Multiple pregnancies in Denmark 1980-1994

The objective was to study trends in national rates of multiple pregnancies that were not explained by changes in maternal age and parity. Information on childbirths to Danish-born women were obtained from national registers. The national incidence of multiple pregnancies increased 1.7-fold during 1980-1994, the increase primarily in 1989-1994 and almost exclusively in primiparous women > or = 30 years, for whom the adjusted population-based twinning rate increased 2.7-fold and the triplet rate 9.1-fold. The proportion of multiple births among infant deaths in primiparous women > or = 30 years increased from 11.5% to 26.9%. In conclusion, the marked increase in the rate of multiple pregnancies, which in particular was observed during the 1990s and in primiparous women > or = 30 years, could not be explained by changes in maternal age or parity. Fertility-enhancing treatments are believed to have caused this increase.     

Subcostal, 3-4 cm, mini-cholecystectomy. A 3-year follow-up

The authors report the results of mini-cholecystectomy performed through a 3 to 4 cm long subcostal incision in 29 patients with the diagnosis of acute or chronic cholecystitis, from February 1991 to November 1922. Some of the patients were obese, diabetics or presented as emergency cases. The patients were operated on in the morning, as in laparoscopic cholecystectomy, began oral intake in the afternoon and were discharged on the day after surgery. Dissection of the gallbladder was facilitated by the use of a modified gynecologic valve and long thin instruments. Duration of surgery varied from 40 to 140 minutes. Patients could return to work on the third day after surgery. Notably, the costs/benefits were on the third more favorable than those of laparoscopic cholecystectomy.     

The Stanmore total hip arthroplasty. A 15- to 20-year follow-up study

An ongoing study was made of 804 primary Stanmore total hip prostheses implanted in 839 patients between 1973 and 1991. The earliest surviving implants were brought back for radiologic and clinical review in 1995 at an average of 17 years after surgery. The remainder of the patients still living were sent a questionnaire to assess their current status. Survivorship was 95% at 10 years, 85% at 15 years, and 73% at 20 years. The average Merle d'Aubigné-Postel score was excellent up until 14 years. Patient satisfaction remained high until 22 years. Overall, 10% of the prostheses had failed. The results of this study suggest that the Stanmore prosthesis is capable of producing satisfactory long-term results that compare favorably with those of other cemented prostheses.     

Epidemiology and prognosis in children treated for intracranial tumours in Denmark 1960-1984

A total of 911 Danish children under 15 years of age were treated for an intracranial tumour in the 25-five year period 1960-1984. All cases were followed up to the end of 1994 or to emigration or death if one of these came sooner. The mean annual incidence was 32.5 per million children with a slight increase over the 25 years. The male/female ratio was 1.15 and close to the M/F ratio for the entire Danish population of children. Of the tumours, 46% were located in the supratentorial and 54% in the infratentorial compartment, and 94% were verified histologically. In order of frequency the most common types were astrocytomas (all grades, 35%), medulloblastomas (20%), ependymomas (14%), and craniopharyngiomas (5%). Total removal of the tumour was performed in 277 and partial removal, including biopsy, in 490 children. In 57 patients a shunt operation only was performed, and 87 children did not have an operation or died before the correct diagnosis was established. Radiotherapy was administered in 55%. The outcome depended on extent of removal, radiation, location and histology of the tumour. Most (784 or 86%) of the children survived more than 1 month after diagnosis or operation, and 353 children (39% of the whole series, 47% of those alive more than 1 month after diagnosis) were alive at follow-up. Of the survivors 29% had a tumour in the supratentorial midline, 26% one in the lateral part of the supratentorial area, 31% a cerebellar tumour and 13% a IV ventricle tumour. It was possible for 66% of the survivors with supratentorial and 90% of those with infratentorial tumours to lead a normal life. The long-term prognosis was especially good for children with cerebellar and supratentorial astrocytomas and optic chiasma tumours. Children with juvenile cerebellar astrocytoma had the best prognosis: 90% were alive at the end of the follow-up period, as against 20% of those with medulloblastoma and 6% of those with glioblastoma. A comparison of the data from the present series and from a similar Danish series of intracranial tumours in 533 children seen in the years 1935-1959 shows no significant differences in location or histology, a slight increase in annual incidence, and improved survival rates during the 50 years in question.     

