Risk factor reduction behaviours in coronary angioplasty and myocardial infarction patients

A recent study asked percutaneous transluminal coronary angioplasty (PTCA) patients in Saskatchewan (n = 210) to identify specific information surrounding their rehabilitation behaviours and motivation to change lifestyle. The scale used to elicit this information was developed and previously used to determine patient risk factor knowledge and lifestyle change behaviours among myocardial infarction (MI) patients during rehabilitation phases. The purpose of this article is to discuss the results of PTCA patients' responses and compare these findings to previously obtained data from MI patients. Risk factors most frequently reported by both PTCA and MI patients as causative factors of their heart problems included diet, job stress, low levels of exercise, and other patient-perceived factors. When asked about lifestyle restrictions post-hospitalization, PTCA patients reported more lifestyle restrictions in activities of daily living (recreation, job, social life, sexual activity and driving) following hospitalization than MI patients. Both groups of patients reported high levels of dietary changes made post-hospitalization but findings reflected that MI patients had initiated more modifiable risk factor changes overall than PTCA patients. Comparative results showed that MI patients were more likely to initiate risk factor reduction behaviours for modifiable factors such as smoking, weight reduction, job/family stress, and exercise than PTCA patients. These findings offer insight into differences between PTCA and MI patients with respect to cardiac rehabilitation behaviours and may suggest the need for different teaching-learning approaches and/or more focused patient education for PTCA patients. A goal of cardiac rehabilitation is to encourage patient initiation and maintenance of lifestyle modification behaviours based on identified risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comments on "Two classic behaviour modification patients: a decade later."

Comments on the article by G. G. Sherwood and J. E. Gray (see record 2007-01479-012) which followed-up on two "classic" patients treated by the current author in his original behaviour modification unit. The major point made by Sherwood and Gray can be characterized by one of their own statements, "our findings are sufficient to indicate that behaviours extinguished in a controlled environment can re-emerge in a different setting." This comment reflects what is currently one of the most important issues in the evaluation of any therapeutic approach, namely the issue of generalization. A follow-up evaluation assumes that behaviour after behavioural intervention takes places in a vacuum. That is to say, it somehow assumes that the individual is no longer in interaction with his current environment and is, therefore, impervious to change. Of course, that is not the ease. Hence, the individual's behaviour will continue to change as a function of his interaction with his current environment, and his history since the behavioural intervention. In fact, the follow-up information offered by the Sherwood and Gray suggests that the re-emergence of old behaviours is very much related to the contingencies in the patients' current situation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Helping the Noncompliant Child: A Clinician's Guide to Parent Training.

Reviews the book, Helping the Noncompliant Child: A Clinician's Guide to Parent Training by Rex L. Forehand and Robert J. McMahon (1981). Clinicians working with families will find Helping the noncompliant child an invaluable book. The six chapters and four appendices provide a comprehensive program for training parents to engage in behaviours that will improve parent-child relationships. The treatment program consists of two phases. In the first phase parents are taught to increase their child's appropriate behaviours through the use of differential attention and rewards. This phase has two main purposes: teaching appropriate behaviours and increasing the "quality" time between parents and their children. These effects should increase the positiveness of the parent-child relationship, and help prevent a return to a coercive relationship. The second phase teaches parents to reduce the frequency of inappropriate behaviours through the use of appropriate commands and the use of time-out. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Microprobe analysis of element distribution in rabbit and dog erythrocytes as examples of "high" and "low" potassium cells

The concentrations of Na, Mg, P, S, Cl, K and Fe were determined by microprobe in near 100% hematocrit suspensions of rabbit and dog erythrocytes prepared by freezing and drying. These cells are representative, respectively, of "high" potassium, "low" sodium, and "high" sodium, "low" potassium cells. Water contents of the cells were the same, as were, approximately, the levels of Cl, S and Fe. Rabbit P was nearly double that of the dog. For the rabbit, the cell Na/K ratio was 0.21 and for the dog 15.4, illustrating the major diffusible electrolyte difference between these two types of cell. The rabbit erythrocytes showed an apparent negative immobile charge density of 95 meq/kg of cell water and the dog 56 meq/kg cell water, a distinct difference. Serum electrolytes in the two species are exactly comparable (Standard Tables). Ionic distribution in these cell types was treated by the Gibbs-Duhem equation representing two heterogeneous systems in thermodynamic equilibrium with the blood serum. Factors to be considered are: (1) the composition of the erythrocyte and its net immobile charge; (2) the physicochemical properties of the individual ions (charge, ionic radius, hydration energy, standard chemical potential); (3) the dielectric constant of the dispersion medium (in this case, water); and (4) the binding constants of the ions. The hypothesis of "active transport" (the sodium-potassium pump) is specifically rejected as an explanation of ionic differences.     

