Scope of hypnosis education in academia: results of a national survey

Nutritional husbandry of captive wild ruminants often requires feeding these animals a supplemental diet to enhance their health, reproductive performance, and productivity. Although supplemental diets for wild ruminants are commercially available, few have been evaluated in controlled intake and digestion trials. Voluntary intake, digestive efficiency, nitrogen retention, and gross energy utilization of pronghorn (Antilocapra americana), mule deer (Odocoileus hemionus), mountain sheep (Ovis canadensis), mountain goats (Oreamnos americanus), and wapiti (Cervus elaphus) consuming a high-energy, high-protein pelleted supplement were compared. Voluntary intake of dry matter, energy, and nitrogen were similar (P > 0.34) between mountain goats and mountain sheep and consistently lower (P < 0.03) for these species than for pronghorn, mule deer, and wapiti. Differences in digestive efficiency among species were inversely related to dry matter intake rates. Apparent digestibility of dry matter, organic matter, and neutral-detergent fiber was 10-20% higher for mountain goats and mountain sheep than for the other species (P < 0.04). Although these findings suggest a superior digestive efficiency for mountain goats and mountain sheep, species comparisons are inconclusive because of the confounding effects of season and ambient temperature on voluntary intake and digestion. Under the conditions of this experiment, the diet tested was safe, nutritious, and highly palatable. Protein and energy concentrations appear to be sufficient to meet or exceed known nutritional requirements of captive wild ruminants.     

Sudden unexpected cardiac death: methods and results of a national pilot survey

In order to develop a methodology for measuring the occurrence and circumstances of sudden unexpected adult deaths due to cardiac and to unidentified causes throughout England, a stratified random pilot sample of 12 of the 133 coroner's jurisdictions in England was invited to survey prospectively a quota sample of 78 consecutive white Caucasians, aged from 16 to 64 years, with no history of ischaemic heart disease, who were last seen alive within 12 h of being found dead, and for whom a coroner's post-mortem examination found either a cardiac or no identifiable cause of death. Eleven (92%) coroners participated. In a median of 105 days (range 21-169), 65 cases (83% of the quota) were ascertained (54 (83%) males). Of the ascertained cases, registration forms were received on 62 (95%), tissue specimens on 63 (97%), and post-mortem reports on 58 (89%). Death was witnessed in 58%, of which 35% were 'instantaneous'. The median time from symptom onset to death was 40 min. In unwitnessed deaths, the median time since last being seen alive was 90 min. Sixty-eight per cent of all deaths were attended--by a relative in 34%, passer-by (8%), ambulance crew (32%), nurse (11%), doctor (38%), and police (9%). Cardio-pulmonary resuscitation was attempted in 38 of the 42 attended deaths. Sixty-seven per cent were taken ill at home, 12% at work, 12% in a public place, and 10% elsewhere. The certified cause of death was ischaemic heart disease in 89%, in whom coronary thrombosis and/or myocardial damage was absent in 6 cases (9%). In the remainder, the certified cause was hypertensive heart disease (5%), hypertrophic obstructive cardiomyopathy (3%), 'cardiomegaly' (1.5%) and 'sudden cardiac arrhythmia' alone (1.5%). A retrospective audit of coroner's records revealed the median case ascertainment rate was 75%. This approach to surveying sudden unexpected adult death nationally resulted in a high response rate (92%) from coroners, consultant pathologists and their staff, the identification of a large proportion of eligible cases, and complete information in most of the identified cases. In from 2% to 15% of cases, death may have been either purely dysrhythmic or due to a sudden adult death syndrome.     

Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience

OBJECTIVE: The primary objectives of this report were, first, to determine the number and incidence of complications of transsphenoidal surgery performed by a cross-section of neurosurgeons in the United States and, second, to ascertain the influence of the surgeon's experience with the procedure on the occurrence of these complications. The secondary objective was to review complications of transsphenoidal surgery from the standpoint of their causation, treatment, and prevention. METHODS: Questionnaires regarding 14 specific complications of transsphenoidal surgery were mailed to 3172 neurosurgeons. The data reported were analyzed from the 958 respondents (82%) who reported performing the operation. The neurosurgeons surveyed were asked to estimate the number of transsphenoidal operations performed, to identify any complications observed, and to estimate the percentage of operations that had resulted in any of the 14 specific complications. The 958 respondents were placed into three experience groups, based on the number of transsphenoidal operations performed. The data were analyzed by using chi 2 tests and Spearman correlation coefficients. The secondary objectives were met through a detailed review of the literature, in light of our experience. RESULTS: Of the respondents, 87.3% reported having performed < 200 operations and 9.7% reported 200 to 500 previous operations. The remaining 3% reported more than 500 previous operations. More extensive previous experience with transsphenoidal surgery was associated with a greater likelihood of having witnessed each specific complication. The mean operative mortality rate for all three groups was 0.9%. Anterior pituitary insufficiency (19.4%) and diabetes insipidus (17.8%) were complications with the highest incidence of occurrence. The overall incidence of cerebrospinal fluid fistulas was 3.9%. Other significant complications, such as carotid artery injuries, hypothalamic injuries, loss of vision, and meningitis, occurred with incidence rates between 1 and 2%. An inverse relationship was found between the experience group and the likelihood of complications, as indicated by significant negative Spearman correlation coefficients for all but 2 of the 14 complications listed in the survey (P < 0.05). Thus, increased experience with transsphenoidal surgery seems to be associated with a decreased percentage of operations resulting in complications. Some caution should be exercised in interpreting these data, because they are based on the respondents' estimates. CONCLUSION: Transsphenoidal surgery seems to be a reasonably safe procedure, with a mortality rate of less than 1%. However, a significant number of complications do occur. The incidence of these complications seems to be higher, with statistical significance, in the hands of less experienced surgeons. The learning curve seems to be relatively shallow, because a statistically significantly decreased incidence of morbidity and death could be documented after 200 and even 500 transsphenoidal operations. Better understanding of the indications for transsphenoidal surgery and improved familiarity with the regional anatomy should further lower the incidence of death and morbidity resulting from this procedure in the hands of all neurosurgeons.     

House staff supervision, workload, and experience in the neonatal intensive care unit: results of a national survey

One hundred fifty-nine pediatric chief residents were surveyed regarding characteristics of the neonatal intensive care unit rotation for house staff at their institution. We documented substantial interinstitution variability in house staff NICU rotations in terms of number of rotations, and the workload and supervision of house staff.     

Identity development from adolescence to adulthood: An extension of theory and a review of research.

Examines, in the light of research findings, those aspects of E. H. Erickson's (1963, 1968) theory of psychosocial development that concern the formation of a sense of personal identity. When the Stage 5 component is considered as a bipolar dimension, the expectation is that the transition from adolescence to adulthood involves a progressive strengthening in the sense of identity. When the identity construct is expanded to include the processes by which an identity is formed, it is hypothesized that identity status will change from the identity diffusion status to the foreclosure and then the moratorium status, and from the moratorium to the identity achievement status. The circumstances associated with these changes, regressive changes, and reentry into an identity crisis are discussed. The review of the literature deals with the direction and timing of identity development, sex differences in development, and the identification of antecedent conditions relating to the choice of development pathways. (2 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stages of drug abuse in adolescence: Personality, peer, and family correlates.

Administered written questionnaires that consisted of personality measures, family measures, peer measures, and measures of drug use to 403 Black and 529 White 1st- and 2nd-yr high school students. Results indicate that (a) domains of personality, peer, and family are important in differentiating among the stages of drug use; (b) drug use by family and peers interacts with the socialization techniques of family and peers and with the personality attributes of the adolescents; and (c) family and peer positive and negative reinforcement are differentially effective, depending on the adolescents' personality attributes. In addition, data support an independent model; that is, each of the 3 domains (personality, peer, and family) was associated with the S's stage of drug use independent of the latter's relationship with the remaining 2 domains. An independent model was also obtained in the following comparisons between successive stages: nonusers vs legal users, legal users vs marihuana users, and marihuana users vs other illicit drug users. Factors affecting drug use stage were similar across races and sexes. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Final bedside verification: results of a national survey of reagents and devices used in France

The national reference Center for blood groups checked samples of reagents and devices used in France for a definitive verification of pretransfusion ABO tests performed at the patient's bedside, as defined by French health authority regulations. The results of an initial inquiry was published in 1991. The new study shows no significant improvement of the quality of reagents and devices. This is a major concern considering the importance of ABO incompatibility in severe hemolytic transfusion reactions.     

