An organization-wide approach for an effective communication system, Part 1

This two-part series provides a cogent discussion of designing and implementing an effective communication system, with a committee structure based on the Joint Commission on Accreditation of Health Care Organizations (JCAHO) functions. Part one includes the development and design using a systems approach. Part two, which will be published in the April 1998 issue of JONA, will address the evaluation of outcomes and implications of this communication system. The experiential learning gained from this process is illustrated by the analysis of themes that surfaced during the implementation.     

Religious life-styles and mental health: An exploratory study.

Conducted an intensive, case-by-case assessment of life-styles of a sample of religious students. We identified differing styles of religiousness and made comparisons by means of tests and interviews between subgroups whose subjects manifested differing religious life-styles. Those subjects with continuous religious development and mild religious experiences appeared to be healthier than those with discontinuous development and intense religious experiences; however, intense religious experiences tended to enhance the adjustment of those who experienced them. There was no evidence in the group as a whole for an overall negative or positive correlation between religiousness and mental health, but some modes of religious involvement appeared to be related to disturbance, whereas other modes appeared to be related to enhanced stability and resilience. Because causality in these relations remains uncertain, we generate hypotheses concerning further studies of life-styles and adjustment. We also discuss implications for student counseling and development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sibling loss and attachment style: An exploratory study.

Current conceptualizations do not adequately explain the particular relational difficulties experienced by young adults who have been faced with the death of a sibling. In this study, the authors explore interrelationships between attachment style, coping style, repressive defensiveness, and the loss of a sibling in childhood. The findings suggest that this type of stressor may result in different coping reactions than other stressors. In particular, sibling loss seems to stimulate greater support seeking than withdrawal, regardless of attachment style. Sibling loss can pose particular relational challenges for the developing child because of the traumatic impact on the primary caregivers. This fact makes it important for therapists to have an understanding of some of the potential consequences of this particular traumatic event. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond relevance--characteristics of key papers for clinicians: an exploratory study in an academic setting

OBJECTIVE: The purpose of this study was to determine what factors beyond relevance influence a clinician's decision to choose to read one journal article over another in satisfying an information need. DESIGN: Seventeen health care providers were interviewed and then surveyed regarding the characteristics of key articles (those they would not want to miss). On a Likert scale, the clinicians graded forty-two characteristics for importance in the decision process. Relevance was assumed and not at issue. SETTING: The study took place in an academic health science center. SUBJECTS: The subjects were seventeen clinicians, all with patient care responsibilities. There were four internists, four surgeons, three family practitioners, three pediatricians, two psychiatrists, and one clinical psychologist. RESULTS: Factors beyond relevance that most often influenced the decision process pertained to methodological rigor, authors and their institutional affiliations, document types, and population studied. CONCLUSIONS: Among the clinicians surveyed, factors beyond topicality influenced judgments as to what constitutes an important article. The emphasis respondents gave to certain attributes is echoed in other published work and highlights the need for more intensive investigation of these non-subject indicators as search parameters. Improved searching capabilities might well lead to a significant reduction in the clinician's information overload.     

Presleep experience and home dream reporting: An exploratory study.

Investigated the effect of presleep stress on home dream recall for a total of 57 male undergraduates who rated themselves on a questionnaire as frequent or infrequent dream recallers. In the stress condition, Ss observed an accomplice being "shocked" for error on a sensorimotor test which Ss expected to be tested on in a few days. There was no difference in amount of home dream recall for the stress and control conditions. The prediction of more dream recall for frequent recallers and less dream recall for infrequent recallers in the stress condition was supported. The tendency toward more contentless and vague dream recall for the stress condition, especially for infrequent recallers, was discussed in terms of (a) the larger percentage of dreams scorable for hostility in the stress condition, and (b) the hypothesis that contentless dreams are correlates of repression. (21 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prison inmate characteristics and suicide attempt lethality: An exploratory study.

Working with suicidal inmates is among the most demanding elements of clinical practice in corrections, yet few studies regarding the characteristics of prison inmate suicide attempters or their attempts exist. This represents a significant gap as the method of attempt, the prison context, and the resulting lethality of these incidents may be different from attempts made outside of prison. This exploratory study is the first to apply a continuous scale rating of suicide attempt lethality to incidents where an inmate survived a suicide attempt. It describes the attempt incident dynamics and resulting range of lethality scores found within the study sample. It also examines the inmate adjustment and mental health characteristics that were associated with the lethality rating. Preliminary findings suggest that increases in suicide attempt lethality are associated with the presence of Axis II disorders, favorable staff interactions, and the decreased use of drugs other than marijuana, alcohol, cocaine, or depressants. A call for research to extend this exploration through replication is made and recommendations for clinical practice are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group-based motivational interviewing for alcohol use among college students: An exploratory study.

