Adaptation to sexual orientation stigma: A comparison of bisexual and lesbian/gay adults.

This study extends research on dimensions of sexual minority experience by examining differences between bisexual and lesbian/gay adults in adaptation to sexual orientation stigma. The authors investigated sexual orientation self-disclosure, connection to community, and 4 identity-related variables (internalized homonegativity, stigma sensitivity, identity confusion, and identity superiority) in a community sample of 613 lesbian, gay, and bisexual adults. Sexual orientation effects were found on 3 of these 6 variables: Bisexual participants reported higher levels of identity confusion and lower levels of both self-disclosure and community connection relative to their lesbian/gay peers. Taken together, the 6 variables predicted indicators of psychosocial functioning. Associations among the 6 dimensions of sexual minority experience and psychosocial functioning did not differ for bisexual and lesbian/gay participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Same-sex attraction, social relationships, psychosocial functioning, and school performance in early adolescence.

The authors examined whether 13- to 15-year-old adolescents who experience feelings of same-sex attraction (SSA) differ from those without such feelings in the quality of relationships with parents, peers, and class mentors and in psychosocial functioning (health status and school performance). The authors also assessed whether differences in psychosocial functioning resulted from differences in the quality of social relationships. Data were collected from 866 Dutch high school students (mean age 13.61 years) by means of a computer-based questionnaire. Of the participants, 74 (8.5%) reported having feelings of SSA. The participants with SSA rated the quality of their relationships with their fathers and their peers lower than did those without SSA. Participants with SSA also had poorer mental health (higher levels of depression and lower levels of self-esteem) and lower school performance. A mediation analysis revealed that differences in psychosocial functioning resulted from differences in the quality of the same-sex attracted youths' social relationships, especially with fathers and peers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Isolation and characterization of cortactin isoforms and a novel cortactin-binding protein, CBP90

RATIONALE AND OBJECTIVES: The goal of this study was to determine if radiologists possess superior visual search and analysis skills compared with those of laypeople. MATERIALS AND METHODS: In two experiments, radiologists and laypeople searched one of two complex pictorial scenes for hidden targets. Eye position was recorded during the search. Two measures of performance were obtained: accuracy of detecting targets as measured by using alternative free response receiver operating characteristic analysis and visual search efficiency as measured by using eye position analysis. RESULTS: There were no statistically significant differences in detection performance between radiologists and laypeople for either of the search tasks. Radiologists took longer on average to search the images and to first fixate on the targets than did the laypeople. For both groups, true-positive and false-positive decisions were associated with longer dwell times than true-negative decisions. As with radiology search tasks, false-negative decisions were also associated with longer dwell times than true-negative decisions. CONCLUSION: Performance on two visual search and detection tasks indicate that radiologists do not possess superior visual skills compared with laypeople. Radiology expertise is more likely to be a combination of specific visual and cognitive skills derived from medical training and experience in detecting and determining the diagnostic importance of radiographic findings.     

Diagnosis of infection in ununited fractures. Combined imaging with indium-111-labeled leukocytes and technetium-99m methylene diphosphonate

The results of combined scintigraphy in which indium-111-labeled leukocytes and technetium-99m methylene diphosphonate were used were compared with the results of cultures of open bone at 102 sites of delayed union or non-union, to determine the effectiveness of this combination as a preoperative indicator of osteomyelitis. There were twenty-five true-positive, fifty-nine true-negative, eleven false-positive, four false-negative, and three indeterminate interpretations, yielding, for the diagnosis of osteomyelitis, a sensitivity of 86 per cent, a specificity of 84 per cent, an accuracy of 82 per cent, a positive predictive value of 69 per cent, and a negative predictive value of 94 per cent. There were few false-negative scans; false-positive results were most likely at a metaphyseal site adjacent to a joint in which there was post-traumatic arthropathy, at the site of a failed arthrodesis, and at the site of an unstable delayed union or non-union.     

Relationship between psychosocial functioning and body fat in preschool children: A longitudinal investigation.