Stability of intelligence: A 40-year follow-up.

Readministered the Revised Examination "M," a measure of intelligence, to 260 men approximately 40 yrs after they had received this test as World War II army recruits. Their average age and educational level was 64.7 yrs and Grade 8.7, respectively. Three sets of scores were compared: those obtained at the time of army enlistment; current scores obtained within the regular time limits of the test; and current scores obtained within double the test's regular time limits. Results indicate a reliable but minor decline in total score in the regular speeded condition and a reliable improvement over wartime total scores in the double-time conditions. Test–retest correlation coefficients, in general, attested to the long-term stability of individual differences among members of the sample. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality resemblance in adoptive families: A 10-year follow-up.

Children from 181 of the 300 families of the Texas Adoption Project were recontacted after a 10-year interval, at an average age of 17. They completed two standard personality tests, the Minnesota Multiphasic Personality Inventory (MMPI) and the Sixteen Personality Factor Questionnaire (16PF), plus a life events questionnaire and were rated by a parent on 24 bipolar trait scales. MMPI and 16PF scores were available from the earlier study for the adoptive parents, and MMPIs were available from the agency files for many of the adopted children's birth mothers. Parent–child correlations and regressions, sibling correlations, and comparison of the means of adopted and biological children were interpreted as indicating a modest genetic influence on personality traits (narrow-sense heritability, uncorrected, of about .25), a near-zero influence of shared family environmental factors, and a substantial contribution of idiosyncratic environment. The relative emotional and social adjustment of the biological and the adopted children had shifted since the time of the first study, to the detriment of the adopted children, but most still fell in the normal range. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Researchers' ethical conscience: Debriefing from 1960 to 1980.

To assess the extent that debriefing was reported in experiments using human Ss, every article in alternate years of the Journal of Abnormal and Social Psychology and Journal of Personality and Social Psychology was examined. Each examined year showed an increase in the percentage of studies reporting debriefing, from 12% in 1964 to 47% in 1980. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of marital distress: A 5-year follow-up.

26 couples (mean age 20.3 yrs) planning marriage participated in the initial stage of the study, and 9 of the 21 couples remaining intact during the study completed data (including the Marital Relationship Inventory) at all 3 follow-up points. A correlation coefficient of .59 was obtained, indicating that the more positively premarital couples had rated their communication, the more satisfied they were with their relationship 5? yrs later. Findings are consistent with the social learning model of marriage hypothesis that communication deficits precede the development of marital distress. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictive validity of the Kuder Occupational Interest Survey: A 12- to 19-year follow-up.

More than 1,000 men and women were located 12-19 yrs after taking an early form of the Kuder Occupational Interest Survey either in high school or in college. Satisfactory data were available for 882 Ss. 51% were employed at the time of the follow-up in an occupation that would have been suggested to them had their inventory been interpreted to them. This compared favorably with other validity findings for occupationally scaled interest inventories and represented about 90% of the possible validity as derived from concurrent validity figures. College major scales from a high school level administration correctly predicted 55%. Ss in occupations consistent with their early interest profiles did not report greater job satisfaction or success, but did show greater continuance in their occupational career. Better prediction was achieved when the occupation was one named on the profile and when the person had gone to or graduated from college or entered a high-level or scientific-technical occupation. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family and individual therapy in anorexia nervosa. A 5-year follow-up

The high prevalence of premature attrition from psychotherapy is a phenomenon which has been well recognized in the psychological literature. The pressing concern that a number of clients may not be benefiting from treatment because they are dropping out has led to a plethora of research in the area of individual psychotherapy. No studies, however, have attempted to investigate the characteristics of dropout in group cognitive behaviour therapy for depression. To address this gap in research, the present study examined the factors associated with dropout in a group cognitive behaviour therapy for depression, using 131 Ss who went through the group therapy for 12 weeks. The results showed that sociodemographic measures (e.g. age) and measures of depressive symptoms (e.g. depression scores) did not discriminate dropouts from completers. An investigation of patterns of mood changes in the course of the therapy also failed to find significant differences between the dropouts and completers. However, weekly therapist rating of client participation revealed that dropouts participated significantly less than completers during the therapy sessions. The results are discussed in light of the findings of current literature and future research in premature attrition.     