How can practicing psychologists help reduce excessive alcohol consumption among college students? Over 80% of college students consume alcohol, and a significant percentage drinks excessively with myriad problems. Brief interventions based on motivational interviewing (MI) have been identified for use with college populations. The authors randomly assigned 91 freshman students to a brief, classroom-based MI intervention or an assessment control condition. At the end of the semester, MI group participants reported fewer drinks per occasion and fewer episodes of intoxication compared to controls. A classroom-based, MI-style intervention might be an efficient, sustainable, and effective means of reducing heavy drinking among college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' helpful and unhelpful situations with LGBT clients: An exploratory study.

The purpose of this exploratory study was to identify a broad range of variables that characterize psychotherapists' perceptions of helpful and unhelpful therapy experiences of lesbian, gay, bisexual, and transgender individuals. In-depth, semistructured interviews were conducted with a diverse sample of 14 psychotherapists to identify such variables and patterns among them. Results suggest that a wide range of variables, including the therapeutic relationship, therapist response to the client's sexual orientation/gender identity, type of presenting concern, and the therapy environment, may affect the therapy experiences of this population. The data also suggest that factors such as ethnicity, gender identity, therapy needs, and socioeconomic status should be considered when providing mental health services to this population. Clients dealing with multiple types of marginalization may be particularly challenging for practitioners. Implications for future research and clinical practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial adaptation in adolescents and young adults with Marfan syndrome: an exploratory study

Endothelium-derived nitric oxide formed by endothelial constitutive nitric oxide synthase (ecNOS) mediates endothelium-dependent vasodilation and antithrombotic action. We analyzed the distribution of a polymorphism of ecNOS (27-bp repeat in intron 4) in 127 ischemic stroke patients (18 with atherothrombotic, 58 with lacunar, and 51 with silent lacunar stroke) and 91 control subjects. When we assigned the four repeats as allele a, and five repeats as allele b, there was no significant difference between the genotype distribution and allele frequencies in the stroke group and in the control group (0.862 versus 0.868 for the b allele frequency). Moreover, there was also no significant difference in the genotype distribution or allele frequencies among the three stroke subgroups (b allele frequency: 0.889 for atherothrombotic stroke; 0.862 for lacunar stroke; 0.853 for silent lacunar stroke). These findings suggest that there is no overt association between this ecNOS gene polymorphism and ischemic stroke. We found no evidence that this polymorphism may be a genetic factor for the onset of cerebrovascular disease in this Japanese population.     

Personality and life adjustment after spinal cord injury: An exploratory study.

This study identified the relationship between personality and multiple components of life adjustment after spinal cord injury (SCI). One hundred five men completed the NEO Personality Inventory (NEO-PI), a measure of personality. In general, the NEO-PI accounted for the greatest amount of variance of scales reflecting general adaptation. Of the global domains, only two scales were strongly associated with the SCI outcomes. Among the NEO-PI facet scales, Depression was correlated with the greatest number of outcomes, whereas Warmth, Positive Emotions, Actions, and Values were correlated with superior outcomes. These findings suggest that assessment of personality is an invaluable aid in predicting long-term outcomes after SCI and should remain a priority in diverse rehabilitation settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The relationships between defenses and experiences of depression: An exploratory study.

This study examined the relationships between defenses and depressive experiences. Two questionnaires, in counterbalanced order, were administered to a community sample of 205 adults: the Depressive Experiences Questionnaire (DEQ; S. Blatt, J. D'Afflitti, & D. Quinlan 1976, 1979) and the Defense Mechanisms Inventory (DMI; D. Ihilevich & G. C. Gleser, 1986). Although turning against self related significantly to both depressive experiences of dependency, especially the less mature neediness in comparison with the more mature connectedness, and self-criticism, other types of defenses, as measured by the DMI, differentiated between interpersonal and self-critical experiences of depression. Results are discussed from psychodynamic and developmental perspectives. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Hearing handicap--an addition to audiometric hearing loss. Results of an exploratory study of auditory communication disorders in the elderly

Hearing problems in elderly patients cannot be evaluated completely with conventional audiological tests in most cases. Two hundred and one subjects aged 60 years or more complaining of hearing problems were studied. The following tests were employed: pure-tone audiometry, the "Basler Satztest" (a German version of the SPIN-test assessing speech perception in noise), and a German version of a "Hearing Handicap Inventory for the Elderly" (HHIE). These latter versions were developed in our institution. An auditory handicap was found in one-third of subjects with mild hearing losses (PTA < 30 dB; n = 135) and in two-thirds of subjects with greater hearing losses (PTA > and = 30 dB; n = 65). The relatively weak correlations of the pure-tone audiogram (r = 0.49) or speech audiometry (r = 0.41) with HHIE indicate that more than 50% of the variance of the hearing handicap was due to non-audiologic factors. For this reason, we recommend that the handicap questionnaire be added to the audiometric evaluation.     