Examined whether preschool children differed on measures of psychosocial functioning both cross-sectionally and longitudinally. 132 children who varied in levels of body fat participated in the study along with their natural parents. Results indicated that the children did not differ in levels of self-esteem and family functioning as a function of their body fat. Prospectively, physical self-esteem weakly (but significantly) correlated with body fat at ages 1 and 2 yrs, and father's perception of family functioning predicted body fat at age 1 yr only. Results suggested that childhood obesity may not develop as a result of psychosocial factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

False-positive Ascaris suum egg counts in pigs

False-positive Ascaris suum egg counts in pig faeces are frequently observed under both experimental and natural conditions. Data from 12 experiments with A. suum infections in pigs were summarized and showed that the percentage of false-positive faecal samples ranged from 4 to 36%. False-positive egg count values varied greatly between pigs and experiments (range 20-1060 eggs per gram faeces). Indoor experiments with pigs housed groupwise in pens generally produced more and higher false-positive egg counts, which may reflect differences in surface area and hence exposure to infective eggs, compared with pasture experiments. The positive predictive value (the number of pigs diagnosed positive by faecal sample that actually harboured worms) was low for indoor experiments (45%) compared with pasture experiments (89%). Differences in design for indoor experiments, such as floor type and use of bedding material, did not influence the positive predictive value (44-47%). A positive correlation was found (r = 0.56, P < 0.05) between faecal egg counts of true-positive and false-positive pigs that were penned together. The results of this survey strongly support previous suggestions that false-positive A. suum egg counts in pigs are the result of coprophagia in indoor experiments and coprophagia/geophagia in pasture experiments. False-positive A. suum egg counts in pig faeces may vary greatly in prevalence and magnitude, and depend in part on management/housing factors.     

Cortisol-Induced Impairments of Working Memory Require Acute Sympathetic Activation.

The present study assessed whether the effects of cortisol on working memory depend on the level of adrenergic activity (as measured by sympathetic activation) during memory performance. After exposure to a psychosocial stress task, participants were divided into cortisol responders and nonresponders. Cortisol responders showed working memory impairments during the psychosocial stress phase, when cortisol and adrenergic activity were enhanced, whereas nonresponders did not. During recovery, however, when cortisol levels were elevated but adrenergic activity was normalized, working memory of responders did not differ from that of nonresponders. Among several stress measures, cortisol was the only significant predictor for working memory performance during stress. These findings suggest that adrenergic activation is essential for the impairing effects of stress-induced cortisol on working memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Value of QT dispersion in the interpretation of exercise stress test in women

BACKGROUND: Exercise testing in women is associated with a high incidence of false-positive ECG changes and should be combined with an imaging study. The QT dispersion (QTD), recorded as the difference between maximum and minimum QT intervals on a 12-lead ECG, is sensitive to myocardial ischemia and may improve the accuracy of exercise testing in women. METHODS AND RESULTS: Exercise ECGs were analyzed in 64 women who had undergone exercise ECG and coronary angiography for clinical indications: 20 patients with normal exercise stress test and nonsignificant (< or = 50% diameter narrowing of a major epicardial coronary artery) coronary artery disease (CAD) on angiography (true-negative; TN group), 20 patients with positive exercise stress tests (> or = 1 mm ST-segment depression or reversible perfusion defects) and significant CAD (true-positive; TP group), and 24 patients with positive exercise stress tests but no significant CAD (false-positive; FP group). The exercise QTD was 45+/-15 ms in TN, 80+/-23 ms in TP (P<.0001 versus TP), and 41+/-14 ms in FP (P=NS versus TN and <.0001 versus TP) groups. A stress QTD of > 60 ms had a sensitivity of 70% and specificity of 95% for the diagnosis of significant CAD compared with 55% (P<.05) and 63% (P<.01), respectively, for > or = 1 mm ST-segment depression during stress. When QTD of > 60 ms was added to ST-segment depression as a condition for positive test, the specificity increased to 100%. CONCLUSIONS: Exercise QTD is an easily measurable ECG variable that significantly increases the accuracy of exercise testing in women.     

