Attitudes toward self-care among practicing physicians

Self-care, although growing as a concept and a movement among providers and consumers, has not been studied systematically in any dimension. Because of the potential role of physicians in establishing the credibility and acceptability of self-care interventions and practices, an exploratory investigation was launched to develop an attitude instrument, to describe the degree to which practicing physicians in a community favor self-care, and to explore some of the correlates of the attitudes expressed. A 13-item attitude scale was developed. Physicians with the most favorable attitudes were most likely to have come from a Jewish religious background, to be under 46 years old, to have health beliefs which reflect an internal locus of control, and to be in a group practice or clinic. Physicians with the least favorable attitudes came from Protestant backgrounds, were 46 to 63 years old, had externally controlled health beliefs, and practiced medicine alone.     

A phenomenological study of ethical decision-making experiences among senior intensive care nurses and doctors concerning withdrawal of treatment

Substantial evidence has recently accumulated showing domestic cats to be the principal reservoirs of Bartonella henselae, the aetiological agent of human diseases including cat-scratch disease, bacillary angiomatosis, bacillary peliosis and a febrile bacteraemia syndrome. To determine the prevalence of antibodies reactive with Bartonella henselae in cats from southern Africa, indirect fluorescent antibody assays were carried out on feline sera from South Africa and Zimbabwe. Overall, 23% (39/171) of cats had antibody titres > or = 1/64, with cats from Zimbabwe (24%; 28/119) having higher seroprevalences than those from South Africa (21%; 11/52) although this difference was not statistically significant. The implications of these findings for veterinarians in southern Africa are discussed.     

Education and self-care activities among persons with rheumatoid arthritis

Associations between low formal education and increased morbidity and mortality have been well established among persons with rheumatoid arthritis (RA) and other conditions. This study attempted to identify a partial explanation for the association between low education and poor outcomes among persons with RA by examining self-care activities performed by persons with different levels of education. Persons with 13+ yr of education were significantly more likely to perform specific self-care activities (e.g., using a heated pool, tub, shower, OR = 2.59; using relaxation methods, OR = 3.00; using stress control methods, OR = 2.41; avoiding certain foods, OR = 1.74). The association between education and performance of self-care activities was not linear. When significant differences were noted, 13 yr of education was usually the point at which performance was significantly different than among lower education groups; individuals with 12 yr of education often exhibited lower frequencies of particular behaviors than did individuals with 9-11 yr of education. The association between higher education and performance of more self-care activities may shed light on previously described associations between education and morbidity. However, low education should not be viewed as the cause of increased morbidity and mortality, but as a proxy for a constellation of factors responsible for poor health outcomes.     

Who does best on CAPD? A study to identify self-care determinants

Individuals with end-stage renal failure (ESRF) may be offered two main types of renal replacement therapy--haemodialysis or continuous ambulatory peritoneal dialysis (CAPD). At present approximately 50% of individuals within the United Kingdom who require dialysis are maintained on CAPD whilst the remainder receive haemodialysis (1).     

Factors associated with the decision to breast-feed among Irish women

On the day of discharge from the postnatal ward a questionnaire was administered to 100 consecutive breastfeeding mothers (BRM) and 100 consecutive bottle-feeding mothers (BOTM). The significant results were as follows. BRM were older than BOTM, were more likely to come from social classes I and II, to be married, to be living with their partner, to have received third level education and to have attended semi-private/private clinics. BRM were less likely to smoke, more likely to have planned their pregnancy, to have been breastfed themselves and to have at least one sibling who was breastfed. They were also more likely to have a sister/sister-in law and a close friend who breastfed, to have discussed infant feeding with their partner and to have been encouraged to breast-feed by him. The reason most commonly quoted for breastfeeding was that it was better for the baby while that for bottle-feeding was that it was more convenient.     

A military application of a medical self-care program

The cost of health care is a growing concern to the military. Many military clinic appointments and emergency department visits are unnecessary; they are for minor, self-limiting illnesses and injuries that could be treated at home. Military health care can no longer afford the luxury of treating minor illnesses and injuries in the hospital setting. This paper examines one method for military beneficiaries to obtain health care services appropriately. A selected group of military family members received a medical self-care book and an education session, which resulted in more appropriate decision-making about when to use the health care system. This was a 6-month, experimental study using control and experimental groups, with surveys before and after the study period. The self-care book was used 628 times to help make more informed decisions about when to seek medical care. The mean number of clinic and emergency room visits (p = 0.02) decreased for those using the medical self-care book.     