The role of the nurse manager in ambulatory care: results of a national survey

Increasing complexity in ambulatory care settings requires nurse managers who can function at higher levels. Little agreement currently exists regarding the role expectations and academic preparation needed for nurse managers in ambulatory care settings. The majority of surveyed ambulatory care nurse managers (40%) have an AD or diploma as their highest level of academic preparation, and have thus acquired the majority of their management skills in the practice setting. The authors express concern that there are pressures to employ non-nurses as managers in ambulatory health care settings and that ambulatory nurse managers are often seen as not needing advanced academic preparation. A wide variety of settings including university and community hospitals, outpatient departments, physician group practices and HMOs, currently employ nurse managers in their multidisciplinary ambulatory care sites. The majority of ambulatory care nurse managers describe their model of care as either the medical model or the functional model.     

Contraceptive behavior in the population of the Czech Republic: results of a national survey

Using an anonymous questionnaire the authors investigated in a representative group of the Czech population above 15 years of age (862 men and 857 women) the use of the main contraceptive methods. During the first intercourse more than half the respondents did not use any contraception, a condom was used only by 19% men and 14% women. In a steady partnership the most frequent method of contraception is coitus interruptus, whereby experience with hormonal contraception was reported by cca one third and with a condom by two thirds of respondents. Among younger men and women there are more users of hormonal contraception and condoms. Only 5% of the examined men and 4% of the women opposed any type of contraception, almost one quarter of respondents use only so-called "natural methods" and almost three quarters of the respondents consider them an essential part of sex life. The attitudes of atheists and junior and more educated women are more liberal.     

Physicians' prevention-related practice behaviors in treating adult patients with asthma: results of a national survey

To improve the health outcome of adults with asthma, it is important to understand the current practice behaviors of physicians related to the prevention and treatment of asthma. A national survey was conducted to ascertain the practice behaviors of physicians in five specialty areas: internal medicine, pulmonary, allergy/immunology, occupational health, and family health. Similarities and differences in practice among the specialty areas are indicated. The data provide a basis for recommendations to improve the management of asthma by standardizing history taking, increasing the use of pulmonary function testing, and using effective counseling and patient education strategies.     

Correlates of alcohol use and misuse in fourth-grade children: psychosocial, peer, parental, and family factors

To determine level of alcohol use/misuse and to examine correlates of these behaviors, 1,314 fourth-grade students were surveyed. The questionnaire included 55 items concerning tolerance of deviance, deviant self-image, self-efficacy, susceptibility to peer pressure, personal and peer approval of alcohol use, peer adjustment, parent nurturance and monitoring, family adjustment, parental permissiveness, peer use of alcohol, and exposure to alcohol. The items were factor analyzed and indices constructed. The indices generally had acceptable alpha coefficients (alpha = .61-.91); two exceptions were peer adjustment (alpha = .51) and parental permissiveness (alpha = .42). Tolerance of deviance, deviant self-image, susceptibility to peer pressure, personal and peer approval, peer use and exposure by peers, and parental permissiveness were positively correlated with alcohol use/misuse. Self-efficacy, child-parent interactions, family adjustment, and peer adjustment were negatively correlated with alcohol use/misuse. Implications for the design of family-based alcohol use/misuse prevention programs are discussed.     

Stroke, disability, and dementia: results of a population survey

The arcuate nucleus of the hypothalamus, a highly sexually dimorphic brain region, has been called the bed nucleus for endogenous opioids. The potential contribution of opioids in this nucleus to modulate control of ventilation in male and female rats has not been investigated. The purpose of the present study is to determine the effect of microinjecting naloxone, an opioid receptor antagonist, into the arcuate nucleus of awake male and female rats on ventilation, oxygen consumption, heart rate, and blood pressure. Results of this study demonstrate that naloxone at doses of 1.5 and 3.0 nmol relative to vehicle caused a depression of ventilation due to a decrease of both frequency of breathing and tidal volume in male rats and a decreased response to a hypercapnic challenge in female rats. Although there were gender differences noted in oxygen consumption, heart rate, blood pressure, and ventilatory response to a hypoxic challenge, only oxygen consumption was significantly affected by naloxone. Potential mechanisms whereby naloxone may act to depressing ventilation are discussed.     

