Soft-copy sonography: cost reduction sensitivity analysis in a pediatric hospital

An assessment of women's knowledge of cervical screening and cervical cancer was considered important as up to 92% of those dying from this form of cancer had never been tested. What were the reasons which determined their non-attendance? Issues to be addressed were reactions to invitation, women's knowledge of screening, and the possible factors which they envisaged as being associated with cervical cancer. Other issues to be considered were practical problems associated with attendance, and preference for the sex and professional status of the health professionals involved; 187 women in a general practitioner practice in Lothian, Scotland were targeted by questionnaire. As with other studies in this field 50% of those contacted were ineligible for a variety of reasons. Seventy-two women completed the questionnaire, providing a mix of qualitative and quantitative data. Although the majority of women felt the invitation to attend screening was clear and easy to understand, there was a lack of knowledge with regard to both the screening itself and the possible causes of cervical cancer. The main 'causes' were seen as higher sexual activity among those aged under 37 and smoking and a virus by those over 37. The majority of women showed preference for a female professional to take the smear. Practical problems of time and venue were not considered insurmountable. The main reasons cited for non-compliance were the fear and dislike of the test itself.     

Do women who undergo further investigation for breast screening suffer adverse psychological consequences? A multi-centre follow-up study comparing different breast screening result groups five months after their last breast screening appointment

BACKGROUND: In 1995-1996 about 53500 women aged 50-64 attending for routine breast screening were called back for further investigation after an initial mammogram. Even when women were found to be clear after further investigation, significant adverse psychological consequences (PCs) can remain one month later. This follow-up study investigates whether residual emotional effects persisted five months after women received a clear result. METHODS: Women who had previously completed a questionnaire one month after their last breast screening appointment, at which they had a clear result, were invited to complete a further postal questionnaire four months later (five months after their last appointment). We compare women who received a clear result after assessment without fine needle aspiration cytology (FNAC), after assessment with FNAC, after a benign biopsy, and those who had been placed on early recall, with those who received a clear result after mammography (reference group). RESULTS: The response rate was 76 per cent (215/284). All groups of women who went on for further investigation suffered significantly greater adverse psychological consequences (PCs) at five months than women who were given a clear result after mammography. Compared with 10 per cent (5/52) of women who received a clear result after a basic mammogram, adverse psychological consequences were experienced by 59 per cent (27/46, p<0.00001) of the women who were placed on six month early recall, 61 per cent (14/23, p<0.0001) of women who had benign surgical biopsy, 44 per cent (18/41, p<0.0001) of women who received a clear result after assessment (with FNAC), and 45 per cent (23/51, p<0.0001) of women who received a clear result after assessment (without FNAC). Whereas all groups who had gone on for further investigations had experienced a significant decrease in PCs between one month and five months, those who were placed on six month early recall showed no significant difference in PCs between these two time periods. Other factors relating to adverse experiences as a result of breast screening are reported. CONCLUSION: Despite receiving a clear final result, women who undergo further investigation suffer significantly greater adverse psychological consequences five months after their last screening appointment than women who receive a clear result after mammography.     

Accidents in obstructive sleep apnea patients treated with nasal continuous positive airway pressure: a prospective study. The Working Group ANTADIR, Paris and CRESGE, Lille, France. Association Nationale de Traitement à Domicile des Insuffisants Respiratoires

Many studies have shown a relationship between obstructive sleep apnea (OSA) and accidents, but to our knowledge, none have investigated prospectively the effects of treatment with nasal continuous positive airway pressure (CPAP). CPAP was proposed to 973 patients, of whom 893 patients actually underwent CPAP. These patients were consecutively invited to enter a prospective follow-up study including a questionnaire before treatment and after 6 and 12 months of treatment; 547 patients completed the study (153 left the study, and only partial data were available for 193). The baseline questionnaire included questions concerning accidents in the previous 12 months, asking whether patients had had an accident and, if so, whether they felt that the accident(s) were related to sleepiness, and whether the patients felt that they had had near-miss accidents due to sleepiness. The questionnaires at 6 and 12 months included the same questions referring to the previous 6 months; the accidents reported on each follow-up questionnaire were cumulated and compared with the accidents during the 1-year period before treatment. The number of patients having an accident decreased with treatment for real accidents (from 60 to 36; p<0.01), as well as for near-miss accidents (from 151 to 32; p<0.01). The average number of accidents per patient also decreased, for real accidents (from 1.6+/-1.3 to 1.1+/-0.3; p<0.01) and for near-miss accidents (from 4.5+/-6.5 to 1.8+/-1.4; p<0.01). The cost, in terms of days in hospital related to accidents, decreased from 885 to 84 days. With caution due to the absence of a control group, it is suggested that treatment with CPAP decreases the number of accidents occurring in OSA patients. This result may have important implications in the evaluation of the cost/benefit ratio when treating OSA patients.     

