), whereas the quality of life due to urinary symptom score nonsignificantly decreased from 2.71 to 2.48 (P=0.057). In patients aged <50 years, all scores did not significantly differ. Pseudoephedrine treatment for nasal congestion requires extra precautions in males >50 years, even without subjective voiding symptoms.

  2. Voiding dysfunction in patients with nasal congestion treated with pseudoephedrine: a prospective study

    PubMed Central

    Shao, I-Hung; Wu, Chia-Chen; Tseng, Hsiao-Jung; Lee, Ta-Jen; Lin, Yu-Hsiang; Tam, Yuan-Yun

    2016-01-01

    Background Pseudoephedrine is a sympathomimetic drug widely used as a nasal decongestant. However, it can cause adverse effects, such as voiding dysfunction. The risk of voiding dysfunction remains uncertain in patients without subjective voiding problems. Methodology We prospectively enrolled patients with nasal congestion who required treatment with pseudoephedrine from May to August 2015. All patients denied concomitant subjective voiding problem. The International Prostate Symptom Score (IPSS) questionnaire was used to evaluate voiding function before and 1 week after the pseudoephedrine treatment. The results of the IPSS questionnaire were analyzed as the total (IPSS-T), voiding (IPSS-V), storage (IPSS-S), and quality of life due to urinary symptom scores. Results We enrolled 131 males with a mean age of 42.0±14.3 years. The IPSS-T, IPSS-V, and IPSS-S scores slightly increased after the medication (IPSS-T increased from 6.49 to 6.77, IPSS-V from 3.33 to 3.53, and IPSS-S from 3.17 to 3.24). The quality of life due to urinary symptom score nonsignificantly decreased from 2.02 to 1.87. We observed that older age and a higher premedication IPSS-V score yielded significant differences (P<0.05) for subclinical voiding dysfunction and unchanged voiding function. In patients aged ≥50 years, the IPSS-T, IPSS-V, and IPSS-S scores significantly increased after the pseudoephedrine treatment (IPSS-T increased from 9.95 to 11.45, IPSS-V from 5.38 to 6.07, and IPSS-S 4.57 to 5.38), whereas the quality of life due to urinary symptom score nonsignificantly decreased from 2.71 to 2.48 (P=0.057). In patients aged <50 years, all scores did not significantly differ. Conclusion Pseudoephedrine treatment for nasal congestion requires extra precautions in males >50 years, even without subjective voiding symptoms. PMID:27486310

  3. The Strengthening Families Program 10-14: influence on parent and youth problem-solving skill.

    PubMed

    Semeniuk, Y; Brown, R L; Riesch, S K; Zywicki, M; Hopper, J; Henriques, J B

    2010-06-01

    The aim of this paper is to report the results of a preliminary examination of the efficacy of the Strengthening Families Program (SFP) 10-14 in improving parent and youth problem-solving skill. The Hypotheses in this paper include: (1) youth and parents who participated in SFP would have lower mean scores immediately (T2) and 6 months (T3) post intervention on indicators of hostile and negative problem-solving strategies; (2) higher mean scores on positive problem-solving strategies; and (3) youth who participated in SFP would have higher mean scores at T2 and at T3 on indicators of individual problem solving and problem-solving efficacy than youth in the comparison group. The dyads were recruited from elementary schools that had been stratified for race and assigned randomly to intervention or comparison conditions. Mean age of youth was 11 years (SD = 1.04). Fifty-seven dyads (34-intervention&23-control) were videotaped discussing a frequently occurring problem. The videotapes were analysed using the Iowa Family Interaction Rating Scale (IFIRS) and data were analysed using Dyadic Assessment Intervention Model. Most mean scores on the IFIRS did not change. One score changed as predicted: youth hostility decreased at T3. Two scores changed contrary to prediction: parent hostility increased T3 and parent positive problem solving decreased at T2. SFP demonstrated questionable efficacy for problem-solving skill in this study.

  4. Variation in the Early Trajectories of Autism Symptoms Is Related to the Development of Language, Cognition, and Behavior Problems.

    PubMed

    Visser, Janne C; Rommelse, Nanda N J; Lappenschaar, Martijn; Servatius-Oosterling, Iris J; Greven, Corina U; Buitelaar, Jan K

    2017-08-01

    The objectives of this study were to model more homogeneous subgroups within autism spectrum disorder (ASD) based on early trajectories of core symptoms; and to further characterize these subgroups in terms of trajectories of language, cognition, co-occurring (attention-deficit/hyperactivity disorder [ADHD]-related) traits and clinical outcome diagnosis. Children (N = 203) referred for possible ASD at ages 1 to 4 years were assessed at three time points at intervals ranging from 9 months to 3 years. Assessments included standardized measures for ASD (Autism Diagnostic Observation Schedule [ADOS]), language (ADOS-language item), nonverbal IQ (NV-IQ; different tests adequate to chronological/mental age), and parent-reported behavioral problems (Infant-Toddler Social and Emotional Assessment, Child Behavior Checklist). Latent-class growth curve analysis with ADOS total scores led to the identification of three main stable and two small improving groups: a severe-stable group (19.5% of sample)-the only group without considerable language improvement-showed persistent low NV-IQ and marked increase in attention problems over time; a moderate-stable group (21.7%) with below-average increasing NV-IQ; and a mild-stable group (48%) with stable-average NV-IQ and the highest scores on ADHD-related traits, whose ASD outcome diagnoses increased despite stable-low ASD scores. Two groups (each 5.4%) improved: one moved from severe to moderate ASD scores, and the other moved from moderate to mild/nonspectrum scores. Both of these groups improved on language, NV-IQ, and ADHD-related traits. Results support the high stability of ASD symptoms into various severity levels, but also highlight the significant contribution of non-ASD domains in defining and explaining the different ASD trajectories. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. Prosocial Behaviors during School Activities among Child Survivors after the 2011 Earthquake and Tsunami in Japan: A Retrospective Observational Study

    PubMed Central

    Usami, Masahide; Iwadare, Yoshitaka; Watanabe, Kyota; Kodaira, Masaki; Ushijima, Hirokage; Tanaka, Tetsuya; Harada, Maiko; Tanaka, Hiromi; Sasaki, Yoshinori; Okamoto, Seiko; Sekine, Keisuke; Saito, Kazuhiko

    2014-01-01

    Background The 2011 Japan massive tsunami traumatized many children. The aim of this study was to assess changes in strengths and difficulties experienced in home and school by among surviving children after the 2011 tsunami, in comparison with published normal Japanese data. Methods In November 2012 (20 months after the disaster) and September 2013 (30 months after the disaster), the Strengths and Difficulties Questionnaire (SDQ), a questionnaire on children's strengths and difficulties in home and school activities, were distributed to 12,193 and 11,819 children, respectively. An effective response of children 20 months and 30 month after the disaster was obtained in 10,597 children (86.9%), and 10,812 children (91.4%), respectively. The SDQ scores evaluated by parents and teachers were compared with published normal Japanese SDQ scores. Results The SDQ scores (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems, and total difficulty score) evaluated by parents of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly high compared with the published normal data of children without traumatic experiences (all P<0.001). The SDQ scores (prosocial behavior) evaluated by teachers of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly low compared with the published normal data of children without traumatic experiences (all P<0.001). Conclusions This study showed that the experience of the disaster affected those children with prosocial behaviors towards teachers and friends at school. However, no significant changes (in their prosocial attitude) had been seen at home, where they continued to keep their respect and caring feelings for parents. These results indicate that for accurate diagnosis, clinicians should not only evaluate these children's daily activities at home but also try to objectively assess their daily activities at school. PMID:25415450

  6. When psychopathology matters most: identifying sensitive periods when within-person changes in conduct, affective and anxiety problems are associated with male adolescent substance use.

    PubMed

    Cerdá, Magdalena; Prins, Seth J; Galea, Sandro; Howe, Chanelle J; Pardini, Dustin

    2016-05-01

    There is a documented link between common psychiatric disorders and substance use in adolescent males. This study addressed two key questions: (1) is there a within-person association between an increase in psychiatric problems and an increase in substance use among adolescent males and (2) are there sensitive periods during male adolescence when such associations are more evident? Analysis of longitudinal data collected annually on boys selected randomly from schools based on a comprehensive public school enrollment list from the Pittsburgh Board of Education. Recruitment occurred in public schools in Pittsburgh, Pennsylvania, USA. A total of 503 boys assessed at ages 13-19 years, average cooperation rate = 92.1%. Diagnostic and Statistical Manual (DSM)-oriented affective, anxiety and conduct disorder problems were measured with items from the caregiver, teacher and youth version of the Achenbach scales. Scales were converted to t-scores using age- and gender-based national norms and combined by taking the average across informants. Alcohol and marijuana use were assessed semi-annually by a 16-item Substance Use Scale adapted from the National Youth Survey. When male adolescents experienced a 1-unit increase in their conduct problems t-score, their rate of marijuana use subsequently increased by 1.03 [95% confidence interval (CI) = 1.01, 1.05], and alcohol quantity increased by 1.01 (95% CI = 1.0002, 1.02). When adolescents experienced a 1-unit increase in their average quantity of alcohol use, their anxiety problems t-score subsequently increased by 0.12 (95% CI = 0.05, 0.19). These associations were strongest in early and late adolescence. When adolescent boys experience an increase in conduct disorder problems, they are more likely to exhibit a subsequent escalation in substance use. As adolescent boys increase their intensity of alcohol use, they become more likely to develop subsequent anxiety problems. Developmental turning points such as early and late adolescence appear to be particularly sensitive periods for boys to develop comorbid patterns of psychiatric problems and substance use. © 2016 Society for the Study of Addiction.

  7. Differences in depression, anxiety, and quality of life between women with and without breast pain prior to breast cancer surgery.

    PubMed

    Kyranou, Maria; Paul, Steven M; Dunn, Laura B; Puntillo, Kathleen; Aouizerat, Bradley E; Abrams, Gary; Hamolsky, Deborah; West, Claudia; Neuhaus, John; Cooper, Bruce; Miaskowski, Christine

    2013-04-01

    Little is known about the relationships between pain, anxiety, and depression in women prior to breast cancer surgery. The purpose of this study was to evaluate for differences in anxiety, depression, and quality of life (QOL) in women who did and did not report the occurrence of breast pain prior to breast cancer surgery. We hypothesized that women with pain would report higher levels of anxiety and depression as well as poorer QOL than women without pain. A total of 390 women completed self-report measures of pain, anxiety depression, and QOL prior to surgery. Women with preoperative breast pain (28%) were significantly younger, had a lower functional status score, were more likely to be Non-white and to have gone through menopause. Over 37% of the sample reported clinically meaningful levels of depressive symptoms. Almost 70% of the sample reported clinically meaningful levels of anxiety. Patients with preoperative breast pain reported significantly higher depression scores and significantly lower physical well-being scores. No between group differences were found for patients' ratings of state and trait anxiety or total QOL scores. Our a priori hypotheses were only partially supported. Findings from this study suggest that, regardless of pain status, anxiety and depression are common problems in women prior to breast cancer surgery. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Military to civilian questionnaire: a measure of postdeployment community reintegration difficulty among veterans using Department of Veterans Affairs medical care.

    PubMed

    Sayer, Nina A; Frazier, Patricia; Orazem, Robert J; Murdoch, Maureen; Gravely, Amy; Carlson, Kathleen F; Hintz, Samuel; Noorbaloochi, Siamak

    2011-12-01

    The primary objective of this study was to describe the development, reliability, and construct validity of scores on the Military to Civilian Questionnaire (M2C-Q), a 16-item self-report measure of postdeployment community reintegration difficulty. We surveyed a national, stratified sample of 1,226 Iraq and Afghanistan veterans who used U.S. Department of Veterans Affairs (VA) medical care; 745 completed the M2C-Q and validated mental health screening measures. All analyses were based on weighted estimates. The internal consistency of the M2C-Q was .95 in this sample. Factor analyses indicated a single total score was the best-fitting model. Total scores were associated with measures theoretically related to reintegration difficulties including perception of overall difficulty readjusting back into civilian life (R(2) = .49), probable PTSD (d = 1.07), probable problem drug or alcohol use (d = 0.34), and overall mental health (r = -.83). Subgroup analyses revealed a similar pattern of findings in those who screened negative for PTSD. Nonwhite and unemployed veterans reported greater community reintegration difficulty (d = 0.20 and 0.45, respectively). Findings offer preliminary support for the reliability and construct validity of M2C-Q scores. Published 2011. This article is a US Government work and is in the public domain in the USA.

  9. Functional independence of Taiwanese children with Prader-Willi syndrome.

    PubMed

    Lee, Chung-Lin; Lin, Hsiang-Yu; Tsai, Li-Ping; Chiu, Huei-Ching; Tu, Ru-Yi; Huang, You-Hsin; Chien, Yin-Hsiu; Lee, Ni-Chung; Niu, Dau-Ming; Chao, Mei-Chyn; Tsai, Fuu-Jen; Chou, Yen-Yin; Chuang, Chih-Kuang; Lin, Shuan-Pei

    2018-06-01

    Prader-Willi syndrome (PWS) is a genetic disorder with obesity, developmental delay, short stature, and behavioral abnormalities. The study aimed to assess the functional independence in children with PWS. The Functional Independence Measure for Children (WeeFIM) was used to evaluate 81 children with PWS (44 boys and 37 girls) with a median age of 11 years 1 month (range 2 years 8 months to 20 years 2 months) were recruited between January 2013 and December 2016. The mean total WeeFIM score was 103.8 (maximum 126). Sixty-five patients (80%) had deletion type PWS, 16 (20.0%) had nondeletion type. The scores were 103.6 ± 18.5 for deletion and 104.8 ± 18.3 for nondeletion type (p = .405), 104.8 ± 19.3 in boys and 102.6 ± 17.3 in girls (p = .293). The mean self-care, mobility, and cognition scores were 47 (maximum 56), 33 (maximum 35), and 24 (maximum 35), respectively. All total scores and 18 subscores in the three functional domains were positively correlated with age (p < .05). Most children required assistance in problem-solving, comprehension, and expression. The WeeFIM identified the strengths and limitations of children with PWS and confirmed that support and supervision were needed in cognitive and self-care tasks. © 2018 Wiley Periodicals, Inc.

  10. Medical laboratory science and nursing students' perception of academic learning environment in a Philippine university using Dundee Ready Educational Environment Measure (DREEM).

    PubMed

    Barcelo, Jonathan M

    2016-01-01

    This study aimed to compare the perception of the academic learning environment between medical laboratory science students and nursing students at Saint Louis University, Baguio City, Philippines. A cross-sectional survey research design was used to measure the perceptions of the participants. A total of 341 students from the Department of Medical Laboratory Science, School of Natural Sciences, and the School of Nursing answered the Dundee Ready Education Environment Measure (DREEM) instrument from April to May 2016. Responses were compared according to course of study, gender, and year level. The total mean DREEM scores of the medical laboratory science students and nursing students did not differ significantly when grouped according to course of study, gender, or year level. Medical laboratory science students had significantly lower mean scores in the sub-domains 'perception of learning' and 'perception of teaching.' Male medical laboratory science students had significantly lower mean scores in the sub-domain 'perception of learning' among second year students. Medical laboratory science students had significantly lower mean scores in the sub-domain 'perception of learning.' Nursing students identified 7 problem areas, most of which were related to their instructors. Medical laboratory science and nursing students viewed their academic learning environment as 'more positive than negative.' However, the relationship of the nursing instructors to their students needs improvement.

  11. Testing a computer-based ostomy care training resource for staff nurses.

    PubMed

    Bales, Isabel

    2010-05-01

    Fragmented teaching and ostomy care provided by nonspecialized clinicians unfamiliar with state-of-the-art care and products have been identified as problems in teaching ostomy care to the new ostomate. After conducting a literature review of theories and concepts related to the impact of nurse behaviors and confidence on ostomy care, the author developed a computer-based learning resource and assessed its effect on staff nurse confidence. Of 189 staff nurses with a minimum of 1 year acute-care experience employed in the acute care, emergency, and rehabilitation departments of an acute care facility in the Midwestern US, 103 agreed to participate and returned completed pre- and post-tests, each comprising the same eight statements about providing ostomy care. F and P values were computed for differences between pre- and post test scores. Based on a scale where 1 = totally disagree and 5 = totally agree with the statement, baseline confidence and perceived mean knowledge scores averaged 3.8 and after viewing the resource program post-test mean scores averaged 4.51, a statistically significant improvement (P = 0.000). The largest difference between pre- and post test scores involved feeling confident in having the resources to learn ostomy skills independently. The availability of an electronic ostomy care resource was rated highly in both pre- and post testing. Studies to assess the effects of increased confidence and knowledge on the quality and provision of care are warranted.

  12. Autistic traits in children with ADHD index clinical and cognitive problems.

    PubMed

    Cooper, Miriam; Martin, Joanna; Langley, Kate; Hamshere, Marian; Thapar, Anita

    2014-01-01

    Traits of autistic spectrum disorders (ASD) occur frequently in attention deficit hyperactivity disorder (ADHD), but the significance of their presence in terms of phenotype and underlying neurobiology is not properly understood. This analysis aimed to determine whether higher levels of autistic traits, as measured by the Social Communication Questionnaire (SCQ), index a more severe presentation in a large, rigorously phenotyped sample of children with ADHD (N=711). Regression analyses were used to examine association of SCQ scores with core ADHD features, clinical comorbidities and cognitive and developmental features, with adjustment for putative confounders. For outcomes showing association with total SCQ score, secondary analyses determined levels of differential association of the three ASD sub-domains. Results suggest that increasing ASD symptomatology within ADHD is associated with a more severe phenotype in terms of oppositional, conduct and anxiety symptoms, lower full-scale IQ, working memory deficits and general motor problems. These associations persisted after accounting for ADHD severity, suggesting that autistic symptomatology independently indexes the severity of comorbid impairments in the context of ADHD. Sub-domain scores did not show unique contributions to most outcomes, except that social deficits were independently associated with oppositional symptoms and repetitive behaviours independently predicted hyperactive-impulsive symptoms and motor problems. It would be worthwhile for clinicians to consider levels of socio-communicative and repetitive traits in those with ADHD who do not meet diagnostic criteria for ASD, as they index higher levels of phenotypic complexity, which may have implications for efficacy of interventions.

  13. The Origins of Mental Toughness - Prosocial Behavior and Low Internalizing and Externalizing Problems at Age 5 Predict Higher Mental Toughness Scores at Age 14.

    PubMed

    Sadeghi Bahmani, Dena; Hatzinger, Martin; Gerber, Markus; Lemola, Sakari; Clough, Peter J; Perren, Sonja; von Klitzing, Kay; von Wyl, Agnes; Holsboer-Trachsler, Edith; Brand, Serge

    2016-01-01

    The concept of mental toughness (MT) has gained increasing importance among groups other than elite athletes by virtue of its psychological importance and explanatory power for a broad range of health-related behaviors. However, no study has focused so far on the psychological origins of MT. Therefore, the aims of the present study were: to explore, to what extent the psychological profiles of preschoolers aged five were associated with both (1) MT scores and (2) sleep disturbances at age 14, and 3) to explore possible gender differences. Nine years after their first assessment at age five (preschoolers), a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females) took part in this follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ), covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, MT, and sleep disturbances. Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, were associated with self-reported higher MT and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbances. The pattern of results suggests that MT traits during adolescence may have their origins in the pre-school years.

  14. Influence of curriculum type on student performance in the United States Medical Licensing Examination Step 1 and Step 2 exams: problem-based learning vs. lecture-based curriculum.

    PubMed

    Enarson, C; Cariaga-Lo, L

    2001-11-01

    The results of the United States Medical Licensing Examination Step 1 and 2 examinations are reported for students enrolled in a problem-based and traditional lecture-based curricula over a seven-year period at a single institution. There were no statistically significant differences in mean scores on either examination over the seven year period as a whole. There were statistically significant main effects noted by cohort year and curricular track for both the Step 1 and 2 examinations. These results support the general, long-term effectiveness of problem-based learning with respect to basic and clinical science knowledge acquisition. This paper reports the United States Medical Licensing Examination Step 1 and Step 2 results for students enrolled in a problem-based and traditional lecture-based learning curricula over the seven-year period (1992-98) in order to evaluate the adequacy of each curriculum in supporting students learning of the basic and clinical sciences. Six hundred and eighty-nine students who took the United States Medical Licensing Examination Step 1 and 540 students who took Step 2 for the first time over the seven-year period were included in the analyses. T-test analyses were utilized to compare students' Step 1 and Step 2 performance by curriculum groups. United States Medical Licensing Examination Step 1 scores over the seven-year period were 214 for Traditional Curriculum students and 208 for Parallel Curriculum students (t-value = 1.32, P=0.21). Mean Step 2 scores over the seven-year period were 208 for Traditional Curriculum students and 206 for Parallel Curriculum students (t-value=1.08, P=0.30). Statistically significant main effects were noted by cohort year and curricular track for both the Step 1 and Step 2 examinations. The totality of experience in both groups, although differing by curricular type, may be similar enough that the comparable scores are what should be expected. These results should be reassuring to curricular planners and faculty that problem-based learning can provide students with the knowledge needed for the subsequent phases of their medical education.

  15. Comparing the symptoms and mechanisms of "dissociation" in dissociative identity disorder and borderline personality disorder.

    PubMed

    Laddis, Andreas; Dell, Paul F; Korzekwa, Marilyn

    2017-01-01

    A total of 75 patients were diagnosed with the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised as having dissociative identity disorder (DID), and 100 patients were diagnosed with the Structured Interview for DSM-IV Personality as having borderline personality disorder (BPD). Both groups were administered the Multidimensional Inventory of Dissociation (MID). DID patients had significantly higher MID scores than BPD patients, different distributions of MID scores, and different MID subscale profiles in 3 ranges of MID scores (0-15, 15-30, 30-45). The core MID symptoms-exhibited at all ranges of MID scores-for DID patients (the presence of alters, identity confusion, and memory problems) and BPD patients (flashbacks, identity confusion, and memory problems) were ostensibly similar but were considered to be mostly produced by different underlying processes. Multiple regression analyses showed that the core MID symptoms of DID patients had different predictors than did the core MID symptoms of BPD patients. Alter identities seemed to generate most-but not all-dissociative phenomena in DID patients, whereas only the 24% highest scoring BPD patients (MID ≥45) seemed to manifest alter-driven dissociative experiences. Most BPD dissociative experiences appeared to be due to 5 other mechanisms: (a) BPD-specific, stress-driven, rapid shifts of self-state; (b and c) nondefensive disruptions of the framework of perceptual organization with or without an accompanying BPD-specific, dissociation-like disintegration of affective/neurocognitive functioning; (d) a defensive distancing or detachment from distress (i.e., simple depersonalization); and (e) Allen, Console, and Lewis's (1999) severe absorptive detachment.

  16. Decreased Visual Function Scores on a Low Luminance Questionnaire Is Associated with Impaired Dark Adaptation.

    PubMed

    Yazdanie, Mohammad; Alvarez, Jason; Agrón, Elvira; Wong, Wai T; Wiley, Henry E; Ferris, Frederick L; Chew, Emily Y; Cukras, Catherine

    2017-09-01

    We investigate whether responses on a Low Luminance Questionnaire (LLQ) in patients with a range of age-related macular degeneration (AMD) severity are associated with their performance on focal dark adaptation (DA) testing and with choroidal thickness. Cross-sectional, single-center, observational study. A total of 113 participants older than 50 years of age with a range of AMD severity. Participants answered the LLQ on the same day they underwent DA testing using a focal dark adaptometer measuring rod intercept time (RIT). We performed univariable and multivariable analyses of the LLQ scores and age, RIT, AMD severity, subfoveal choroidal thickness [SFCT], phakic status, and best-corrected visual acuity. The primary outcome of this study was the score on the 32-question LLQ. Each item in the LLQ is designated to 1 of 6 subscales describing functional problems in low luminance: driving, emotional distress, mobility, extreme lighting, peripheral vision, and general dim lighting. Scores were computed for each subscale, in addition to a weighted total mean score. Responses from 113 participants (mean age, 76.2±9.3 years; 58.4% were female) and 113 study eyes were analyzed. Univariable analysis demonstrated that lower scores on all LLQ subscales were correlated with prolonged DA testing (longer RIT) and decreased choroidal thickness. All associations were statistically significant except for the association of choroidal thickness and "peripheral vision." The strongest association was the LLQ subscale of driving with RIT (r =-0.97, P < 0.001). Multivariable analysis for each of the LLQ subscale outcomes, adjusted for age, included RIT, with total LLQ score, "driving," "extreme lighting," and "mobility" also including choroidal thickness. In all multivariable analyses, RIT had a stronger association than choroidal thickness. This cross-sectional analysis demonstrates associations of patient-reported functional deficits, as assessed on the LLQ, with both reduced DA and reduced choroidal thickness, in a population of older adults with varying degrees of AMD severity and good visual acuity in at least 1 eye. These analyses suggest that local functional measurements of DA testing (RIT) and choroidal thickness are associated with patient-reported functional deficits. Published by Elsevier Inc.

  17. Changes in social interaction over 20 years and the effects of community resources use among community-dwelling elderly persons.

    PubMed

    Watanabe, Kumi; Tanaka, Emiko; Wu, Bailiang; Kobayashi, Zyunko; Mochizuki, Yukiko; Kim, Yeon; Watanabe, Taeko; Okumura, Rika; Ito, Sumio; Anme, Tokie

    2017-01-01

    Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social interaction, including social curiosity and independence, has increased over 20 years. The effect of preventive intervention in local elderly management centers, health care centers, and health promotion facilities may be one of the causes for this increase.

  18. Building research capacity in developing countries: cost-effectiveness of an epidemiology course taught by traditional and video-teleconferencing methods in Pakistan.