Magnetic resonance coronary angiography in heart transplant recipients

BACKGROUND: Magnetic resonance angiography (MRA) using segmented k-space fast low-angle shot imaging has recently been used to demonstrate the proximal coronary arteries in healthy subjects and in patients with coronary artery disease. We assessed the sensitivity and specificity of coronary MRA in heart transplant recipients and investigated the feasibility of coronary MRA in patients with metallic sutures and clips in the chest. MATERIALS AND METHODS: Sixteen cardiac transplant patients aged 57.2 +/- 7.9 years (mean +/- SD) were recruited. Forty-eight arterial segments were evaluated, including the left main artery (LMA), left anterior descending artery (LADA) and right coronary artery (RCA). We excluded the left circumflex artery which could not be imaged accurately. The average time between heart transplant operation and MRA was 6 years, whereas that between MRA and X-ray angiography was 4 months. The coronary MRA was interpreted by two experienced investigators who were blinded to the coronary X-ray angiography results. Similarly, the coronary X-ray angiography results were interpreted by two experienced investigators blinded to the MRA results. The coronary arterial segments were classified by MRA as being normal or as having an amount of disease that was significant (> 50% lesion) or insignificant (< 50% lesion). RESULTS: There were 28 true-negative, five true-positive, four false-negative and six false-positive results. Of the 28 true-negative cases, 13 were in the LMA, six in the LADA and nine in the RCA. There was one false-positive LMA, two false-positive LADA and three false-positive RCA stenoses. There were four false-negative results in the LADA and one in the RCA. Clips precluded evaluation in one LMA, one LADA and one RCA. One LMA and one LADA were not evaluated as a result of poor images. One false-positive RCA stenosis was caused by a metallic clip. Three of the false-negative LADA stenoses had lesions in the distal third of the artery. The sensitivity, specificity, negative and positive predictive values were generally poor for the left coronary artery. The best results were for the RCA (sensitivity 100%, specificity 75%, positive predictive value 50% and negative predictive value 100%). The specificity in the left coronary arteries (LMA and LADA) was 86%, but the other indicators were all poorer. For the RCA, LMA and LADA combined, the overall sensitivity was 56%, specificity 82%, predictive accuracy 45% and negative predictive value 88%. In three patients, < 50% RCA lesions were seen in the MRA data, which were all confirmed by angiography. No < 50% lesions were seen in the LMA or in the LADA by MRA or by X-ray angiography. CONCLUSION: Coronary MRA using the segmented fast low-angle shot technique is feasible in heart transplant recipients but the sensitivity and specificity of this method are limited. Further developments in coil design, rapid imaging techniques and respiratory monitoring methods are necessary to improve the accuracy of coronary MRA.     

Nonproblem drinking outcomes in adolescents treated for alcohol use disorders.

Change to nonproblem drinking was studied in 159 adolescents (70% male) presenting for alcohol use disorders (AUDs) treatment. A community sample (n=148, 47% male) also was assessed. Clinical participants had a current AUD at baseline; 1 year later, 17% remained abstinent, 60% had at least 1 AUD symptom (problem drinkers), and 23% were drinking but had no AUD symptoms (nonproblem drinkers). Drinking among the nonproblem drinkers decreased and was lower than in the problem drinkers. Nonproblem drinkers increased in psychosocial functioning and decreased in the number of illicit drugs used relative to problem drinkers and generally did not differ from the abstainers. The results suggest alternative views of treatment goals, relapse, and treatment outcome in adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial outcomes of children of unipolar depressed, bipolar, medically ill, and normal women: A longitudinal study.

The psychosocial functioning of children of unipolar depressed, bipolar, medically ill, and psychiatrically normal women was studied over a 2-yr period. 96 children aged 8–16 yrs were assessed at 6-mo intervals on Child Behavior Checklist behavior problems, social competence, internalizing and externalizing behaviors, academic performance, and school behavior. The children of unipolar mothers showed significantly poorer functioning on all measures as compared with the other 3 groups of children, including bipolar offspring. A greater proportion of children in the unipolar group also had relatively chronic, clinically significant problems in psychosocial functioning. Children of bipolar women did not differ from children of psychiatrically normal women. Results are discussed in terms of consequences of children's continuing exposure to maternal depression and attendant stressors, as well as the contribution of social and academic difficulties in a vicious cycle of maladjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Failure of positive but not negative emotional valence to enhance memory in schizophrenia.