Early postoperative nutrition after laparoscopic and open colorectal resection

OBJECTIVE: In the United Kingdom in 1994-95 about 16,500 women aged 50 to 64 were asked to come back earlier than the usual three yearly screening interval for further mammography (early rescreen (ES)) or for a range of further investigations at an assessment centre (early recall (ER)). This study aimed at providing epidemiological data on ES/ER, in particular, how often and why it is used, and what the outcome is of using it. SETTING: National Health Service breast screening programme in the United Kingdom. METHODS: All breast screening units were invited to complete a postal questionnaire. Two reminders were sent. The units were asked retrospectively to provide breast screening data about women aged 50 to 64 from their local computer systems. Women placed on ES/ER were followed up for at least one year. RESULTS: The response rate was 71% (69/97), of which 14% (10/69) were unable to provide the required data, leaving 59 completed questionnaires (61%). The rate of placing women on ES/ER was above 1.0% for 26/54 (48%) responding breast screening units and above 2.0% for 13/54 (24%) units. Women were placed on ES/ER because of (a) previous breast cancer (21% of cases; cancer detection rate 2.4%), (b) diagnostic uncertainty (51%; cancer detection rate 3.0%), or (c) family history (27%; cancer detection rate 0.6%). Breast screening units with a high rate of placing women on ER were significantly more likely to have a high recall rate (rs = 0.63; n = 53; p < 0.0005) or a high benign surgical biopsy rate (rs = 0.33; n = 49; p < 0.05), or both. The cancer detection rate of ES/ER tended to decrease with increasing ES/ER rates (rs = -0.37; n = 51; p < 0.01). CONCLUSIONS: A relatively large number of women were placed on ES or ER for a range of reasons. If the recommendations given are followed, the number of women placed on ER may be reduced while maintaining the cancer detection rate at the required level. The option of ES should not be used.     

Videotape reconstruction of emotions and cognitions related to shyness.

This study tested predictions of the self-presentational approach to situational and dispositional shyness within a broader perspective. Forty subjects who were high in self-rated dispositional shyness and 30 subjects who were low in self-rated dispositional shyness watched videotapes of their interaction with a confederate of the experimenter in various situations, including apprehension of evaluation and positive feedback provided by the confederate. The subjects' free verbal responses to particular events during these situations were content-analyzed. Compared with the group lower in shyness, the shy subjects (a) recalled more fear of social evaluation (including fear of positive evaluation) but did not more often report other kinds of fear, (b) had more negatively biased thoughts about the impression made on their partner but not more impression-related thoughts in general, and (c) showed more negatively biased reactions to the positive feedback of their partner. These results support the self-presentational view that fear of being socially evaluated is pivotal to dispositional shyness. However, some unexpected findings suggest that social evaluative situations also arouse fears of having to evaluate others; this would limit self-presentational explanations of situational shyness in these situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shyness: Conceptualization and measurement.

Examined the concept of shyness and its measurement by collecting and analyzing data in 3 phases: (1) the revision and continued development of a measure of shyness, the Social Reticence Scale (SRS), which was designed by W. H. Jones and D. Russell (see record 1983-09411-001); (2) a psychometric comparison among 5 measures of shyness; and (3) an examination of the factor structure underlying the construct of shyness. Phase 1 assessed the reliability (n?=?252 college students) and validity (n?=?164 college students) of the SRS, including ratings of videotaped monologs and ratings by significant others. Phase 2, using 1,213 Ss (aged 15–25 yrs), compared the 5 shyness measures with one another on indices of internal consistency and with other relevant measures of emotionality, personality, relationships, and behavior. Items from the 5 shyness measures were combined in a factor analysis in Phase 3, and the resulting factors were correlated with the self-report and rating data obtained in Phase 2. Results confirmed that the shyness measures were valid, reliable, and empirically distinct from measures of related constructs. Behavioral validity was observed for several of the shyness scales. Additional analyses suggested that 3 interpretable factors underlie responses to the shyness scale—Social Avoidance and Distress, Social Facility, and Fear of High Status Others—but provided little support for drawing conceptual distinctions among types of shyness. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic study on the neuronal excitability of the cochlear nuclei of the cat following electrical stimulation