Development of a vibratory white finger prevention program for shipyard workers: an exploratory study

OBJECTIVE: To study the effects of thevetoside (TS), a cardiac glycoside, and an inhibitor of Na+, K(+)-ATPase, on tumor cells cultured in vitro. METHODS: The cytotoxic effects of TS on tumor cells were determined by trypan blue dye exclusion, neutral red vital staining and clonogenic assay. The time-effect relationship and growth inhibition of tumor cells by TS were assayed with trypan blue exclusion method. RESULTS: TS at low doses (0.005-0.1 mg.L-1), with dose dependence, was able to kill SMMC-7721, SGC-7901 and HeLa cells. IC50 values for SMMC-7721, SGC-7901 and HeLa cells were 0.007, 0.011 and 0.018 mg.L-1 by trypan blue dye exclusion test and 0.016, 0.055 and 0.078 mg.L-1 by neutral red vital staining test. TS inhibited the clonal forming rate of SMMC-7721 and SGC-7901 significantly with IC50 values of 0.021 and 0.036 mg.L-1, respectively. Only when the cells were continuously treated with TS for more than 8 hours, the drug-induced cell lethality could be displayed and strengthened quickly. The growth of tumor cells was notably inhibited after they were exposed to 0.1 microgram/ml of TS for 12 hours. All the experimental results of antitumor activity in vitro showed that SMMC-7721 was most sensitive to TS among the three kinds of tumor cells. CONCLUSIONS: TS has cytotoxic action on tumor cells cultured in vitro and this lethal effect must have an action process, in which tumor cells are not dead but suffer from deadly injury and lost the capability of unlimited proliferation.     

Professional education and training: How satisfied are we? An exploratory study.

A survey of 497 interns, residents, and psychologists indicated general satisfaction with their career choices and training. A majority of respondents (about 68%) desired more training in career/workplace issues and 44% wanted additional training in the biological bases of behavior. Some believed that the financial and time commitments needed to become a psychologist might outweigh the long-term benefits. Limitations of the study including low sample size were discussed. Results were also discussed in terms of abbreviating the current training curriculum to maintain competitiveness in the workplace, and in terms of the costs versus benefits of becoming psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Level of analysis in the perception of ongoing instruction: An exploratory study.

The level of perceptual analysis at which learners operate during ongoing instruction is suggested to be a variable mediating the effects of instructional variables on learner outcomes. Several instructional variables were manipulated to determine whether they influence the level of perceptual analyses; Ss were 184 undergraduates. Unitization instructions, lesson difficulty, teacher effectiveness, and teacher order were found to influence perceptual analysis significantly. The relationships of perceptual analysis to concept learning and to evaluations of the instructors were also examined. Partial support was obtained for the hypotheses that finer levels of perceptual analysis are associated with more favorable instructor evaluations and with concept learning. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motor performance following a mild traumatic brain injury in children: an exploratory study

Mild Traumatic Brain Injury (TBI) is a common occurrence in the paediatric population and, as the concept of motor performance has not been assessed specifically in this population, the purpose of this study was to determine if motor performance deficits are present and can be objectively identified in a sample of children having sustained a mild TBI (Glasgow Coma Scale score 13-15). Twenty-eight children aged between 5 and 15 years were recruited immediately post-trauma. Subjects were considered normal on standard neurological exam at the time of discharge. They were assessed 13-18 days post-trauma using the Bruininks-Oseretsky Test of Motor Proficiency, a norm referenced clinical standardized assessment tool. Compared to published norms, motor performance was significantly lower in domains of balance, response speed and running speed an agility (t-test p < 0.01), and significantly higher in domains of upper extremity coordination and visual motor control (t-test p < 0.01). Although excellent performance can be observed in domains requiring upper limb coordination, motor planning and execution of motor tasks, deficits in balance and response speed can be identified in a significant number of children even after mild TBI. More specific and sensitive evaluations are necessary to identify the exact nature of the problems and evaluate their functional impact on daily activities.     

Mentoring relationships of New Zealand nurses: an empirical study (Part 1)

A national, random, postal survey (n = 298) of mentoring behaviour among New Zealand nurses was undertaken. The initial research problem was to seek an explanation for the apparent lack of mentoring in New Zealand nursing. However, as the study evolved the lack of agreement concerning the definition of mentoring became a major research obstacle. A new conceptual framework of mentoring grounded in the work of Kathy Kram (1985) was devised. A quantitative global measure of mentoring behaviour (the TMS score) was used to measure levels of mentoring behaviour. This score was used as the dependent variable in subsequent statistical tests of: the definitional hypothesis-the study's validity check; the peer mentoring hypothesis which explored selected dynamics of mentor protégé relationships, and four allied research questions. The conceptual framework and approach are discussed in part one.