Abnormalities in the integration of emotion and cognition have long been considered hallmark characteristics of schizophrenia. Study authors used a well-established emotional memory model from the neuroscience literature to assess the facilitative impact of emotional valence of information on long-term memory consolidation in schizophrenia. Participants with schizophrenia (n=33) indicated somewhat higher levels of emotional intensity in response to emotional images than did healthy (n=28) participants. However, when recognition memory was tested 24 hr later, schizophrenia participants did not show enhancement of memory for positive images as was found in healthy participants. Their memory enhancement for negative images did not differ from that of healthy participants. Correlations between self-reported physical and social anhedonia were significantly inversely correlated with intensity ratings of positive stimuli during the encoding phase for healthy participants but were negligible for schizophrenia participants. These results suggest a failure to adequately integrate positive emotional experience in memory consolidation processes in schizophrenia participants, despite appropriate initial response to positive stimuli, which may contribute to symptoms such as anhedonia by reducing the long-term impact of positive experiences in motivating hedonic behavior in day-to-day life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Putamen volume in idiopathic focal dystonia

PURPOSE: To determine the accuracy of magnetic resonance (MR) imaging in evaluating the invasive cervical carcinoma response to concurrent chemotherapy and radiation therapy. MATERIALS AND METHODS: MR imaging was performed before and after concurrent chemotherapy and radiation therapy in 18 patients with locally invasive cervical carcinoma. Surgery followed neoadjuvant therapy in all patients. The presence of a lesion, signal intensity, zonal anatomy integrity, vaginal and parametrial invasion, and lymph node enlargement was determined. Posttreatment MR and histopathologic findings were correlated. RESULTS: Fourteen patients had histopathologic confirmation of MR findings: Twelve had true-negative and two had true-positive findings. (Two had microscopic neoplastic foci beyond the spatial resolution of MR images; these foci do not change surgical treatment planning and probably do not influence prognosis. Therefore, these two patients were considered to have complete response). Four patients had false-positive findings; the hyperintense lesion on posttreatment MR images was due to a tunnel cluster pattern (focal hyperplasia of the endocervical glands with inflammation) in three patients and necrosis in one patient, without any evidence of neoplastic tissue. Thirty-three of 36 parametrial halves and 67 of 72 vaginal fornices were correctly interpreted on posttreatment images. Involvement of three parametrial halves and five fornices was overestimated at MR, because edema or inflammation was not distinguishable from tumor. CONCLUSION: MR imaging is 78% accurate in evaluation of tumor response; in 22% of patients, however, benign conditions were not distinguishable from tumor.     

Concurrent and longitudinal effects of ethnic identity and experiences of discrimination on psychosocial adjustment of Navajo adolescents.

In this study, we examined concurrent and longitudinal relations among Navajo adolescents' ethnic identity, experiences of discrimination, and psychosocial outcomes (i.e., self-esteem, substance use, and social functioning). At Time 1, 137 Navajo adolescents (67 male, 70 female), primarily in Grades 9 and 10, completed a written survey assessing ethnic identity, discrimination experiences, and a range of internalizing and externalizing behaviors. Two years later, 92 participants completed the same survey again. Ethnic and cultural identification was assessed via the Multiethnic Ethnic Identity Measure (MEIM; Phinney, 1992) and the Orthogonal Cultural Identification Scale (OCIS; Oetting & Beauvais, 1990). At Time 1, MEIM Affirmation and Belonging, MEIM Exploration, and OCIS White American identification all demonstrated strong, positive associations with adaptive functioning for male and female adolescents, whereas discrimination experiences were linked to lower self-esteem and social functioning for male adolescents. By Time 2, fewer significant concurrent associations between ethnic identity and psychosocial functioning scores remained, and discrimination experiences emerged as the most consistent correlate of poorer psychosocial functioning for male adolescents. Controlling for Time 1 psychosocial functioning, relatively few direct effects of ethnic and cultural identification variables predicted psychosocial functioning longitudinally, but discrimination experiences demonstrated strong and consistent longitudinal links with boys' substance use. Finally, interaction effects assessing the moderating influence of ethnic and cultural identification on negative links between discrimination and psychosocial functioning suggested that embeddedness in and connection to Navajo culture and, in some cases, connection to White American culture, served as a buffer to the negative effects of discrimination experiences. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The psychosocial functioning of wife-dominant families.

