Using ultrasound to assess the fetus at risk

In early pregnancy, ultrasonic scanning is valuable if the patient's menstrual history is unreliable or if uterine size is less than expected. The crown-rump length of the embryo can be measured from the sixth week of gestation, and pulsation of the heart detected from the seventh. The crown-rump length of the early embryo gives precise information about maturity. Somewhat later in pregnancy, fetal maturity and growth rate can be assessed accurately by measurement of the biparietal diameter. The head circumference and the fetal upper abdominal circumference together give the head-abdomen ratio, which can be helpful in assessing fetal nutrition. The abdominal circumference also may be used to predict fetal weight.     

Using the patient's plan to assess progress in psychotherapy.

Describes the application of a formulation of the patient's plan in psychotherapy research. Use of patient plan formulations to (1) study the effects of therapist intervention on patient progress (within-session change) and (2) develop individualized psychodynamic outcome measures (plan attainment) are discussed in studies by G. Silberschatz (1986) and Silberschatz et al (see record 1987-07982-001), respectively. If the therapist helps the patient disconfirm pathological beliefs (by passing tests or intervening in plan-compatible ways) the patient is likely to progress toward achieving therapy goals with a more favorable outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using the incremental method to assess the economic effect of capital investments

Questions of applying the incremental method to calculate the economic effect of capital investments are considered. The author’s methodology for determining the economic effect with this method while allowing for the specific features of fiscal accounting in the Russian Federation is suggested, and an example of calculating the integrated economic effect and pay-back period with its use is presented.     

Using analog baselines to assess the effects of naltrexone on self-injurious behavior

Healthy male and female human volunteers were exposed to 50 ppm or 100 ppm trichloroethylene (Tri) by inhalation for 4 h. Blood and urine samples were taken at various times before, during, and after the exposure period for analysis of glutathione (GSH), related thiols and disulfides, and GSH-derived metabolites of Tri. The GSH conjugate of Tri, S-(1,2-dichlorovinyl)glutathione (DCVG), was found in the blood of all subjects from 30 min after the start of the 4-h exposure to Tri to 1 to 8 h after the end of the exposure period, depending on the dose of Tri and the sex of the subject. Male subjects exposed to 100 ppm Tri exhibited a maximal content of DCVG in the blood at 2 h after the start of the exposure of 46.1 +/- 14.2 nmol/ml (n = 8), whereas female subjects exposed to 100 ppm Tri exhibited a maximal content of DCVG in the blood at 4 h after the start of the exposure of only 13.4 /- 6.6 nmol/ml (n = 8). Pharmacokinetic analysis of blood DCVG concentrations showed that the area under the curve value was 3.4-fold greater in males than in females, while the t1/2 values for systemic clearance of DCVG were similar in the two sexes. Analysis of the distribution of individual values indicated a possible sorting, irrespective of gender, into a high- and a low-activity population, which suggests the possibility of a polymorphism. The mercapturates N-acetyl-1,2-DCVC and N-acetyl-2,2-DCVC were only observed in the urine of 1 male subject exposed to 100 ppm Tri. Higher contents of glutamate were generally found in the blood of females, but no marked differences between sexes were observed in contents of cyst(e)ine or GSH or in GSH redox status in the blood. Urinary GSH output exhibited a diurnal variation with no apparent sex- or Tri exposure-dependent differences. These results provide direct, in vivo evidence of GSH conjugation of Tri in humans exposed to Tri and demonstrate markedly higher amounts of DCVG formation in males, suggesting that their potential risk to Tri-induced renal toxicity may be greater than that of females.     

Using portfolios to assess student performance in school health education

Outcome-based education is a topic of growing interest in educational circles today. More performance-oriented than traditional learning approaches, outcome-based education requires students to demonstrate what they know and what they can do. Because of this emphasis, outcome-based curricula will require new methods to assess student achievement. One approach is the portfolio, a repository that enables students to document authentic examples of academic work and presentations as well as nonschool accomplishments. The possibility of using portfolio-based assessment as a viable mechanism to promote comprehensive school health education is examined. Practical recommendations concerning portfolio development and evaluation are offered.     