Developmental links of adolescent disclosure, parental solicitation, and control with delinquency: Moderation by parental support.

This 4-wave study among 309 Dutch adolescents and their parents examined changes in adolescent disclosure, parental solicitation, and parental control and their links with the development of delinquent activities. Annually, adolescents and both parents reported on adolescent disclosure, parental solicitation, and parental control, and adolescents reported on delinquent activities and parental support. Latent growth curve analyses revealed a linear decline in parental control between ages 13 and 16. Adolescent disclosure decreased gradually in adolescent reports and showed an L-shaped pattern in father reports and a V-shaped pattern in mother reports. A stronger increase in delinquent activities was related to a stronger decrease in disclosure in mother and adolescent reports and to lower levels of disclosure in father reports. The linkages between levels of disclosure and delinquent activities were stronger in families with high parental support than in families with lower support. Furthermore, in lower parental support families, a stronger decrease in paternal control was related to a stronger increase in delinquent activities. In high parental support families, however, a stronger decrease in adolescent-reported parental control was related to a less strong increase in delinquent activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Workplace smoking policies in the United States: results from a national survey of more than 100,000 workers

To investigate the activity of cortical regions in the control of movement, we studied event-related desynchronization/synchronization (ERD/ERS), event-related coherence (ERC), and phase coherence in 29-channel EEGs from 9 subjects performing self-paced movements of the right index finger. Movement preparation and execution produced ERD over the sensorimotor areas at 10 Hz and 20 Hz, followed by ERS. ERD corresponded spatiotemporally to an increase in coherence over the frontocentral areas. For both frequency bands, ERD began over the left sensorimotor areas and became bilateral at the time of movement onset. The coherence increase with frontal areas began in the left central areas and became symmetrical after EMG onset. The ERD and coherence increase was longer at 10 Hz than at 20 Hz. Phase coherence at 10 Hz showed a lead of anterior regions to posterior regions throughout the time period, and at 20 Hz showed a tendency toward zero phase delay corresponding with the movement. EEG desynchronization parallels functional coupling over sensorimotor and frontal areas. Event-related coherence and phase coherence findings implicate the frontal lobes in control of movement planning and execution. The involvement of different frequency bands with different timings may represent parallel changes in the cortical network.     

Attachment, family dysfunction, parental alcoholism, and interpersonal distress in late adolescence: A structural model.

Parental attachment was hypothesized as a mediational variable, explaining the relationship between parental alcoholism, family dysfunction, and the expression of interpersonal distress. Undergraduate students (N?=?152) were administered questionnaires to assess parental attachment, parental alcoholism, family dysfunction, and interpersonal distress; structural analysis was used to specify the relations among measured constructs. Parental alcoholism was not a significant predictor of attachment to parents or interpersonal distress; however, the mediating role of parental attachment was evident when family dysfunction was examined. As the level of family dysfunction increased, participants reported less parental attachment and more interpersonal distress. Viewing parental attachment as a mediator has important implications for theory and clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Systemic chemotherapy for psoriasis: a national survey

A questionnaire that was mailed to 510 randomly selected dermatologists in the United States surveyed their use of three systemic chemotherapeutic agents for the treatment of psoriasis during the two-year period of 1973 to 1974. Methotrexate was used by 52% of the surveyed dermatologists, while hydroxyurea and azaribine were used by 10% and 2%, respectively. Seventy-five percent of the dermatologists who used methotrexate treated ten or fewer psoriatic patients with this drug. Multiple dose therapy with methotrexate divided over a period of 36 hours each week was the preferred schedule of 66% of the dermatologists. Liver biopsy specimens and creatinine clearance tests were obtained for only 17% and 35% of patients, respectively, prior to initiating methotrexate therapy. The estimated number of dermatologist-treated psoriatics nationwide receiving methotrexate is 25,000.