Investigated the hypothesis that wife-dominance is associated with psychosocial dysfunction in the family, using data from 94 intact families with male adolescents (mean age 14.9 yrs). Families were classified as wife dominant (WD), husband dominant (HD), or egalitarian based on family and observer's ratings and measures of family psychosocial functioning. Results indicate that (1) family members did not evidence more neurotic symptoms and (2) there was not a higher percentage of adolescent delinquency in WD families compared with either HD or egalitarian families. Results do not support the hypothesis. Rates of positive parental communication by race are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A method of determining peritoneal penetration in gunshot wounds to the abdomen

BACKGROUND: It has previously been shown that 98% of gunshot wounds that penetrate the peritoneal cavity cause injuries that require surgical repair. Many gunshot wounds in the vicinity of the abdomen (GSWA) may actually be tangential and not penetrate the peritoneal cavity at all. Patients with such wounds may not require laparotomy. It is important to determine which patients with a potential tangential GSWA actually have penetration of the peritoneal cavity to minimize negative laparotomies. This study was undertaken to determine the sensitivity, specificity, and accuracy of diagnostic peritoneal lavage (DPL) in the determination of peritoneal penetration for patients who sustain GSWA. METHODS: DPL was performed for all patients who had sustained a GSWA in whom peritoneal penetration was unclear, i.e., patients whose GSWA appeared to be tangential, thoracoabdominal, or transpelvic and for whom a clear indication for laparotomy (shock, peritonitis, etc.) did not exist. Our threshold for a positive DPL was 10,000 red blood cells (RBC)/mm3. A prospective data base was kept with information on the location of the wound, DPL result, findings at laparotomy, and outcome. RESULTS: During a 4-year period, 429 consecutive DPLs were performed for GSWA at our urban Level I trauma center. One hundred fifty DPLs were positive, with more than 10,000 RBC/mm3. Six of these patients were found to have no peritoneal penetration at laparotomy (false-positive). The remaining 144 patients with positive DPLs were found to have operative injuries (true-positive). Of the 279 patients with DPL counts less than 10,000 RBC/mm3, 2 developed indications for laparotomy and were found to have intraperitoneal injuries (false-negative). The remaining 277 patients had no peritoneal injuries (true-negative). This was demonstrated either by laparotomy done for another indication (n = 7) or by uneventful inpatient observation for 24 hours (n = 270). The sensitivity, specificity, and accuracy of DPL in determining peritoneal penetration in GSWA is therefore 99, 98, and 98%, respectively. CONCLUSION: For patients who sustain GSWA for whom peritoneal penetration is unclear, DPL is a sensitive, specific, and accurate test to determine the need for laparotomy. It remains our test of choice when confronted with these patients.     

Resection of residual retroperitoneal masses in testicular cancer: evaluation and improvement of selection criteria. The ReHiT study group. Re-analysis of histology in testicular cancer