    PubMed

    Dodani, Sunita; Songer, Thomas; Ahmed, Zakiuddin; Laporte, Ronald E

    2012-10-01

    Building research capacity in developing countries using cost-effective methods has been recognized as an important pillar for the production of a sound evidence base for decision-making in policy and practice. We assessed the effectiveness and cost-effectiveness of a research training course conducted using traditional methods as well as the video-teleconferencing (VTC) method in Pakistan. A 9-day epidemiology research training course was offered to physicians in Pakistan (92%) and Bangladesh (8%). The course was taught using (1) a traditional classroom face-to face (F2F) method at the Aga Khan University, Karachi, Pakistan, and (2) the VTC method at two medical institutions within Pakistan. In total, 40 participants were selected for the F2F group and 46 for the VTC group. Outcome parameters were assessed pre- and post-course (short-term) as well as after 1 year (long-term). Costs of conducting the training by both methods were also identified using cost-effectiveness analysis. The total study sample included 56 participants (F2F n =38, VTC n=18) for the short-term and 49 participants for the long-term assessment. After the end of the course (Day 9), mean post-test 1 scores showed significant improvement in both groups: 15.08 ± 1.75 in F2F (p=0.001) versus 13.122 ± 1.87 in VTC (p=0.001). Mean scores 1 year after the course (post-test 2) were lower than mean post-test 1 scores in both groups (13.42 ± 2.61 in F2F versus 12.31 ± 2.08 in VTC) but were higher than the baseline pretest scores. The total incremental cost per score gained was higher for the VTC group for both short-term (VTC incremental cost was $166/score gained) and long-term (VTC incremental cost was $458/ score gained) course effectiveness. The use of e-technologies in developing countries proves to be an effective way of building capacity and reducing the problems of brain drain. This initial study provides a foundation from which larger studies may be developed.

  19. Fat scoring: Sources of variability

    USGS Publications Warehouse

    Krementz, D.G.; Pendleton, G.W.

    1990-01-01

    Fat scoring is a widely used nondestructive method of assessing total body fat in birds. This method has not been rigorously investigated. We investigated inter- and intraobserver variability in scoring as well as the predictive ability of fat scoring using five species of passerines. Between-observer variation in scoring was variable and great at times. Observers did not consistently score species higher or lower relative to other observers nor did they always score birds with more total body fat higher. We found that within-observer variation was acceptable but was dependent on the species being scored. The precision of fat scoring was species-specific and for most species, fat scores accounted for less than 50% of the variation in true total body fat. Overall, we would describe fat scoring as a fairly precise method of indexing total body fat but with limited reliability among observers.

  20. The association between dietary intake of folate and physical activity with psychological dimensions of depressive symptoms among students from Iran.

    PubMed

    Yary, Teymoor

    2013-01-01

    Depression in students is a major public health problem. Although several risk factors associated with depression have been identified, the cause of depression is still not clear. Several studies have demonstrated that physical activity and nutrient intake, such as increased levels of B vitamins in serum, decrease symptoms of depression. The aim of this study was to investigate the association between physical activity and dietary intake of vitamins B₆, B₉, and B₁₂ and symptoms of depression among postgraduate students. The results of this study suggest that intake of vitamin B9 may modulate the total score of Center for Epidemiological Studies Depression Scale (CES-D) and two subscales of the CES-D including depressive affect and interpersonal difficulties. This study also showed that moderate/high levels of physical activity were inversely and significantly associated with symptoms of depression (total scores) and three subscales of the CES-D including depressive affect, positive affect, and somatic complaints.

  1. Measurement and associations of pregnancy risk factors with genetic influences, postnatal environmental influences, and toddler behavior

    PubMed Central

    Marceau, Kristine; Hajal, Nastassia; Leve, Leslie D.; Reiss, David; Shaw, Daniel S.; Ganiban, Jody M.; Mayes, Linda C.; Neiderhiser, Jenae M.

    2014-01-01

    This study demonstrates the unique contributions of perinatal risk and genetic and environmental influences on child behavior using data from 561 domestic US adoption triads (birth mothers, adopted child, and adoptive parents). Findings show distinct patterns of associations among genetic (birth mother psychopathology), prenatal (six maternal reported aggregate scores characterizing total obstetric complications, perinatal internalizing symptoms, pregnancy complications, exposure to toxins, substance use, and neonatal complications), and postnatal influences (adoptive parent 18-month internalizing symptoms and over-reactive parenting) and toddler behavior problems (CBCL subscales at 27 months). Findings highlight multiple pathways for toddler’s behavioral development, including genetic, pregnancy, and postnatal main effects. Findings suggest distinct types of pregnancy risk may transmit genetic influences for specific behavior problems rather than broadband problems. PMID:24839336

  2. Providing Hospitalized Patients With an Educational Booklet Increases the Quality of Colonoscopy Bowel Preparation.

    PubMed

    Ergen, William F; Pasricha, Trisha; Hubbard, Francie J; Higginbotham, Tina; Givens, Tonya; Slaughter, James C; Obstein, Keith L

    2016-06-01

    Inadequate bowel preparation is a problem frequently encountered by gastroenterologists who perform colonoscopies on hospitalized patients. A method is needed to increase the quality of bowel preparation in inpatients. An educational booklet has been shown to increase the overall quality of bowel preparation for outpatients. We performed a prospective study to evaluate the effects of an educational booklet on the quality of bowel preparation in a group of hospitalized patients. We performed a randomized, single-blind, controlled trial of all inpatients at a tertiary care medical center scheduled for inpatient colonoscopy from October 2013 through March 2014. They were randomly assigned to groups that were (n = 45) or were not (controls, n = 40) given the booklet before bowel preparation the evening before their colonoscopy. All patients received a standard bowel preparation (clear liquid diet the day before the procedure, followed by split-dose GoLYTELY). At the colonoscopy, the Boston Bowel preparation scale (BBPS) was used to assess bowel preparation. The primary outcome measure was adequate bowel preparation (a total BBPS score ≥6 with all segment scores ≥2). Secondary outcomes assessed included total BBPS score, BBPS segment score, and a total BBPS score of 0. There were no differences between the groups in age, race, sex, body mass index, history of colonoscopy, history of polyps, or time of colonoscopy. Twenty-eight patients who received the booklet (62%) and 14 who did not (35%) had an adequate bowel preparation (P = .012). The number needed to treat to attain adequate bowel preparation was 4. After adjusting for age and history of prior colonoscopies, the odds of achieving an adequate bowel preparation and a higher total BBPS score after receipt of the booklet were 3.14 (95% confidence interval, 1.29-7.83) and 2.27 (95% confidence interval, 1.05-4.88), respectively. Three patients in the booklet group and 9 in the no-booklet group had a BBPS score of 0 (P = .036). The mean BBPS segment score was greater for the booklet group than the no-booklet group (right colon, P = .097; transverse colon, P = .023; left colon, P = .045). In a randomized controlled trial, we found that providing hospitalized patients with an educational booklet on colonoscopy preparation increases the odds of a quality bowel preparation more than 2-fold. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  3. Developmental Eye Movement (DEM) Test Norms for Mandarin Chinese-Speaking Chinese Children.

    PubMed

    Xie, Yachun; Shi, Chunmei; Tong, Meiling; Zhang, Min; Li, Tingting; Xu, Yaqin; Guo, Xirong; Hong, Qin; Chi, Xia

    2016-01-01

    The Developmental Eye Movement (DEM) test is commonly used as a clinical visual-verbal ocular motor assessment tool to screen and diagnose reading problems at the onset. No established norm exists for using the DEM test with Mandarin Chinese-speaking Chinese children. This study aims to establish the normative values of the DEM test for the Mandarin Chinese-speaking population in China; it also aims to compare the values with three other published norms for English-, Spanish-, and Cantonese-speaking Chinese children. A random stratified sampling method was used to recruit children from eight kindergartens and eight primary schools in the main urban and suburban areas of Nanjing. A total of 1,425 Mandarin Chinese-speaking children aged 5 to 12 years took the DEM test in Mandarin Chinese. A digital recorder was used to record the process. All of the subjects completed a symptomatology survey, and their DEM scores were determined by a trained tester. The scores were computed using the formula in the DEM manual, except that the "vertical scores" were adjusted by taking the vertical errors into consideration. The results were compared with the three other published norms. In our subjects, a general decrease with age was observed for the four eye movement indexes: vertical score, adjusted horizontal score, ratio, and total error. For both the vertical and adjusted horizontal scores, the Mandarin Chinese-speaking children completed the tests much more quickly than the norms for English- and Spanish-speaking children. However, the same group completed the test slightly more slowly than the norms for Cantonese-speaking children. The differences in the means were significant (P<0.001) in all age groups. For several ages, the scores obtained in this study were significantly different from the reported scores of Cantonese-speaking Chinese children (P<0.005). Compared with English-speaking children, only the vertical score of the 6-year-old group, the vertical-horizontal time ratio of the 8-year-old group and the errors of 9-year-old group had no significant difference (P>0.05); compared with Spanish-speaking children, the scores were statistically significant (P<0.001) for the total error scores of the age groups, except the 6-, 9-, 10-, and 11-year-old age groups (P>0.05). DEM norms may be affected by differences in language, cultural, and educational systems among various ethnicities. The norms of the DEM test are proposed for use with Mandarin Chinese-speaking children in Nanjing and will be proposed for children throughout China.

  4. Empirically based assessment and taxonomy of psychopathology for ages 1½-90+ years: Developmental, multi-informant, and multicultural findings.

    PubMed

    Achenbach, Thomas M; Ivanova, Masha Y; Rescorla, Leslie A

    2017-11-01

    Originating in the 1960s, the Achenbach System of Empirically Based Assessment (ASEBA) comprises a family of instruments for assessing problems and strengths for ages 1½-90+ years. To provide an overview of the ASEBA, related research, and future directions for empirically based assessment and taxonomy. Standardized, multi-informant ratings of transdiagnostic dimensions of behavioral, emotional, social, and thought problems are hierarchically scored on narrow-spectrum syndrome scales, broad-spectrum internalizing and externalizing scales, and a total problems (general psychopathology) scale. DSM-oriented and strengths scales are also scored. The instruments and scales have been iteratively developed from assessments of clinical and population samples of hundreds of thousands of individuals. Items, instruments, scales, and norms are tailored to different kinds of informants for ages 1½-5, 6-18, 18-59, and 60-90+ years. To take account of differences between informants' ratings, parallel instruments are completed by parents, teachers, youths, adult probands, and adult collaterals. Syndromes and Internalizing/Externalizing scales derived from factor analyses of each instrument capture variations in patterns of problems that reflect different informants' perspectives. Confirmatory factor analyses have supported the syndrome structures in dozens of societies. Software displays scale scores in relation to user-selected multicultural norms for the age and gender of the person being assessed, according to ratings by each type of informant. Multicultural norms are derived from population samples in 57 societies on every inhabited continent. Ongoing and future research includes multicultural assessment of elders; advancing transdiagnostic progress and outcomes assessment; and testing higher order structures of psychopathology. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Problem-Solving After Traumatic Brain Injury in Adolescence: Associations With Functional Outcomes

    PubMed Central

    Wade, Shari L.; Cassedy, Amy E.; Fulks, Lauren E.; Taylor, H. Gerry; Stancin, Terry; Kirkwood, Michael W.; Yeates, Keith O.; Kurowski, Brad G.

    2017-01-01

    Objective To examine the association of problem-solving with functioning in youth with traumatic brain injury (TBI). Design Cross-sectional evaluation of pretreatment data from a randomized controlled trial. Setting Four children’s hospitals and 1 general hospital, with level 1 trauma units. Participants Youth, ages 11 to 18 years, who sustained moderate or severe TBI in the last 18 months (N=153). Main Outcome Measures Problem-solving skills were assessed using the Social Problem-Solving Inventory (SPSI) and the Dodge Social Information Processing Short Stories. Everyday functioning was assessed based on a structured clinical interview using the Child and Adolescent Functional Assessment Scale (CAFAS) and via adolescent ratings on the Youth Self Report (YSR). Correlations and multiple regression analyses were used to examine associations among measures. Results The TBI group endorsed lower levels of maladaptive problem-solving (negative problem orientation, careless/impulsive responding, and avoidant style) and lower levels of rational problem-solving, resulting in higher total problem-solving scores for the TBI group compared with a normative sample (P<.001). Dodge Social Information Processing Short Stories dimensions were correlated (r=.23–.37) with SPSI subscales in the anticipated direction. Although both maladaptive (P<.001) and adaptive (P=.006) problem-solving composites were associated with overall functioning on the CAFAS, only maladaptive problem-solving (P<.001) was related to the YSR total when outcomes were continuous. For the both CAFAS and YSR logistic models, maladaptive style was significantly associated with greater risk of impairment (P=.001). Conclusions Problem-solving after TBI differs from normative samples and is associated with functional impairments. The relation of problem-solving deficits after TBI with global functioning merits further investigation, with consideration of the potential effects of problem-solving interventions on functional outcomes. PMID:28389109

  6. Problem-Solving After Traumatic Brain Injury in Adolescence: Associations With Functional Outcomes.

    PubMed

    Wade, Shari L; Cassedy, Amy E; Fulks, Lauren E; Taylor, H Gerry; Stancin, Terry; Kirkwood, Michael W; Yeates, Keith O; Kurowski, Brad G

    2017-08-01

    To examine the association of problem-solving with functioning in youth with traumatic brain injury (TBI). Cross-sectional evaluation of pretreatment data from a randomized controlled trial. Four children's hospitals and 1 general hospital, with level 1 trauma units. Youth, ages 11 to 18 years, who sustained moderate or severe TBI in the last 18 months (N=153). Problem-solving skills were assessed using the Social Problem-Solving Inventory (SPSI) and the Dodge Social Information Processing Short Stories. Everyday functioning was assessed based on a structured clinical interview using the Child and Adolescent Functional Assessment Scale (CAFAS) and via adolescent ratings on the Youth Self Report (YSR). Correlations and multiple regression analyses were used to examine associations among measures. The TBI group endorsed lower levels of maladaptive problem-solving (negative problem orientation, careless/impulsive responding, and avoidant style) and lower levels of rational problem-solving, resulting in higher total problem-solving scores for the TBI group compared with a normative sample (P<.001). Dodge Social Information Processing Short Stories dimensions were correlated (r=.23-.37) with SPSI subscales in the anticipated direction. Although both maladaptive (P<.001) and adaptive (P=.006) problem-solving composites were associated with overall functioning on the CAFAS, only maladaptive problem-solving (P<.001) was related to the YSR total when outcomes were continuous. For the both CAFAS and YSR logistic models, maladaptive style was significantly associated with greater risk of impairment (P=.001). Problem-solving after TBI differs from normative samples and is associated with functional impairments. The relation of problem-solving deficits after TBI with global functioning merits further investigation, with consideration of the potential effects of problem-solving interventions on functional outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. The relationship between interpersonal problems and occupational stress in physicians.

    PubMed

    Falkum, Erik; Vaglum, Per

    2005-01-01

    This article examined the associations between occupational stress and interpersonal problems in physicians. A nationwide representative sample of Norwegian physicians received the 64-item version of the Inventory of Interpersonal Problems (IIP-64) (N=862, response rate=70%) and six instruments measuring occupational stress. Comparison of means, correlation and reliability statistics and multiple regression analyses were applied. The IIP-64 total score had a significant impact on job satisfaction, perceived unrealistic expectancies, communication with colleagues and nurses and on stress from interaction with patients. Being overly subassertive was related to low job satisfaction. Being overly expressive was linked to the experience of unrealistic expectancies from others and lack of positive feedback, whereas overly competitive physicians tended to have poorer relationships with both colleagues and nurses. Addressing interpersonal problems in medical school and postgraduate training may be a valuable measure to prevent job stress and promote quality of care.

  8. Relationship between sleep quality and mental health according to demographics of 850 patients with chronic obstructive pulmonary disease.

    PubMed

    Eslaminejad, Alireza; Safa, Mitra; Ghassem Boroujerdi, Fatemeh; Hajizadeh, Farzaneh; Pashm Foroush, Maryam

    2017-10-01

    We aimed to study sleep problems in hospitalized chronic obstructive pulmonary disease patients and assess the relationship of sleep quality with mental health and demographics of patients. Our study sample consisted of 850 chronic obstructive pulmonary disease patients hospitalized in Masih Daneshvari Hospital. Demographic data were collected and the Pittsburgh Sleep Quality and mental health questionnaires were filled out for patients. The results showed that 5.9 percent were suffering from severe sleep problems, while 4.7 percent had severe mental problems. A strong positive correlation was found between the total scores of mental health and sleep quality ( p < 0.01). The prevalence of sleep and mental health problems was higher in females compared to males. Mental health and sleep quality play important roles in quality of life of chronic obstructive pulmonary disease patients.

  9. Correlates of AUDIT risk status for male and female college students.

    PubMed

    Demartini, Kelly S; Carey, Kate B

    2009-01-01

    The current study identified gender-specific correlates of hazardous drinker status as defined by the AUDIT. A total of 462 college student volunteers completed the study in 2006. The sample was predominantly Caucasian (75%) and female (55%). Participants completed a survey assessing demographics, alcohol use patterns, and health indices. Scores of 8 or more on the AUDIT defined the at-risk subsample. Logistic regression models determined which variables predicted AUDIT risk status for men and women. The at-risk participants reported higher alcohol use and related problems, elevated sleep problems and lower health ratings. High typical blood alcohol concentration (BAC), lifetime drug use, and psychosocial problems predicted risk status for males. Binge frequency and psychosocial problems predicted risk status for females. Different behavioral profiles emerged for men and women identified as hazardous drinkers on the AUDIT. The efficacy of brief alcohol interventions could be enhanced by addressing these behavioral correlates.

  10. Speech, language, and reading skills in 10-year-old children with palatal clefts: The impact of additional conditions.

    PubMed

    Feragen, Kristin Billaud; Aukner, Ragnhild; Særvold, Tone K; Hide, Øydis

    2017-03-01

    This study examined speech (hypernasality and intelligibility), language, and reading skills in children with a cleft palate, specifically investigating additional conditions to the cleft, in order to differentiate challenges related to a cleft only, and challenges associated with an additional condition. Cross-sectional data collected during routine assessments of speech and language in a centralised treatment setting. Children born with cleft with palatal involvement from four birth cohorts (n=184), aged 10. Speech: SVANTE-N; Language: Language 6-16; Reading: Word Chain Test and Reading Comprehension Test. Descriptive analyses revealed that 123 of the children had a cleft only (66.8%), while 61 children (33.2%) had a cleft that was associated with an additional condition (syndrome, developmental difficulty, attentional difficulties). Due to close associations with the outcome variables, children with specific language impairments and dyslexia were excluded from the sample (n=14). In the total cleft sample, 33.1% had mild to severe hypernasality, and 27.9% had mild to severe intelligibility deviances. Most children with intelligibility and hypernasality scores within the normal range had a cleft without any other condition. A high number of children with developmental difficulties (63.2%) or AD/HD (45.5%) had problems with intelligibility. Hypernasality scores were also associated with developmental difficulties (58.8%), whereas most children with AD/HD had normal hypernasality scores (83.3%). As could be expected, results demonstrated that children with a cleft and an additional condition had language and reading scores below average. Children with a cleft only had language and reading scores within the normal range. Among the children with scores below average, 33.3-44.7% had no other conditions explaining difficulties with language and reading. The findings highlight the need for routine assessments of language and reading skills, in addition to assessments of speech, in children with a cleft, in order to identify potential problems as early as possible. Study designs need to take additional difficulties into account, so that potential problems with language and reading are not ascribed the cleft diagnosis, and can be followed by appropriate treatment and interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The relationship between body composition and femoral neck osteoporosis or osteopenia in adults with previous poliomyelitis.

    PubMed

    Chang, Kwang-Hwa; Tseng, Sung-Hui; Lin, Yu-Ching; Lai, Chien-Hung; Hsiao, Wen-Tien; Chen, Shih-Ching

    2015-04-01

    Articles in the literature describing the association between body composition and osteoporosis in subjects with poliomyelitis are scarce. To assess the relationship between body composition and femoral neck osteoporosis or osteopenia in adults with previous polio. After excluding postmenopausal women, 44 polio (mean age ± standard deviation, 46.1 ± 3.3 years) and 44 able-bodied control volunteers (47.0 ± 4.0 years) participated in the study. Each participant's femoral neck bone mineral density (FNBMD) and whole body composition were measured using dual-energy X-ray absorptiometry. With local reference BMD values of normal young adults installed in the instrument, we obtained T-score values that depended on each FNBMD value. A T-score value of ≤-1.0 indicated decreased T-score, including osteoporosis (T-score ≤ -2.5) and osteopenia (-1.0 to -2.5). This study conducted logistic regression analyses to find factors associated with osteoporosis and osteopenia. Based on the FNBMD T-score values, 60.0% of middle-aged men with polio had osteoporosis. In adjusted logistic regression analyses, total lean tissue mass (Adjusted odds ratio [95% confidence interval], 0.74 [0.56-0.99], P < 0.05) and male gender (947.16 [6.02-148,926.16], P < 0.01) were important factors associated with decreased T-score in polio group. Osteoporosis or osteopenia is a common medical problem for middle-aged men with polio. Reduced total lean tissue mass seems to be one of the important factors associated with osteoporosis or osteopenia among subjects with polio. Further research for a clinical tool to assess lean tissue mass for subjects with polio is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. German version of the intuitive eating scale: Psychometric evaluation and application to an eating disordered population.

    PubMed

    van Dyck, Zoé; Herbert, Beate M; Happ, Christian; Kleveman, Gillian V; Vögele, Claus

    2016-10-01

    Intuitive eating has been described to represent an adaptive eating behaviour that is characterised by eating in response to physiological hunger and satiety cues, rather than situational and emotional stimuli. The Intuitive Eating Scale-2 (IES-2) has been developed to measure such attitudes and behaviours on four subscales: unconditional permission to eat (UPE), eating for physical rather than emotional reasons (EPR), reliance on internal hunger and satiety cues (RHSC), and body-food choice congruence (B-FCC). The present study aimed at validating the psychometric properties of the German translation of the IES-2 in a large German-speaking sample. A second objective was to assess levels of intuitive eating in participants with an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or binge eating disorder). The proposed factor structure of the IES-2 could be confirmed for the German translation of the questionnaire. The total score and most subscale scores were negatively related to eating disorder symptomatology, problems in appetite and emotional awareness, body dissatisfaction, and self-objectification. Women with eating disorders had significantly lower values on all IES-2 subscale scores and the total score than women without an eating disorder diagnosis. Women with a binge eating disorder (BED) diagnosis had higher scores on the UPE subscale compared to participants with anorexia nervosa (AN) or bulimia nervosa (BN), and those diagnosed with AN had higher scores on the EPR subscale than individuals with BN or BED. We conclude that the German IES-2 constitutes a useful self-report instrument for the assessment of intuitive eating in German-speaking samples. Further studies are warranted to evaluate psychometric properties of the IES-2 in different samples, and to investigate its application in a clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Externalizing and internalizing syndromes in relation to school truancy among adolescents in high-risk urban schools.

    PubMed

    Nik Jaafar, Nik Ruzyanei; Tuti Iryani, Mohammad Daud; Wan Salwina, Wan Ismail; Fairuz Nazri, Abdul Rahman; Kamal, Nor Azlin; Prakash, Reddy Jaya; Shah, Shamsul Azhar

    2013-04-01

    To examine the relationship between externalizing/internalizing syndromes and school truancy among Form Four (10th grade) students attending "high-risk" schools in Kuala Lumpur. This is a cross-sectional study conducted upon 16-year-old adolescents attending three high-risk schools in Kuala Lumpur. A total of 373 students completed self-administered questionnaires on the sociodemographic variables and externalizing/internalizing syndromes. The number of truant-days per student during the study period was obtained from the school records. The mean internalizing score, externalizing score and total problem score of those who were truant were found to be significantly higher (P < 0.05) than those who were non-truant. Multiple logistic regressions showed externalizing syndrome (odds ratio [OR] = 1.044; confidence interval [CI] = 1.012-1.078, P = 0.018) significantly predicts truancy but not the internalizing syndrome. Two other psychosocial factors, namely, having divorced parents (OR = 2.495, CI = 1.058-5.886, P = 0.037) and did not understand or were uncertain of the purpose of schooling (OR = 2.621, CI = 1.265-5.433, P = 0.010) were also showed to be stronger predictors of truancy compared to externalizing/internalizing syndromes. Truancy has significant association to externalizing syndrome, in addition to other significant psychosocial variables like parental and schooling factors. This finding indicated the need for comprehensive assessment of students presenting with truant behavior, including the identification of associated psychological and behavioral problems which highlights the roles of mental health professionals in tackling truancy. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  14. Prevalence of juvenile fibromyalgia syndrome in an urban population of Turkish adolescents: impact on depressive symptoms, quality of life and school performance.

    PubMed

    Durmaz, Yunus; Alayli, Gamze; Canbaz, Sevgi; Zahiroglu, Yeliz; Bilgici, Ayhan; Ilhanli, Ilker; Kuru, Omer

    2013-01-01

    Juvenile Fibromyalgia Syndrome (JFMS) is a chronic health condition characterized by widespread musculoskeletal pain and multiple tender points (TP). The objective of this study was to determine the prevalence of JFMS in the urban population of Samsun and to determine the impact of JFMS on depression symptoms, school performance and quality of life (QOL). A cross-sectional study was conducted in 1109 children (mean age (14.8 ± 2.0) years old). A questionnaire was applied to the children and a medical examination including TP was performed. Yunus and Masi's criteria were used for diagnosis of JFMS. The children with JFMS were compared with an age and sex matched non-JFMS group. Depression was assessed with Children's Depression Inventory (CDI) and QOL was evaluated with Pediatric Quality of Life Inventory 4.0 (PedsQL4.0). Sixty-one (5.5%) (13 boys and 48 girls) of 1109 children met the diagnostic criteria of JFMS. While PedsQL scores of children with JFMS were lower than the non-JFMS group for physical, emotional, social, school functioning and total score (P = 0.001), CDI total score was higher in the JFMS group than in the non-JFMS group (P = 0.001). The JFMS group reported more school absences (P = 0.001) and the average school grade was lower in the JFMS group than in the non-JFMS group (P = 0.03). The prevalence of JFMS is high in school age children. Since JFMS is a common problem of childhood, early diagnosis and identification of the disorder and more comprehensive and successful treatment approaches with appropriate psychological assistance may prevent more complex and severe problems in adulthood.