The incidence of cancers among second-generation Irish living in England and Wales

The incidence of ovarian, cervical, lung and prostatic cancer was higher in second-generation Irish living in England and Wales than in all other persons in England and Wales. A higher incidence of ovarian cancer was not found in first-generation Irish. Differences in socioeconomic status did not explain these patterns.     

The medical-psychiatry unit. A pilot study of conjoint care within an Irish general hospital

The establishment of medical-psychiatry units within the general hospital is an important advancement for psychiatry and has met with favorable response within the American health care system. A brief account is given here of the piloting of such a unit within an Irish hospital, and the merits of this strategy are discussed.     

Diabetes-specific social learning variables and self-care behaviors among persons with Type II diabetes.

Assessed the relationship between diabetes-specific social learning factors and diabetes self-care in 127 outpatients (age 40–88 yrs) with Type II diabetes. Predictor variables were collected within the categories of knowledge (e.g., behavioral demonstrations, pencil-and-paper tests), beliefs/expectations (e.g., self-efficacy, self-motivation), skills (e.g., problem-solving and refusal skills), and environmental support (e.g., barriers to adherence, family support). Multiple regression analyses revealed that social learning variables consistently improved the prediction of self-care beyond that attributable to demographic variables. However, the categories of social learning variables most closely related to self-care varied across 3 regimen areas (diet, exercise, and glucose testing). It is concluded that behavioral research on Type II diabetes should focus on ways to initiate and maintain lifestyle changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevention and treatment of pressure ulcers. A plan for self-care

Decubitus ulcers present a real challenge to health care workers. Primary care nurses, in particular, are faced with special considerations when treating a patient in his or her home. For them, it is often necessary to adapt or design treatments to meet the particular circumstances of the patient. Within their Home Health Program, the authors have developed a self care method that is based on educating patients and the family members who will assist them. In this way the families and patients become partners in the planning and application of the proper nursing care that will allow them a greater independence and quality of life.     

A case-control study of lung cancer among Vietnam veterans

Because of concerns among veterans over Agent Orange exposure, the Department of Veterans Affairs (VA) has conducted a series of studies of specific cancers among Vietnam veterans. Lung cancer is the topic of investigation in this report. The VA's Patient Treatment File (PTF) was used to identify 329 Vietnam era veterans with a diagnosis of lung cancer made between 1983 and 1990. The PTF is a computerized hospitalized database of inpatient records, including patients' demographic data, and diagnoses. A record is created for each patient discharged from any one of the VA's Medical Centers. Variables abstracted from the military record include education, race, branch of service, Military Occupational Specialty Code, rank, and units served within Vietnam. Two hundred sixty-nine controls were randomly selected from the PTF file of men hospitalized for a reason other than cancer. A second control group numbering 111 patients with colon cancer was also selected from the PTF file. Data were also gathered on exposure to Agent Orange through the location of each individual ground troop veteran's unit in relation to an area sprayed and the time elapsed since that area was sprayed. The crude odds ratio between service in Vietnam and lung cancer was of borderline significance (odds ratio = 1.39 with 95% confidence interval = 1.01-1.92). The relationship disappeared when the confounder year of birth was considered. We conclude from these data that there is no evidence of increased risk in lung cancer associated with service in Vietnam at this time.     

Fertility parameters in male Irish wolfhounds: a two-year follow-up study

The reproductive performance of 25 male Irish wolfhounds was examined in a two-year follow-up study. Results of a previous study showed that 37 Irish wolfhounds had lower libidos, smaller testicles and poorer semen quality than 67 control dogs examined. This study was undertaken to determine whether fertility parameters had changed after a further two years. Forty-four dogs of 21 breeds were used as controls. No change in libido was observed in either group after two years; the Irish wolfhounds still exhibited lower libidos than the control dogs. In both studies, the Irish wolfhounds showed a softening of testicular tissue with a significantly higher incidence than control dogs. This difference became more marked after two years. Semen quality had declined in Irish wolfhounds and the differences between the two groups became more accentuated. Inbreeding coefficients for the Irish wolfhounds were low, suggesting that this was a factor contributing to the poor reproductive function. However, several Irish wolfhounds had been ill during the follow-up period which, together with the decline in reproductive efficiency, may reflect a change due to ageing.     