OBJECTIVES: To determine: (i) the prevalence, reasons for, and demographic and psychosocial predictors of prostate cancer screening among a randomly selected sample of men; and (ii) to estimate the community expenditure involved in the screening of asymptomatic men. SUBJECTS AND METHODS: A random sample of men aged 40-79 years was selected from the State Electoral Register of New South Wales, Australia, and asked to complete a computer-assisted telephone interview. The questions determined their demographic characteristics, their subjective health rating compared with others of the same age (5-point scale), the prevalence and reasons for any screening for prostate cancer ('ever screened' and 'screened within the last 12 months'), whether they had undergone a digital rectal examination (DRE), a blood test for prostate-specific antigen (PSA) or transrectal ultrasonography (TRUS), and the prevalence of urinary symptoms. Those who had been screened were then asked to nominate the single most important factor in the decision to undergo prostate cancer screening. To estimate community expenditure, the costs for prostate cancer screening were estimated by applying Medicare schedule charges to the screening and subsequent diagnostic tests performed. Two scenarios were developed to estimate costs: the first used guidelines which do not recommend the use of routine screening for all asymptomatic men, and the second was based on guidelines where the routine use of PSA or TRUS as part of a periodic health examination is not recommended, but the use of DRE in asymptomatic men aged 50-70 years is. RESULTS: Of the 551 eligible participants, 86% completed the interview; 44% of participants reported that they had 'ever' been screened, whilst 23% had been screened in the year before the study. Among those who had been screened, the reason reported most often for screening, apart from symptoms and family history, was the doctor's recommendation after a medical assessment of their prostate cancer risk status. Screening status was predicted both by the age of the man and his symptom score. As a result, the community expenditure in New South Wales for screening among asymptomatic men was estimated to be A$6.4 million and A$5.2 million for the first and second scenarios, respectively. CONCLUSIONS: The results of this study suggest that, despite the recommendations of primary bodies that asymptomatic men not be screened for prostate cancer, screening is occurring at a high level and with significant costs to the healthcare system.     

Retained glass foreign bodies in wounds: predictive value of wound characteristics, patient perception, and wound exploration

This report describes associations of demographic and health-related characteristics with use of prostate cancer screening. Data are from a random-digit dial survey of Washington State residents. Analyses are restricted to men ages 40-79 years (n = 332) and examine both digital rectal examination (DRE) and blood tests for prostate-specific antigen (PSA) in the previous 2 years. Results are adjusted to be representative of the state's population. In 1996, 53.6% of men received either DRE, PSA, or both. Among those screened, 42% received DRE alone, 15% PSA alone, and 43% both PSA and DRE, and the percentages of men receiving PSA increased markedly with age (30%, ages 40-49 years; 58%, ages 50-59 years; and 77%, ages 60-79 years). After control for other demographic characteristics, the relative odds for any prostate cancer screening were 5.5 for ages 60-79 versus 40-49 years, 2.4 for 16+ versus < or = 12 years of education, and 4.0 for 2+ versus no physician visits in the previous 2 years (all P < 0.05). Characteristics generally associated with good health, including regular exercise and low fat and high fruit and vegetable intakes, were also significantly associated with prostate cancer screening. In conclusion, in 1996, approximately one-half of the men in Washington State over age 40 years had received prostate cancer screening in the previous 2 years. Few men were screened with PSA alone, and the use of PSA as part of prostate cancer screening increased markedly with age. Because PSA screening increases detection of prostate cancer, epidemiological studies of health behavior and cancer risk must carefully control for screening history to avoid detection bias.     

Digital anomalies, microcephaly, and normal intelligence: new syndrome or Feingold syndrome?

To investigate risk factors for spinal fracture, we studied the relationship between the prevalence of asymptomatic spinal fracture and various morphological measures including spinal bone mineral density (BMD) in women. A total of 122 women ranging in age from 55 to 79 years were studied. The group consisted of 46 women aged 55-59 years (18 with fracture), 51 women aged 60-69 years (26 with fracture), and 26 women aged 70-79 years (14 with fracture). BMD of cortical and trabecular bone from L1 to L3 was measured using quantitative computed tomography (QCT). Run-length analysis was applied to evaluate the spinal trabecular textural features using CT images; the texture indices which represent the mean width of trabecular (the T-texture) and that of intertrabecular spaces (the I-texture) were obtained. Anthropometric factors including body weight and height, psoas muscle area, and vertebral bone volume were measured using CT images. Among the various factors, trabecular BMD in women aged 55-69 years showed the highest odds ratio for the presence of fracture per standard deviation (SD) decrease in bone density. However, in women aged 70-79 years, the highest odds ratio was observed for trabecular texture index but not for trabecular BMD. The I-texture in women aged 55-59 years, the muscle area in women aged 60-69 years, and cortical BMD and muscle area in women aged 70-79 years were also considered significantly related to the risk of fracture.     