  15. Predicting Motor Skills from Strengths and Difficulties Questionnaire Scores, Language Ability, and Other Features of New Zealand Children Entering Primary School

    ERIC Educational Resources Information Center

    Sargisson, Rebecca J.; Powell, Cheniel; Stanley, Peter; de Candole, Rosalind

    2014-01-01

    The motor and language skills, emotional and behavioural problems of 245 children were measured at school entry. Fine motor scores were significantly predicted by hyperactivity, phonetic awareness, prosocial behaviour, and the presence of medical problems. Gross motor scores were significantly predicted by the presence of medical problems. The…

  16. Assessing the effectiveness of problem-based learning in physical diagnostics education in China: a meta-analysis

    PubMed Central

    Wang, Jianmiao; Xu, Yongjian; Liu, Xiansheng; Xiong, Weining; Xie, Jungang; Zhao, Jianping

    2016-01-01

    Problem-based learning (PBL) has been extensively applied as an experimental educational method in Chinese medical schools over the past decade. A meta-analysis was performed to assess the effectiveness of PBL on students’ learning outcomes in physical diagnostics education. Related databases were searched for eligible studies evaluating the effects of PBL compared to traditional teaching on students’ knowledge and/or skill scores of physical diagnostics. Standardized mean difference (SMD) with 95% confidence interval (CI) was estimated. Thirteen studies with a total of 2086 medical students were included in this meta-analysis. All of these studies provided usable data on knowledge scores, and the pooled analysis showed a significant difference in favor of PBL compared to the traditional teaching (SMD = 0.76, 95%CI = 0.33–1.19). Ten studies provided usable data on skill scores, and a significant difference in favor of PBL was also observed (SMD = 1.46, 95%CI = 0.89–2.02). Statistically similar results were obtained in the sensitivity analysis, and there was no significant evidence of publication bias. These results suggested that PBL in physical diagnostics education in China appeared to be more effective than traditional teaching method in improving knowledge and skills. PMID:27808158

  17. Assessing the effectiveness of problem-based learning in physical diagnostics education in China: a meta-analysis.

    PubMed

    Wang, Jianmiao; Xu, Yongjian; Liu, Xiansheng; Xiong, Weining; Xie, Jungang; Zhao, Jianping

    2016-11-03

    Problem-based learning (PBL) has been extensively applied as an experimental educational method in Chinese medical schools over the past decade. A meta-analysis was performed to assess the effectiveness of PBL on students' learning outcomes in physical diagnostics education. Related databases were searched for eligible studies evaluating the effects of PBL compared to traditional teaching on students' knowledge and/or skill scores of physical diagnostics. Standardized mean difference (SMD) with 95% confidence interval (CI) was estimated. Thirteen studies with a total of 2086 medical students were included in this meta-analysis. All of these studies provided usable data on knowledge scores, and the pooled analysis showed a significant difference in favor of PBL compared to the traditional teaching (SMD = 0.76, 95%CI = 0.33-1.19). Ten studies provided usable data on skill scores, and a significant difference in favor of PBL was also observed (SMD = 1.46, 95%CI = 0.89-2.02). Statistically similar results were obtained in the sensitivity analysis, and there was no significant evidence of publication bias. These results suggested that PBL in physical diagnostics education in China appeared to be more effective than traditional teaching method in improving knowledge and skills.

  18. Enzyme potentiated desensitisation in treatment of seasonal allergic rhinitis: double blind randomised controlled study.

    PubMed

    Radcliffe, Michael J; Lewith, George T; Turner, Richard G; Prescott, Philip; Church, Martin K; Holgate, Stephen T

    2003-08-02

    To assess the efficacy of enzyme potentiated desensitisation in the treatment of severe summer hay fever poorly controlled by pharmacotherapy. Double blind randomised placebo controlled parallel group study. Hospital in Hampshire. 183 participants aged between 18 and 64 with a history of severe summer hay fever for at least two years; all were skin prick test positive to timothy grass pollen. 90 randomised to active treatment; 93 randomised to placebo. Active treatment: two injections of enzyme potentiated desensitisation, given between eight and 11 weeks apart, each comprising 200 Fishman units of beta glucuronidase, 50 pg 1,3-cyclohexanediol, 50 ng protamine sulphate, and a mixed inhaled allergen extract (pollen mixes for trees, grasses, and weeds; allergenic fungal spores; cat and dog danders; dust and storage mites) in a total volume of 0.05 ml of buffered saline. Placebo: two injections of 0.05 ml buffered saline solution. Proportion of problem-free days; global rhinoconjunctivitis quality of life scores assessed weekly during pollen season. The active treatment group and the placebo group did not differ in the proportion of problem-free days, quality of life scores, symptom severity scores, change in quantitative skin prick provocation threshold, or change in conjunctival provocation threshold. No clinically significant adverse reactions occurred. Enzyme potentiated desensitisation showed no treatment effect in this study.

  19. Reliability and Validity of the Diabetes Eating Problem Survey in Turkish Children and Adolescents with Type 1 Diabetes Mellitus.

    PubMed

    Atik Altınok, Yasemin; Özgür, Suriye; Meseri, Reci; Özen, Samim; Darcan, Şükran; Gökşen, Damla

    2017-12-15

    The aim of this study was to show the reliability and validity of a Turkish version of Diabetes Eating Problem Survey-Revised (DEPS-R) in children and adolescents with type 1 diabetes mellitus. A total of 200 children and adolescents with type 1 diabetes, ages 9-18 years, completed the DEPS-R Turkish version. In addition to tests of validity, confirmatory factor analysis was conducted to investigate the factor structure of the 16-item Turkish version of DEPS-R. The Turkish version of DEPS-R demonstrated satisfactory Cronbach's ∝ (0.847) and was significantly correlated with age (r=0.194; p<0.01), hemoglobin A1c levels (r=0.303; p<0.01), and body mass index-standard deviation score (r=0.412; p<0.01) indicating criterion validity. Median DEPS-R scores of Turkish version for the total samples, females, and males were 11.0, 11.5, and 10.5, respectively. Disturbed eating behaviors and insulin restriction were associated with poor metabolic control. A short, self-administered diabetes-specific screening tool for disordered eating behavior can be used routinely in the clinical care of adolescents with type 1 diabetes. The Turkish version of DEPS-R is a valid screening tool for disordered eating behaviors in type 1 diabetes and it is potentially important to early detect disordered eating behaviors.

  20. Cognition in patients with burn injury in the inpatient rehabilitation population.

    PubMed

    Purohit, Maulik; Goldstein, Richard; Nadler, Deborah; Mathews, Katie; Slocum, Chloe; Gerrard, Paul; DiVita, Margaret A; Ryan, Colleen M; Zafonte, Ross; Kowalske, Karen; Schneider, Jeffrey C

    2014-07-01

    To analyze potential cognitive impairment in patients with burn injury in the inpatient rehabilitation population. Rehabilitation patients with burn injury were compared with the following impairment groups: spinal cord injury, amputation, polytrauma and multiple fractures, and hip replacement. Differences between the groups were calculated for each cognitive subscale item and total cognitive FIM. Patients with burn injury were compared with the other groups using a bivariate linear regression model. A multivariable linear regression model was used to determine whether differences in cognition existed after adjusting for covariates (eg, sociodemographic factors, facility factors, medical complications) based on previous studies. Inpatient rehabilitation facilities. Data from Uniform Data System for Medical Rehabilitation from 2002 to 2011 for adults with burn injury (N=5347) were compared with other rehabilitation populations (N=668,816). Not applicable. Comparison of total cognitive FIM scores and subscales (memory, verbal comprehension, verbal expression, social interaction, problem solving) for patients with burn injury versus other rehabilitation populations. Adults with burn injuries had an average total cognitive FIM score ± SD of 26.8±7.0 compared with an average FIM score ± SD of 28.7±6.0 for the other groups combined (P<.001). The subscale with the greatest difference between those with burn injury and the other groups was memory (5.1±1.7 compared with 5.6±1.5, P<.001). These differences persisted after adjustment for covariates. Adults with burn injury have worse cognitive FIM scores than other rehabilitation populations. Future research is needed to determine the impact of this comorbidity on patient outcomes and potential interventions for these deficits. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Joint health and functional ability in children with haemophilia who receive intensive replacement therapy.

    PubMed

    Groen, W; van der Net, J; Bos, K; Abad, A; Bergstrom, B-M; Blanchette, V S; Feldman, B M; Funk, S; Helders, P; Hilliard, P; Manco-Johnson, M; Petrini, P; Zourikian, N; Fischer, K

    2011-09-01

    Joint physical examination is an important outcome in haemophilia; however its relationship with functional ability is not well established in children with intensive replacement therapy. Boys aged 4-16 years were recruited from two European and three North American treatment centres. Joint physical structure and function was measured with the Haemophilia Joint Health Score (HJHS) while functional ability was measured with the revised Childhood Health Assessment Questionnaire (CHAQ₃₈. Two haemophilia-specific domains were created by selecting items of the CHAQ₃₈ that cover haemophilia-specific problems. Associations between CHAQ, HJHS, cumulative number of haemarthroses and age were assessed. A total of 226 subjects - mean 10.8 years old (SD 3.8) - participated; the majority (68%) had severe haemophilia. Most severe patients (91%) were on prophylactic treatment. Lifetime number of haemarthroses [median=5; interquartile range (IQR)=1-12] and total HJHS (median = 5; IQR=1-12) correlated strongly (ρ = 0.51). Total HJHS did not correlate with age and only weakly (ρ=-0.19) with functional ability scores (median=0; IQR=-0.06-0). Overall, haemarthroses were reported most frequently in the ankles. Detailed analysis of ankle joint health scores revealed moderate associations (ρ=0.3-0.5) of strength, gait and atrophy with lower extremity tasks (e.g. stair climbing). In this population, HJHS summating six joints did not perform as well as individual joint scores, however, certain elements of ankle impairment, specifically muscle strength, atrophy and gait associated significantly with functional loss in lower extremity activities. Mild abnormalities in ankle assessment by HJHS may lead to functional loss. Therefore, ankle joints may warrant special attention in the follow up of these children. © 2011 Blackwell Publishing Ltd.

  2. Correlation of VHI-30 to Acoustic Measurements Across Three Common Voice Disorders.

    PubMed

    Dehqan, Ali; Yadegari, Fariba; Scherer, Ronald C; Dabirmoghadam, Peyman

    2017-01-01

    Voice disorders that affect the quality of voice also result in varying degrees of psychological and social problems. The research question here is whether the correlations between Voice Handicap Index (VHI)-30 scores and objective acoustic measures differ in patients with different types of voice disorders. The subjects were divided into three groups: muscle tension dysphonia (MTD), benign mid-membranous vocal fold lesions, and unilateral vocal fold paralysis (UVFP). All participants were male. The mean age for the groups were 32.85 ± 8.6 years in the MTD group, 33.24 ± 7.32 years in the benign lesions group, and 34.24 ± 7.51 years in the UVFP group. The participants completed the Persian VHI-30 questionnaire. PRAAT software was used to obtain acoustic analyses. There was a significant correlation between the physical subscale of the VHI-30 and the total score of the VHI-30 and maximum phonation time (MPT) in the MTD group. Also, there was a significant correlation between the total VHI-30 score and the MPT value. There were relatively strong and significant correlations between the physical subscale of the VHI-30 with jitter and shimmer, harmonics-to-noise ratio (HNR) for the group with benign lesions such as nodules and polyps. Also, in this group, there was a significant correlation between the total VHI-30 score and the jitter value. The physical scale had strong and significant correlations between jitter, shimmer, and HNR in the unilateral paralysis group. Findings suggest that although the VHI-30 and the acoustic measurements of voice provide independent information, they are associated to some extent. Copyright © 2017 The Voice Foundation. All rights reserved.

  3. Are the women with Sjögren's Syndrome satisfied with their sexual activity?

    PubMed

    Isik, Hatice; Isik, Metin; Aynioglu, Oner; Karcaaltincaba, Deniz; Sahbaz, Ahmet; Beyazcicek, Tugba; Harma, Mehmet Ibrahim; Demircan, Nejat

    Females with Sjögren's Syndrome (SS) often experience vaginal dryness and dyspareunia, along with glandular and extraglandular symptoms. We aimed to evaluate sexual function and life quality in women with SS. Forty-six premenopausal women with SS and 47 age-matched controls were studied. Age, duration of the disease, medications, and comorbid diseases were noted. Participants completed 36-Item Short Form Health Survey (SF-36) and Female Sexual Function Index (FSFI). Patients were asked about vaginal discharge and itching in the last month, and if they informed their rheumatologists about any sexual problems. Gynecologic examinations were performed and vaginal smears were taken on each participant. The median total scores of FSFI were significantly lower in the SS group than the controls [17.12 (2.4-27.8) and 27.4 (16.9-36.0), respectively, p<0.001]. In the SS group, 37 (80.4%) and in the control group 18 (38.3%) of patients were sexually dissatisfied (p<0.001). Vaginal dryness and lubricant use were significantly increased in patients with SS compared to controls (p<0.001). Life quality scores were significantly lower in patients with SS than the controls (p<0.001). Vaginal dryness was negatively correlated with FSFI total (r=-0.312, p=0.035) and subscores except desire and arousal. Physical functioning, role physical and role emotional scores were positively correlated with total FSFI scores (r=0.449, p=0.002, r=0.371, p=0.011, r=0.299, p=0.043, respectively). Women with SS experience less satisfaction with sexual activity, which can be affected by age, vaginal dryness, physical pain, and impaired function due to the disease. Therefore, rheumatologists should pay attention to these symptoms and management. Copyright © 2017 Elsevier Editora Ltda. All rights reserved.

  4. Efficacy of a potassium-competitive acid blocker for improving symptoms in patients with reflux esophagitis, non-erosive reflux disease, and functional dyspepsia.

    PubMed

    Asaoka, Daisuke; Nagahara, Akihito; Hojo, Mariko; Matsumoto, Kenshi; Ueyama, Hiroya; Matsumoto, Kohei; Izumi, Kentaro; Takeda, Tsutomu; Komori, Hiroyuki; Akazawa, Yoichi; Shimada, Yuji; Osada, Taro; Watanabe, Sumio

    2017-02-01

    The aim of the present study was to investigate the efficacy of a potassium-competitive acid blocker (PCAB) named vonoprazan (VPZ) for improving symptoms in patients with reflux esophagitis (RE), non-erosive reflux disease (NERD), and functional dyspepsia (FD). A hospital-based, retrospective study of outpatients in our department (Department of Gastroenterology, University of Juntendo, Tokyo, Japan) between March 2015 and August 2016 was performed. The patients who were experiencing heartburn, acid regurgitation, gastric pain, and/or a heavy feeling in the stomach of at least moderate severity at baseline were treated with 20 mg VPZ once daily for 4 weeks. The patients completed the global overall symptom (GOS) scale to determine their symptom severity at baseline and after the 4 week treatment period. The proportions of patients with RE, NERD, and FD achieving improvement of their symptoms, defined as a GOS scale score of 1 ('no problem') or 2 ('minimal problem'), were evaluated. During 4 weeks of VPZ therapy, changes in the gastroesophageal reflux disease (GERD) score, which was defined as the total points for heartburn and acid regurgitation on the GOS scale in patients with RE and NERD, and in the FD score, which was defined as the total points for gastric pain and a heavy feeling in the stomach on the GOS scale in patients with FD, were also evaluated. A total of 88 eligible cases were included in the present study, comprising 20 patients with RE, 25 patients with NERD, and 43 patients with FD. The rates of symptomatic improvement in patients with RE, NERD, and FD were 75.0, 60.0, and 48.8%, respectively. For the patients who were first administered VPZ, the rates of symptomatic improvement were 90.9, 66.7, and 58.8% in patients with RE, NERD, and FD, respectively. For those patients who were resistant to 8 weeks of proton pump inhibitor therapy, the rates of symptomatic improvement were 55.6, 53.8, and 42.3% in patients with RE, NERD, and FD, respectively. The GERD score in patients with RE and NERD, and the FD score in FD patients, were decreased after 4 weeks of VPZ therapy (P<0.01). In patients with RE, NERD and FD, the possibility that PCAB may be used as a novel therapeutic drug was suggested. However, the number of study subjects was small; therefore, further, larger and prospective studies are required.

  5. Prevalence of and risk factors for sexual dysfunction in young Chinese women according to the Female Sexual Function Index: an internet-based survey.

    PubMed

    Du, Juan; Ruan, Xiangyan; Gu, Muqing; Bitzer, Johannes; Mueck, Alfred O

    2016-06-01

    Female sexual dysfunction (FSD) is a very common sexual health problem worldwide. The prevalence of FSD in Chinese women is, however, unknown. This is the first study to investigate a large number of young women throughout China via the internet, to determine the prevalence and types of FSD and to identify the risk factors for FSD. The primary endpoint was the Female Sexual Function Index (FSFI) score, with additional questions on contraception, sexual activity, relationship stability, pregnancy and other factors which may influence sexual function. The online questionnaire was completed by women from 31 of the 34 Chinese provinces. A total of 1618 completed questionnaires were received, and 1010 were included in the analyses after screening (62.4%). The mean age of the respondents was 25.1 ± 4.5 years. The mean total FSFI score was 24.99 ± 4.60. According to FSFI definitions (cut-off score 26.55), 60.2% of women were at risk of FSD. Based on domain scores, 52 were considered at high risk of dysfunction for pain (5.1%), 35 for orgasm (3.5%), 33 for desire (3.3%), 20 for arousal (2.0%), 6 for satisfaction (0.6%) and 2 for lubrication (0.2%). The prevalence of FSFI scores indicating risk of sexual dysfunction was about 60% in Chinese women. An unstable relationship, pressure to become pregnant, non-use of contraception, negative self-evaluation of appearance and increasing age were significantly associated with FSD in young Chinese women.

  6. Sensitivity and specificity of the Brøset Violence Checklist as predictor of violence in forensic psychiatry.

    PubMed

    Hvidhjelm, Jacob; Sestoft, Dorte; Skovgaard, Lene Theil; Bue Bjorner, Jakob

    2014-11-01

    Violence and aggressive behavior within psychiatric facilities are serious work environment problems, which have negative consequences for both patients and staff. It is therefore of great importance to reduce both the number and the severity of these violent incidents to improve quality of care. To evaluate the specificity and sensitivity of the Brøset Violence Checklist (BVC) as a predictor of violent incidents for Danish forensic psychiatry patients. A total of 156 patients were assessed three times daily with the BVC for 24 months. All aggressive or violent incidents were recorded using the Staff Observation Aggression Scale-Revised (SOAS-R). SOAS-R scores of 9 or more defined violent incidents. Data were analyzed using standard logistic regression models as well as models incorporating a random person effect. We used receiver operating curve (ROC) analysis to evaluate different BVC thresholds. Of a total of 139,579 BVC registrations we found 1999 scores above 0 and 419 violent incidents. The BVC score was a strong predictor of violence. For the standard cut-off point of 3, specificity was 0.997 and sensitivity was 0.656. For the general risk of violence seen in this study, the risk of violence given a BVC score > 3 (positive predictive value) was 37.2%, and the risk of violence given a BVC score < 3 (negative predictive value) was 0.1%. The BVC showed satisfactory specificity and sensitivity as a predictor of the short-term risk of violence against staff and others by patients in a forensic setting.

  7. Parent vs burn-injured child self-report: contributions to a better understanding of anxiety levels.

    PubMed

    Rimmer, R B; Bay, R C; Sadler, I J; Alam, N B; Foster, K N; Caruso, D M

    2014-01-01

    Anxiety disorders are the most commonly reported form of mental health problem among youth, but they often go undiagnosed and untreated. This study examined the relationship between burn-injured youths' self-reported anxiety levels, as compared with their parent's perceptions of their child's emotional well-being. Burn-injured children were invited to voluntarily complete the Child Version of the 41-item survey, Screen for Child Anxiety Related Disorders, which consists of five anxiety subscales as well as a Total Anxiety Score. Parents were invited to complete the Parent Version. Sixty-three parent-child dyads, with girls (57%) and boys (43%), completed surveys. Mothers (73%) fathers (16%), and other caregivers (11%) participated. Youth mean age was 12.63 years and 60% reported visible burn scars. Matched-pairs t-tests were used to compare parent and child reports. Significantly lower mean scores were found between Screen for Child Anxiety Related Disorders Total Anxiety Score--Parent mean score of 10.52 vs the Youth mean score 21.06 (P<.001), as well as on all subscales including; panic disorder/somatic symptoms (P<.001), generalized anxiety disorder (P=.004), social anxiety disorder (separation anxiety (P<.001), and school avoidance (P<0.001). Results indicate that parents may be severely underestimating the psychological well-being of burn-injured youth. Findings emphasize the importance of a comprehensive approach in assessment for anxiety, involving the collection of feedback from both child and parent. Asking children for input into their psychological well-being is important. This study reinforces the need for a course of ongoing patient and parent education.

  8. Measuring mental health following the 6-year American invasion of Iraq. A general health questionnaire analysis of Iraqi medical and dentistry students.

    PubMed

    Al-Nimer, Marwan S

    2010-01-01

    To explore the current psychological problems among Iraqi medical and dentistry students using a General Health Questionnaire after 6 years of armed conflicts. This study was carried out in the Department of Pharmacology, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq from January to May 2009. A total of 440 medical and dentistry students were asked to complete the 12-item (GHQ-12) and 30-item (GHQ-30) General Health Questionnaire-Arabic version to measure the level of their psychological distress. The analysis of this cross-sectional study is based on a voluntary self-rating questionnaire survey of the assessment of common mental problems. Based on the GHQ-12, using simple Likert scoring, probable psychiatric illness (score >12) was approximately equal in dentistry (50.6%; 89 out of 176) and medical (51.1%; 135 out of 264) students, with an odds ratio of 1.138. Based on GHQ-30 using binary scoring, the probable cases (score > or = 5) were reported significantly (p<0.001) higher in medical students than dentistry students, with an odds ratio of 3.251. The means of overall categorized psychiatric morbidity, other than social dysfunction, reported in male dentistry students were non-significantly higher than corresponding medical students. The impact of armed conflicts is obvious, therefore, medical and dentistry students need to receive effective mental health outreach and treatment, including lifestyle modification, at each stage of college life.

  9. Identity development in adolescents with mental problems.

    PubMed

    Jung, Emanuel; Pick, Oliver; Schlüter-Müller, Susanne; Schmeck, Klaus; Goth, Kirstin

    2013-07-31

    In the revision of the Diagnostic and Statistical Manual (DSM-5), "Identity" is an essential diagnostic criterion for personality disorders (self-related personality functioning) in the alternative approach to the diagnosis of personality disorders in Section III of DSM-5. Integrating a broad range of established identity concepts, AIDA (Assessment of Identity Development in Adolescence) is a new questionnaire to assess pathology-related identity development in healthy and disturbed adolescents aged 12 to 18 years. Aim of the present study is to investigate differences in identity development between adolescents with different psychiatric diagnoses. Participants were 86 adolescent psychiatric in- and outpatients aged 12 to 18 years. The test set includes the questionnaire AIDA and two semi-structured psychiatric interviews (SCID-II, K-DIPS). The patients were assigned to three diagnostic groups (personality disorders, internalizing disorders, externalizing disorders). Differences were analyzed by multivariate analysis of variance MANOVA. In line with our hypotheses, patients with personality disorders showed the highest scores in all AIDA scales with T>70. Patients with externalizing disorders showed scores in an average range compared to population norms, while patients with internalizing disorders lay in between with scores around T=60. The AIDA total score was highly significant between the groups with a remarkable effect size of f= 0.44. Impairment of identity development differs between adolescent patients with different forms of mental disorders. The AIDA questionnaire is able to discriminate between these groups. This may help to improve assessment and treatment of adolescents with severe psychiatric problems.

  10. Knowledge of attention deficit hyperactivity disorder and its associated factors among teachers in 3 large primary schools in Phra Nakorn Sri Ayutthaya Province, Thailand.

    PubMed

    Muanprasart, Pongchanok; Traivaree, Chanchai; Arunyanart, Wirongrong; Teeranate, Chakriya

    2014-02-01

    Though attention deficit, hyperactivity disorder ADHD is a common problem in childhood. Thai teachers' knowledge regarding the disease has never been assessed. To identify knowledge of Thai teachers regardingADHD and its influencingfactors. Cross-sectional study was operated in three primary schools in Ayutthaya, Thailand. Standardized questionnaires comprised ofdemographic data, ADHD experiences and the Knowledge of Attention Deficit Disorder Scale, KADDS, were distributed to participating teachers. Results were reported using frequency, percent, mean, and standard deviation. Association between demographic and ADHD experiences and the KADDS score was identified by logistic regression analysis. Lack ofknowledge of ADHD among teachers was apparent. Only 19.4% of them passed the total scale of KADDS. Teachers under 31-years-old were more likely to pass general information and signs, symptoms & diagnosis subscales and total scale. In addition, familiarity with ADHD patients was associated with passing scores of general information subscale and total scale. Despite public awareness of ADHD, Thai teachers lacked knowledge concerning the disease. Young teachers were more acquainted with ADHD. Direct experience with ADHD patient might help teachers develop their knowledge on ADHD.

  11. Problem and pro-social behavior among Nigerian children with intellectual disability: the implication for developing policy for school based mental health programs

    PubMed Central

    2010-01-01

    Background School based mental health programs are absent in most educational institutions for intellectually disabled children and adolescents in Nigeria and co-morbid behavioral problems often complicate intellectual disability in children and adolescents receiving special education instructions. Little is known about prevalence and pattern of behavioral problems existing co-morbidly among sub-Saharan African children with intellectual disability. This study assessed the prevalence and pattern of behavioral problems among Nigerian children with intellectual disability and also the associated factors. Method Teachers' rated Strengths and Difficulties Questionnaire (SDQ) was used to screen for behavioral problems among children with intellectual disability in a special education facility in south eastern Nigeria. Socio-demographic questionnaire was used to obtain socio-demographic information of the children. Results A total of forty four (44) children with intellectual disability were involved in the study. Twenty one (47.7%) of the children were classified as having behavioral problems in the borderline and abnormal categories on total difficulties clinical scale of SDQ using the cut-off point recommended by Goodman. Mild mental retardation as compared to moderate, severe and profound retardation was associated with highest total difficulties mean score. Males were more likely to exhibit conduct and hyperactivity behavioral problems compared to the females. The inter-clinical scales correlations of teachers' rated SDQ in the studied population also showed good internal consistency (Cronbach Alpha = 0.63). Conclusion Significant behavioral problems occur co-morbidly among Nigerian children with intellectual disability receiving special education instructions and this could impact negatively on educational learning and other areas of functioning. There is an urgent need for establishing school-based mental health program and appropriate screening measure in this environment. These would afford early identification of intellectually disabled children with behavioral problems and appropriate referral for clinical evaluation and interventions. The need to focus policy making attention on hidden burden of intellectual disability in sub-Saharan African children is essential. PMID:20465841

  12. The long-term effects of parental divorce on the mental health of young adults: a developmental perspective.

    PubMed

    Chase-Lansdale, P L; Cherlin, A J; Kiernan, K E

    1995-12-01

    The effects of parental divorce during childhood and adolescence on the mental health of young adults (age 23) were examined, using the National Child Development Study (NCDS), a longitudinal, multimethod, nationally representative survey of all children born in Great Britain during 1 week in 1958 (N = 17,414). Children were assessed at birth and subsequently followed up at ages 7, 11, 16, and 23 by means of maternal and child interviews, and by psychological, school, and medical assessments. Parental divorce had a moderate, long-term negative impact on adult mental health, as measured by the Malaise Inventory total score, and controlling for economic status, children's emotional problems, and school performance preceding marital dissolution. The likelihood of scoring above the clinical cutoff of the Malaise Inventory rose from 8% to 11% due to parental divorce. This indicated that the relative risk of serious emotional disorders increased in the aftermath of divorce, but that the large majority of individuals did not exhibit such risks. Path analyses revealed that the negative effects of divorce on adult mental health operated indirectly through higher emotional problems and lower levels of school achievement and family economic status at age 16. Results related to timing of divorce, remarriage, and interactions between age 7 emotional problems and divorce, and between age 7 emotional problems and child gender, are also discussed.