A study of sexual behavior among rural residents of China

Besides the fast tetrodotoxin-sensitive Na+ current, small dorsal root ganglion neurones of rats also possess a slower tetrodotoxin-resistant Na+ current. The blocking effect of commonly used local anaesthetics upon the tetrodotoxin-resistant Na+ current was investigated in the present paper. Dorsal root ganglia were dissected from adult rats and cells were enzymatically isolated. The whole-cell patch clamp technique was then used to measure inward Na+ currents of small dorsal root ganglion neurones. Externally applied local anaesthetics reversibly blocked the tetrodotoxin-resistant Na+ current in a dose-dependent manner. Half-maximal blocking concentrations for tonic block were: lignocaine, 326 microM; prilocaine, 253 microM; mepivacaine, 166 microM; etidocaine, 196 microM bupivacaine, 57 microM procaine, 518 microM benzocaine, 489 microM; tetracaine, 21 microM; and dibucaine, 23 microM. Blocking of the current by lignocaine was independent of temperature. The quaternary lignocaine derivative OX-314 did not have any effect upon the tetrodotoxin-resistant Na+ current when applied externally. High concentrations of tetrodotoxin also blocked the tetrodotoxin-resistant Na+ current with a half-maximal blocking concentration of 115 microM. The block by high tetrodotoxin concentrations did not compete with the lignocaine block, suggesting that there were two independent blocking mechanisms for the two substances. The tetrodotoxin-resistant Na+ currents also showed a marked sensitivity to phasic (use-dependent) block by local anaesthetics.     

The exercise of self-care agency scale

Cdk7 has been shown previously to be able to phosphorylate and activate many different Cdks in vitro. However, conclusive evidence that Cdk7 acts as a Cdk-activating kinase (CAK) in vivo has remained elusive. Adding to the controversy is the fact that in the budding yeast Saccharomyces cerevisiae, CAK activity is provided by the CAK1/Civ1 protein, which is unrelated to Cdk7. Furthermore Kin28, the budding yeast Cdk7 homolog, functions not as a CAK but as the catalytic subunit of TFIIH. Vertebrate Cdk7 is also known to be part of TFIIH. Therefore, in the absence of better genetic evidence, it was proposed that the CAK activity of Cdk7 may be an in vitro artifact. In an attempt to resolve this issue, we cloned the Drosophila cdk7 homolog and created null and temperature-sensitive mutations. Here we demonstrate that cdk7 is necessary for CAK activity in vivo in a multicellular organism. We show that cdk7 activity is required for the activation of both Cdc2/Cyclin A and Cdc2/Cyclin B complexes, and for cell division. These results suggest that there may be a fundamental difference in the way metazoans and budding yeast effect a key modification of Cdks.     

Perceptual and enactment measurement of self-care

The concept of self-care was conceptualized as having three major components: enabling perceptual elements (motivation, values, responsibility, and decision making); domains for enactment (cognitive/ perceptual, psychosocial/affective, and physical functioning); and self-care enactment factors (capacity), which included self-care action and knowledge adequate for self-care. A new tool, The Self-Care Agency Inventory, was designed to discriminate between those who will enact self-care and those who will not because of either a lack of knowledge or a lack of motivation. Content validity was demonstrated (.77 or greater from each scale) and concurrent validity documented. Alpha reliability for the new scale and principal components factor analysis of the scale items did not achieve desired levels, although a pilot sample demonstrated test-retest reliability of .82. The conceptual model is presented.     

Suicide among gifted women: A prospective study.

The longitudinal data from the Terman Genetic Studies of Genius (L. M. Terman, 1925; Terman and M. Oden, 1947, 1959) were used to predict suicide in 40 women: 8 suicides, 15 Ss who were matched with the suicides on age of death, and 17 Ss who were still living in 1964. The Terman studies covered 60 yrs and followed 1,528 gifted individuals (IQs over 135) from childhood into the retirement years. Seven variables from the Ss' files were assessed as possible predictors of suicide: S's physical health, early loss of the father, stress in the family of origin, problems with alcohol, and 3 indices of mental health ("signatures" [e.g., suicide attempts, alcohol abuse, depression]; self-reports of temperament; and a cumulative mental health rating developed by Terman). A discriminant function analysis was able to differentiate the women who committed suicide from the 2 control groups. A 7-variable function predicted 100% of the suicides. A 4-variable function predicted 75% of the suicides. It is concluded that suicide risk factors can be identified in women and that certain signatures of suicide are as useful in predicting female suicide as male suicide. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

浅谈博士生招生中的质量保证工作

当前,以知识的不断创新、高新技术迅速产业化为基本特征的知识经济正成为世界潮流,党中央适时提出了科教兴国的战略.