Using response time measures to assess "guilty knowledge".

How can a suspect's guilt or innocence be reliably tested? The validity of the polygraph, which measures changes in physiological arousal during a "guilty knowledge" test, is controversial (e.g., T. R. Bashore & P. E. Rapp, 1993; T. P. Cross & L. Saxe, 1992; D. T. Lykken, 1998; J. P. Rosenfeld, 1995; R. Steinbrook, 1992). One alternative to the polygraph examines event-related potentials recorded during a memory interference task (L. A. Farwell & E. Donchin, 1991). The present study extended this paradigm to determine whether response times (RTs) can accurately identify participants possessing specific guilty knowledge. Results from Experiment I showed that RT alone can reliably discriminate "guilty" from "innocent" participants. Experiments 2a and 2b indicated that an RT-based paradigm is more resistant to strategic manipulation than previously suggested (Farwell & Donchin, 1991). This RT-based paradigm may be a viable alternative to the polygraph for detecting guilty knowledge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using career-related aspects to assess person–environment fit.

The relations between person and environment (P-E) fit, defined on the basis of career-related aspects and occupational satisfaction, was examined. The characteristics of 12 occupations along 36 career-related aspects were elicited from 12 career counselors. Thirty professionals in each of the 12 occupations reported their preferences in the same set of aspects, and their occupational satisfaction. Two measures of P-E fit were defined as the mean absolute gap between the professional's preferences and the respective characteristics of their occupation (a) in all 36 aspects and (b) in the core aspects of each occupation only. The median within-occupation correlation between P-E fit and occupational satisfaction was .27 when all aspects were considered, and .85 when only the core aspects were taken into account. The implications for counseling research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using lexical familiarity judgments to assess verbally mediated intelligence in aphasia.

In this study, a task using forced-choice lexical familiarity judgments of irregular versus archaic words (a newly developed measure called the Lexical Orthographic Familiarity Test; LOFT) was compared to a standardized oral word-reading measure (the Wechsler Test of Adult Reading; WTAR) in a group of 35 aphasic adults and a comparison group of 125 community dwelling, nonbrain damaged adults. When compared to the comparison group, aphasics had significantly lower scores on the WTAR but not the LOFT. Although both the WTAR and LOFT were significantly correlated with education in the nonbrain-damaged group, only the LOFT was correlated with education and also with the Barona full scale IQ index in the aphasic group. Lastly, WTAR performance showed a significantly greater relationship to the severity of language disorder in the aphasic group than did the LOFT. These results have both theoretical and clinical implications for the assessment of language-disordered adults, as they indicate that patients with aphasia may retain aspects of verbally mediated intelligence, and that the LOFT may provide a better estimate of premorbid functioning in aphasia than other currently available measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using information theory to assess the diversity, complexity, and development of communicative repertoires.

The application of quantitative and comparative measures from information theory on animal communication can provide novel insights into the ecological, environmental, social, and contextual properties that shape the structure, organization, and function of signal repertoires. Using 2 phylogenetically different mammalian species that share similar ecological and social constraints as examples, the authors quantitatively examined the internal structure and development of a subsystem of these species' vocal repertoires in comparison with that of human language and illustrated that these species exhibit convergent developmental processes. The authors also discussed how predictions on the structure and organization of animal communication systems can be made from this new application of information theoretic measures with respect to behavioral ecology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using the ALPHA form in practice to assess antenatal psychosocial health. Antenatal Psychosocial Health Assessment