In vivo 1H MRS of normal breast and breast tumors using a dedicated double breast coil

OBJECTIVE: To characterize sleep patterns of patients with juvenile rheumatoid arthritis (JRA). METHODS: Sixteen patients with JRA aged 12+/-4 years and 9 controls aged 11+/-3 years underwent a comprehensive evaluation by self-report questionnaire and formal all night polysomnographic recordings. Multiple sleep latency test was performed in 7 patients. RESULTS: Patients had 90% more arousals and awakenings (p<0.01) and the median length of occurrences of uninterrupted sleep in stages 2 and 3 and rapid eye movement (REM) sleep was 60% shorter than in controls (p<0.01). The overall amount of sleep stage shift from deeper to lighter sleep was 23.5+/-10.8 events in patients compared to 14.9+/-4.0 in controls (p<0.05). In 15 of 16 patients 15% of non-REM sleep consisted of alpha-delta (alpha-rating) sleep, compared with less than 1% in controls (p<0.001). Multiple sleep latency test for patients was 10.3+/-2.6 min. There were no differences between JRA and controls in self-reported questions. However, patients reported longer afternoon naps, 1.8+/-1.3 h compared to 0.3+/-0.8 h in controls (p<0.05). CONCLUSION: Objective polysomnographic evidence of abnormal sleep has been confirmed in patients with JRA. Sleep disturbance was associated with daytime sleepiness as evidenced by abnormal multiple sleep latency test and longer afternoon naptime.     

Peas in a pod: Biases in the measurement of sibling temperament?

The authors of the present study addressed the measurement of temperament by examining the convergence between observational and questionnaire measures and the occurrence of contrast effects in parental ratings of nontwin siblings on the Children's Behavior Questionnaire. Fathers', mothers', and observers' ratings of 94 early-school-age sibling pairs were obtained longitudinally such that siblings were rated at the same time and when they were the same ages. Convergence between laboratory observations and questionnaires was generally modest to moderate for shyness and activity level; low to modest for positive emotionality, fear, and interest; and low for anger and sadness. We found some evidence of contrast effects for activity level and fathers' ratings of shyness and of assimilation effects for anger and sadness. The results highlight the complexity of measuring temperament and suggest that rater biases should be evaluated according to the measurement instrument used. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An assessment of neck and upper extremity disorders by questionnaire and clinical examination

To study the usefulness of a screening questionnaire for neck/upper extremity complaints, 165 women in either repetitive industrial, or mobile and varied work, were studied by the questionnaire and by a detailed clinical physical examination. A total of 94 subjects recorded complaints in the questionnaire. In 140 subjects findings were recorded at the examination. Most subjects with findings at the clinical examination of shoulders reported complaints in the questionnaire (sensitivity 80%). For the other anatomical regions, the sensitivity was rather low (42-65%). For all regions, most subjects without findings reported no complaints (specificity 77-97%). A total of 75 subjects were given clinical diagnoses according to a set of predetermined diagnostic criteria. The capacity of the questionnaire to identify diagnoses of shoulders was higher (sensitivity 92%) than for the other regions (66-79%). Of subjects who did not qualify for diagnosis, a majority (specificity 71-81%) did not report complaints in the questionnaire. We conclude that the questionnaire approach gives a fairly good picture of the neck/upper extremity status of a working female population. However, a clear view of the size of a problem is obtained only by a detailed clinical examination, particularly as regards the neck, elbows and hands, for which the questionnaire gave an underestimate.     