Residual retroperitoneal masses may remain after chemotherapy for metastatic non-seminomatous testicular cancer, which harbour residual tumour or totally benign tissue (necrosis/fibrosis). These residual masses may be effectively removed by a surgical resection. We evaluated current selection criteria and tried to develop alternative criteria in a data set of 544 patients, who had retroperitoneal lymph node dissection of residual masses. Six resection policies were identified from the literature. Two alternative policies were developed with logistic regression analysis. Evaluation of the policies focused on the true-positive rate (resection in case of tumour), and the false-positive rate (resection in case of necrosis). It appeared that most current policies use the size of the residual mass (> or = 10 mm or > or = 20 mm) as the predominant selection criterion. This resulted in high true-positive rates (most > 90%), but false-positive rates between 37% and 87%. The alternative policies included five well-known predictors of necrosis in addition to residual mass size (primary tumour histology, prechemotherapy levels of the three tumour markers alphafetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH) and mass shrinkage during chemotherapy). This strategy resulted in improved true- and false-positive rates, even when categories of the predictors were simplified for practical application. We conclude that a simple statistical model, based on a limited number of patient characteristics, provides better guidelines for patient selection than those currently used in clinical practice.     

Psychosocial functioning in the context of diagnosis: Assessment and theoretical issues.

Psychosocial functioning is an important focus of attention in the revision of the Diagnostic and Statistical Manual of Mental Disorders. Researchers and clinicians are converging upon the opinion that psychometrically strong, comprehensive assessment of individuals’ functioning is needed to characterize disorder fully. Also shared is the realization that existing theory and research in this domain have critical shortcomings. The authors urge that the field reexamine the empirical evidence and address theoretical issues to guide future development of the construct and its measurement. The authors first discuss several theoretical issues relevant to the conceptualization and assessment of functioning: (a) definitions of functioning, (b) the role of functioning in defining disorder, and (c) understanding functioning within environmental contexts. The authors then present data regarding empirical domains of psychosocial functioning and their interrelations. Self-reported data on multiple domains of psychosocial functioning were collected from 429 participants. Factor-analytic results (promax rotation) suggest a 4-factor structure of psychosocial functioning: Well-Being, Basic Functioning, Self-Mastery, and Interpersonal and Social Relationships. Finally, the authors propose an integration of theory and empirical findings, which they believe will better incorporate psychosocial functioning into future diagnostic systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion regulation in schizophrenia: Affective, social, and clinical correlates of suppression and reappraisal.

Individuals can exert considerable control over their experience and expression of emotion by applying different regulatory strategies such as reappraisal and suppression. However, although it has been suggested that blunted affect in schizophrenia, characterized by markedly reduced emotion expressivity alongside apparently normal emotion experience, may reflect overuse of suppression, no study to date has assessed self-reported use of these different emotion regulatory strategies in relation to this disorder. In the present study, 41 individuals with schizophrenia and 38 control participants completed a self-report measure that differentiated between use of suppression and reappraisal. Symptom severity and various aspects of cognitive and psychosocial functioning were also assessed. Relative to controls, individuals with schizophrenia did not differ with regard to their reported use of suppression and reappraisal, and reported use of both strategies was unrelated to clinical ratings of blunted affect. However, whereas (lower) use of reappraisal was associated with greater social function impairment for both groups, only for controls was (greater) use of suppression associated with reduced social functioning. Implications for understanding blunted affect and social dysfunction in schizophrenia are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emergency center arteriography in the evaluation of suspected peripheral vascular injuries in children

During the 6-year period from 1983 to 1989, 109 children aged 3 to 18 years (mean, 16) with suspected peripheral vascular injuries underwent 113 emergency center arteriograms (ECA) performed by hand injection of contrast material using a single roentgenographic film. The most common indication for ECA was the proximity of the injury in 93 (82.3%) of the cases as penetrating injury accounted for 106 (94%) of the cases. There were 89 true-negative, 14 true-positive, 1 false-negative, and no false-positive arteriograms. The remaining 9 arteriograms were either equivocal or technically inadequate. The sensitivity, specificity, and diagnostic accuracy of this procedure were 98.9%, 100%, and 91.2%, respectively. Operative intervention was required for 9 (64.2%) injuries detected by emergency arteriography. The remaining 5 injuries were considered minor and were observed with no complications during a period of 21 months. Sixty-eight children (76.4%) with negative ECA were followed for a mean of 12 months with no vascular complications or growth abnormalities noted. ECA is a rapid, accurate, and cost-effective technique. It is of particular value in detecting the presence of occult arterial injuries that might have deleterious effects in the growing child.