Comparing master's clinical training with professional responsibilities in community mental health centers.

100 directors from randomly selected, federally funded community mental health centers and 70 coordinators from university-based, master's-level clinical training programs were surveyed by mail. A 5-part questionnaire sought information regarding (a) relative amount of time spent by master's-level clinicians performing 10 specified professional responsibilities, including psychodiagnostics, psychotherapy and counseling, research, administration, and consultation, or relative time spent at them in training; (b) the same estimates projected 10 yrs into the future; (c) differences in the groups' ratings of master's-level clinician's competency for the same 10 responsibilities; (d) perceived relative importance of each responsibility for the clinicians; and (e) estimates of importance 10 yrs hence. Results are based on return rates of 33% for center directors and 60% for program coordinators and are presented in both between- and within-groups comparisons. Master's-level clinicians were seen as competent professionals having a continuing role in mental health service delivery. Implications for training, provision of service, and degree recognition are considered. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship among work-family conflict and enhancement, organizational work-family culture, and work outcomes for older working women.

This article examines the relationship among work-family conflict and enhancement, organizational work-family culture, and four work outcomes for 489 working women over the age of 50. Survey results from two U.S. health care organizations and one U.S. financial services organization indicate that older working women experience differing amounts of work-to-family conflict, family-to-work conflict, work-to-family enhancement, and family-to-work enhancement. Hypotheses relating organizational work-family culture to work-family conflict and enhancement were partially supported, and hypotheses relating conflict and enhancement to four work outcomes were partially supported. Work-to-family conflict and work-to-family enhancement partially mediate the relationship between organizational work-family culture and selected work outcomes. Implications for theory and practice, limitations of this study, and directions for future research are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health status measurement in Toxic Oil Syndrome

Toxic Oil Syndrome (TOS) is a previously unreported condition which affected more than 20,000 people in Spain in 1981 and whose natural history is unknown. In 1993-94, a stratified random sample of 1400 survivors was drawn to measure their health status through clinical examination and their self-perception of well-being through the Nottingham Health Profile Questionnaire (NHPQ). Two-thirds of the sample population responded; indirect estimates suggest that selection bias was limited. Clear and intermediate signs of neuropathy were found in one-fifth and one-half of the patients, respectively. One-fourth and one-sixth showed some degree of scleroderma and contractures. All conditions were more frequent in women than in men and in age >50 than in younger ages. Although no concurrent control group was included in the study, prevalences of these conditions are well above expectations and are largely attributable to TOS. NHPQ scores increased with age in both sexes up to age 50, after which they reached a plateau (with values around 48 in men and 62 in women). Scores were associated to the occurrence of peripheral neurological changes, contractures, and scleroderma-like conditions. A multivariate analysis indicated age, sex, and severity of neurological conditions as major determinants of the NHPQ scores. This overall pattern of findings is peculiar to TOS and differs from the typical post-disaster nonspecific syndrome.     

Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States

OBJECTIVE: To provide a single source for the best available estimates of the national prevalence of arthritis in general and of selected musculoskeletal disorders (osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, the spondylarthropathies, systemic lupus erythematosus, scleroderma, polymyalgia rheumatica/giant cell arteritis, gout, fibromyalgia, and low back pain). METHODS: The National Arthritis Data Workgroup reviewed data from available surveys, such as the National Health and Nutrition Examination Survey series. For overall national estimates, we used surveys based on representative samples. Because data based on national population samples are unavailable for most specific musculoskeletal conditions, we derived data from various smaller survey samples from defined populations. Prevalence estimates from these surveys were linked to 1990 US Bureau of the Census population data to calculate national estimates. We also estimated the expected frequency of arthritis in the year 2020. RESULTS: Current national estimates are provided, with important caveats regarding their interpretation, for self-reported arthritis and selected conditions. An estimated 15% (40 million) of Americans had some form of arthritis in 1995. By the year 2020, an estimated 18.2% (59.4 million) will be affected. CONCLUSION: Given the limitations of the data on which they are based, this report provides the best available prevalence estimates for arthritis and other rheumatic conditions overall, and for selected musculoskeletal disorders, in the US population.     