  13. A speech and psychological profile of treatment-seeking adolescents who stutter.

    PubMed

    Iverach, Lisa; Lowe, Robyn; Jones, Mark; O'Brian, Susan; Menzies, Ross G; Packman, Ann; Onslow, Mark

    2017-03-01

    The purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter. Participants were 102 adolescents (11-17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11-14 years, n=57) and older (15-17 years, n=45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering. The impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems-aggression, rule-breaking-in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering. To our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter. Copyright © 2016. Published by Elsevier Inc.

  14. The effects of maternal stress and child language ability on behavioral outcomes of children with congenital hearing loss at 18-24months.

    PubMed

    Topol, Deborah; Girard, Nicole; St Pierre, Lucille; Tucker, Richard; Vohr, Betty

    2011-12-01

    Prior studies have shown that children with congenital hearing loss have increased rates of behavior disorders. Child hearing loss has also been reported to be associated with increased maternal stress. Little is known about the behavior or the predictors of behavioral outcomes of children with hearing loss identified early and receiving Early Intervention services. The objective of this study was to identify the behavioral outcomes in early identified children with hearing loss and control hearing children at 18-24 months of age and to examine the impact of stress on early behavior development. It was hypothesized that children with hearing loss will have more behavior problems, and maternal stress will be associated with child behavior problems. Prospective observational. Children with and without congenital hearing loss and their mothers. The Parenting Stress Index and the Child Behavior Checklist. Children with hearing loss had increased scores for withdrawn and internalizing behavior. In multivariate analyses after adjusting for hearing loss, Neonatal Intensive Care Unit stay, and socioeconomic status, maternal stress independently contributed to higher scores for internalizing behavior, externalizing behavior, and total behavior problems. Maternal stress is an important correlate of behavior problems for children with hearing loss and should be considered by Early Intervention providers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Association of Stressful Life Events with Psychological Problems: A Large-Scale Community-Based Study Using Grouped Outcomes Latent Factor Regression with Latent Predictors

    PubMed Central

    Hassanzadeh, Akbar; Heidari, Zahra; Hassanzadeh Keshteli, Ammar; Afshar, Hamid

    2017-01-01

    Objective The current study is aimed at investigating the association between stressful life events and psychological problems in a large sample of Iranian adults. Method In a cross-sectional large-scale community-based study, 4763 Iranian adults, living in Isfahan, Iran, were investigated. Grouped outcomes latent factor regression on latent predictors was used for modeling the association of psychological problems (depression, anxiety, and psychological distress), measured by Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ-12), as the grouped outcomes, and stressful life events, measured by a self-administered stressful life events (SLEs) questionnaire, as the latent predictors. Results The results showed that the personal stressors domain has significant positive association with psychological distress (β = 0.19), anxiety (β = 0.25), depression (β = 0.15), and their collective profile score (β = 0.20), with greater associations in females (β = 0.28) than in males (β = 0.13) (all P < 0.001). In addition, in the adjusted models, the regression coefficients for the association of social stressors domain and psychological problems profile score were 0.37, 0.35, and 0.46 in total sample, males, and females, respectively (P < 0.001). Conclusion Results of our study indicated that different stressors, particularly those socioeconomic related, have an effective impact on psychological problems. It is important to consider the social and cultural background of a population for managing the stressors as an effective approach for preventing and reducing the destructive burden of psychological problems. PMID:29312459

  16. Development and validation of Arabic version of the postoperative quality of recovery-40 questionnaire.

    PubMed

    Terkawi, Abdullah Sulieman; Myles, Paul S; Riad, Waleed; Nassar, Sumaya Nemer; Mahmoud, Maissa; AlKahtani, Ghadah Jumaan; Sala, Fatima Jaina; Abdulrahman, Anas; Doais, Khaled S; Terkawi, Rayan Suliman; Tsang, Siny

    2017-05-01

    The postoperative quality of recovery-40 (QoR-40) is one of the most frequently used tools to assess the quality of recovery after surgery. The aim of the current study was to translate, culturally adapt, and validate the QoR-40 questionnaire in Arabic. A systematic translation process was used to translate the original English QoR-40 into Arabic. After the pilot study, the translated version was validated among patients who underwent different types of surgeries. The reliability (using internal consistency) and validity of our translated Arabic version was examined. To investigate the responsiveness of the translated QoR-40, the questionnaire was administered five times among the same group of patients (once before surgery as baseline measure, and four times after surgery, up to 1 week after surgery). A total of 182 participants (7 men, 175 women) were included in the study. The QoR-40 total scale and all subscales showed excellent internal consistencies over time, with the exception of the QoR-40 pain subscale at postoperative day 1. The QoR-40 total and subscale scores were inversely associated with patients' self-report pain scores but positively correlated with patients' self-report recovery scores. Patients' QoR-40 total, comfort, emotions, and physical subscale scores increased over time after surgery, indicating a general trend of recovery over time. Patients' scores in the QoR-40 pain and support subscales remained stable over time, suggesting no substantial changes were reported in these two domains. Quality of recovery was also found to be related to patients' ages, American Society of Anesthesiologists Physical Status, and the extent of surgery (major vs. minor). Most patients found the Arabic QoR-40 questions to be clear and easy to understand and thought the questionnaire items covered all their problem areas regarding their quality of recovery. Our translated version of QoR-40 was reliable and valid for use among Arabic-speaking patients. In addition, the QoR-40 was able to assess the quality of recovery in several domains among patients who underwent surgical procedures.

  17. Associations of Patient Health-Related Problem Solving with Disease Control, Emergency Department Visits, and Hospitalizations in HIV and Diabetes Clinic Samples

    PubMed Central

    Gemmell, Leigh; Kulkarni, Babul; Klick, Brendan; Brancati, Frederick L.

    2007-01-01

    Background Patient problem solving and decision making are recognized as essential to effective self-management across multiple chronic diseases. However, a health-related problem-solving instrument that demonstrates sensitivity to disease control parameters in multiple diseases has not been established. Objectives To determine, in two disease samples, internal consistency and associations with disease control of the Health Problem-Solving Scale (HPSS), a 50-item measure with 7 subscales assessing effective and ineffective problem-solving approaches, learning from past experiences, and motivation/orientation. Design Cross-sectional study. Participants Outpatients from university-affiliated medical center HIV (N = 111) and diabetes mellitus (DM, N = 78) clinics. Measurements HPSS, CD4, hemoglobin A1c (HbA1c), and number of hospitalizations in the previous year and Emergency Department (ED) visits in the previous 6 months. Results Administration time for the HPSS ranged from 5 to 10 minutes. Cronbach’s alpha for the total HPSS was 0.86 and 0.89 for HIV and DM, respectively. Higher total scores (better problem solving) were associated with higher CD4 and fewer hospitalizations in HIV and lower HbA1c and fewer ED visits in DM. Health Problem-Solving Scale subscales representing negative problem-solving approaches were consistently associated with more hospitalizations (HIV, DM) and ED visits (DM). Conclusions The HPSS may identify problem-solving difficulties with disease self-management and assess effectiveness of interventions targeting patient decision making in self-care. PMID:17443373

  18. Estimating Total-Test Scores from Partial Scores in a Matrix Sampling Design.

    ERIC Educational Resources Information Center

    Sachar, Jane; Suppes, Patrick

    1980-01-01

    The present study compared six methods, two of which utilize the content structure of items, to estimate total-test scores using 450 students and 60 items of the 110-item Stanford Mental Arithmetic Test. Three methods yielded fairly good estimates of the total-test score. (Author/RL)

  19. The efficacy of an educational intervention on health behaviors in a sample of Turkish female nursing students: a longitudinal, quasi-experimental study.

    PubMed

    Kara, Belgüzar

    2015-01-01

    Unhealthy behaviors are a key factors leading to health problems. It remains unclear whether an educational intervention has a long term effect on health behaviors of nursing students. The aim of this study was to evaluate the long term effect of an educational intervention on the health behaviors and examine predictors of change in these behaviors in Turkish female baccalaureate nursing students. Quasi-experimental design with one-group, pre- and posttest, and 3-year follow-up. The study was conducted in a school of nursing in Turkey. One hundred-eight students participated in this study. Data were collected before and after the implementation of the educational intervention by using the Health-Promoting Lifestyle Profile-I (HPLP-I). Descriptive statistics, the one-way analysis of variance for repeated measures and multiple linear regression analysis were used. There were significant differences among the three time points in terms of the HPLP-I total and subscales scores (self-actualization, health responsibility, exercise, nutrition and stress management), except for interpersonal support (p<.05). The positive effect of intervention on the HPLP-I total and health responsibility subscale scores was maintained during the 3-year follow-up period (p<.05). The amount of change from pretest to posttest in the total HPLP-I score was the only predictor of the 3-year change in the total scale score (unstandardized β=0.538; p<.001), after adjustment for the potential confounding factors. The educational intervention was partially effective in improving all health behaviors of the nursing students over the long term. Nursing students who demonstrated higher levels of benefit from the intervention were more likely to have more positive health behaviors at the 3-year point. The findings of this study highlight the importance of the integration of health behaviors within the nursing curriculum. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Silexan, an orally administered Lavandula oil preparation, is effective in the treatment of 'subsyndromal' anxiety disorder: a randomized, double-blind, placebo controlled trial.

    PubMed

    Kasper, Siegfried; Gastpar, Markus; Müller, Walter E; Volz, Hans-Peter; Möller, Hans-Jürgen; Dienel, Angelika; Schläfke, Sandra

    2010-09-01

    This study was performed to investigate the anxiolytic efficacy of silexan, a new oral lavender oil capsule preparation, in comparison to placebo in primary care. In 27 general and psychiatric practices 221 adults suffering from anxiety disorder not otherwise specified (Diagnostic and Statistical Manual of Mental disorders-IV 300.00 or International Statistical Classification of Diseases and Related Health Problems, Tenth revision F41.9) were randomized to 80 mg/day of a defined, orally administered preparation from Lavandula species or placebo for 10 weeks with visits every 2 weeks. A Hamilton Anxiety Scale (HAMA) total score >or=18 and a total score >5 for the Pittsburgh Sleep Quality Index (PSQI) were required. The primary outcome measures were HAMA and PSQI total score decrease between baseline and week 10. Secondary efficacy measures included the Clinical Global Impressions scale, the Zung Self-rating Anxiety Scale, and the SF-36 Health Survey Questionnaire. Patients treated with silexan showed a total score decrease by 16.0+/-8.3 points (mean+/-SD, 59.3%) for the HAMA and by 5.5+/-4.4 points (44.7%) for the PSQI compared to 9.5+/-9.1 (35.4%) and 3.8+/-4.1 points (30.9%) in the placebo group (P<0.01 one-sided, intention to treat). Silexan was superior to placebo regarding the percentage of responders (76.9 vs. 49.1%, P<0.001) and remitters (60.6 vs. 42.6%, P=0.009). Lavandula oil preparation had a significant beneficial influence on quality and duration of sleep and improved general mental and physical health without causing any unwanted sedative or other drug specific effects. Lavandula oil preparation silexan is both efficacious and safe for the relief of anxiety disorder not otherwise specified. It has a clinically meaningful anxiolytic effect and alleviates anxiety related disturbed sleep.

  1. Validity and psychometric properties of the General Health Questionnaire-12 in young Australian adolescents.

    PubMed

    Tait, Robert J; French, Davina J; Hulse, Gary K

    2003-06-01

    The General Health Questionnaire (GHQ) is a measure of current mental wellbeing that has been extensively validated with adults. The instrument has also been used with adolescents. (i) To assess the psychometric properties of the GHQ-12 among school students in grades 7-10; (ii) to validate it against other psychological tests; and (iii) to suggest a threshold score. The survey was conducted in single sex and mixed schools from the state and private system in Perth, Western Australia. The survey contained the GHQ-12 and measures of anxiety, depression, self-esteem, stress, generalized self-efficacy, social desirability and negative affectivity. There were 336 students (female 55%) with an age range of 11-15 years (median 13). The GHQ showed good internal consistency (alpha 0.88). Girls had higher mean GHQ-12 scores than boys (F (1,326) 15.0, p < 0.001) and scores for both genders increased with school grade (F (3,326) 4.2, p < 0.01). Multiple linear regression showed that depression, anxiety, self-esteem and stress were significant independent predictors of GHQ scores. The model accounted for 68% of the variance (adjusted R 2). Screening indices were calculated by comparison with a combined depression and/or anxiety category. Threshold scores of 13/14 for males and 18/19 for females appeared optimal. General Health Questionnaire scores were compared with two criterion groups: adolescents in hospital with alcohol or drug (AOD) related problems and those with problems not related to AOD use. Only the former group had significantly higher total scores. The GHQ-12 showed good structural characteristics and was appropriately correlated with other measures of related traits. Overall, the GHQ-12 appears to be a valid index of psychological wellbeing in this population and was considerably shorter than some of the other instruments.

  2. Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS): reliability, initial validity and normative scores in higher education students.

    PubMed

    Allen Gomes, Ana; Ruivo Marques, Daniel; Meia-Via, Ana Maria; Meia-Via, Mariana; Tavares, José; Fernandes da Silva, Carlos; Pinto de Azevedo, Maria Helena

    2015-04-01

    Based on successive samples totaling more than 5000 higher education students, we scrutinized the reliability, structure, initial validity and normative scores of a brief self-report seven-item scale to screen for the continuum of nighttime insomnia complaints/perceived sleep quality, used by our team for more than a decade, henceforth labeled the Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS). In study/sample 1 (n = 1654), the items were developed based on part of a larger survey on higher education sleep-wake patterns. The test-retest study was conducted in an independent small group (n = 33) with a 2-8 week gap. In study/sample 2 (n = 360), focused mainly on validity, the BaSIQS was completed together with the Pittsburgh Sleep Quality Index (PSQI). In study 3, a large recent sample of students from universities all over the country (n = 2995) answered the BaSIQS items, based on which normative scores were determined, and an additional question on perceived sleep problems in order to further analyze the scale's validity. Regarding reliability, Cronbach alpha coefficients were systematically higher than 0.7, and the test-retest correlation coefficient was greater than 0.8. Structure analyses revealed consistently satisfactory two-factor and single-factor solutions. Concerning validity analyses, BaSIQS scores were significantly correlated with PSQI component scores and overall score (r = 0.652 corresponding to a large association); mean scores were significantly higher in those students classifying themselves as having sleep problems (p < 0.0001, d = 0.99 corresponding to a large effect size). In conclusion, the BaSIQS is very easy to administer, and appears to be a reliable and valid scale in higher education students. It might be a convenient short tool in research and applied settings to rapidly assess sleep quality or screen for insomnia complaints, and it may be easily used in other populations with minor adaptations.

  3. Adaptation and validation of the Malayalam pediatric voice handicap index.

    PubMed

    Devadas, Usha; Dhanya, M; Gunjawate, Dhanshree

    2015-09-01

    The aim of the present study was to adapt and validate the English version of pediatric voice handicap index (pVHI) into Malayalam language. The English version of pediatric voice handicap index was translated into Malayalam language using parallel back translation. The translated version was content validated by three qualified speech language pathologists. The content familiarity was carried out by 10 parents of children with voice problems. This was distributed to 136 parents (57 parents of children with dysphonia, 79 parents of children with no voice problems). The internal consistency and test--retest reliability was determined using Cronbach's alpha and intraclass correlation coefficient. Independent sample t-test was used to assess the difference in means. Kappa coefficient was used to determine the correlation between overall severity of the problem and total pVHI. Discriminant analysis was used to identify thresholds for differentiating between normal and dysphonic participants. The results obtained revealed that the Malayalam version of pVHI has an excellent internal consistency; total (α=0.974), functional (α=0.922), physical (α=0.953), and emotional (α=0.923). There was an excellent test-retest reliability; total (r=0.937), functional (r=0.954), physical (r=0.95), and emotional (r=0.929). The prediction probability of the dysphonics is 98.2% using the discriminant score function. The translated and validated pVHI tool can be effectively used in the assessment of children with voice problems. It can provide a better insight into the parents' perception of their child's voice problems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Direct and Indirect Effects of Behavioral Parent Training on Infant Language Production

    PubMed Central

    Bagner, Daniel M.; Garcia, Dainelys; Hill, Ryan

    2016-01-01

    Given the strong association between early behavior problems and language impairment, we examined the effect of a brief home-based adaptation of Parent–child Interaction Therapy on infant language production. Sixty infants (55% male; mean age 13.47 ± 1.31 months) were recruited at a large urban primary care clinic and were included if their scores exceeded the 75th percentile on a brief screener of early behavior problems. Families were randomly assigned to receive the home-based parenting intervention or standard pediatric primary care. The observed number of infant total (i.e., token) and different (i.e., type) utterances spoken during an observation of an infant-led play and a parent-report measure of infant externalizing behavior problems were examined at pre- and post-intervention and at 3- and 6-month follow-ups. Infants receiving the intervention demonstrated a significantly higher number of observed different and total utterances at the 6-month follow-up compared to infants in standard care. Furthermore, there was an indirect effect of the intervention on infant language production, such that the intervention led to decreases in infant externalizing behavior problems from pre- to post-intervention, which, in turn, led to increases in infant different utterances at the 3- and 6-month follow-ups and total utterances at the 6-month follow-up. Results provide initial evidence for the effect of this brief and home-based intervention on infant language production, including the indirect effect of the intervention on infant language through improvements in infant behavior, highlighting the importance of targeting behavior problems in early intervention. PMID:26956651

  5. Effects of Adenotonsillectomy on Parent-Reported Behavior in Children With Obstructive Sleep Apnea

    PubMed Central

    Thomas, Nina Hattiangadi; Xanthopoulos, Melissa S.; Kim, Ji Young; Shults, Justine; Escobar, Emma; Giordani, Bruno; Hodges, Elise; Chervin, Ronald D.; Paruthi, Shalini; Rosen, Carol L.; Taylor, Gerry H.; Arens, Raanan; Katz, Eliot S.; Beebe, Dean W.; Redline, Susan; Radcliffe, Jerilynn

    2017-01-01

    Abstract Objectives: The childhood obstructive sleep apnea syndrome (OSAS) is associated with behavioral abnormalities. Studies on the effects of OSAS treatment on behavior are conflicting, with few studies using a randomized design. Further, studies may be confounded by the inclusion of behavioral outcome measures directly related to sleep. The objective of this study was to determine the effect of adenotonsillectomy on behavior in children with OSAS. We hypothesized that surgery would improve behavioral ratings, even when sleep symptom items were excluded from the analysis. Methods: This was a secondary analysis of Child Behavior Checklist (CBCL) data, with and without exclusion of sleep-specific items, from the Childhood Adenotonsillectomy Trial (CHAT). CBCL was completed by caregivers of 380 children (7.0+1.4 [range 5–9] years) with OSAS randomized to early adenotonsillectomy (eAT) versus 7 months of watchful waiting with supportive care (WWSC). Results: There was a high prevalence of behavioral problems at baseline; 16.6% of children had a Total Problems score in the clinically abnormal range. At follow-up, there were significant improvements in Total Problems (p < .001), Internalizing Behaviors (p = .04), Somatic Complaints (p = .01), and Thought Problems (p = .01) in eAT vs. WWSC participants. When specific sleep-related question items were removed from the analysis, eAT showed an overall improvement in Total (p = .02) and Other (p = .01) problems. Black children had less improvement in behavior following eAT than white children, but this difference attenuated when sleep-related items were excluded. Conclusions: This large, randomized trial showed that adenotonsillectomy for OSAS improved parent-rated behavioral problems, even when sleep-specific behavioral issues were excluded from the analysis. PMID:28199697

  6. The cross-lagged relationship between father absence and child problem behaviour in the early years.

    PubMed

    Flouri, E; Narayanan, M K; Midouhas, E

    2015-11-01

    Father absence has negative consequences for children's behaviour. Yet research has not examined how father absence and child behaviour may influence each other. This study models the cross-lagged relationship between father absence (non-residence) and child problem behaviour in the early years. We used data from the UK's Millennium Cohort Study, at children's ages 3, 5 and 7 years (Sweeps 2-4). The sample was 15,293 families in which both biological parents were co-resident at Sweep 1, when the child was aged 9 months. Child problem behaviour was assessed using the clinical cut-offs of the Strengths and Difficulties Questionnaire (SDQ). We also investigated gender differences in the association between father absence and problem behaviour. Father absence at age 3 predicted a higher probability of the child scoring above cut-off for total difficulties at age 5, as did father absence at age 5 for total difficulties at age 7. There were no significant effects for total difficulties on father absence. Similar father absence effects were found for individual SDQ subscales. Using these subscales, we found few child behaviour effects, mostly during the preschool years: children's severe externalizing and social (but not emotional) problems were associated with a greater probability of the father being absent in the next sweep. All cross-lagged relationships were similar for boys and girls. Father absence seems to be mainly the cause rather than the outcome of child problem behaviour in young UK families, and to affect boys and girls similarly. There were some child (mostly externalizing) behaviour effects on father absence, particularly in the early years. © 2015 John Wiley & Sons Ltd.

  7. The cross‐lagged relationship between father absence and child problem behaviour in the early years

    PubMed Central

    Narayanan, M. K.; Midouhas, E.

    2015-01-01

    Abstract Background Father absence has negative consequences for children's behaviour. Yet research has not examined how father absence and child behaviour may influence each other. This study models the cross‐lagged relationship between father absence (non‐residence) and child problem behaviour in the early years. Methods We used data from the UK's Millennium Cohort Study, at children's ages 3, 5 and 7 years (Sweeps 2–4). The sample was 15 293 families in which both biological parents were co‐resident at Sweep 1, when the child was aged 9 months. Child problem behaviour was assessed using the clinical cut‐offs of the Strengths and Difficulties Questionnaire (SDQ). We also investigated gender differences in the association between father absence and problem behaviour. Results Father absence at age 3 predicted a higher probability of the child scoring above cut‐off for total difficulties at age 5, as did father absence at age 5 for total difficulties at age 7. There were no significant effects for total difficulties on father absence. Similar father absence effects were found for individual SDQ subscales. Using these subscales, we found few child behaviour effects, mostly during the preschool years: children's severe externalizing and social (but not emotional) problems were associated with a greater probability of the father being absent in the next sweep. All cross‐lagged relationships were similar for boys and girls. Conclusions Father absence seems to be mainly the cause rather than the outcome of child problem behaviour in young UK families, and to affect boys and girls similarly. There were some child (mostly externalizing) behaviour effects on father absence, particularly in the early years. PMID:25708874

  8. Developmental Eye Movement (DEM) Test Norms for Mandarin Chinese-Speaking Chinese Children

    PubMed Central

    Tong, Meiling; Zhang, Min; Li, Tingting; Xu, Yaqin; Guo, Xirong; Hong, Qin; Chi, Xia

    2016-01-01

    The Developmental Eye Movement (DEM) test is commonly used as a clinical visual-verbal ocular motor assessment tool to screen and diagnose reading problems at the onset. No established norm exists for using the DEM test with Mandarin Chinese-speaking Chinese children. This study aims to establish the normative values of the DEM test for the Mandarin Chinese-speaking population in China; it also aims to compare the values with three other published norms for English-, Spanish-, and Cantonese-speaking Chinese children. A random stratified sampling method was used to recruit children from eight kindergartens and eight primary schools in the main urban and suburban areas of Nanjing. A total of 1,425 Mandarin Chinese-speaking children aged 5 to 12 years took the DEM test in Mandarin Chinese. A digital recorder was used to record the process. All of the subjects completed a symptomatology survey, and their DEM scores were determined by a trained tester. The scores were computed using the formula in the DEM manual, except that the “vertical scores” were adjusted by taking the vertical errors into consideration. The results were compared with the three other published norms. In our subjects, a general decrease with age was observed for the four eye movement indexes: vertical score, adjusted horizontal score, ratio, and total error. For both the vertical and adjusted horizontal scores, the Mandarin Chinese-speaking children completed the tests much more quickly than the norms for English- and Spanish-speaking children. However, the same group completed the test slightly more slowly than the norms for Cantonese-speaking children. The differences in the means were significant (P<0.001) in all age groups. For several ages, the scores obtained in this study were significantly different from the reported scores of Cantonese-speaking Chinese children (P<0.005). Compared with English-speaking children, only the vertical score of the 6-year-old group, the vertical-horizontal time ratio of the 8-year-old group and the errors of 9-year-old group had no significant difference (P>0.05); compared with Spanish-speaking children, the scores were statistically significant (P<0.001) for the total error scores of the age groups, except the 6-, 9-, 10-, and 11-year-old age groups (P>0.05). DEM norms may be affected by differences in language, cultural, and educational systems among various ethnicities. The norms of the DEM test are proposed for use with Mandarin Chinese-speaking children in Nanjing and will be proposed for children throughout China. PMID:26881754

  9. Single-stage in situ suture repair of multiple-ligament knee injury: a retrospective study of 17 patients (18 knees).

    PubMed

    Hua, Xingyi; Tao, Hui; Fang, Wang; Tang, Jian

    2016-01-22

    Multiple-ligament injured knee (MLIK) is a rare but severe injury. Although the principles of MLIK management have progressed over the past 40 years, there is a paucity of high-quality evidence upon which to base the management of MLIK. Treatment strategies for MLIK are challenging for most orthopedic surgeons, and the optimal treatment remains controversial, especially with regard to repair vs. reconstruction of the ligaments. The aim of the present study was to observe clinical outcomes of single-stage in situ suture repair of knee dislocation with multiple-ligament injury using nonabsorbable suture material. Consecutive patients with MLIK between 2002 and 2010 were included, for a total of 25 patients with knee dislocation. 17 patients (18 knees) with closed knee dislocation with a mean follow-up of 4.8 ± 1.3 years were retrospective analyzed. All patients were treated surgically with single-stage in situ suture repair for all injured ligaments and followed a standardized postoperative rehabilitation protocol. The VAS score, satisfactory score, total SF-36 score, Lysholm score, Tegner score, the Meyers functional rating and the ranges of motion and knee stability were used to evaluate outcomes. At final follow-up, mean visual analog scale score was 2.4 ± 0.9, patient satisfaction score was 8.0 ± 1.1, 36-item Short-Form Health Survey total score was 85.5 ± 10.4, and mean Lysholm score was 87.5 ± 7.7. There were significant differences between mean preinjury and postoperative Tegner activity scores (5.6 ± 1.4 and 3.4 ± 1.7, respectively; P < 0.01) and in mean range of motion between the injured and contralateral knees (112.5 ± 8.4° and 129.6 ± 10.3°, respectively; P < 0.01). At final follow-up, no patient demonstrated obvious ligamentous laxity, and only one patient was unable to return to work. Three patients had knee joint stiffness, two had wound problems (infection or fat liquefaction), and two had heterotopic bone formation. Single-stage in situ suture repair of injured ligaments confers advantages of reliable fixation and early exercise. It could be considered as an alternate and effective option in the dislocation knee with multiple-ligament injury.