BACKGROUND: The assessment of the psychosocial health of pregnant women and their families, although recommended, is not carried out by most practitioners. One reason is the lack of a practical and evidence-based tool. In response, a multidisciplinary group created the Antenatal Psychosocial Health Assessment (ALPHA) form. This article describes the development of this tool and experience with it in an initial field trial. METHODS: A systematic literature review revealed 15 antenatal psychosocial risk factors associated with poor postpartum family outcomes of woman abuse, child abuse, postpartum depression, marital/couple dysfunction and increased physical illness. The ALPHA form, incorporating these risk factors, was developed and refined through several focus groups. It was then used by 5 obstetricians, 10 family physicians, 7 midwives and 4 antenatal clinic nurses in various urban, rural and culturally diverse locations across Ontario. After 3 months, these health care providers met in focus groups to discuss their experiences. A sample of pregnant women assessed using the ALPHA form were interviewed about their experience as well. Results were analysed according to qualitative methods. RESULTS: The final version of the ALPHA form grouped the 15 risk factors into 4 categories--family factors, maternal factors, substance abuse and family violence--with suggested questions for each area of enquiry. The health care providers uniformly reported that the form helped them to uncover new and often surprising information, even when the women were well known to them. Incorporating the form into practice was usually accomplished after a period of familiarization. Most of the providers said the form was useful and would continue to use it if it became part of standard care. The pregnant women in the sample said they valued the enquiry and felt comfortable with the process, unless there were large cultural barriers. INTERPRETATION: The ALPHA form appears to be an important tool in assessing psychosocial health in pregnancy and to be readily integrated into practice. More study is required to quantify the number of risks identified and resources used, to determine the form's reliability and validity and, ultimately, to assess the effect of its use on postpartum outcomes.     

Using the NIH Stroke Scale to assess stroke patients. The NINDS rt-PA Stroke Study Group

The stroke patient is acutely ill within minutes of symptom onset. Typically, he or she is awake and thus requires a focal neurologic exam to evaluate vision, movement, sensation and language. With the advent of acute stroke treatments that need to be rapidly implemented, it is critical that the nurse be able to assess patients and relay the information accurately and efficiently to other members of the health care team. Performing and documenting the awake stroke exam in the most efficient and useful manner is key to the nursing care of the stroke patient. The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool designed to measure the neurologic deficits most often seen with acute stroke patients. Originally designed as a research tool, it is a nonlinear ordinal scale, with possible scores ranging form 0-42. Exam performance has been timed to take 5-8 minutes. Use of the NIHSS includes documentation of neurologic status and outcome, data collection for planning safe nursing care and standardization of information exchanges between nurse caregivers and other health care professionals.     

Using cognitive science methods to assess the role of social information processing in sexually coercive behavior.

74 undergraduate men completed cognitive performance tasks assessing perceptual organization, classification, and category learning, as well as self-report measures relevant to sexual coercion. The stimuli were slides of Caucasian women who varied along affect and physical exposure (i.e., sensuality) dimensions. Data were analyzed using a weighted multidimensional scaling model, signal-detection theory analyses, and a connectionist learning model (RASHNL; J. K. Kruschke and M. K. Johansen, 1999). Individual differences in performance on the classification and category-learning tasks were congruent with individual differences in perceptual organization. Additionally, participants who showed relatively more attention to exposure than to affect were less sensitive to women's negative responses to unwanted sexual advances. Overall, the study demonstrates the feasibility and utility of cognitive science methods for studying information processing in psychopathology, (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does cytological screening have a place in sexually active teenagers?

The aim of the present investigation is to determine what is the place of cytological screening of the uterine cervix in sexually active teenagers. MATERIAL AND METHODS: The study was based on 83 girls aged between 14 and 19 (mean age 18.13 years) without childbirth in history, who visited our clinic with non-specific gynecological complaints. All patients were submitted to brush cytology applying the classical method and classifying the smears according to the Bethesda system (1991). RESULTS AND DISCUSSION: A high adequacy of the cytologic smears was found, reaching up to 98.8% and the following distribution of the findings according to the various criteria was observed: cells within normal limits in 34.1% of the patients, benign cellular changes due to reactive changes associated with inflammation in 34.1%, atypical epithelial cell abnormalities of undetermined significance in 18.4%, low grade SIL with HPV in 11.0%, without HPV in 1.2% and high grade SIL in 1.2% of thr patients. The role of cytological screening in sexually active adolescent girls is discussed in the context of the obtained results.     