Health related behavioural change in context: young people in transition

Post-modern theorists have highlighted the impacts of rapid social and economic change in lessening structural constraints, arguing that the concepts of "gender" and "social class" are now less useful in understanding people's life chances and choices. While the epochal nature of such changes has been questioned, increasing levels of individualisation and reflexivity have been widely recognised. Agency is prioritised and structural disembeddedness increasingly assumed: people are held to construct their identities and biographies reflexively from a diverse range of experiences and opportunities. When used in relation to understanding health related behaviours this theorising has led to an increasing focus upon the symbolic significance of consumption (and indeed risk) in defining lifestyles and identities. Here we report on the health related behaviours of 106 young people (15/16 yr) during their transition from school to employment, training or further education. This period is arguably central in the process of creating adult identities and accordingly should involve considerable lifestyle choice, reflexivity and symbolic consumption as identities are formed. By drawing on two rounds of data (semi-structured interviews and structured questionnaires) we consider how smoking and drinking behaviours related to the wider social transitions towards adulthood. We provide a situated account of health related behaviours which acknowledges both subjective experience and social location. We argue that the current challenge is to integrate the different levels of structural constraint and individual agency within the context of current rapid social and economic change and suggest that it is only through empirical investigation which embraces an analysis both at the level of structure and individual experience that the conditions of late modernity can be more thoroughly understood.     

Visual "closed-loop" and "open-loop" characteristics of voluntary movement in patients with Parkinsonism and intention tremor

Normal voluntary movements are considered to be of two kinds, or to involve two components, (i) a ballistic or "open-loop" type, which are preprogrammed and executed without reference to current sensory information and (ii) a corrective or "closed-loop" type, whose course or termination are regulated by such information. In a previous paper it was suggested that Parkinsonism disrupted the first kind of movement, but intention tremor did not. In the present paper three experiments designed to test this hypothesis are described. Subjects were tested on an acquisition-tracking task using an oscilloscope display and joystick control, and measurements were made of the duration, velocity and error of their initial movements to acquire the target. Parkinsonian movements were found to be considerably different from normal in that (a) most movements by this group lasted longer than the reaction time for their initiation, as if including some secondary correction in their execution, (b) the rate of movement was not varied for different amplitudes (so keeping the duration fairly constant) as in normal subjects, but rather movements of all amplitudes were made at a constant slow rate, so that duration increased markedly with the larger steps, (c) error increased disproportionately as the velocity of movement increased; in particular any movements completed in one reaction time or less tended to be wildly inaccurate, (d) removing either the target or the response marker from the screen at the beginning of a movement had a significant effect, making it shorter in duration and smaller in amplitude than those usually produced with both markers visible all the time. Parkinsonian subjects showed no improvement in performance with repeated attempts at one movement over a whole sequence, so their deficit appears to be stable even after practice on a known fixed task. These results are interpreted as supporting the hypothesis that Parkinsonism interferes with the generation of accurate ballistic action which are characteristic of normal skilled movement. Tremor subjects in general resembled normal control subjects in their initial acquistion movements, but their accuracy was less with the larger steps.     

The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults

STUDY DESIGN: Population-based, cross-sectional, mailed survey. OBJECTIVES: To determine the lifetime, 6-month period, and point prevalence of low back pain and its related disability among Saskatchewan adults and to investigate the presence and strength of selective response bias. SUMMARY OF BACKGROUND DATA: There have been many reports of the prevalence of low back pain in different populations, and the estimates vary widely depending on case definition. However, most studies fail to differentiate between trivial and disabling back pain, which raises the issue of the usefulness of these estimates. No studies have yet documented the prevalence of graded low back pain severity and its related disability in a North American, general, population-based survey. METHODS: The Saskatchewan Health and Back Pain Survey was mailed to a probability sample of 2184 Saskatchewan adults between 20 and 69 years of age. Fifty-five percent of the eligible population responded to the survey. Respondents were compared with nonrespondents, and the presence of selective response bias by back pain status was investigated by wave analysis. The point and lifetime prevalence of low back pain was determined by simple questions, and the 6-month period prevalence of low back pain was determined by the Chronic Pain Questionnaire. All estimates were age standardized to the Saskatchewan population. RESULTS: The authors estimate that at the time of the survey 28.4% (95% confidence interval, 25.6-31.1) of the Saskatchewan adult population were experiencing low back pain, and 84.1% (95% confidence interval, 81.9-86.3) had experienced it during their lifetime. Overall, 48.9% (95% confidence interval, 45.9-52.0) of the population had experienced low intensity/low-disability low back pain in the previous 6 months, 12.3% (95% confidence interval, 10.3-14.4) had experienced high-intensity/low-disability low back pain, and an additional 10.7% (95% confidence interval, 8.8-12.5) had experienced high-disability low back pain in the previous 6 months. There was little variation in the estimates over age groups, but women experienced more high-disability back pain than men. There was no evidence of selective response bias by low back pain status in the survey. CONCLUSION: Low-intensity/low-disability low back pain is a common problem in the general population. Approximately 11% of the adult population studied had been disabled by low back pain in the previous 6 months.     