  10. Psychopathology and behavior problems in children and adolescents with Williams syndrome: Distinctive relationships with cognition.

    PubMed

    Osório, Ana A C; Rossi, Natália F; Gonçalves, Óscar F; Sampaio, Adriana; Giacheti, Célia M

    2017-08-01

    Several studies have documented the high prevalence of psychopathology and behavior problems in Williams syndrome (WS). However, the links between cognitive development and such symptoms need further clarification. Our study aims to expand current knowledge on levels of behavior problems and its links to cognition in a sample of Brazilian individuals with WS. A total of 25 children and adolescents with WS and their parents participated in this study. The participants' IQs were assessed with the Wechsler Scales of Intelligence (for children or adults) and parental reports of psychopathology/behavior problems were collected using the Child Behavior Checklist (CBCL). The presence of clinically significant attention problems was a main feature in our sample of children and adolescents with WS. In the children, higher IQ scores were found to be significantly associated with less externalizing problems, while in the adolescents cognitive abilities were found to be associated with less internalizing symptoms. These results provide further insight into the links between psychopathology and behavior problems and cognitive abilities in WS, and suggest the need to take age into consideration when analyzing such relationships.

  11. Family-centered prevention ameliorates the association between adverse childhood experiences and prediabetes status in young black adults.

    PubMed

    Brody, Gene H; Yu, Tianyi; Chen, Edith; Miller, Gregory E

    2017-07-01

    Individuals exposed to adverse childhood experiences (ACEs) are vulnerable to various health problems later in life. This study was designed to determine whether participation in an efficacious program to enhance supportive parenting would ameliorate the association between ACEs and prediabetes status at age 25. Rural African American parents and their 11-year-old children (N=390) participated in the Strong African American Families (SAAF) program or a control condition. Each youth at age 25 provided a total ACEs score and a blood sample from which overnight fasting glucose was assayed. Logistic regression equations were used to test the hypotheses. The logistic regression analyses revealed a significant interaction between total ACEs and random assignment to SAAF or control, OR=0.56, 95% CI [0.36, 0.88]. Follow-up analyses indicated that, for participants in the control condition, a 1-point increase in ACEs was associated with a 37.3% increase in risk of having prediabetes. ACEs were not associated with the likelihood of having prediabetes among participants in the SAAF condition. Control participants with high total ACEs scores were 3.54 times more likely to have prediabetes than were SAAF participants with similar scores. This study indicated that participation at age 11 in a randomized controlled trial designed to enhance supportive parenting ameliorated the association of ACEs with prediabetes at age 25. If substantiated, these findings may provide a strategy for preventing negative health consequences of ACEs. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Validation of a new scale to assess olfactory dysfunction in patients with Parkinson's disease.

    PubMed

    Millar Vernetti, Patricio; Perez Lloret, Santiago; Rossi, Malco; Cerquetti, Daniel; Merello, Marcelo

    2012-05-01

    BAKCKGROUND: Olfactory dysfunction is present in up to 90% of Parkinson's disease (PD) patients. It is usually evaluated by means of objective standardized tests; however no self-administered scales have been developed for olfactory dysfunction bedside assessment. We present validation of a new scale to assess this symptom in PD patients. Seventy-five PD patients and 25 control subjects were evaluated using a Hyposmia Rating Scale developed in-house, combined with the extended Sniffin' Sticks test. Total score of the 6-item Hyposmia Rating Scale showed significant correlation with threshold, discrimination, identification and total Sniffin' Sticks test scores (r = 0.53; r = 0.60; r = 0.57; r = 0.65 respectively, p < 0.001 for all values). Area under the curve of the receiver operating curve for the ability of Hyposmia Rating Scale to discriminate patients with Sniffin' Sticks test total scores below or above the cut-off point was 80 ± 6% (p < 0.001). Considering Sniffin' Sticks test as the gold standard method for olfactory dysfunction detection, an affirmative response to a single screening question about smelling ability problems showed 35% sensitivity (95%CI = 23-47%) and 100% specificity. The best cut-off point for Hyposmia Rating Scale was 22.5 with a sensitivity of 70% (60-81%) and a specificity of 85% (65-100%). The Hyposmia Rating Scale here presented may offer a simple, cost-effective, time-saving and reliable approach to evaluate olfactory dysfunction in PD patients. Copyright © 2011. Published by Elsevier Ltd.

  13. Correlations between psychopathology and self-reported quality of life among adolescents in youth correctional facilities in Lagos, Nigeria: A short report.

    PubMed

    Atilola, Olayinka; Ola, Bolanle; Abiri, Gbonjubola; Adewuya, Abiodun O

    2018-02-01

    The relationship between psychopathology and quality of life (QoL) and well-being among young incarcerated offenders has hardly been explored. Our aim was to test the hypothesis that higher self-rated psychopathology would be associated with lower QoL among adolescents resident within youth correctional facilities in Lagos. Psychopathology was assessed using the Strength and Difficulty Questionnaire (SDQ), while QoL was measured by using the Paediatric Quality of Life. One hundred and sixty-five adolescents completed the study, mostly boys (n = 124; 75%) with a mean age of 14.3 ± 2.1 years. Nearly, a fifth (30, 18%) of respondents had abnormal total SDQ scores (≥17), suggestive of definite psychiatric disorder, while another 44 (27%) had highly probable psychopathology (total SDQ scores 15-16). There was strong negative correlation (r = -0.51, p < 0.001) between total SDQ scores and overall self-reported QoL among respondents. Although we were unable to infer direction of relationship between psychopathology and QoL among these adolescents, it is plausible to suppose that treatment of mental health problems could have a positive impact on rehabilitation and reintegration. Given the rate of likely psychopathology, mental health screening within young offender institutions should be routine, and followed, as necessary with full assessment and resultant treatment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Chronic kidney-disease screening service quality: questionnaire survey research evidence from Taichung City.

    PubMed

    Lin, Deng-Juin; Li, Ya-Hsin; Pai, Jar-Yuan; Sheu, Ing-Cheau; Glen, Robert; Chou, Ming-Jen; Lee, Ching-Yi

    2009-12-19

    Chronic kidney disease (CKD) is a serious public health problem in Taiwan and the world. The most effective, affordable treatments involve early prevention/detection/intervention, requiring screening. Successfully implementing CKD programs requires good patient participation, affected by patient perceptions of screening service quality. Service quality improvements can help make such programs more successful. Thus, good tools for assessing service quality perceptions are important. to investigate using a modified SERVQUAL questionnaire in assessing patient expectations, perceptions, and loyalty towards kidney disease screening service quality. 1595 kidney disease screening program patients in Taichung City were requested to complete and return a modified kidney disease screening SERVQUAL questionnaire. 1187 returned them. Incomplete ones (102) were culled and 1085 were chosen as effective for use. Paired t-tests, correlation tests, ANOVA, LSD test, and factor analysis identified the characteristics and factors of service quality. The paired t-test tested expectation score and perception score gaps. A structural equation modeling system examined satisfaction-based components' relationships. The effective response rate was 91.4%. Several methods verified validity. Cronbach's alpha on internal reliability was above 0.902. On patient satisfaction, expectation scores are high: 6.50 (0.82), but perception scores are significantly lower 6.14 (1.02). Older patients' perception scores are lower than younger patients'. Expectation and perception scores for patients with different types of jobs are significantly different. Patients higher on education have lower scores for expectation (r = -0.09) and perception (r = -0.26). Factor analysis identified three factors in the 22 item SERVQUAL form, which account for 80.8% of the total variance for the expectation scores and 86.9% of the total variance for the satisfaction scores. Expectation and perception score gaps in all 22 items are significant. The goodness-of-fit summary of the SEM results indicates that expectations and perceptions are positively correlated, perceptions and loyalty are positively correlated, but expectations and loyalty are not positively correlated. The results of this research suggest that the SERVQUAL instrument is a useful measurement tool in assessing and monitoring service quality in kidney disease screening services, enabling the staff to identify where service improvements are needed from the patients' perspectives.

  15. A randomized, double-blind study of SHP465 mixed amphetamine salts extended-release in adults with ADHD using a simulated adult workplace design.

    PubMed

    Wigal, Timothy; Brams, Matthew; Frick, Glen; Yan, Brian; Madhoo, Manisha

    2018-06-18

    The objective of this paper was to evaluate the efficacy, duration of effect, and tolerability of SHP465 mixed amphetamine salts (MAS) extended-release versus placebo and immediate-release MAS (MAS IR) in adults with attention-deficit/hyperactivity disorder (ADHD). Adults with ADHD Rating Scale, Version IV (ADHD-RS-IV) scores ≥24 were randomized to SHP465 MAS (50 or 75 mg), placebo, or 25 mg MAS IR in a double-blind, three-period, crossover study using a simulated adult workplace environment. On the final day of each 7-day treatment period, efficacy was assessed for 16 h postdose. Primary efficacy analyses for Permanent Product Measure of Performance (PERMP) total score averaged across all postdose assessments and each postdose time point were conducted in the intent-to-treat population using a mixed linear model. Secondary end-points included PERMP problems attempted and answered correctly and ADHD-RS-IV scores based on clinician ratings of counselor observations using the Time Segment Rating System and participant self-report. Tolerability assessments included treatment-emergent adverse events (TEAEs) and vital signs. Least squares mean (95% CI) treatment differences (combined 50/75 mg SHP465 MAS-placebo) significantly favored SHP465 MAS over placebo for PERMP total score averaged across all postdose assessments (18.38 [11.28, 25.47]; P < .0001) and at each postdose assessment (all P < .02). Nominal superiority of MAS IR over placebo for PERMP total score averaged across all postdose assessments was observed (nominal P = .0001); treatment differences between SHP465 MAS and MAS IR were not significant (nominal P = .2443). The two most frequently reported TEAEs associated with SHP465 MAS were insomnia (36.5%) and anorexia (21.2%). Mean increases in pulse and blood pressure with SHP465 MAS exceeded those of placebo. SHP465 MAS (combined 50/75 mg) significantly improved PERMP total score versus placebo, with superiority observed from 2 to 16 h postdose. The tolerability profile of SHP465 MAS was similar to previous reports of SHP465 MAS in adults with ADHD. https://clinicaltrials.gov/ct2/show/NCT00928148 identifier is NCT00928148.

  16. Insight into alcohol-related problems and its associations with severity of alcohol consumption, mental health status, race, and level of acculturation in southern Taiwanese indigenous people with alcoholism.

    PubMed

    Yen, Cheng-Fang; Hsiao, Ray C; Ries, Richard; Liu, Shu-Chun; Huang, Chi-Fen; Chang, Yu-Ping; Yu, Ming-Lung

    2008-01-01

    While not well known in the West, Taiwan has a substantial indigenous population, and this population has rapidly developed alcohol problems. This study examined the level of insight into alcohol-related problems and its associations with the severity of alcohol consumption, mental health status, race, and the level of acculturation among indigenous populations with alcohol problems in southern Taiwan. A total of 332 indigenes, whose total Alcohol Use Disorders Identification Test (AUDIT) score was equal to 8 or higher, were interviewed. The associations between the level of insight into alcohol-related problems and the severity of alcohol drinking on the AUDIT, mental health status on the Chinese Health Questionnaire-12 (>or= 4 vs. < 4), race (Bunun vs. non-Bunun), and the level of acculturation on the Taiwan Aboriginal Acculturation Scale were examined using logistic regression models. The results of this study found that 72.6% of the participants had poor insight into alcohol-related problems and no participant had good insight. Participants who had more severe alcohol drinking or poor mental health were more likely to have a higher level of insight into alcohol-related problems. Participants who were non-Bunun were also more likely to have a higher level of insight into alcohol-related problems, but the level of acculturation was not associated with the level of insight into alcohol-related problems. These findings suggest that most alcoholic indigenes in southern Taiwan have poor insight into their own alcohol-related problems. Cultural specific interventions targeting and improving the indigenes' insight into alcohol-related problems are needed.

  17. Promoting Students' Problem Solving Skills and Knowledge of STEM Concepts in a Data-Rich Learning Environment: Using Online Data as a Tool for Teaching about Renewable Energy Technologies

    NASA Astrophysics Data System (ADS)

    Thurmond, Brandi

    This study sought to compare a data-rich learning (DRL) environment that utilized online data as a tool for teaching about renewable energy technologies (RET) to a lecture-based learning environment to determine the impact of the learning environment on students' knowledge of Science, Technology, Engineering, and Math (STEM) concepts related to renewable energy technologies and students' problem solving skills. Two purposefully selected Advanced Placement (AP) Environmental Science teachers were included in the study. Each teacher taught one class about RET in a lecture-based environment (control) and another class in a DRL environment (treatment), for a total of four classes of students (n=128). This study utilized a quasi-experimental, pretest/posttest, control-group design. The initial hypothesis that the treatment group would have a significant gain in knowledge of STEM concepts related to RET and be better able to solve problems when compared to the control group was not supported by the data. Although students in the DRL environment had a significant gain in knowledge after instruction, posttest score comparisons of the control and treatment groups revealed no significant differences between the groups. Further, no significant differences were noted in students' problem solving abilities as measured by scores on a problem-based activity and self-reported abilities on a reflective questionnaire. This suggests that the DRL environment is at least as effective as the lecture-based learning environment in teaching AP Environmental Science students about RET and fostering the development of problem solving skills. As this was a small scale study, further research is needed to provide information about effectiveness of DRL environments in promoting students' knowledge of STEM concepts and problem-solving skills.

  18. Estimating Total-test Scores from Partial Scores in a Matrix Sampling Design.

    ERIC Educational Resources Information Center

    Sachar, Jane; Suppes, Patrick

    It is sometimes desirable to obtain an estimated total-test score for an individual who was administered only a subset of the items in a total test. The present study compared six methods, two of which utilize the content structure of items, to estimate total-test scores using 450 students in grades 3-5 and 60 items of the ll0-item Stanford Mental…

  19. Relationship between cognitive and non-cognitive symptoms of delirium.

    PubMed

    Rajlakshmi, Aarya Krishnan; Mattoo, Surendra Kumar; Grover, Sandeep

    2013-04-01

    To study relationship between the cognitive and the non-cognitive symptoms of delirium. Eighty-four patients referred to psychiatry liaison services and met DSM-IVTR criteria of delirium were assessed using the Delirium Rating Scale Revised-1998 (DRSR-98) and Cognitive Test for Delirium (CTD). The mean DRS-R-98 severity score was 17.19 and DRS-R-98 total score was 23.36. The mean total score on CTD was 11.75. The mean scores on CTD were highest for comprehension (3.47) and lowest for vigilance (1.71). Poor attention was associated with significantly higher motor retardation and higher DRS-R-98 severity scores minus the attention scores. There were no significant differences between those with and without poor attention. Higher attention deficits were associated with higher dysfunction on all other domains of cognition on CTD. There was significant correlation between cognitive functions as assessed on CTD and total DRS-R-98 score, DRS-R-98 severity score and DRS-R-98 severity score without the attention item score. However, few correlations emerged between CTD domains and CTD total scores with cognitive symptom total score of DRS-R-98 (items 9-13) and non-cognitive symptom total score of DRS-R-98 (items 1-8). Our study suggests that in delirium, cognitive deficits are quite prevalent and correlate with overall severity of delirium. Attention deficit is a core symptom of delirium. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Assertiveness and problem solving in midwives.

    PubMed

    Yurtsal, Zeliha Burcu; Özdemir, Levent

    2015-01-01

    Midwifery profession is required to bring solutions to problems and a midwife is expected to be an assertive person and to develop midwifery care. This study was planned to examine the relationship between assertiveness and problem-solving skills of midwives. This cross-sectional study was conducted with 201 midwives between July 2008 and February 2009 in the city center of Sivas. The Rathus Assertiveness Schedule (RAS) and Problem Solving Inventory (PSI) were used to determine the level of assertiveness and problem-solving skills of midwives. Statistical methods were used as mean, standard deviation, percentage, Student's T, ANOVA and Tukey HSD, Kruskal Wallis, Fisher Exact, Pearson Correlation and Chi-square tests and P < 0.05. The RAS mean scores and the PSI mean scores showed statistically significant differences in terms of a midwife's considering herself as a member of the health team, expressing herself within the health care team, being able to say "no" when necessary, cooperating with her colleagues, taking part in problem-solving skills training. A statistically significant negative correlation was found between the RAS and PSI scores. The RAS scores decreased while the problem-solving scores increased (r: -0451, P < 0.01). There were significant statistical differences between assertiveness levels and problem solving skills of midwives, and midwives who were assertive solved their problems better than did others. Assertiveness and problem-solving skills training will contribute to the success of the midwifery profession. Midwives able to solve problems, and display assertive behaviors will contribute to the development of midwifery profession.

  1. Is emotional dysregulation a risk indicator for auto-aggression behaviors in adolescents with oppositional defiant disorder?

    PubMed

    Muratori, Pietro; Pisano, Simone; Milone, Annarita; Masi, Gabriele

    2017-01-15

    The Child Behavior Checklist Dysregulation Profile (CBCL-DP), (high scores in Anxious/Depressed, Attention Problems, and Aggressive Behavior subscales), has been related to poor emotional and behavioral self-regulation in children and adolescents. Our aim is to evaluate if it may be associated with auto-aggression in youth with oppositional defiant disorder (ODD). Method In 72 consecutively referred youths with ODD, emotional dysregulation was assessed with the CBCL-DP, auto-aggression and physical aggression against other persons with the Modified Overt Aggression Scale. Regression analysis showed that greater higher CBCL-DP scores were associated to higher levels of auto-aggression, even when controlling for the levels of physical aggression against others and CBCL Total score. The small sample size, the cross-sectional design, and the lack of a control group limit the generalization of our findings. Referred ODD youths with higher scores of CBCL-DP are more likely to present auto-aggression, besides aggression against others. The CBCL could improve the screening and detection of these high-risk patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Association between long work hours and depressive state: a pilot study of propensity score matched Japanese white-collar workers.

    PubMed

    Uchida, Mitsuo; Morita, Hiroshi

    2018-06-01

    Although long work hours have been associated with various physical health problems, studies of their association with mental health have yielded inconsistent results, due to differences in study settings, study outcome and/or unmeasured background factors. In this study, we used a propensity score method to evaluate the association between work hours and depressive state. A total of 467 Japanese white-collar workers were surveyed and divided into long and regular work hour groups according to overtime work records. Propensity score matching was performed based on 32 individual background and workplace factors, yielding 74 pairs of propensity-matched subjects. CES-D score, an indicator of depressive state, did not differ significantly among the two groups (p=0.203). However, work motivation, work control, social support and emotional stability correlated with CES-D score. These findings suggest that work control and social support factors are more associated with depressive state than control of work hours. These results also suggest that it is possible to use propensity score matching to evaluate the association between work hours and mental health in occupational study settings. Further studies, in larger populations, are required to determine the association between work hours and mental health parameters.

  3. Effects of childhood trauma on personality in a sample of Chinese adolescents.

    PubMed

    Li, XianBin; Wang, ZhiMin; Hou, YeZhi; Wang, Ying; Liu, JinTong; Wang, ChuanYue

    2014-04-01

    Childhood trauma is a major public health problem which has an impact on personality development, yet no studies have examined the association between exposure to trauma and personality in a sample of Chinese adolescents. Four hundred eighty-five students completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the Eysenck Personality Questionnaire (EPQ). The CTQ-SF cut-off scores for exposure were used to calculate the prevalence of trauma. The possible associations between specific types of trauma and the EPQ subscale scores were examined. The rates of emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN) were 18.76%, 11.13%, 27.01%, 49.48%, and 68.66%, respectively. Individuals subjected to EA, PA, and SA had significantly higher neuroticism (EPQ-N) and psychoticism (EPQ-P) scores on the EPQ compared with those who had not experienced EA, PA, or SA (all p values<0.05). Significant positive correlations existed between CTQ-SF subscale scores for EA, SA, CTQ-SF total scores, and EPQ-N, EPQ-P scores (all p values<0.05). Significant number of subjects in this adolescent sample reported experience of childhood abuse and neglect. Exposure to childhood trauma is associated with personality development in Chinese adolescents. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Diagnostic performance and optimal cut-off scores of the Massachusetts youth screening instrument-second version in a sample of Swiss youths in welfare and juvenile justice institutions.

    PubMed

    Dölitzsch, Claudia; Leenarts, Laura E W; Schmeck, Klaus; Fegert, Jorg M; Grisso, Thomas; Schmid, Marc

    2017-02-08

    There is a growing consensus about the importance of mental health screening of youths in welfare and juvenile justice institutions. The Massachusetts Youth Screening Instrument-second version (MAYSI-2) was specifically designed, normed and validated to assist juvenile justice facilities in the United States of America (USA), in identifying youths with potential emotional or behavioral problems. However, it is not known if the USA norm-based cut-off scores can be used in Switzerland. Therefore, the primary purpose of the current study was to estimate the diagnostic performance and optimal cut-off scores of the MAYSI-2 in a sample of Swiss youths in welfare and juvenile justice institutions. As the sample was drawn from the French-, German- and Italian-speaking parts of Switzerland, the three languages were represented in the total sample of the current study and consequently we could estimate the diagnostic performance and the optimal cut-off scores of the MAYSI-2 for the language regions separately. The other main purpose of the current study was to identify potential gender differences in the diagnostic performance and optimal cut-off scores. Participants were 297 boys and 149 girls (mean age = 16.2, SD = 2.5) recruited from 64 youth welfare and juvenile justice institutions (drawn from the French-, German- and Italian-speaking parts of Switzerland). The MAYSI-2 was used to screen for mental health or behavioral problems that could require further evaluation. Psychiatric classification was based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime version (K-SADS-PL). The MAYSI-2 scores were submitted into Receiver-Operating Characteristic (ROC) analyses to estimate the diagnostic performance and optimal 'caution' cut-off scores of the MAYSI-2. The ROC analyses revealed that nearly all homotypic mappings of MAYSI-2 scales onto (cluster of) psychiatric disorders revealed above chance level accuracy. The optimal 'caution' cut-off scores derived from the ROC curve for predicting (cluster of) psychiatric disorders were, for several MAYSI-2 scales, comparable to the USA norm-based 'caution' cut-off scores. For some MAYSI-2 scales, however, higher optimal 'caution' cut-off scores were found. With adjusted optimal 'caution' cut-off scores, the MAYSI-2 screens potential emotional or behavioral problems well in a sample of Swiss youths in welfare and juvenile justice institutions. However, as for choosing the optimal 'caution' cut off score for the MAYSI-2, both language as well as gender seems to be of importance. The results of this study point to a compelling need to test the diagnostic performance and optimal 'caution' cut-off scores of the MAYSI-2 more elaborately in larger differentiated language samples in Europe.

  5. Functional independence of residents in urban and rural long-term care facilities in Taiwan.

    PubMed

    Lin, Kwan-Hwa; Wu, Shiao-Chi; Hsiung, Chia-Ling; Hu, Ming-Hsia; Hsieh, Ching-Lin; Lin, Jau-Hong; Kuo, Mei-Ying

    2004-02-04

    To compare the score of functional independence measure (FIM) between urban and rural residents living in long-term care facilities (LTCF) in Taiwan. A total of 437 subjects in 112 licensed LTCF in Taiwan were randomly selected by stratification strategy. Physical therapists interviewed the subjects in nursing homes (NH) and intermediate care facilities (ICF) to obtain the basic data, and the FIM score. (1) There was no significant difference in basic demographic data between urban and rural LTC subjects. (2) Most of the subjects in urban and rural LTCF were males, less than 80 years old, single/widowed, having multiple diseases, using more than one assistive devices, and having social welfare financial support. (3) Motor abilities (eating, grooming, and transfer) and cognition (comprehension, social interaction and problem solving) in rural LTCF subjects were significantly (p < 0.05) higher than those in urban areas as revealed by the FIM assessment. (4) The median of FIM total score of rural LTCF subjects was 90.5, which was significantly (p < 0.05) higher than that of urban LTCF subjects (median = 76). Some of the functional performance of subjects in rural long-term care institutions is better than those in urban areas. Our results may provide guidelines for the manpower and equipment supply estimation.

  6. Attention deficit-hyperactivity disorder symptoms in women with polycystic ovary syndrome.

    PubMed

    Hergüner, Sabri; Harmancı, Hatice; Toy, Harun

    2015-01-01

    Several studies suggest that androgens are involved in the etiology of attention deficit-hyperactivity disorder (ADHD). In this study, we investigated the ADHD symptoms in women with polycystic ovary syndrome (PCOS), a complex endocrine, hormonal, and metabolic condition associated with hyperandrogenism. Forty women between the ages of 18 and 35 years with PCOS were recruited for the study group. For comparison, 40 healthy women who had regular menses were included. Current and childhood ADHD symptoms were assessed by using the Adult ADHD Self-Report Scale and Wender-Utah Rating Scale, respectively. Women with PCOS had higher total Adult ADHD Self-Report Scale and total Wender-Utah Rating Scale scores than controls. According to the Wender-Utah Rating Scale, the frequency of childhood ADHD was significantly higher in PCOS group than the control. Adult ADHD Self-Report Scale: Hyperactivity-Impulsivity and Wender-Utah Rating Scale: Behavioral Problems/Impulsivity scores were significantly higher in women with PCOS. However, there were no significant differences between groups in both current and childhood inattention scores. We found no correlations between ADHD symptoms and serum hormone levels including testosterone in women with PCOS. These results suggest that women with PCOS have higher ADHD symptoms. Further studies are needed to investigate the association between PCOS and ADHD. © The Author(s) 2015.

  7. The Impact of Racial and Socioeconomic Disparities on Binge Eating and Self-Efficacy among Adults in a Behavioral Weight Loss Trial

    PubMed Central

    Goode, Rachel; Ye, Lei; Zheng, Yaguang; Ma, Qianheng; Sereika, Susan M.; Burke, Lora E.