A 3- to 6-year follow-up of former long-stay psychiatric patients in Northern Ireland

Little is known about the first patients who left hospital before and during the official implementation of the hospital discharge policy in Northern Ireland. This study describes patterns of residential provision for former long-stay patients (approximately two-thirds of whom had an ICD-9 diagnosis of schizophrenia) discharged from the six major psychiatric hospitals in Northern Ireland between 1987 and 1990 (n = 321). It also employs several instruments within a retrospective survey design to examine outcomes for a 35% sample of people (112/321) discharged between 1997 and 1990 and followed up in 1993. Almost two-thirds (61%) had been discharged to independent living or low-staffed statutory settings. None of the group was homeless, one person was in prison and three people had committed suicide during the first 2 years after discharged. Almost one-third had to be re-admitted at some stage during the 6-year period and 13% had died. 'Moderate' to 'major problems' with most daily living skills were reported for less than 25% of people, while 15% or less had problem behaviour. Approximately 90% or more were satisfied with most aspects of their new homes and most also reported feeling happier (77%), healthier (63%) and more independent (78%) since discharge. However, social, recreational and occupational opportunities were limited. Purchasers, providers and practitioners need to review ways in which former long-stay patients might be empowered to live more meaningful and integrated lives in the community, particularly as the current government strategy for health and social well-being (1997-2002) in Northern Ireland points to the closure of existing psychiatric hospitals.     

A 35-year follow-up study on burnout among Finnish employees.

This three-wave 35-year prospective study used the Job Demands-Resources model and life course epidemiology to examine how life conditions in adolescence (1961–1963) through achieved educational level and working conditions in early adulthood (1985) may be indirectly related to job burnout 35 years later (1998). We used data (N = 511) from the Finnish Healthy Child study (1961–1963) to investigate the hypothesized relationships by employing structural equation modeling analyses. The results supported the hypothesized model in which both socioeconomic status and cognitive ability in adolescence (1961–1963) were positively associated with educational level (measured in 1985), which in turn was related to working conditions in early adulthood (1985). Furthermore, working conditions (1985) were associated with job burnout (1998) 13 years later. Moreover, adult education (1985) and skill variety (1985) mediated the associations between original socioeconomic status and cognitive ability, and burnout over a 35-year time period. The results suggest that socioeconomic, individual, and work-related resources may accumulate over the life course and may protect employees from job burnout. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Health outcomes for burn survivors: A 2-year follow-up.

Objective: To determine the evolution of health-related function in survivors of burn injuries. Design: Prospective cohort. Measure: Sickness Impact Profile (SIP). Participants: Adults who completed the SIP 1 month (n=237), 1 year (n=183), and 2 years (n=117) after burn injury. Results: Participants reported relatively low sickness impact compared with other medical populations within 1 year of injury. Overall health improved between 1 month and 1 year postinjury, after which it stabilized. Survivors reported worse psychosocial than physical function, regardless of age, gender, burn size, or days hospitalized. Conclusions: Most burn survivors can expect good physical recovery, even after large burn injuries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pollicisation of the index finger. A 27-year follow-up study

We have reviewed 11 patients with congenital absence of the thumb, treated by pollicisation of the index finger, after follow-up for 20 to 38 years. Seven of the hands also had an associated radial club-hand deformity. Function as assessed by the Percival score was excellent in six, good in three, fair in two and poor in four; three of the poor results were in patients with radial club hand. Ten of the 15 transfers were used as normal thumbs, but in five hands function required trick movements. Of the seven unilateral cases, two transplants were used as the dominant hand, and in another two thumb strength was more than 50% of that on the opposite side. For patients with isolated congenital absence of the thumb, pollicisation of the index finger gives good functional and cosmetic results which are maintained. The results are less reliable for those with radial club hand.     