Large-sample confidence intervals for validity and reliability coefficients.

Large-sample confidence intervals (CI) for reliability, validity, and unattenuated validity are presented. The CI for unattenuated validity is based on the Bonferroni inequality, which relies on one CI for test–retest reliability and one for validity. Covered are four reliability–validity situations: (a) both estimates were from random samples; (b) reliability was from a random sample but validity was from a selected sample; (c) validity was from a random sample but reliability was from a selected sample; and (d) both estimates were from selected samples. All CIs were evaluated by using a simulation. CIs on reliability, validity, or unattenuated validity are accurate as long as selection ratio is at least 20% and selected sample size is 100 or larger. When selection ratio is less than 20%, estimators tend to underestimate their parameters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurorehabilitation outcome in moyamoya disease

OBJECTIVE: To assess the contribution of emotional health problems to the burden of disability affecting people of working age. DESIGN: Analysis of data collected in a postal questionnaire survey of a random sample of people aged 18-64 years. SETTING: The four counties of the old Oxford region in 1991. SUBJECTS: 9332 people who responded to a questionnaire survey mailed to 14,000 people randomly selected from the Family Health Service Authority registers of the four counties of Berkshire, Buckinghamshire, Oxfordshire, and Northamptonshire. OUTCOMES MEASURES: Interference with work or other regular daily activity as reported in questions 4 and 5 of the health status measure SF-36. RESULTS: In this population the prevalence of disability attributable to emotional health problems was greater than that attributable to all physical health problems combined. People reporting that their work or other regular daily activity was affected by their emotional health were much less likely to report a long-standing illness, consultation with a GP or consultation with a hospital doctor than people reporting a physical health problem. CONCLUSIONS: Emotional health problems are a more important cause of disability in adults of working age than all physical health problems put together. Their importance is underestimated in health needs assessment exercises, which are based on NHS consultation rates or reporting of chronic illness. Research into the causes, prevention, and management of emotional health problems should be a national priority for the health service.     

Lunar Base Parametric Model

A steady-state model for first-order magnitude estimates of lunar base masses is presented. The main focus of the model is the derivation of initial and annual resupply mass estimates for a lunar base at certain development stages. These estimates are not only a function of several thousand input parameters and boundary conditions such as crew size; lunar base location; and environmental conditions, but also specific system masses; specific power requirements; and specific thermal loads. This integrated lunar base model indicates which systems and subsystems have the greatest mass impact on the overall base. Also, brief overviews of possible activities at a lunar base and of lunar development strategies are given.     

Shelley E. Taylor.

Acknowledges Shelley E. Taylor for outstanding contributions to social psychology and health psychology. Her fundamental contributions to basic social psychology have identified the importance of people's positive illusions, synthesized social comparison research in natural settings, and documented the asymmetrical impact of positive and negative events. In health psychology, she has brilliantly analyzed people's responses to intensely stressful negative events and created cognitive adaptation theory. A citation, biography, and selected bibliography of Taylor's work are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health, health promotion and the elderly

Health promotion is a mode of practice which is being increasingly examined by policymakers (DHSS, 1987; DoH, 1992). Although practitioners are being required to screen people over 75 years of age and are exhorted to reduce accidents in the elderly by 33% between 1990 and 2005 (DoH, 1992), there is evidence that they do not value this sort of work (Pursey & Luker, 1993). This paper looks at the findings from 178 interviews with people aged over 75 years, examining the importance of health and health promotion to the elderly. Further to the work of Cox et al. (1987), it is clear that people aged over 75 years continue to engage in a wide variety of activities which are designed to keep or improve their health. Elderly people's accounts of their health suggest that the real influence of social circumstances and environment must be assessed and planned for if health promotion activity is to have relevance and meaning to this group of people. Evidence is presented which indicates that the elderly are a group of people who would welcome health-promotion activity provided it is given in easily accessible forms. The notion of client participation is highlighted as a difficult area, which is likely to require particular skill in working with elderly clients. In the light of these findings, practitioners may need to examine their own attitudes to their work with the elderly.     