    2016-01-01

    The prevalence of obesity is a significant problem among racial and ethnic minorities and those of low socioeconomic status (SES). Psychosocial barriers, such as binge eating and low self-efficacy, are known to hinder the adoption of a more healthful diet. There is limited research identifying racial and SES differences in binge eating and self-efficacy. Further investigations of these constructs may allow researchers to improve the effectiveness of weight management interventions and increase social worker involvement. In this article, the authors examine the socioeconomic and racial differences in binge eating and eating self-efficacy in a sample of individuals seeking weight loss treatment (N = 151). They explore associations between various sociodemographic variables and the Binge Eating Scale and Weight Efficacy Lifestyle Questionnaire (WEL). At baseline, nonwhite participants or those with fewer years of education exhibited more confidence resisting eating when food was available. Moreover, nonwhite participants reported more self-confidence eating under social pressure and had higher total WEL scores than white participants. However, at six months, nonwhite participants’ WEL scores decreased. White participants increased their total WEL scores and obtained a higher percent weight change by the end of the intervention. Additional investigations on the dynamics affecting the development of self-efficacy are warranted. PMID:29206958

  8. Pre and post-amputation mobility of trans-tibial amputees: correlation to medical problems, age and mortality.

    PubMed

    Johnson, V J; Kondziela, S; Gottschalk, F

    1995-12-01

    This retrospective study compares pre and post-amputation mobility and the influence of age and associated medical problems. Data from the charts of 120 male patients who underwent unilateral trans-tibial (below-knee) amputation at the Dallas Veteran's Administration Hospital between June, 1983 and October, 1991, were collected and analyzed. Mobility was assessed with a six level scale developed by Volpicelli et al. (1983). The presence of cardiac disease, pulmonary disease (COPD), peripheral vascular disease (PVD), diabetes mellitus, degenerative joint disease, blindness, cerebral vascular accident (CVA), and age are correlated with changes in mobility after amputation. Older patients had more medical problems and lower post-amputation scores Individual medical problems did not influence mobility scores, but the presence of COPD and PVD lowered pre-amputation mobility scores. Cardiac disease and diabetes mellitus influenced post-amputation mobility scores by lowering them, either together or individually. Regardless of age, however, patients with more medical problems were poor ambulators. The cause of amputation per se did not influence mobility scores.

  9. Humanistic and economic burden of nausea and vomiting among migraine sufferers.

    PubMed

    Gajria, Kavita; Lee, Lulu K; Flores, Natalia M; Aycardi, Ernesto; Gandhi, Sanjay K

    2017-01-01

    While studies have demonstrated the economic burden of migraines in terms of quality of life, health care resource use (HRU), and costs, there exists a notable paucity of data comparing such outcomes among migraineurs with nausea and vomiting (N/V) and those without. The current study aimed to address this gap. This was a retrospective study using data from the 2013 US National Health and Wellness Survey, a cross-sectional, internet-based survey. Respondents self-reported their migraine with or without N/V along with demographics and outcomes including depression (Patient Health Questionnaire total score; PHQ-9), sleep problems (11-item total score of sleep problems), HRU (number of physician visits, emergency room [ER] visits, and hospitalizations) and Work Productivity and Activity Impairment-General Health Scale (WPAI-GH), and associated mean annual costs. Generalized linear models, adjusting for covariates, assessed the burden of N/V on all outcomes. Among all migraineurs (N=7,855), 73.4% were female, mean age was 41.82 years old, and 57.6% reported experiencing N/V. Adjusting for covariates, migraineurs with N/V vs without N/V had higher mean PHQ-9 scores (7.91 vs 7.02, p <0.001) and mean sleep problems (3.29 vs 2.64, p <0.001). Mean ER visits were more frequent among migraineurs with N/V than those without N/V (0.48 vs 0.38, p =0.001). This difference translated into a 26.3% increase in estimated mean ER costs (N/V=US$1,499 vs without N/V=US$1,187, p =0.002). Mean percentage activity impairment was higher in migraineurs with N/V than in those without N/V (37.73% vs 35.12%, p =0.002) and migraineurs with N/V had higher work productivity loss costs (N/V=US$10,344 vs without N/V=US$9,218, p =0.016). Migraine patients with N/V reported worse depression, sleep problems, and activity impairment, and higher ER visits than those without N/V. Migraine with N/V was also associated with an increase in mean annual ER visit costs and work productivity loss costs. Study findings suggest unmet needs with current treatment options for migraine patients with N/V.

  10. Prenatal Exposure to Perfluoroalkyl Substances and Behavioral Development in Children.

    PubMed

    Quaak, Ilona; de Cock, Marijke; de Boer, Michiel; Lamoree, Marja; Leonards, Pim; van de Bor, Margot

    2016-05-19

    In recent years, prevalence rates of behavioral disorders in children have increased. One factor possibly implied in the etiology of behavioral disorders is exposure to perfluoroalkyl substances (PFASs). The use of PFASs is highly integrated into everyday life, and exposure is ubiquitous. Exposure to PFASs during early life may be particularly harmful, as it represents a critical time window for brain development. However, research in the area is limited, especially among preschool children. The objective of the current study was to explore the relationship between prenatal exposure to several PFASs and behavioral development at the age of 18 months. Data from the Dutch cohort LINC (Linking Maternal Nutrition to Child Health) were used. Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) were measured in cord plasma. The total exposure of PFASs was also calculated (ΣPFASs). Behavioral development was assessed with the Child Behavior Checklist 1.5-5 (CBCL 1.5-5). The CBCL scales "Attention Deficit Hyperactivity Disorder" (ADHD) and "Externalizing problems" were used for further analysis. Separate regression models were composed for each combination, in which exposure levels were classified in tertiles. Both whole population and sex-stratified analyses were performed. A family history of ADHD, the educational level, smoking or using alcohol or illicit drugs during pregnancy were considered as confounders. In total, data from 76 mother-child pairs was included. No significant associations were found between prenatal PFAS exposure and ADHD scores in the whole population and in the sex-stratified analyses. With regard to externalizing behavior, a significant negative association was found between the highest levels of ΣPFAS exposure and externalizing problem behavior in the whole population, but only in the crude model. After stratifying for sex, boys in the second and third tertile of exposure to PFOA presented significantly lower scores on the Externalizing Problem Scale than boys with the lowest exposure levels in the adjusted model. Girls exposed to higher levels of ΣPFAS exposure (T2) showed significantly lower scores on the Externalizing Problem Scale, in both crude and adjusted models. No significant associations with PFOS were found. RESULTS from the current study show that prenatal exposure to PFOA was negatively related to externalizing behavior in boys. RESULTS were different for boys and girls, emphasizing that mechanisms at work might be sex-dependent. However, results should be interpreted with caution as the sample size was small.

  11. An observation tool for instructor and student behaviors to measure in-class learner engagement: a validation study

    PubMed Central

    Alimoglu, Mustafa K.; Sarac, Didar B.; Alparslan, Derya; Karakas, Ayse A.; Altintas, Levent

    2014-01-01

    Background Efforts are made to enhance in-class learner engagement because it stimulates and enhances learning. However, it is not easy to quantify learner engagement. This study aimed to develop and validate an observation tool for instructor and student behaviors to determine and compare in-class learner engagement levels in four different class types delivered by the same instructor. Methods Observer pairs observed instructor and student behaviors during lectures in large class (LLC, n=2) with third-year medical students, lectures in small class (LSC, n=6) and case-based teaching sessions (CBT, n=4) with fifth-year students, and problem-based learning (PBL) sessions (~7 hours) with second-year students. The observation tool was a revised form of STROBE, an instrument for recording behaviors of an instructor and four randomly selected students as snapshots for 5-min cycles. Instructor and student behaviors were scored 1–5 on this tool named ‘in-class engagement measure (IEM)’. The IEM scores were parallel to the degree of behavior's contribution to active student engagement, so higher scores were associated with more in-class learner engagement. Additionally, the number of questions asked by the instructor and students were recorded. A total of 203 5-min observations were performed (LLC 20, LSC 85, CBT 50, and PBL 48). Results Interobserver agreement on instructor and student behaviors was 93.7% (κ=0.87) and 80.6% (κ=0.71), respectively. Higher median IEM scores were found in student-centered and problem-oriented methods such as CBT and PBL. A moderate correlation was found between instructor and student behaviors (r=0.689). Conclusions This study provides some evidence for validity of the IEM scores as a measure of student engagement in different class types. PMID:25308966

  12. Quality of Life in Medical Students With Internet Addiction.

    PubMed

    Fatehi, Farzad; Monajemi, Alireza; Sadeghi, Anahita; Mojtahedzadeh, Rita; Mirzazadeh, Azim

    2016-10-01

    The widespread use of internet has caused new psychological, social, and educational problems for the students. The aim of this study was to examine the quality of life in medical students who suffer from internet addiction. This cross-sectional survey was carried out in Tehran University of Medical Sciences, and a total of 174 fourth-to seventh-year undergraduate medical students were enrolled. The quality of life was assessed by WHOQOL-BREF questionnaire which covers four domains of physical health, psychological, social relationships, and the environment. For assessing internet addiction, we used Internet Addiction Test (IAT) of Young. The students with IAT score higher than 50 were considered as addicted. For evaluating academic performance, the students were requested to report their grade point average (GPA). The mean IA score (±SD) was 34.13±12.76. Twenty-eight students (16.90%) had IAT score above 50. The mean quality of life score in internet addicted group was 54.97±11.38 versus 61.65±11.21 in normal group (P=0.005). Furthermore, there was a negative correlation between IA score and physical domain (r=-0.18, P=0.02); psychological domain (r=-0.35, P=0.000); and social relation domain (r=-0.26, P=0.001). Mean GPA was significantly lower in the addicted group. It seems that quality of life is lower in the internet addicted medical students; moreover, such students academically perform poorer in comparison with non-addicts. Since internet addiction is increasing at a rapid pace which may provoke considerable academic, psychological and social implications; as a result, it may require screening programs to the immediate finding of such problem to give consultations to prevent unwanted complications.

  13. Packaging: a grounded theory of how to report physiological deterioration effectively.

    PubMed

    Andrews, Tom; Waterman, Heather

    2005-12-01

    The aim of this paper is to present a study of how ward-based staff use vital signs and the Early Warning Score to package physiological deterioration effectively to ensure successful referral to doctors. The literature tends to emphasize the identification of premonitory signs in predicting physiological deterioration. However, these signs lack sensitivity and specificity, and there is evidence that nurses rely on subjective and subtle indicators. The Early Warning Score was developed for the early detection of deterioration and has been widely implemented, with various modifications. The data reported here form part of a larger study investigating the practical problems faced by general ward staff in detecting physiological deterioration. During 2002, interviews and observations were carried out using a grounded theory approach, and a total of 44 participants were interviewed (30 nurses, 7 doctors and 7 health care support workers). Participants reported that quantifiable evidence is the most effective means of referring patients to doctors, and the Early Warning Score achieves this by improving communication between professionals. Rather than reporting changes in individual vital signs, the Early Warning Score effectively packages them together, resulting in a much more convincing referral. It gives nurses a precise, concise and unambiguous means of communicating deterioration, and confidence in using medical language. Thus, nurses are empowered and doctors can focus quickly on identified problems. The Early Warning Score leads to successful referral of patients by providing an agreed framework for assessment, increasing confidence in the use of medical language and empowering nurses. It is essential that nurses and nursing students are supported in its use and in developing confidence in using medical language by continued emphasis on physiology and pathophysiology in the nursing curriculum.

  14. The Origins of Mental Toughness – Prosocial Behavior and Low Internalizing and Externalizing Problems at Age 5 Predict Higher Mental Toughness Scores at Age 14

    PubMed Central

    Sadeghi Bahmani, Dena; Hatzinger, Martin; Gerber, Markus; Lemola, Sakari; Clough, Peter J.; Perren, Sonja; von Klitzing, Kay; von Wyl, Agnes; Holsboer-Trachsler, Edith; Brand, Serge

    2016-01-01

    Background: The concept of mental toughness (MT) has gained increasing importance among groups other than elite athletes by virtue of its psychological importance and explanatory power for a broad range of health-related behaviors. However, no study has focused so far on the psychological origins of MT. Therefore, the aims of the present study were: to explore, to what extent the psychological profiles of preschoolers aged five were associated with both (1) MT scores and (2) sleep disturbances at age 14, and 3) to explore possible gender differences. Method: Nine years after their first assessment at age five (preschoolers), a total of 77 adolescents (mean age: 14.35 years; SD = 1.22; 42% females) took part in this follow-up study. At baseline, both parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ), covering internalizing and externalizing problems, hyperactivity, negative peer relationships, and prosocial behavior. At follow-up, participants completed a booklet of questionnaires covering socio-demographic data, MT, and sleep disturbances. Results: Higher prosocial behavior, lower negative peer relationships, and lower internalizing and externalizing problems at age five, as rated by parents and teachers, were associated with self-reported higher MT and lower sleep disturbances at age 14. At age 14, and relative to males, females had lower MT scores and reported more sleep disturbances. Conclusion: The pattern of results suggests that MT traits during adolescence may have their origins in the pre-school years. PMID:27605919

  15. Medical laboratory science and nursing students’ perception of academic learning environment in a Philippine university using Dundee Ready Educational Environment Measure (DREEM)

    PubMed Central

    2016-01-01

    Purpose This study aimed to compare the perception of the academic learning environment between medical laboratory science students and nursing students at Saint Louis University, Baguio City, Philippines. Methods A cross-sectional survey research design was used to measure the perceptions of the participants. A total of 341 students from the Department of Medical Laboratory Science, School of Natural Sciences, and the School of Nursing answered the Dundee Ready Education Environment Measure (DREEM) instrument from April to May 2016. Responses were compared according to course of study, gender, and year level. Results The total mean DREEM scores of the medical laboratory science students and nursing students did not differ significantly when grouped according to course of study, gender, or year level. Medical laboratory science students had significantly lower mean scores in the sub-domains ‘perception of learning’ and ‘perception of teaching.’ Male medical laboratory science students had significantly lower mean scores in the sub-domain ‘perception of learning’ among second year students. Medical laboratory science students had significantly lower mean scores in the sub-domain ‘perception of learning.’ Nursing students identified 7 problem areas, most of which were related to their instructors. Conclusion Medical laboratory science and nursing students viewed their academic learning environment as ‘more positive than negative.’ However, the relationship of the nursing instructors to their students needs improvement. PMID:27649901

  16. Enduring effects of prenatal and infancy home visiting by nurses on children: follow-up of a randomized trial among children at age 12 years.

    PubMed

    Kitzman, Harriet J; Olds, David L; Cole, Robert E; Hanks, Carole A; Anson, Elizabeth A; Arcoleo, Kimberly J; Luckey, Dennis W; Knudtson, Michael D; Henderson, Charles R; Holmberg, John R

    2010-05-01

    To test the effect of prenatal and infancy home visits by nurses on 12-year-old, firstborn children's use of substances, behavioral adjustment, and academic achievement. Randomized controlled trial. Public system of obstetric and pediatric care in Memphis, Tennessee. We studied 12-year-old, firstborn children (n = 613) of primarily African American, economically disadvantaged women (743 randomized during pregnancy). Program of prenatal and infancy home visits by nurses. Use of cigarettes, alcohol, and marijuana; internalizing, externalizing, and total behavioral problems; and academic achievement. By the time the firstborn child was 12 years of age, those visited by nurses, compared with those in the control group, reported fewer days of having used cigarettes, alcohol, and marijuana during the 30-day period before the 12-year interview (0.03 vs 0.18, P = .02) and were less likely to report having internalizing disorders that met the borderline or clinical threshold (22.1% vs 30.9%, P = .04). Nurse-visited children born to mothers with low psychological resources, compared with their control group counterparts, scored higher on the Peabody Individual Achievement Tests in reading and math (88.78 vs 85.70, P = .009) and, during their first 6 years of education, scored higher on group-administered standardized tests of math and reading achievement (40.52 vs 34.85, P = .02). No statistically significant program effects were found on children's externalizing or total behavioral problems. Through age 12, the program reduced children's use of substances and internalizing mental health problems and improved the academic achievement of children born to mothers with low psychological resources.

  17. Reliability and validity of the Dutch pediatric Voice Handicap Index.

    PubMed

    Veder, Laura; Pullens, Bas; Timmerman, Marieke; Hoeve, Hans; Joosten, Koen; Hakkesteegt, Marieke

    2017-05-01

    The pediatric voice handicap index (pVHI) has been developed to provide a better insight into the parents' perception of their child's voice related quality of life. The purpose of the present study was to validate the Dutch pVHI by evaluating its internal consistency and reliability. Furthermore, we determined the optimal cut-off point for a normal pVHI score. All items of the English pVHI were translated into Dutch. Parents of children in our dysphonic and control group were asked to fill out the questionnaire. For the test re-test analysis we used a different study group who filled out the pVHI twice as part of a large follow up study. Internal consistency was analyzed through Cronbach's α coefficient. The test-retest reliability was assessed by determining Pearson's correlation coefficient. Mann-Whitney test was used to compare the scores of the questionnaire of the control group with the dysphonic group. By calculating receiver operating characteristic (ROC) curves, sensitivity and specificity we were able to set a cut-off point. We obtained data from 122 asymptomatic children and from 79 dysphonic children. The scores of the questionnaire significantly differed between both groups. The internal consistency showed an overall Cronbach α coefficient of 0.96 and an excellent test-retest reliability of the total pVHI questionnaire with a Pearson's correlation coefficient of 0.90. A cut-off point for the total pVHI questionnaire was set at 7 points with a specificity of 85% and sensitivity of 100%. A cut-off point for the VAS score was set at 13 with a specificity of 93% and sensitivity of 97%. The Dutch pVHI is a valid and reliable tool for the assessment of children with voice problems. By setting a cut-off point for the score of the total pVHI questionnaire of 7 points and the VAS score of 13, the pVHI might be used as a screening tool to assess dysphonic complaints and the pVHI might be a useful and complementary tool to identify children with dysphonia. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Social problem-solving in Chinese baccalaureate nursing students.

    PubMed

    Fang, Jinbo; Luo, Ying; Li, Yanhua; Huang, Wenxia

    2016-11-01

    To describe social problem solving in Chinese baccalaureate nursing students. A descriptive cross-sectional study was conducted with a cluster sample of 681 Chinese baccalaureate nursing students. The Chinese version of the Social Problem-Solving scale was used. Descriptive analyses, independent t-test and one-way analysis of variance were applied to analyze the data. The final year nursing students presented the highest scores of positive social problem-solving skills. Students with experiences of self-directed and problem-based learning presented significantly higher scores in Positive Problem Orientation subscale. The group with Critical thinking training experience, however, displayed higher negative problem solving scores compared with nonexperience group. Social problem solving abilities varied based upon teaching-learning strategies. Self-directed and problem-based learning may be recommended as effective way to improve social problem-solving ability. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  19. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population.

    PubMed

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A; Ono, Yutaka

    2016-01-01

    Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical pattern.

  20. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    PubMed Central

    Kawasaki, Yohei; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A.; Ono, Yutaka

    2016-01-01

    Background Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Methods Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. Results The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. Discussion The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical pattern. PMID:27761346

  1. Measuring social anxiety in college students: a comprehensive evaluation of the psychometric properties of the SPAI-23.

    PubMed

    Schry, Amie R; Roberson-Nay, Roxann; White, Susan W

    2012-12-01

    Social anxiety disorder (SAD) is 1 of the most prevalent psychological disorders, and among college students in particular, social anxiety has been associated with other problems such as substance use problems and increased vulnerability to other psychiatric disorders. The Social Phobia and Anxiety Inventory-23 (SPAI-23; Roberson-Nay, Strong, Nay, Beidel, & Turner, 2007) may be a useful, brief measure of problematic social anxiety in college students. Results from 4 studies (total n = 2,436) using the SPAI-23 with college student samples are presented. Scores on the SPAI-23 demonstrated strong convergent validity with other measures of social anxiety and discriminant validity as evidenced by lower correlations with measures of dissimilar constructs. Difference scores on the SPAI-23 also demonstrated adequate test-retest reliability over 5 ½ weeks (r = .72). Exploratory factor analysis suggested a two-factor structure: social anxiety and agoraphobia. Finally, differential item function analyses suggested that the items function similarly in men and women. In conclusion, the SPAI-23 demonstrated strong psychometric properties for use with college students.

  2. Gender Differences in the Behavioral Symptom Severity of Prader-Willi Syndrome.

    PubMed

    Gito, Masao; Ihara, Hiroshi; Ogata, Hiroyuki; Sayama, Masayuki; Murakami, Nobuyuki; Nagai, Toshiro; Ayabe, Tadayuki; Oto, Yuji; Shimoda, Kazutaka

    2015-01-01

    This study measured gender differences in Prader-Willi syndrome (PWS) in regard to the severity of behavioral symptoms. The Food Related Problem Questionnaire (FRPQ), the Aberrant Behavior Checklist Japanese Version, the Childhood Routines Inventory, the Pervasive Developmental Disorders Autism Society Japan Rating Scale, and Japanese ADHD-RS were administered to PWS patients (45 males aged 6 to 58 and 37 females aged 6 to 45). To examine the effects that gender and genotype have on the severity of each symptom, two-way ANOVAs were conducted. Significant interactions were found only in regard to FRPQ scores, such as FRPQ total score (F(1, 78) = 8.43, p < 0.01). The FRPQ of male deletion (DEL) individuals was higher than that of female DEL and male mUPD. The FRPQ of male maternal uniparental disomy (mUPD) was lower than that of female mUPD. In terms of problem behaviors, routines, autistic behaviors, and hyperactivity, no significant differences were found. Food-related behaviors in DEL were more severe in males, although those in mUPD were less severe in males.

  3. Decision-making in multiple sclerosis consultations in Italy: third observer and patient assessments.

    PubMed

    Pietrolongo, Erika; Giordano, Andrea; Kleinefeld, Monica; Confalonieri, Paolo; Lugaresi, Alessandra; Tortorella, Carla; Pugliatti, Maura; Radice, Davide; Goss, Claudia; Heesen, Christoph; Solari, Alessandra

    2013-01-01

    To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives. Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS). Mean patient age was 37.5, 66% were women, 72% had MS, and 28% had possible MS or other disease. Mean PICS subscale scores (range 0 poor, 100 best possible) were 71.9 (SD 24.3) for "physician facilitation" (PICS-F); 74.6 (SD 22.9) for "patient information exchange" (PICS-I); and only 22.5 (SD 16.2) for "patient decision making" (PICS-DM). Mean OPTION total score (0 poor, 100 best possible) was 29.6 (SD 10.3). Poorest OPTION scores were found for items assessing "preferred patient approach to receiving information" and "preferred patient level of involvement." Highest scores were for "clinician drawing attention to identified problem", "indicating need for decision making," and "need to review the decision." Consultation time, woman physician, patient-physician gender concordance and PICS-F were associated with higher OPTION total score; older physician and second opinion consultation were associated with lower OPTION score. In line with findings in other settings, our third observer findings indicated limited patient involvement abilities of MS physicians during first consultations. Patient perceptions of physician skills were better than third observers', although they correlated. Consultations with women physicians, and younger physicians, were associated with higher third observer and patient-based scores. Our findings reveal a need to empower Italian MS physicians with better communication and shared decision-making skills, and show in particular that attention to MS patient preferences for reception of information and involvement in health decisions, need to be improved.

  4. Prevalence of depressive symptoms and associated developmental disorders in preschool children: a population-based study.

    PubMed

    Fuhrmann, Pia; Equit, Monika; Schmidt, Karin; von Gontard, Alexander

    2014-04-01

    Depression is an incapacitating disorder, which is often overlooked in preschool children. The aim of this study was to analyse the prevalence of depressive symptoms and co-occurring risk factors in a large, population-based sample of preschool children. All 653 children (of a total of 731) in a defined geographical area were assessed during the school-entry exam by community care paediatricians. In addition to clinical appraisal, parents filled out the Preschool Feelings Checklist, a 16-item screening instrument with good psychometric properties. The mean age was 6.2 years (range 5.0-7.6 years) and the sample included 344 boys and 305 girls. The prevalence of depressive symptoms of clinical relevance (total score ≥3) was 5.7% (37). There were no differences between boys and girls, and between younger (<6 years) and older (>6 years) children. Depressive symptoms were associated with parental separation and comorbid behavioural problems, but especially with developmental motor and speech problems and disorders. Migration to Germany had no influence. Depressive symptoms are common in preschool children and associated with developmental problems. Depression should be considered in children with speech and motor problems who are at special risk. Early detection and treatment are recommended.

  5. The prevalence of mental illness in homeless children: a systematic review and meta-analysis.

    PubMed

    Bassuk, Ellen L; Richard, Molly K; Tsertsvadze, Alexander

    2015-02-01

    The numbers of children experiencing homelessness have increased. To develop responsive interventions, we must understand their mental health/behavioral needs. The purpose of this systematic review was to update the evidence base by identifying, appraising, and summarizing studies on the prevalence of mental health issues among homeless children, comparing these individuals to low-income-housed children, and discussing research, practice, and policy implications. We searched 3 electronic databases and included empirical studies investigating the prevalence of mental illness in homeless children in the United States (1990-2014). Retrieved publications were screened, data extracted, and study quality appraised by independent reviewers. Evidence synthesis was based on qualitative and quantitative analyses. Prevalence odds ratios (OR) of individual studies were pooled using an inverse-variance random effects model. Twelve studies were included and reviewed. Overall, 10% to 26% of homeless preschoolers had mental health problems requiring clinical evaluation. This proportion increased to 24% to 40% among homeless school-age children, a rate 2 to 4 times higher than poor children aged 6 to 11 years in the National Survey of America's Families. According to our meta-analyses, the difference in prevalence measured by Child Behavior Checklist (CBCL) Total Problems (T score ≥60-64) was not significantly different between homeless and housed preschool children (OR = 1.49; 95% CI = 0.97-2.28). School-age homeless children compared to housed children were significantly more likely to have a mental health problem as defined by the CBCL Total Problems subscale (T score ≥60; OR = 1.78; 95% CI = 1.19-2.66). Evidence-based mental health interventions for children experiencing homelessness are long overdue. Universal screening, treatment plan development, and support of adaptive systems that focus on positive parenting and children's self-regulation are essential. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Correlations between impairment, psychological distress, disability, and quality of life in peripheral facial palsy.