The development of ADHD boys: A 12-year follow-up.

12 yrs after initial assessment, 33 male attention deficit hyperactivity disorder (ADHD) Ss (aged 14.4–24.9 yrs) were compared with 52 normal controls. Controls (selected at follow-up) were sex-, SES-, language-, and age-matched. According to childhood scores from the IOWA Conners Teacher Rating Scale, 24 ADHD Ss were inattentive/overactive (IO) and 9 were aggressive plus inattentive/overactive (A–IO). Ss and parents were interviewed and Ss completed a battery of tests. Core deficits of the disorder persisted in more than half of the ADHD group. IO Ss did not differ significantly from the controls in psychiatric functioning, except for their persistent ADHD. A–IO Ss had received the most individual and residential treatment for their behavior problems. ADHD Ss experienced significantly more problems in high school and displayed significantly poorer spelling, arithmetic, and reading comprehension skills than did controls. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Japanese career progress study: A 7-year follow-up.

A longitudinal study of managerial progress, begun by the present 1st author and colleagues (1978, 1980) in 1972 in a Japanese department store chain, monitored the professional and dyadic development of a cohort group of 80 newly recruited male college graduates (mean age 23.6 yrs) over their 1st 3 yrs with the company. Seven waves of data were collected from Ss, their immediate superiors, and company records. After 7 yrs with the company, Ss were promoted to their 1st management positions. The present study examined the preemployment selection test results and measured quality of vertical dyadic exchanges between S and his immediate superior over the 1st 3 yrs and the interaction of these 2 factors in predicting the speed of promotion, annual salary, and size of bonus after 7 yrs. Results show that the 1st 3 yrs were critically important to Ss; the combined effect of exchange and ability produced significant contributions to all 3 career outcomes assessed. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arthroscopic-assisted anterior cruciate ligament reconstruction with the central third patellar tendon. A 5-8-year follow-up

We reviewed 89 arthroscopically assisted patellar tendon anterior cruciate ligament (ACL) reconstructions for chronic isolated injuries with an average follow-up of 7 years (range 5.4 to 8.6 years). Pain was present in 7 knees (8%). Giving-way symptoms were reported by 7 patients (8%). A KT-2000 side-to-side difference over 5 mm at 30 lbs was recorded in 12 cases (16%). The pivot shift was glide in 17 cases (19%) and clunk in 10 (11%). A 3 degrees-5 degrees extension loss compared with the normal side was present in 20 knees (22%) and 6 degrees-10 degrees in 4 knees (4%). The intra-articular exit of the femoral tunnel was misplaced in the anterior 50% of the condyles along the roof of the notch in 10% of the knees. This positioning significantly (P = 0.003) increased the frequency of graft failure (62.5%) compared with the cases with a more posterior placement (graft failure 12%). An anterior position of the intra-articular exit of the tibial tunnel (in the anterior 15% of the sagittal width of the tibia) significantly (P = 0.01) increased the frequency of extension loss > 5 degrees. Medial meniscectomy was associated with a 35% incidence of narrowing of the medial joint space, which was significantly higher compared with knees with normal menisci (9%; P = 0.04) or with medial meniscal repair (7%; P = 0.05). In conclusion this study showed satisfactory anterior stability (KT-2000 side-to-side difference up to 5 mm and pivot absent or glide) in 83% of the knees. This percentage increases to 88% in the knees with a correct posterior and proximal femoral tunnel placement. Accuracy in tunnel positioning is essential for the success of ACL surgery. Meniscal repair was effective in decreasing joint space narrowing and should be attempted when possible.     

Preventing marital distress through communication and conflict management training: A 4- and 5-year follow-up.