Cost effectiveness of screening for primary open angle glaucoma

OBJECTIVES AND SETTING: To determine the cost effectiveness of screening for glaucoma. METHODS: Information on treatment efficacy, diagnostic methods, epidemiological characteristics of glaucoma, and costs were determined from the literature, from administrative databases, and from experts. Scenarios with different screening frequency, age, participation in screening, compliance with treatment, treatment efficacy, and diagnostic tests were examined. RESULTS: The initial scenario comprised three-yearly screening of subjects aged 40-79 by funduscopy and tonometry, followed by perimetry when abnormalities were discovered. The assumption of levels of participation in screening and of compliance with treatment of 75%, and treatment efficacy of 50% resulted in a cost of $C100,000 per year of blindness prevented. A scenario in which screening was restricted to subjects aged 65-79, with the same input variables, would prevent 81% of the cases of blindness prevented with scenario 1, at a cost of $C42,000 per year of blindness prevented. Screening with tonometry only as the initial diagnostic test in subjects aged 65-79 would result in a cost of $C36,000 per year of blindness prevented, but would only prevent 59% of the cases prevented with scenario 1. CONCLUSIONS: There is as yet no proof that treatment of glaucoma or of high intraocular pressure will arrest the progression of glaucoma to blindness. Even when treatment efficacy is assumed to be as high as 50%, however, the cost effectiveness of most glaucoma screening programmes considered would not be competitive.     

Do You "Want" to Play? Distinguishing Between Conflicted Shyness and Social Disinterest in Early Childhood.

This study attempted to distinguish two types of social withdrawal in early childhood: (a) one based on social fear and anxiety despite a desire to interact socially (conflicted shyness) and (b) one based on the lack of a strong motivation to engage in social interaction (social disinterest). Two samples of preschoolers (n = 119 and n = 127) 3-5 years of age participated. Their mothers completed the newly developed Child Social Preference Scale, which was designed to assess conflicted shyness and social disinterest. Maternal ratings of child temperament, parenting style, and social goals, teacher ratings of child social adjustment, observations of child free-play behaviors, and child interview assessments of perceived competence and preference for playing with peers were also collected. Distinct patterns of associations were found between conflicted shyness and social disinterest and outcome variables. Implications for the motivational underpinnings and adjustment outcomes of shyness and social disinterest are explored (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alfentanil or fentanyl during isoflurane-based anaesthesia for day-care knee arthroscopy?

Previously published ultrasound screening programmes for abdominal aortic aneurysm (AAA) have concentrated on males in the 65 to 75 year age range, suggesting this as the most cost-effective cohort to target. In this unique study we have broadened the criteria for screening. General practitioners in one health district were approached to supply details of all males aged 50 years and over to be offered aortic ultrasound scanning. Over a period of 18 months, 4145 individuals were asked to attend and 3030 (73%) have attended. Attendance rates were: between 50 and 64 years, 73%; between 65 and 79 years, 75%; for 80 years and over, 64%--significantly less (p = 0.01-0.001) than the other two age bands. Aortic dilatation (diameter > or = 2.5 cm) was found in 6.3% of the 50 to 64 year age group, 16.8% of the 65 to 79 year age group, and 23.3% of the 80 years and over age group. An established aneurysm (> or = 4.6 cm) was found in 0.3%--6 individuals (50-64 years), 2.5% (65-79 years) and 4.1% (> or = 80 years). The results suggest that aortic screening may be worthwhile extending to a wider age band. By focusing follow-up, this should give greater value for younger men in terms of community productivity and allows for selective intervention in the elderly.     

"Nonspecific" chest pain associated with high long-term mortality: results from the primary prevention study in G?teborg, Sweden