    PubMed

    Díaz-Aristizabal, U; Valdés-Vilches, M; Fernández-Ferreras, T R; Calero-Muñoz, E; Bienzobas-Allué, E; Moracén-Naranjo, T

    2017-05-23

    This paper analyses the correlations between scores on scales assessing impairment, psychological distress, disability, and quality of life in patients with peripheral facial palsy (PFP). We conducted a retrospective cross-sectional study including 30 patients in whom PFP had not resolved completely. We used tools for assessing impairment (Sunnybrook Facial Grading System [FGS]), psychological distress (Hospital Anxiety and Depression Scale [HADS]), disability (Facial Disability Index [FDI]), and quality of life (Facial Clinimetric Evaluation [FaCE] scale). We found no correlations between FGS and HADS scores, or between FGS and FDI social function scores. However, we did find a correlation between FGS and FDI physical function scores (r=0.54; P<.01), FDI total score (r=0.4; P<.05), FaCE total scores (ρ=0.66; P<.01), and FaCE social function scores (ρ=0.5; P<.01). We also observed a correlation between HADS Anxiety scores and FDI physical function (r=-0.47; P<.01), FDI social function (r=-0.47; P<.01), FDI total (r=-0.55; P<.01), FaCE total (ρ=-0.49; P<.01), and FaCE social scores (ρ=-0.46; P<.05). Significant correlations were also found between HADS Depression scores and FDI physical function (r=-0.61; P<.01), FDI social function (r=-0.53; P<.01), FDI total (r=-0.66; P<.01), FaCE total (ρ=-0.67; P<.01), and FaCE social scores (ρ=-0.68; P<.01), between FDI physical function scores and FaCE total scores (ρ=0.87; P<.01) and FaCE social function (ρ=0.74; P<.01), between FDI social function and FaCE total (ρ=0.66; P<.01) and FaCE social function scores (ρ=0.72; P<.01), and between FDI total scores and FaCE total (ρ = 0,87; P<.01) and FaCE social function scores (ρ=0.84; P<.01). In our sample, patients with more severe impairment displayed greater physical and global disability and poorer quality of life without significantly higher levels of social disability and psychological distress. Patients with more disability experienced greater psychological distress and had a poorer quality of life. Lastly, patients with more psychological distress also had a poorer quality of life. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Comparison of self-reported emotional and behavioural problems in adolescents from Greece and Finland.

    PubMed

    Kapi, Aikaterini; Veltsista, Alexandra; Sovio, Ulla; Järvelin, Marjo-Riitta; Bakoula, Chryssa

    2007-08-01

    To compare self-reported emotional and behavioural problems among Greek and Finnish adolescents. Youth Self-Report scores were analysed for 3373 Greek adolescents aged 18 years and 7039 Finnish adolescents aged 15-16 years from the general population in both countries. The impact of country, gender, place of residence, socioeconomic status (SES) and family stability on the scores was evaluated. Only country and gender yielded small to medium effect on the scores. Greek boys scored significantly higher than Finns on 10 of the 11 YSR syndromes, particularly on the anxious/depressed scale. Greek girls scored significantly lower than Finnish girls on the somatic complaints and delinquent behaviour scales. In general, girls scored higher than boys on both internalising and externalising problems. The gender by country interaction revealed that Finnish girls reported more externalising problems. The main differences marked in this comparison were the higher level of anxiety and depression in Greeks than Finns and the higher level of externalising problems in Finnish girls than boys. Cultural standards could play an important role in explaining these differences. Overall, it seems that only a small number of differences exist between a northern and southern European region.

  8. What does the MADRS mean? Equipercentile linking with the CGI using a company database of mirtazapine studies.

    PubMed

    Leucht, Stefan; Fennema, Hein; Engel, Rolf R; Kaspers-Janssen, Marion; Lepping, Peter; Szegedi, Armin

    2017-03-01

    Little is known about the clinical relevance of the Montgomery Asberg Depression Rating Scale (MADRS) total scores. It is unclear how total scores translate into clinical severity, or how commonly used measures for response (reduction from baseline of ≥50% in the total score) translate into clinical relevance. Moreover, MADRS based definitions of remission vary. We therefore compared: a/ the MADRS total score with the Clinical Global Impression - Severity Score (CGI-S) b/ the percentage and absolute change in the MADRS total scores with Clinical Global Impression - Improvement (CGI-I); c/ the absolute and percentage change in the MADRS total scores with CGI-S absolute change. The method used was equipercentile linking of MADRS and CGI ratings from 22 drug trials in patients with Major Depressive Disorder (MDD) (n=3288). Our results confirm the validity of the commonly used measures for response in MDD trials: a CGI-I score of 2 ('much improved') corresponded to a percentage MADRS reduction from baseline of 48-57%, and a CGI-I score of 1 ('very much improved') to a reduction of 80-84%. If a state of almost complete absence of symptoms were required for a definition of remission, a MADRS total score would be <8, because such scores corresponded to a CGI-S score of 2 ('borderline mentally ill'). Although our analysis is based on a large number of patients, the original trials were not specifically designed to examine our research question. The results might contribute to a better understanding and improved interpretation of clinical trial results in MDD. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Psychological adjustment and behaviours in children of migrant workers in China.

    PubMed

    Wang, F; Zhou, X; Hesketh, T

    2017-11-01

    In China, there are around 274 million rural-urban migrants, an estimated 61 million children left behind in rural areas by parents, and 29 million children who accompany their parents to cities. The aim of this study was to compare the psychosocial adjustment and behaviours of left-behind children and migrant children. Full data were available for 761 left-behind children and 1,392 migrant children aged 11 to 17 in Zhejiang Province, eastern China. Participants completed a questionnaire focusing on migration status, risks behaviours, and psychological well-being, measured with the Strengths and Difficulties Questionnaire. There were more left behind girls and more urban migrant boys (p < .001). The mean scores on the Strengths and Difficulties Questionnaire were all higher in left-behind children than migrant children: for emotional symptoms (3.82 vs. 3.03, p < .001), conduct problems (2.55 vs. 2.41, p = .048), hyperactivity (4.25 vs. 3.81, p < .001), and total difficulties (13.46 vs. 12.00, p = .020), whereas the prosocial score was lower (6.68 vs. 6.90, p < .001), all indicating lower levels of well-being in left-behind children. Overall, 11.4% of left-behind children and 8.8% of migrant children scored in the abnormal range for total difficulties. Left behind girls were particularly vulnerable to emotional problems. Left-behind children were more likely to admit to stealing and cheating on exams, but there were no differences in other risks behaviours, such as smoking and drinking. Migration with parents, rather than separation from parents, was associated with better psychological well-being and fewer behavioural problems. Our findings have relevance for migrant parents in helping to inform decisions about where to raise their children as well as for policymakers in countries where migration is a major issue. When children are left behind, models of community support need to be considered, especially for those who are most vulnerable. © 2017 John Wiley & Sons Ltd.

  10. Best candidates for cognitive treatment of illness perceptions in chronic low back pain: results of a theory-driven predictor study.

    PubMed

    Siemonsma, Petra C; Stuvie, Ilse; Roorda, Leo D; Vollebregt, Joke A; Lankhorst, Gustaaf J; Lettinga, Ant T

    2011-04-01

    The aim of this study was to identify treatment-specific predictors of the effectiveness of a method of evidence-based treatment: cognitive treatment of illness perceptions. This study focuses on what treatment works for whom, whereas most prognostic studies focusing on chronic non-specific low back pain rehabilitation aim to reduce the heterogeneity of the population of patients who are suitable for rehabilitation treatment in general. Three treatment-specific predictors were studied in patients with chronic non-specific low back pain receiving cognitive treatment of illness perceptions: a rational approach to problem-solving, discussion skills and verbal skills. Hierarchical linear regression analysis was used to assess their predictive value. Short-term changes in physical activity, measured with the Patient-Specific Functioning List, were the outcome measure for cognitive treatment of illness perceptions effect. A total of 156 patients with chronic non-specific low back pain participated in the study. Rational problem-solving was found to be a significant predictor for the change in physical activity. Discussion skills and verbal skills were non-significant. Rational problem-solving explained 3.9% of the total variance. The rational problem-solving scale results are encouraging, because chronic non-specific low back pain problems are complex by nature and can be influenced by a variety of factors. A minimum score of 44 points on the rational problem-solving scale may assist clinicians in selecting the most appropriate candidates for cognitive treatment of illness perceptions.

  11. Stress and prevalence of hearing problems in the Swedish working population

    PubMed Central

    2011-01-01

    Background Current human and experimental studies are indicating an association between stress and hearing problems; however potential risk factors have not been established. Hearing problems are projected to become among the top ten disabilities according to the WHO in the near future. Therefore a better understanding of the relationships between stress and hearing is warranted. Here we describe the prevalence of two common hearing problems, i.e. hearing complaints and tinnitus, in relation to different work-and health-related stressors. Methods A total of 18,734 individuals were invited to participate in the study, out of which 9,756 (52%) enrolled. Results The results demonstrate a clear and mostly linear relationship between higher prevalence of hearing problems (tinnitus or hearing loss or both) and different stressors, e.g. occupational, poorer self-rated health, long-term illness, poorer sleep quality, and higher burnout scores. Conclusions The present study unambiguously demonstrates associations between hearing problems and various stressors that have not been previously described for the auditory system. These findings will open new avenues for future investigations. PMID:21345187

  12. Vulnerability for autism traits in boys and men with an extra X chromosome (47,XXY): the mediating role of cognitive flexibility.

    PubMed

    van Rijn, Sophie; Bierman, Marit; Bruining, Hilgo; Swaab, Hanna

    2012-10-01

    The XXY chromosomal pattern (Klinefelter syndrome, KS) has been associated with specific effects on physical, neurobiological, endocrinological and psychological development. This study was focused on the described risk for autism in KS, and the cognitive mechanisms that mediate this risk. Our aim was to assess whether autistic features in KS result from impairments in executive functioning, more specifically difficulties in cognitive flexibility. In total, 71 boys and men with KS and 61 non-clinical controls participated in the study. Autistic features were assessed using the Autism-spectrum Quotient (AQ). Mental flexibility was measured using the Wisconsin Card Sorting Test (WCST). The level of autism traits was significantly increased in the KS group, the effect size for total AQ score was 1.6. The KS group also showed significantly more difficulties in cognitive flexibility, as indicated by and increased number of perseverative (but not non-perseverative) errors in the WCST. This effect was independent of intellectual functioning, age or testosterone supplements. Within the KS group, the number of perseverative errors was significantly (positively) correlated with total AQ score. Our findings suggest that KS can be associated with dysfunctions in mental flexibility, and that individuals with more mental flexibility problems also have more autism traits. This insight is relevant for diagnosis, prevention and treatment of severe problems in individuals with KS. Implications also extend beyond this specific syndrome. As executive dysfunctions in KS have also been linked to ADHD symptoms and thought disorder, this could be a shared mechanism contributing to overlap in symptoms and comorbidity between different psychiatric conditions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial.

    PubMed

    Johnson, Aimee K; Johnson, Alisa J; Barton, Debra; Elkins, Gary

    2016-01-01

    Sexual dysfunction is a common problem for postmenopausal women. This study, as part of a larger randomized controlled trial, examined the effect of hypnotic relaxation therapy on sexual dysfunction, a secondary study outcome, in postmenopausal women. Sexual function was assessed using the Sexual Activity Questionnaire (SAQ). Significant improvement in sexual pleasure and discomfort were reported following 5 weekly sessions of hypnotic relaxation therapy, compared with those receiving an attention control. Total SAQ scores showed significant improvement in the hypnotic relaxation therapy treatment group while holding baseline SAQ scores constant. Improvements showed a slight increase at the Week 12 follow-up. The results of this analysis provide initial support for the use of hypnotic relaxation therapy to improve sexual function in postmenopausal women.

  14. Conduct symptoms and emotion recognition in adolescent boys with externalization problems.

    PubMed

    Aspan, Nikoletta; Vida, Peter; Gadoros, Julia; Halasz, Jozsef

    2013-01-01

    In adults with antisocial personality disorder, marked alterations in the recognition of facial affect were described. Less consistent data are available on the emotion recognition in adolescents with externalization problems. The aim of the present study was to assess the relation between the recognition of emotions and conduct symptoms in adolescent boys with externalization problems. Adolescent boys with externalization problems referred to Vadaskert Child Psychiatry Hospital participated in the study after informed consent (N = 114, 11-17 years, mean = 13.4). The conduct problems scale of the strengths and difficulties questionnaire (parent and self-report) was used. The performance in a facial emotion recognition test was assessed. Conduct problems score (parent and self-report) was inversely correlated with the overall emotion recognition. In the self-report, conduct problems score was inversely correlated with the recognition of anger, fear, and sadness. Adolescents with high conduct problems scores were significantly worse in the recognition of fear, sadness, and overall recognition than adolescents with low conduct scores, irrespective of age and IQ. Our results suggest that impaired emotion recognition is dimensionally related to conduct problems and might have importance in the development of antisocial behavior.

  15. Atherosclerotic involvement in patients with left or right dominant coronary circulation.

    PubMed

    Balci, Bahattin; Yilmaz, Ozcan

    2004-06-01

    There are variations in the anatomy of the coronary arteries in patients with left dominant circulation. The influence of anatomical variations in patients with left dominant circulation on coronary arteriosclerosis is not clear. We investigated whether atherosclerotic involvement in patients with left dominant circulation differs from that in patients with right dominant circulation. We retrospectively compared 38 consecutive angiograms with left coronary dominance with 459 consecutive angiograms with right coronary dominance. By using the 29-segment coding system of the American College of Cardiology/American Heart Association, numerical values were given to each segment, according to the percentage of the decrease in luminary diameter. Using, the sum of numerical values in each coronary artery, LAD score, LCx score, RCA score, and left main coronary artery (LMCA) score were obtained. Using the sum of these 4 vessel scores, the coronary artery disease (CAD) score was calculated. Total LAD score (49+/-48 vs 47+/-57), total LCx score (29+/-45 vs 41+/-58), total RCA score (32+/-68 vs 30+/-51), total LMCA score (1.8+/-11.3 vs 2.9+/-13.6) and total CAD score (108+/-108 vs 108+/-123) were similar in patients with left and right dominant circulation (all differences NS). The extent of coronary atherosclerosis does not depend on the type of dominant coronary circulation.

  16. Assertiveness and problem solving in midwives

    PubMed Central

    Yurtsal, Zeliha Burcu; Özdemir, Levent

    2015-01-01

    Background: Midwifery profession is required to bring solutions to problems and a midwife is expected to be an assertive person and to develop midwifery care. This study was planned to examine the relationship between assertiveness and problem-solving skills of midwives. Materials and Methods: This cross-sectional study was conducted with 201 midwives between July 2008 and February 2009 in the city center of Sivas. The Rathus Assertiveness Schedule (RAS) and Problem Solving Inventory (PSI) were used to determine the level of assertiveness and problem-solving skills of midwives. Statistical methods were used as mean, standard deviation, percentage, Student's T, ANOVA and Tukey HSD, Kruskal Wallis, Fisher Exact, Pearson Correlation and Chi-square tests and P < 0.05. Results: The RAS mean scores and the PSI mean scores showed statistically significant differences in terms of a midwife's considering herself as a member of the health team, expressing herself within the health care team, being able to say “no” when necessary, cooperating with her colleagues, taking part in problem-solving skills training. A statistically significant negative correlation was found between the RAS and PSI scores. The RAS scores decreased while the problem-solving scores increased (r: -0451, P < 0.01). Conclusions: There were significant statistical differences between assertiveness levels and problem solving skills of midwives, and midwives who were assertive solved their problems better than did others. Assertiveness and problem-solving skills training will contribute to the success of the midwifery profession. Midwives able to solve problems, and display assertive behaviors will contribute to the development of midwifery profession. PMID:26793247

  17. Gender Differences in Perceived Social Support and Stressful Life Events in Depressed Patients.

    PubMed

    Soman, S; Bhat, S M; Latha, K S; Praharaj, S K

    2016-03-01

    To study the gender differences in perceived social support and life events in patients with depression. A total of 118 patients aged 18 to 60 years, with depressive disorder according to the DSM-IV-TR, were evaluated using the Multidimensional Scale of Perceived Social Support and Presumptive Stressful Life Events Scale. The perceived social support score was significantly higher in males than females (p < 0.001). Males perceived significantly higher social support from friends than females (p < 0.001), whereas support from significant others was higher in females. There was a higher mean number of total life events as well as specific type of life events in males that became apparent after controlling for education (p < 0.05). Financial loss or problems was the most commonly reported life event in both males and females. Work-related problems were more commonly reported by males, whereas family and marital conflict were more frequently reported by females. Perceived social support and stressful life events were higher in males with depression than females.

  18. Hours of sleep in adolescents and its association with anxiety, emotional concerns, and suicidal ideation.

    PubMed

    Sarchiapone, Marco; Mandelli, Laura; Carli, Vladimir; Iosue, Miriam; Wasserman, Camilla; Hadlaczky, Gergö; Hoven, Christina W; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Haring, Christian; Kaess, Michael; Keeley, Helen; Keresztény, Agnes; Kahn, Jean-Pierre; Postuvan, Vita; Mars, Urša; Saiz, Pilar A; Varnik, Peter; Sisask, Merike; Wasserman, Danuta

    2014-02-01

    Anxiety and concerns in daily life may result in sleep problems and consistent evidence suggests that inadequate sleep has several negative consequences on cognitive performance, physical activity, and health. The aim of our study was to evaluate the association between mean hours of sleep per night, psychologic distress, and behavioral concerns. A cross-sectional analysis of the correlation between the number of hours of sleep per night and the Zung Self-rating Anxiety Scale (Z-SAS), the Paykel Suicidal Scale (PSS), and the Strengths and Difficulties Questionnaire (SDQ), was performed on 11,788 pupils (mean age±standard deviation [SD], 14.9±0.9; 55.8% girls) from 11 different European countries enrolled in the SEYLE (Saving and Empowering Young Lives in Europe) project. The mean number of reported hours of sleep per night during school days was 7.7 (SD, ±1.3), with moderate differences across countries (r=0.06; P<.001). A reduced number of sleeping hours (less than the average) was more common in girls (β=0.10 controlling for age) and older pupils (β=0.10 controlling for sex). Reduced sleep was found to be associated with increased scores on SDQ subscales of emotional (β=-0.13) and peer-related problems (β=-0.06), conduct (β=-0.07), total SDQ score (β=-0.07), anxiety (Z-SAS scores, β=-10), and suicidal ideation (PSS, β=-0.16). In a multivariate model including all significant variables, older age, emotional and peer-related problems, and suicidal ideation were the variables most strongly associated with reduced sleep hours, though female gender, conduct problems measured by the SDQ, and anxiety only showed modest effects (β=0.03-0.04). Our study supports evidence that reduced hours of sleep are associated with potentially severe mental health problems in adolescents. Because sleep problems are common among adolescents partly due to maturational processes and changes in sleep patterns, parents, other adults, and adolescents should pay more attention to their sleep patterns and implement interventions, if needed. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Antisocial and psychopathic personalities in a sample of addicted subjects: differences in psychological resources, symptoms, alexithymia and impulsivity.

    PubMed

    Gori, Alessio; Craparo, Giuseppe; Sareri, Giuseppe Iraci; Caretti, Vincenzo; Giannini, Marco; Meringolo, Patrizia

    2014-10-01

    Psychopathy and antisocial personality disorder (ASPD) are two constructs not interchangeable. Compared to the ASPD, psychopathy is characterized by lack of anxiety, low withdrawal, and high levels of attention seeking. The sample of this study included 76 subjects with a substance use disorder. Subjects were aged between 18 and 59 years old (M=32.87, SD=9.36). With respect to level of education 3 subjects are elementary school graduates, 49 have a middle school diploma, 21 own a high school diploma, and 3 participants have a bachelor's degree. We administered the following measures: a) Psychopathic Personality Inventory-Revised (PPI-R); b) Psychological Treatment Inventory (PTI); c) 20-Item-Toronto Alexithymia Scale (TAS-20); d) Barratt Impulsiveness Scale (BIS). Most of the significant correlations between the Psychopathic Index (PPI-R total score), and the measures administered are listed below: PPI-R total score and Deviance (r=.482, p<.001), PPI-R total score and Hypomania (r=.369, p < .001), PPI-R total score and Unresolved attachment (r=.293, p<.001), PPI-R total score and Manipulativeness (r=.550, p<.001), PPI-R total score and the TAS-20 total score (r=.230; p<.001), PPI-R total score and Difficulty in Identifying Feelings (DIF) factor (r=.250, p<.001), PPI-R total score and Attentional Impulsiveness (r=.409, p<.001); PPI-R total score and Motor Impulsiveness (r=.526, p<.001). Results of MANOVAs between the two groups also revealed significant differences on several variables analyzed. Our study showed that addicted subjects with psychopathic tendencies are more likely to experience negative emotions and have a peculiar cognitive style with respect to antisocial addicts. These results partially confirm those ones of previous studies underlining that psychopathic population is generally characterized for a major need for stimulation, poor behavioral controls, lack of realistic long-term goals, impulsivity, irresponsibility. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Novel examination for evaluating medical student clinical reasoning: reliability and association with patients seen.

    PubMed

    Hemmer, Paul A; Dong, Ting; Durning, Steven J; Pangaro, Louis N

    2015-04-01

    Medical students learn clinical reasoning, in part, through patient care. Although the numbers of patients seen is associated with knowledge examination scores, studies have not demonstrated an association between patient problems and an assessment of clinical reasoning. To examine the reliability of a clinical reasoning examination and investigate whether there was association between internal medicine core clerkship students' performance on this examination and the number of patients they saw with matching problems during their internal medicine clerkship. Students on the core internal medicine clerkship at the Uniformed Services University students log 11 core patient problems based on the Clerkship Directors in Internal Medicine curriculum. On a final clerkship examination (Multistep), students watch a scripted video encounter between physician and patient actors that assesses three sequential steps in clinical reasoning: Step One focuses on history and physical examination; Step Two, students write a problem list after viewing additional clinical findings; Step Three, students complete a prioritized differential diagnosis and treatment plan. Each Multistep examination has three different cases. For graduating classes 2010-2012 (n = 497), we matched the number of patients seen with the problem most represented by the Multistep cases (epigastric pain, generalized edema, monoarticular arthritis, angina, syncope, pleuritic chest pain). We report two-way Pearson correlations between the number of patients students reported with similar problems and the student's percent score on: Step One, Step Two, Step Three, and Overall Test. Multistep reliability: Step 1, 0.6 to 0.8; Step 2, 0.41 to 0.65; Step 3, 0.53 to 0.78; Overall examination (3 cases): 0.74 to 0.83. For three problems, the number of patients seen had small to modest correlations with the Multistep Examination of Analytic Ability total score (r = 0.27 for pleuritic pain, p < 0.05, n = 81 patients; r = 0.14 for epigastric pain, p < 0.05, n = 324 patients; r = 0.19 for generalized edema, p < 0.05, n = 118 patients). DISCUSSION or Although a reliable assessment, student performance on a clinical reasoning examination was weakly associated with the numbers of patients seen with similar problems. This may be as a result of transfer of knowledge between clinical and examination settings, the complexity of clinical reasoning, or the limits of reliability with patient logs and the Multistep. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  1. Anxiety, Anxiety Sensitivity, and Perceived Stress as Predictors of Recent Drinking, Alcohol Craving, and Social Stress Response in Heavy Drinkers.

    PubMed

    McCaul, Mary E; Hutton, Heidi E; Stephens, Mary Ann C; Xu, Xiaoqiang; Wand, Gary S

    2017-04-01

    Stress and anxiety are widely considered to be causally related to alcohol craving and consumption, as well as development and maintenance of alcohol use disorder (AUD). However, numerous preclinical and human studies examining effects of stress or anxiety on alcohol use and alcohol-related problems have been equivocal. This study examined relationships between scores on self-report anxiety, anxiety sensitivity, and stress measures and frequency and intensity of recent drinking, alcohol craving during early withdrawal, as well as laboratory measures of alcohol craving and stress reactivity among heavy drinkers with AUD. Media-recruited, heavy drinkers with AUD (N = 87) were assessed for recent alcohol consumption. Anxiety and stress levels were characterized using paper-and-pencil measures, including the Beck Anxiety Inventory (BAI), the Anxiety Sensitivity Index-3 (ASI-3), and the Perceived Stress Scale (PSS). Eligible subjects (N = 30) underwent alcohol abstinence on the Clinical Research Unit; twice daily measures of alcohol craving were collected. On day 4, subjects participated in the Trier Social Stress Test; measures of cortisol and alcohol craving were collected. In multivariate analyses, higher BAI scores were associated with lower drinking frequency and reduced drinks/drinking day; in contrast, higher ASI-3 scores were associated with higher drinking frequency. BAI anxiety symptom and ASI-3 scores also were positively related to Alcohol Use Disorders Identification Test total scores and AUD symptom and problem subscale measures. Higher BAI and ASI-3 scores but not PSS scores were related to greater self-reported alcohol craving during early alcohol abstinence. Finally, BAI scores were positively related to laboratory stress-induced cortisol and alcohol craving. In contrast, the PSS showed no relationship with most measures of alcohol craving or stress reactivity. Overall, clinically oriented measures of anxiety compared with perceived stress were more strongly associated with a variety of alcohol-related measures in current heavy drinkers with AUD. Copyright © 2017 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley Periodicals, Inc. on behalf of Research Society on Alcoholism.

  2. Emotion dysregulation, problem-solving, and hopelessness.

    PubMed

    Vatan, Sevginar; Lester, David; Gunn, John F

    2014-04-01

    A sample of 87 Turkish undergraduate students was administered scales to measure hopelessness, problem-solving skills, emotion dysregulation, and psychiatric symptoms. All of the scores from these scales were strongly associated. In a multiple regression, hopelessness scores were predicted by poor problem-solving skills and emotion dysregulation.

  3. Do continuing medical education articles foster shared decision making?

    PubMed

    Labrecque, Michel; Lafortune, Valérie; Lajeunesse, Judith; Lambert-Perrault, Anne-Marie; Manrique, Hermes; Blais, Johanne; Légaré, France

    2010-01-01

    Defined as reviews of clinical aspects of a specific health problem published in peer-reviewed and non-peer-reviewed medical journals, offered without charge, continuing medical education (CME) articles form a key strategy for translating knowledge into practice. This study assessed CME articles for mention of evidence-based information on benefits and harms of available treatment and/or preventive options that are deemed essential for shared decision making (SDM) to occur in clinical practice. Articles were selected from 5 medical journals that publish CME articles and are provided free of charge to primary-care physicians of the Province of Quebec, Canada. Two individuals independently scored each article with the use of a 10-item checklist based on the International Patient Decision Aid Standards. In case of discrepancy, the item score was established by team consensus. Scores were added to produce a total article score ranging from 0 (no item present) to 10 (all items present). Thirty articles (6 articles per journal) were selected. Total article scores ranged from 1 to 9, with a mean (+/- SD) of 3.1 +/- 2.0 (95% confidence interval 2.8-4.3). Health conditions and treatment options were the items most frequently discussed in the articles; next came treatment benefits. Possible harms, the use of the same denominators for benefits and harms, and methods to facilitate the communication of benefits and harms to patients were almost never described. No significant differences between journals were observed. The CME articles evaluated did not include the evidence-based information necessary to foster SDM in clinical practice. Peer-reviewed and non-peer-reviewed medical journals should require CME articles to include this type of information.