Effectiveness of complex sanatorium-climatic treatment of patients with recurrences of pulmonary tuberculosis

From the point of view of social hygiene is shown, in what way social conditions are given and sued in the GDR to take influence on the state of health up to old age. As main factors of work dwelling and social or cultural care are considered. Resuming his treatise the author confirms that not yet all sources are used to solve the problems regarded. References to law-materials and other principles are given to support physicians in treating and guiding older people and to enable authorities not belonging to health service to fulfill the adequate tasks.     

Successful transplantation of adult-sized kidneys into infants requires maintenance of high aortic blood flow

Geographical Information Systems-computerised systems for the capture, storage, retrieval, analysis and display of spatial data-have recently been promoted as important tools for the study of public health. Attention must also be given to the issues involved in this relatively new application, especially in Australian conditions. These include the coarse spatial resolution of most health and social data, the propagation of error through the need to use estimates and concordance tables to handle data in mismatched official spatial boundaries, the inflexible analytical capacity of most GIS for the needs of epidemiology, and difficulties in access to data, which are compounded by the absence of a good metadata register. The conflict between the need for spatial precision in GIS and preserving the confidentiality of health data is a salient issue. Medical geographers and public health researchers using GIS must recognise these issues in order to work together and toward extending the use of GIS technology beyond broad ecological and accessibility studies.     

Abstracts: Selected symposia/paper/poster presentations: APA annual convention.

Presents a collection of abstracts of selected symposia, papers and posters presented at the annual convention of the American Psychological Association (APA). These include symposia on rehabilitation psychologist training; culture and the rehabiltation process; the effects of physical trauma on distress and observer bias; geriatric rehabilitation; disability assessment; intervention of substance abuse after traumatic brain injury; and health care reform and pediatric rehabilitation. Paper sessions focused broadly on family issues in health and disability, and self and affect as correlates of disabling conditions; and, poster sessions addressed new directions in rehabilitation psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Population attributable fraction estimation for established breast cancer risk factors: considering the issues of high prevalence and unmodifiability

Established breast cancer risk factors, in addition to being relatively unmodifiable, are highly prevalent among US women. Previous reports of population attributable fraction for the established risk factors have used definitions that resulted in 75-100% of women in the source population labeled exposed. The practical value of such estimates has not been discussed; further, the estimates have frequently been misinterpreted. In the context of examining the interpretation and public health value of such estimates, the authors demonstrate the sensitivity of the population attributable fraction to changes in exposure cutpoints. They use data from the Carolina Breast Cancer Study, a case-control study of breast cancer conducted in North Carolina between 1993 and 1996. For the four established risk factors (menarche before age 14 years, first birth at age 20 years or later/nulliparity, family history of breast cancer, and history of benign breast biopsy), the estimated population attributable fraction was 0.25 (95% confidence interval 0.06-0.48). Over 98% of the source population was exposed to at least one of these risk factors. The population attributable fraction estimate was reduced to 0.15 when more restrictive definitions of early menarche (less than age 12 years) and late age at first full-term pregnancy (30 years or more) were used (proportion exposed, 0.62). Population attributable fractions for established breast cancer risk factors probably have little public health value because of both the high proportions exposed and the relative unmodifiability of the risk factor distributions.     