BACKGROUND: The syndrome angina pectoris with effort-related chest pain or discomfort is usually easy to recognize. However, vague and nonspecific symptoms may cause little reason for extensive evaluation. The prognosis of such patients in the general population has so far not been well described. HYPOTHESIS: The study was undertaken to investigate long-term prognosis in men with chest pain considered to be nonspecific in comparison with men with typical angina pectoris (AP) or prior myocardial infarction (MI), and men without chest pain. METHODS: At the second screening of the G?teborg Primary Prevention Study in 1974-1977, 6,488 men aged 51 to 59 years at baseline were available for the present analysis. Men who had responded positively to a postal questionnaire about chest pain during exercise or at rest were interviewed by a physician according to a Rose questionnaire at the screening examination. Those with typical or probable AP were further examined by single experienced physician. The following four groups were formed: Group 1: men who did not complain of chest pain (n = 5,545). Group 2: men who had not consulted any doctor because of chest pain, but who had chest pain according to a questionnaire (n = 441); these men were not considered to have AP according to a three-step examination by experienced physicians. Group 3: typical AP (n = 232). Group 4: men who had suffered an MI (n = 134). RESULTS: During 16 years of follow-up, coronary heart disease (CHD) mortality for Groups 1-4 was 8.0, 19.5, 24.8, and 48.5%, respectively. Mortality from all cardiovascular diseases was 11.5, 24.5, 31.2, and 59.0%, respectively. Noncardiovascular disease mortality was 14.1, 17.7, 14.3, and 8.7%, respectively. Thus, the relative risk (RR) for CHD mortality among men with nonspecific chest pain (Group 2) was 2.77 [95% confidence interval (CI) 2.20, 3.50], for all cardiovascular disease mortality 2.46 (95% CI 2.00, 3.02), and for noncardiovascular disease mortality 1.60 (95% CI 1.28, 2.00). Total mortality in this group was as high (44%) as among those with typical AP (45%), but the highest mortality was found among men with a previous MI (68%). In men without chest pain it was 26%. Patients of Groups 2-4 had higher levels of cardiovascular risk factors than those in Group 1. Neither any specific questions in the Rose questionnaire, nor electrocardiographic changes at rest (uncommon) were of prognostic significance. Serum cholesterol, systolic blood pressure, diabetes, and smoking were significant predictors of outcome, both with respect to fatal CHD and to total mortality during the 16-year follow-up. CONCLUSION: We found a high cardiovascular as well as noncardiovascular mortality among patients with chest pain who had not been considered to have AP at a three-step examination procedure. It is important to be suspicious of early CHD symptoms in men (and women?) with "nonspecific" chest symptoms and to analyze their cardiovascular risk factor pattern further because they are at considerably higher risk for future events than those in whom CHD is not suspected.     

Prevalence of symptomatic leg ischaemia in a Swedish community--an epidemiological study

The prevalence of symptomatic leg ischaemia (SLI) was studied using a standardised postal questionnaire and by measuring ankle systolic blood pressure among those with leg pain. All individuals, aged 50-89 years, of both sexes (n = 2748) in a community of 7524 inhabitants were included. The overall questionnaire response rate was 92%, of whom 441 (17%) reported any form of leg pain. Ankle systolic blood pressure (ASBP) was measured in 353 (80%) of those. Ankle/brachial index (ABI) < or = 0.8 was chosen as the criterion for verified SLI. One hundred and seven (30%) had a verified SLI (ABI < or = 0.8). Hospital records could be reviewed in 83% of the non-responders, and revealed corresponding distributions of risk factors among the non-responders and the questionnaire-responders. Risk factor frequencies among ASBP-examined and not examined individuals were also comparable. The overall prevalence of SLI in the age 50-89 years was 4.1%, ranging from 1.5% in the age decade of 50-59 years, to maximum 7.1% in the decade 70-79 years. A slight but not significant male predominance was recorded, except for the age decade 70-79 years. The prevalence of SLI in the whole community population was approximately 2000/100,000 of which 5% were possible candidates for vascular intervention.     

Peur du mouvement chez des accidentés du travail: L'échelle de Kinésiophobie de Tampa (EKT).

Studied the psychometric properties of the French-Canadian version of the Tampa Scale of Kinesiophobia (TSK-FC; S. H. Kori et al, 1990). The TSK-FC was administered to 70 male and female French-Canadian workers (aged 19-59 yrs) with various occupational injuries. The Beck Depression Inventory, the State-Trait Anxiety Inventory, subscales from the Pain Experience section of the West Haven-Yale Multidimensional Pain Inventory, and a questionnaire on disability also were completed. The results indicate satisfactory internal consistency for the TSK-FC. Construct validity analyses showed that higher levels of fear of movement and reinjury were associated with a higher level of perceived pain-related disability and with increased levels of psychological distress. Higher scores on the TSK-FC also were associated with lower levels of perceived life control and a decreased probability of work resumption following occupational rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blood pressure and twenty-year mortality in the city of Bergen, Norway

A blood pressure survey was carried out in 1963 in the city of Bergen, Norway. The relation between 20-year mortality and blood pressure in 52,064 participants aged 30-89 years at examination was analyzed. Increased blood pressure was related to increased mortality from coronary heart disease, stroke, and all causes in all age groups except the oldest, where a more irregular pattern was present. The relative risks decreased with age at screening, while the absolute increase in mortality with increasing blood pressure was greatest in persons aged 60-69 or 70-79 years at screening. A log-linear relation between systolic blood pressure and coronary heart disease and stroke mortality was seen in both men and women. An upturn in total mortality at low systolic blood pressures was suggested in the groups aged 60 years or more at screening. An upturn, or leveling off, was also seen at low diastolic blood pressures for total deaths and stroke deaths in both men and women.