Using survey data to assess neonatal tetanus mortality levels and trends in developing countries

Demographic and health surveys are a useful source of information on the levels and trends of neonatal mortality in developing countries. Such surveys provide data on mortality occurring at 4-14 days of life, which is a sensitive indicator of neonatal tetanus mortality. We analyze birth history data from 37 national surveys in developing countries to assess the quality of neonatal mortality data and to estimate levels and trends in mortality occurring at 4-14 days. It is shown that mortality at 4-14 days has declined considerably during the last decade in most developing countries, concomitant with development and expansion of programs to reduce neonatal tetanus. These declines show that reductions in neonatal tetanus mortality probably have been an important contributor to the decline of neonatal and infant mortality during the 1980s.     

Using the national cancer institute anticancer drug screen to assess the effect of MRP expression on drug sensitivity profiles

The MRP gene contributes to one form of multidrug resistance. To identify drugs interacting with MRP, we measured MRP mRNA expression by quantitative PCR in 60 cell lines of the National Cancer Institute Anticancer Drug Screen. Expression was detected in all cell lines (highest in lung carcinomas and central nervous system tumors) with a range of 14-fold. A mean graph of MRP mRNA levels was constructed to determine Pearson correlation coefficients (PCCs) with mean graphs of >40,000 compounds using the COMPARE analysis. Only 20 compounds had PCCs of >/=0.500. The PCCs for VP-16, doxorubicin, and vincristine were 0.008, 0.13, and 0.257, respectively. Initially, 36 compounds with PCCs of >/=0.428 were analyzed using two MRP-overexpressing cell lines; low levels of cross-resistance was demonstrated for 23 compounds (1.3-9.4-fold). Twenty-four compounds also were available for further studies. Using a fluorescence activated cell sorter assay to measure competition of calcein efflux from MRP-overexpressing cells, 10 compounds were found to increase calcein retention by >/=2-fold. Ten compounds also were able to reduce ATP-dependent [3H]LTC4 transport into vesicles from MRP-overexpressing cells. These results contrast with previous studies with MDR-1 in which high correlations were found and confirmed for a large number of compounds. Although other assays may be more revealing, in these unselected cell lines, MRP mRNA expression was a poor predictor of drug sensitivity. This raises the possibility that other factors, including conjugating enzymes, glutathione levels, or other transporters, confound the MRP effect.     

Using implementation intentions to increase attendance for cervical cancer screening.

This article evaluates an intervention based on P. A Gollwitzer's (1993) concept of implementation intentions. Women registered at a medical practice in rural England (N?=?114) completed measures of the theory of planned behavior variables before a manipulation that induced one half of the sample to form implementation intentions specifying when, where, and how they would make the appointment. Subsequent attendance was determined from medical records. Findings show that the theory of planned behavior variables and previous delay behavior provided good prediction of attendance. However, despite equivalent motivation to attend, participants who formed implementation intentions were much more likely to attend for screening compared with controls (92% vs. 69%). Evidence also suggests that implementation intentions attenuated the relationship between previous delay behavior and subsequent attendance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using a cost-construction model to assess the cost of educating undergraduate medical students at the University of Texas--Houston Medical School

Spontaneous resolution of deformities after excision of facial skin lesions has been known and used for a long time by plastic surgeons. The resorption mechanism of deformity is based on natural skin expansion, and seems to be directly related to the action of the muscles of facial expression and their skin relations. Natural expansion has been shown to be effective in children. Between 1990 and 1994 excision of skin lesions, including congenital nevi, leading to postoperative deformity of the cheek, labial commissure, nose, eyelid and forehead, was performed on 35 patients, aged from 3 month to 12 years. The average follow-up is 24 months. For 26 patients (74%), natural resorption was observed 4 or 6 weeks later with good aesthetic results. For 6 patients (17%), the deformity persisted 3 or 6 months later, but did not require any further surgery. For 3 patients (9%), a second operation was necessary. Using the skins natural capacity for expansion in the treatment of facial skin defects in children is a method of reconstruction which has already been used for excision in enforced position. The platysma and muscles of facial expression by their action on skin mobilisation, allow natural expansion. A better knowledge of cutaneous biomechanical properties enables plastic surgeons to find an alternative to other classical methods.