  4. Routine behavioral and mental health screening in young children with type 1 diabetes mellitus.

    PubMed

    Zenlea, Ian Spencer; Mednick, Lauren; Rein, Jennifer; Quinn, Maryanne; Wolfsdorf, Joseph; Rhodes, Erinn T

    2014-08-01

    The American Diabetes Association and International Society for Pediatric and Adolescent Diabetes recommend that providers of diabetes care receive training in the recognition of psychosocial problems related to diabetes. To report the results of routine behavioral/mental health screening for children with type 1 diabetes mellitus (T1D) seen in a multidisciplinary pediatric diabetes program. This was a cross-sectional study of children with T1D ages 4-11 years, who underwent behavioral/mental health screening as part of their diabetes care. Screening utilized the Strengths and Difficulties Questionnaire (SDQ) Parent Proxy Version, and scores were reviewed by a social worker. SDQ scale and total difficulties scores were compared by gender, visit type, age, T1D duration, and HbA1c. Scores were also compared to age-appropriate normative data for children in United States of America (US). SDQ Parent Proxy Version total difficulties and scale scores did not differ by patient or visit characteristics. Compared with normative data for US children, a greater proportion of children with T1D ages 4-7 and 8-10 years had borderline/abnormal scores on the emotional symptoms scale (p = 0.01 and p = 0.03, respectively), suggesting risk for psychological disorders, such as anxiety and depression. Our findings suggest that children less than 11 years old with T1D may have greater emotional symptoms as compared to their age-matched healthy peers. Pediatric diabetes care providers, with access to mental health services, should consider incorporating routine behavioral/mental health screening for children less than 12 years old in their practice. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Dietary health behaviors of women living in high rise dwellings: a case study of an urban community in Malaysia.

    PubMed

    Karupaiah, Tilakavati; Swee, Winnie Chee Siew; Liew, Siew Ying; Ng, Boon Koon; Chinna, Karuthan

    2013-02-01

    Diet-related non-communicable disease (DR-NCD) occurrence is a serious problem amongst Malaysian women and urbanization is probably a challenge to their achieving the nutritional environment conducive to healthy eating. This case study aimed to determine diet quality of an urban community using women respondents from high rise dwellings in Kuala Lumpur. The sample consisted of 135 households and a healthy eating index (HEI) scale was used to evaluate the women's diet quality. A total of 128 women (Malays = 45, Chinese = 56, Indian = 27) participated. Total HEI score was significantly different (P < 0.05) within ethnicity (Indians = 75.7 ± 8.1 0.05) regardless of ethnicity. Income strata (ρ = 0.159, P = 0.048) and eating out frequency (ρ = -0.149, P = 0.046) also independently affected HEI scores. Income negatively correlated with sodium restriction score (ρ = -0.294, P = 0.001) but positively with cereals (ρ = 0.181; P = 0.025), fruits (ρ = 0.178; P = 0.022), dairy products (ρ = 0.198; P = 0.013) and food variety (ρ = 0.219, P = 0.007). Decreased vegetable intake (ρ = -0.320; P < 0.001) and sodium excess (ρ = -0.135, P = 0.065) were associated with eating out frequency and poor HEI scores. This case study suggests health promotion for DR-NCD prevention is needed at the community level to improve diet quality of urban women.

  6. Infant-onset eczema in relation to mental health problems at age 10 years: results from a prospective birth cohort study (German Infant Nutrition Intervention plus).

    PubMed

    Schmitt, Jochen; Apfelbacher, Christian; Chen, Chih-Mei; Romanos, Marcel; Sausenthaler, Stefanie; Koletzko, Sibylle; Bauer, Carl-Peter; Hoffmann, Ute; Krämer, Ursula; Berdel, Dietrich; von Berg, Andrea; Wichmann, H-Erich; Heinrich, Joachim

    2010-02-01

    Cross-sectional studies suggest an association between eczema and mental health problems, but the temporal relationship is unclear. To assess the association between infant-onset eczema and mental health problems in a prospective study. Between 1995 and 1998, a birth cohort study was recruited and followed until age 10 years. Physician-diagnosed eczema, comorbidities, and a broad set of environmental exposures were assessed at age 1, 2, 3, 4, 6, and 10 years. First, we investigated the association between infant-onset eczema (age 1-2 years) and mental health problems at age 10 years according to the Strengths and Difficulties Questionnaire. Second, we analyzed the likelihood of mental health problems at age 10 years in relation to the course of eczema. A total of 2916 infants were eligible for analysis. Compared with participants never diagnosed as having eczema, children with infant-onset eczema had a significantly increased risk for possible/probable mental health problems (Strengths and Difficulties Questionnaire total score) at age 10 years (odds ratio, 1.49; 95% CI, 1.13-1.96) and for emotional symptoms (odds ratio, 1.62; 95% CI, 1.25-2.09). Eczema limited to infancy predicted a significantly higher risk for conduct problems at age 10 years. The strength of the association between eczema and emotional problems at age 10 years increased with increasing eczema persistence. Infants with eczema are at increased risk for mental health problems at age 10 years. Even if cleared afterward, eczema at age 1 to 2 years may cause persistent emotional and behavioral difficulties. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  7. Adolescent behavior and PTSD 6-7 years after the World Trade Center terrorist attacks of September 11, 2001.

    PubMed

    Mann, Mana; Li, Jiehui; Farfel, Mark R; Maslow, Carey B; Osahan, Sukhminder; Stellman, Steven D

    2014-01-01

    Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2-3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11-18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5-12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1-28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners.

  8. Use of the Pediatric Symptom Checklist for the detection of psychosocial problems in preventive child healthcare

    PubMed Central

    Reijneveld, Sijmen A; Vogels, Anton GC; Hoekstra, Femke; Crone, Matty R

    2006-01-01

    Background Early detection and treatment of psychosocial problems by preventive child healthcare may lead to considerable health benefits, and a short questionnaire could support this aim. The aim of this study was to assess whether the Dutch version of the US Pediatric Symptom checklist (PSC) is valid and suitable for the early detection of psychosocial problems among children. Methods We included 687 children (response 84.3%) aged 7–12 undergoing routine health assessments in nine Preventive Child Health Services across the Netherlands. Child health professionals interviewed and examined children and parents. Before the interview, parents completed an authorised Dutch translation of the PSC and the Child Behavior Checklist (CBCL). The CBCL and data on the child's current treatment status were used as criteria for the validity of the PSC. Results The consistency of the Dutch PSC was good (Cronbach alpha 0.89). The area under the ROC curve using the CBCL as a criterion was 0.94 (95% confidence interval 0.92 to 0.96). At the US cut-off (28 and above), the prevalence rate of an increased score and sensitivity were lower than in the USA. At a lower cut-off (22 and above), sensitivity and specificity were similar to that of the US version (71.7% and 93.0% respectively). Information on the PSC also helped in the identification of children with elevated CBCL Total Problems Scores, above solely clinical judgment. Conclusion The PSC is also useful for the early detection of psychosocial problems in preventive child healthcare outside the USA, especially with an adjusted cut-off. PMID:16872535

  9. The Effect of Foot Reflexology on the Anxiety Levels of Women in Labor.

    PubMed

    Yılar Erkek, Zümrüt; Aktas, Songul

    2018-04-01

    This research was conducted to analyze the effect of foot reflexology on the anxiety levels of women during labor. The study was conducted as a semiexperimental study. It was conducted with 154 nulliparous pregnant women who applied to a maternity unit of a state hospital in the north-western part of Turkey to give birth. Foot reflexology was applied once to the pregnant women in the experimental group when cervical dilation was 3-4 cm. The treatment was applied to the right foot and left foot reflex points for 15 min, for a total of 30 min. The data in the study were collected using the "Pregnant Women Introductory Information Form" and the "Spielberger State-trait Anxiety Inventory" (STAI TX-1). In evaluating the data, number, percentage, Chi-square, independent samples t-test, and repeated measure analysis of variance test were used. The mean scores of the STAI TX-1 were used to analyze the results. The mean STAI TX-1 scores were measured before reflexology, in the latent and active phases of labor and early in postpartum period (four times in total). The mean STAI TX-1 scores were higher in the experimental group than in the control group (p < 0.001). The mean STAI TX-1 scores postreflexology application (when cervical dilation was 3-4 cm) and during the active phase of the labor (when cervical dilation was 6-8 cm) of the pregnant women in the experimental group were lower than those of the control group (respectively p = 0.010, p < 0.001). In the experimental group, there was no statistically significant difference between the mean STAI TX-1 scores pre- and postreflexology (p = 0.820). The mean STAI TX-1 scores in the early postpartum period were similar in the experimental and control groups (p = 0.080). Foot reflexology was found to have a positive effect in lowering the total anxiety scores of the pregnant women. Reflexology is a noninvasive and economical method, which may be used by health professionals to reduce problems during labor. A decrease in anxiety experienced at birth improves women's positive birth experiences, promotes a secure mother-infant attachment, and protects postpartum mental health.

  10. Prevalence, associated factors and impact of loneliness and interpersonal problems on internet addiction: A study in Chiang Mai medical students.

    PubMed

    Simcharoen, Sutapat; Pinyopornpanish, Manee; Haoprom, Pattaraporn; Kuntawong, Pimolpun; Wongpakaran, Nahathai; Wongpakaran, Tinakon

    2018-01-01

    Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students. Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction. In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p < 0.05, beta = 0.219, p < 0.001 and beta = 0.203 p < 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score. Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Differences in problem behaviour among ethnic minority and majority preschoolers in the Netherlands and the role of family functioning and parenting factors as mediators: the Generation R Study.

    PubMed

    Flink, Ilse J E; Jansen, Pauline W; Beirens, Tinneke M J; Tiemeier, Henning; van IJzendoorn, Marinus H; Jaddoe, Vincent W V; Hofman, Albert; Raat, Hein

    2012-12-19

    Studies have shown that, compared to native counterparts, preschoolers from ethnic minorities are at an increased risk of problem behaviour. Socio-economic factors only partly explain this increased risk. This study aimed to further unravel the differences in problem behaviour among ethnic minority and native preschoolers by examining the mediating role of family functioning and parenting factors. We included 4,282 preschoolers participating in the Generation R Study, an ethnically-diverse cohort study with inclusion in early pregnancy. At child age 3 years, parents completed the Child Behavior Checklist (CBCL/1,5-5); information on demographics, socio-economic status and measures of family functioning (maternal psychopathology; general family functioning) and parenting (parenting stress; harsh parenting) were retrieved from questionnaires. CBCL Total Problems scores in each ethnic subgroup were compared with scores in the Dutch reference population. Mediation was evaluated using multivariate regression models. After adjustment for confounders, preschoolers from ethnic minorities were more likely to present problem behaviour than the Dutch subgroup (e.g. CBCL Total Problems Turkish subgroup (OR 7.0 (95% CI 4.9; 10.1)). When considering generational status, children of first generation immigrants were worse off than the second generation (P<0.01). Adjustment for socio-economic factors mediated the association between the ethnic minority status and child problem behaviour (e.g. attenuation in OR by 54.4% (P<0.05) from OR 5.1 (95% CI 2.8; 9.4) to OR 2.9 (95% CI 1.5; 5.6) in Cape Verdean subgroup). However, associations remained significant in most ethnic subgroups. A final adjustment for family functioning and parenting factors further attenuated the association (e.g. attenuation in OR by 55.5% (P<0.05) from OR 2.2 (95% CI 1.3; 4.4) to OR 1.5 (95% CI 1.0; 2.4) in European other subgroup). This study showed that preschoolers from ethnic minorities and particularly children of first generation immigrants are at an increased risk of problem behaviour compared to children born to a Dutch mother. Although socio-economic factors were found to partly explain the association between the ethnic minority status and child problem behaviour, a similar part was explained by family functioning and parenting factors. Considering these findings, it is important for health care workers to also be attentive to symptoms of parental psychopathology (e.g. depression), poor family functioning, high levels of parenting stress or harsh parenting in first and second generation immigrants with young children.

  12. Outcomes of total knee arthroplasty in relation to preoperative patient-reported and radiographic measures: data from the osteoarthritis initiative.

    PubMed

    Kahn, Timothy L; Soheili, Aydin; Schwarzkopf, Ran

    2013-12-01

    Total knee arthroplasty (TKA) is the preferred surgical treatment for end-stage osteoarthritis. However, substantial numbers of patients still experience poor outcomes. Consequently, it is important to identify which patient characteristics are predictive of outcomes in order to guide clinical decisions. Our hypothesis is that preoperative patient-reported outcome measures and radiographic measures may help to predict TKA outcomes. Using cohort data from the Osteoarthritis Initiative, we studied 172 patients who underwent TKA. For each patient, we compiled pre- and postoperative Western Ontario and McMaster University Arthritis Index (WOMAC) scores. Radiographs were measured for knee joint angles, femorotibial angles, anatomical lateral distal femoral angles, and anatomical medial proximal tibial angles; Kellgren and Lawrence (KL) grades were assigned to each compartment of the knee. All studied measurements were compared to WOMAC outcomes. Preoperative WOMAC disability, pain, and total scores were positively associated with postoperative WOMAC total scores (P = .010, P = .010, and P = .009, respectively) and were associated with improvement in WOMAC total scores (P < .001, P < .001, and P < .001, respectively). For radiographic measurements, preoperative joint angles were positively associated with improvements in postoperative WOMAC total scores (P = .044). Combined KL grades (medial and lateral compartments) were negatively correlated with postoperative WOMAC disability and pain scores (P = .045 and P = .044) and were positively correlated with improvements in WOMAC total scores (P = .001). All preoperative WOMAC scores demonstrated positive associations with postoperative WOMAC scores, while among the preoperative radiographic measurements only combined KL grades and joint angles showed any correlation with postoperative WOMAC scores. Higher preoperative KL grades and joint angles were associated with better (lower) postoperative WOMAC scores, demonstrating an inverse correlation.

  13. Diet Quality Scores of Australian Adults Who Have Completed the Healthy Eating Quiz.

    PubMed

    Williams, Rebecca L; Rollo, Megan E; Schumacher, Tracy; Collins, Clare E

    2017-08-15

    Higher scores obtained using diet quality and variety indices are indicators of more optimal food and nutrient intakes and lower chronic disease risk. The aim of this paper is to describe the overall diet quality and variety in a sample of Australian adults who completed an online diet quality self-assessment tool, the Healthy Eating Quiz. The Healthy Eating Quiz takes approximately five minutes to complete online and computes user responses into a total diet quality score (out of a maximum of 73 points) and then categorizes them into the following groups: 'needs work' (<33), 'getting there' (33-38), 'excellent' (39-46), or 'outstanding' (47+). There was a total of 93,252 first-time respondents, of which 76% were female. Over 80% of respondents were between 16-44 years of age. The mean total score was 34.1 ± 9.7 points. Females had a higher total score than males ( p < 0.001) and vegetarians had higher total scores than non-vegetarians ( p < 0.001). Healthy eating quiz scores were higher in those aged 45-75 years compared to 16-44 years ( p < 0.001). When comparing Socioeconomic Indices for Areas deciles, those most disadvantaged had a lower total score than those least disadvantaged ( p < 0.001). Repeat measures showed that those who scored lowest (needs work) in their first completion increased their total score by 3.2 ± 7.4 at their second completion ( p < 0.001). While the Healthy Eating Quiz data indicates that individuals receiving feedback on how to improve their score can improve their diet quality, there is a need for further nutrition promotion interventions in Australian adults.

  14. The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001-2004 matriculants.

    PubMed

    Dunleavy, Dana M; Kroopnick, Marc H; Dowd, Keith W; Searcy, Cynthia A; Zhao, Xiaohui

    2013-05-01

    Most research examining the predictive validity of the Medical College Admission Test (MCAT) has focused on the relationship between MCAT scores and scores on the United States Medical Licensing Examination Step exams. This study examined whether MCAT scores predict students' unimpeded progress toward graduation (UP), which the authors defined as not withdrawing or being dismissed for academic reasons, graduating within five years of matriculation, and passing the Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills exams on the first attempt. Students who matriculated during 2001-2004 at 119 U.S. medical schools were included in the analyses. Logistic regression analyses were used to estimate the relationships between UP and MCAT total scores alone, undergraduate grade point averages (UGPAs) alone, and UGPAs and MCAT total scores together. All analyses were conducted at the school level and were considered together to evaluate relationships across schools. The majority of matriculants experienced UP. Together, UGPAs and MCAT total scores predicted UP well. MCAT total scores alone were a better predictor than UGPAs alone. Relationships were similar across schools; however, there was more variability across schools in the relationship between UP and UGPAs than between UP and MCAT total scores. The combination of UGPAs and MCAT total scores performs well as a predictor of UP. Both UGPAs and MCAT total scores are strong predictors of academic performance in medical school through graduation, not just the first two years. Further, these relationships generalize across medical schools.

  15. Assessing the risk of imminent aggression in institutionalized youth offenders using the dynamic appraisal of situational aggression

    PubMed Central

    Chu, Chi Meng; Hoo, Eric; Daffern, Michael; Tan, Jolie

    2012-01-01

    Aggressive behavior in incarcerated youth presents a significant problem for staff, co-residents and the functioning of the institution. This study aimed to examine the predictive validity of an empirically validated measure, designed to appraise the risk of imminent aggression within institutionalized adult psychiatric patients (Dynamic Appraisal of Situational Aggression; DASA), in adolescent male and female offenders. The supervising staff members on the residential units rated the DASA daily for 49 youth (29 males and 20 females) over two months. The results showed that DASA total scores significantly predicted institutional aggression in the following 24 and 48 hrs; however, the predictive validity of the DASA for institutional aggression was, at best, modest. Further analyses on male and female subsamples revealed that the DASA total scores only predicted imminent institutional aggression in the male subsample. Item analyses showed that negative attitudes, anger when requests are denied, and unwillingness to follow instructions predicted institutional aggression more strongly as compared with other behavioral manifestations of an irritable and unstable mental state as assessed by the DASA. PMID:25999797

  16. Relationship between spirituality/religiousness and coping in patients with residual schizophrenia.

    PubMed

    Shah, Ruchita; Kulhara, Parmanand; Grover, Sandeep; Kumar, Suresh; Malhotra, Rama; Tyagi, Shikha

    2011-09-01

    To measure spirituality/religiousness and its relation to coping skills in patients with residual schizophrenia. Using a cross-sectional design, 103 persons with residual schizophrenia were assessed on Positive and Negative Syndrome Scale [PANSS] and Ways of Coping Checklist [WCC] to assess the repertoire of coping skills and WHO Quality of Life-Spirituality, Religiousness and Personal Belief scale [WHOQOL-SRPB] to assess religiousness and spirituality. Positive reappraisal as a coping strategy had significant positive correlation with all the facets of WHOQOL-SRPB and SRPB total domain scores. The coping subscales of accepting responsibility, planful problem solving, distancing, confrontive coping, and self-controlling also had significant positive correlations with different facets of WHOQOL-SRPB and total SRPB domain score. Seeking social support and escape-avoidance as coping mechanisms had no correlations with any of the WHOQOL-SRPB facets. A sound spiritual, religious, or personal belief system is associated with active and adaptive coping skills in subjects with residual schizophrenia. Understanding and assessing the spirituality and religiousness of subjects with schizophrenia can help in better management of the disorder.

  17. The psychological problems of north korean adolescent refugees living in South Korea.

    PubMed

    Lee, Young Mun; Shin, Ok Ja; Lim, Myung Ho

    2012-09-01

    As the number of North Korean adolescent refugees drastically increased in South Korea, there is a growing interest in them. Our study was conducted to evaluate the mental health of the North Korean adolescent refugees residing in South Korea. The subjects of this study were 102 North Korean adolescent refugees in Hangyeore middle and high School, the public educational institution for the North Korean adolescent refugees residing in South Korea, and 766 general adolescents in the same region. The Korean version of Child Behavior Check List (K-CBCL) standardized in South Korea was employed as the mental health evaluation tool. The adolescent refugees group showed a significantly different score with that of the normal control group in the K-CBCL subscales for sociality (t=29.67, p=0.000), academic performance (t=17.79, p=0.000), total social function (t=35.52, p=0.000), social withdrawal (t=18.01, p=0.000), somatic symptoms (t=28.85, p=0.000), depression/anxiety (t=13.08, p=0.000), thought problems (t=6.24, p=0.013), attention problems (t=4.14, p=0.042), internalized problems (t=26.54, p=0.000) and total problems (t=5.23, p=0.022). The mental health of the North Korean adolescent refugees was severe particularly in internalized problems when compared with that of the general adolescents in South Korea. This result indicates the need for interest in not only the behavior of the North Korean adolescent refugees but also their emotional problem.

  18. Emotion Processing in Parkinson’s Disease: A Three-Level Study on Recognition, Representation, and Regulation

    PubMed Central

    Enrici, Ivan; Adenzato, Mauro; Ardito, Rita B.; Mitkova, Antonia; Cavallo, Marco; Zibetti, Maurizio; Lopiano, Leonardo; Castelli, Lorys

    2015-01-01

    Background Parkinson’s disease (PD) is characterised by well-known motor symptoms, whereas the presence of cognitive non-motor symptoms, such as emotional disturbances, is still underestimated. One of the major problems in studying emotion deficits in PD is an atomising approach that does not take into account different levels of emotion elaboration. Our study addressed the question of whether people with PD exhibit difficulties in one or more specific dimensions of emotion processing, investigating three different levels of analyses, that is, recognition, representation, and regulation. Methodology Thirty-two consecutive medicated patients with PD and 25 healthy controls were enrolled in the study. Participants performed a three-level analysis assessment of emotional processing using quantitative standardised emotional tasks: the Ekman 60-Faces for emotion recognition, the full 36-item version of the Reading the Mind in the Eyes (RME) for emotion representation, and the 20-item Toronto Alexithymia Scale (TAS-20) for emotion regulation. Principal Findings Regarding emotion recognition, patients obtained significantly worse scores than controls in the total score of Ekman 60-Faces but not in any other basic emotions. For emotion representation, patients obtained significantly worse scores than controls in the RME experimental score but no in the RME gender control task. Finally, on emotion regulation, PD and controls did not perform differently at TAS-20 and no specific differences were found on TAS-20 subscales. The PD impairments on emotion recognition and representation do not correlate with dopamine therapy, disease severity, or with the duration of illness. These results are independent from other cognitive processes, such as global cognitive status and executive function, or from psychiatric status, such as depression, anxiety or apathy. Conclusions These results may contribute to better understanding of the emotional problems that are often seen in patients with PD and the measures used to test these problems, in particular on the use of different versions of the RME task. PMID:26110271

  19. Family violence influences mental health of school girls in Iran: Results of a preliminary study.

    PubMed

    Fakhari, Ali; Tabatabavakili, Mehdi; Javid, Yousef Sayah; Farhang, Sara

    2012-03-01

    The family plays the first and may be the most important role in the development of individuals' personality, health and function. The current study aimed to evaluate different aspects of violence against a sample of school girls of Iranian population and its effect on their mental health. A cluster, randomized sample consisting of 399 school girls was selected from all of the high schools in Tabriz city, northwest of Iran. Students were asked to participate in this study anonymously. Signs and symptoms of depression and anxiety were assessed by the General health questionnaire-28 (GHQ-28) measuring their social function and physical situation as well. Another inquiry form involving questions about different kinds of violence and neglect gathered information about their situation during the recent year. The mean (SD) age of the students was 14.9 (0.8) and all were under 18. The mean (SD) total score of GHQ-28 was 24.18(13.61). The sub-threshold score in GHQ-28 (under 23) was observed in 44.1% of students which indicates considerable problems in mental health status. The type of reported violence was not significantly associated with an abnormal score of GHQ-28. A higher score of somatic symptoms was related to verbal violence at home by parents and the educational level of mother. High score on social dysfunction was predicted by lower educational level of mother. The depression scale was related to humility, neglect and discrimination at home. The factors were not predicting the score of anxiety or insomnia subscales. The current study observed a noticeable amount of problems in the mental health of teenage girls in a sample of the Iranian population. The educational level of the mother plays an important role in the mental health of school girls. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. An Internet-based education program improves breastfeeding knowledge of maternal-child healthcare providers.

    PubMed

    O'Connor, Mary E; Brown, Emil W; Lewin, Linda Orkin

    2011-12-01

    Breastfeeding rates in the United States remain below the Surgeon General's Healthy People 2010 goals. Encouragement of breastfeeding and education by maternal-child healthcare (MCH) providers (physicians, residents, and midlevel providers) improves breastfeeding initiation and duration. Surveys of MCH providers show lack of knowledge about breastfeeding. This study evaluated the effect of usage of "BreastfeedingBasics," a free Internet-based educational course, on the knowledge of MCH providers and evaluation of the baseline knowledge of course users. A before and after intervention study was done of MCH providers using the "BreastfeedingBasics" website between 1999 and 2008. Baseline knowledge and change in knowledge were assessed by computer-scored pretests and posttests. Of 3,456 MCH providers enrolled, 2,237 (65%) completed one or more pretest. Total mean pretest/posttest scores were as follows: midlevel providers, 81%/89%; residents, 84%/93%; and physicians, 85%/92% (p < 0.001 among groups and between pretests and posttests). Mean pretest/posttest scores of the modules were as follows: Anatomy/Physiology, 79%/93%; Growth/Development, 72%/91%; Mother-Infant Couple (normal newborn), 82%/92%; and Breastfed Infant with Problems, 77%/91% (p < 0.001 for all). Specific topics with the lowest pretest scores and subsequent posttest scores were as follows (pretest/posttest): supplementation with vitamin D, 61%/93%; breastfeeding physiology, 38%/65%; growth of breastfed infants at 10 days, 80%/95%, 14 days, 72%/91%, and 3-4 months, 39%/84%; and stopping breastfeeding for maternal problems when not indicated, 69%/93% (p < 0.001 for all). Use of an Internet-based educational program improved knowledge of MCH providers as measured by pretest and posttest scores. Knowledge of the growth of breastfed infants is particularly poor. Increasing knowledge is the first step in improving clinical practice that is necessary for increasing breastfeeding rates and duration.

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