Race differences in labor force attachment and disability status

We used the first wave of the Health and Retirement Survey to study the effect of health on the labor force activity of black and white men and women in their 50s. The evidence we present confirms the notion that health is an extremely important determinant of early labor force exit. Our estimates suggest that health differences between blacks and whites can account for most of the racial gap in labor force attachment for men. For women, when participation rates are comparable, our estimates imply that black women would be substantially more likely to work than white women were it not for the marked health differences. We also found for both men and women that poor health has a substantially larger effect on labor force behavior for blacks. The evidence suggests that these differences result from black/white differences in access to the resources necessary to retire.     

Trends in health and ability to work among the older working-age population

OBJECTIVES: Because of recent changes in Social Security regulations that will soon begin to raise the age of eligibility for full retirement benefits, it is important to determine whether health and ability to work at older ages have improved in recent years. METHODS: Individual-level data from the National Health Interview Survey from 1982 through 1993 are used in this analysis. Trends in self-reported ability to work, presence of disease, and causes of actual work limitation are examined. RESULTS: Men and women in their 60s, that is those in the older working ages and younger retirement ages, report significant improvement in their ability to work. The change in work ability is large enough so the percentage unable to work at age 67 in 1993 is lower than the percentage unable to work at age 65 in 1982. This improvement appears to have been similar for racial and ethnic groups and across educational subgroups of the population, although African Americans and those with lower educational attainment are less healthy to begin with. The improvement in health is due to the changing educational composition of the population, which is linked to better life-long health, different occupational circumstances, and better health behaviors. In addition, the improvement in work ability is explained by decline in the prevalence of cerebro/cardiovascular diseases and arthritis. DISCUSSION: The level of observed improvement in work ability means that the legislated rise in age of full eligibility for Social Security benefits should be more than compensated for by the improved ability to work.     

Leopold Bellak.

Since 1979, Professional Awards have been presented to individual members of the Association whose distinguished contributions have served to advance psychology as a profession in the areas of knowledge, professional practice, and public service. In 1992, Leopold Bellak received the award for Distinguished Professional Contributions to Knowledge. His professional career as psychologist, psychiatrist, and psychoanalyst encompassed seminal contributions to the fields of psychopathology, psychoanalysis, psychological testing, brief psychotherapy, and community mental health. The author of more than 200 publications, he is perhaps best known to psychologists for his work with the Thematic Apperception Test (TAT) and the development of the Children's Apperception Test. A citation and biography are presented for Bellak, along with a selected bibliography of his work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of goal value upon expectancy.

Within the framework of Rotter's social learning theory, this study investigated the effect of different goal (reinforcement) values upon expectancy. 94 boys, ranging in age from 9 to 11, were selected from the fifth and sixth grades of a public school system to serve as Ss. The tasks, representing three different levels of goal value, were the Rotter level-of-aspiration board, a rotary pursuit test, and a six-block tapping test. 71 Ss performed the tasks without a penalty for inaccuracy of estimates, and 23 performed the same tasks with a penalty imposed for inaccuracy of estimates. The most consistent finding was that the value of an event has some effect upon stated expectancy. It was also found that expectancies were significantly lower in highly valued situations; that with continued experience expectancies remained significantly lower in high value conditions; and that the association of a goal value for accuracy (penalty) to expectancy statements leads to more realistic expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Association of Computerized Medical Records Users in Perinatology, Obstetrics and Gynecology Sentinel Network for maternity hospitals. I. Perinatal health indicators in 1994]

A first experiment aimed at collecting data from 98 maternity hospitals grouped in the AUDIPOG Sentinel Network addressed 7,837 deliveries in January, 1994. The technique used for recovering the results was adapted from the quota method and aimed at strict respect of marginal distributions of deliveries per regional area and per hospital type, and at the best the joint distribution of deliveries per regional area/hospital type, to obtain estimates of perinatal health indicators. Selection indicators (age, family status, socio-economic conditions, previous history), practising indicators (supervision of the pregnancy, entrance motive, presentation, delivery mode, anaesthetic) and result indicators (prematurity, small for date, transfer, pathology of the new-born) are given.