Reports the 4- and 5-yr follow-up results of evaluating the effects of a marital distress prevention program. The Prevention and Relationship Enhancement Program (PREP) is a 5-session program designed to teach couples effective communication and conflict management skills. At the 5-yr follow-up, intervention (as compared with control) couples had higher levels of positive and lower levels of negative communication skills and lower levels of marital violence. Data are also presented on couples who declined the program. Issues are discussed concerning selection effects, change mechanisms, and future directions for prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lung cancer--hopelessness in inoperability? A 10-year follow-up

BACKGROUND: According to reports of Durrant et al. [19] and Berry et al. [5] it was concluded that non-operable non-small cell lung tumors cannot be cured. In this consequence initiation of radiotherapy was fixed at the beginning of symptoms. However, long-time survivors in our follow-up lead us to analyse not only quality of life and secondary therapeutic effects but also this special group with the results of the whole collective treated in the same period of interest. PATIENTS AND METHODS: Between 1.1. 1981 and 31. 12. 1983 a number of 169 patients had been recommended for locoregional radiotherapy treatment of lung cancer; 145 patients received at least 50 Gy, 134 out of them 60 Gy or more. Men/female ratio was 137:8, median age was 65 (36 to 88) years. Classified according to the TN-stage there were 59 patients in T1-4 N0 and 86 patients in T1-4 N1-3 M0. Histologically: 98 squamous cell carcinomas, 23 adenocarcinomas, 9 large cell carcinomas and 15 specimens mixed from the named subgroup or rare histologies. Treatment concept including repetition of bronchoscopic evaluation after 60 Gy was prospectively discussed and fixed with our pneumologist. Radiation dose was given with a shrinking-field technique to mediastinum and primary. In case of macroscopically or microscopically persistence of tumor we continued radiation dose up to 80 Gy. Radiotherapy was not followed by chemotherapy. A telecobalt unit has been used for treatment due to the lack of high-voltage linear accelerators. In absence of a computer assisted planning system-a problem in most of the radiotherapeutic centers in this time-dose calculation was done by central beam planning of ICRU-point in the middle of the tumor respectively the center of target volume on the base of a cross section. Usually there was used a 3-field plan ap/pa opposite and an oblique field with an angle of 30 degrees from the ipsilateral back or ventral side, depending on the position of the tumor. Spinal cord was shielded to avoid a dose-more than 36 to 42 Gy. The longer distance and higher weightiness of the oblique fields had as consequence lung fibrosis in the irradiated lung area and a considerable higher maximal dose situated in the soft tissue and skin often followed by strong indurations in this area 1 to 3 years after radiation therapy without further limitations of quality of life. RESULTS: From 145 patients with non-small cell lung cancer 64.1% (93/145) survived 6 months, 42.8% (62/145) 1 year, 19.3% (28/145) 2 years and 7.6% (11/145) 5 and 4.8 (7/145) more than 10 years. According to TN-stages T1-4 N0 collective had a survival rate of 67.8% (40/59) after half a year, 50.8% (30/59) after 1 year, 23.7% (14/59) after 2 and 11.9% (7/59) after 5 years. Treatment results by patients with positive lymph nodes T1-4 N1-3 after the same intervals are: 61.6% (53/86), 37.2% (32/86), 16.2% (14/86) respectively 4.7% (4/86). In the period 5 to 10 years after irradiation 4 patients died, 1 with local relapse, 2 with contralateral lung cancer-ipsilateral region was endoscopically and histologically free of tumor- and 1 patient in consequence of heart insufficiency of several years. Seven patients are still alive after 13 to 16 years. There is no sign of tumor in this group or any effects limitating their quality of life. Twenty-four patients received less than 50 Gy. All patients but 2 did not survive 6 months. One patient survived half a year and 1 patient 2 years. CONCLUSIONS: The reported treatment results in a period with modest technological possibilities, a telecobalt unit, should encourage to a curative intention, when dissemination cannot be proved. If lung cancer is limited to the primary region with or without lymph node metastases the possibility of tumor elimination is small but feasible. If inoperable lung cancer is not curable, this mostly is not due to inability of locoregional radiotherapy, but rather can be seen as a lack of reliable and permanent elimination or prevention of