Definition of "salt sensitivity"

To examine how the term "salt sensitivity" has heretofore been defined, two medical data bases, DIMDI and MEDLINE were searched. 32 clinical studies, published between 1978-1992 and using the terms salt-, sodium- or sodium chloride-sensitive or sensitivity were found and analysed. Salt sensitivity was experimentally determined and applied in quite varied ways to normotensive and hypertensive persons. There were three types of studies: in type 1 (n = 15), a phase of low sodium intake was followed by one with a high intake; in type 2 (n = 8), a phase of high or "normal" sodium intake was followed by a low intake one; in type 3 (n = 9), there was a randomized sequence of differing sodium intake phases, in some cases with cross-over. It is concluded from these studies that there is insufficient evidence to distinguish between salt sensitive and salt insensitive subjects. Consequently scientific discussion of this question should not lead to hypertensives being discouraged from reducing their salt intake.     

Urban Runoff Quality Characterization and Load Estimation in Saskatoon, Canada

The improvement in the effluent quality of the treated sanitary sewage entering the South Saskatchewan River at Saskatoon, Canada, and the impending change in provincial legislation governing urban runoff, provided the impetus for Saskatchewan Environment to initiate the stormwater runoff quality study reported in this paper. Among others, the study involved a field program for characterizing the urban runoff water quality from four catchments, each representing a different type of land use. Both a site mean concentration approach and a multiple variable regression analysis approach were used to quantify the pollutant load contained within the runoff. Thereafter, using the runoff water quality characterizations developed in the study, rainfall–runoff pollutant loads from the entire city were estimated and compared with two local point sources to the receiving stream. On the basis of this analysis, it was found that urban runoff contributes more total suspended solids and total Kjeldahl nitrogen load, similar chemical oxygen demand load, and slightly less total phosphorus load than the two local point sources.     

Manager-employee "understanding" in the retail grocery and meat market.

Employees and managers in each of eleven retail food stores provided measures of "understanding" of each other by predicting the other's responses on two questionnaires. From these data, four measures of "understanding" were derived. These were correlated with rankings of the stores based on (1) employee ratings by the manager, (2) manager evaluations by the employees, (3) job satisfaction scores of the employees, and (4) judged efficiency of the retail unit. The first two ratings were not related to any of the measures of "understanding," but the latter two variables were significantly correlated with certain of the measures of "understanding." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Transient structures": the effects of practice and distractor grouping on within-dimension conjunction searches

It has been stated that whereas between-dimension (color x orientation) conjunctions can be searched in a "parallel" fashion, within-dimension (color x color) conjunctions are necessarily searched in a "serial self-terminating" fashion (Wolfe et al., 1990). We explored the effects of practice (within 1-h experimental session) and distractor grouping on within-dimension conjunction search tasks. In Experiments 1 and 3, the stimuli were rectangles formed by two adjacent squares; in Experiment 2, the stimuli were plus signs formed by two segments and an intersection. In Experiments 1 and 2, observers were assigned to one of two experimental conditions: In one, all the distractors shared a simple feature (the color blue); in the other, distractors did not share that simple feature. In the first condition, search became more efficient with practice and observers' performance was characterized by a shallow reaction time (RT) x set size slope; in the second condition, observers' performance did not improve as much with practice. We propose that the differential effects of practice between these two experimental conditions can be explained in terms of distractor grouping induced by the shared color of the distractors. Experiment 3 showed that, with practice, a shallow RT x set size slope characterized observers' search for a color x color target among four different distractors that shared a common color. The present results contradict a main tenet of some current visual search models--namely, that within-dimension conjunctions cannot be searched in parallel, and question the validity of using RT x set size slope functions to distinguish between preattentive versus attentive search.     

CMA-sponsored Task Force on the Allocation of Health Care Resources.

Hurray for the Canadian Medical Association! They have just released Health: A Need for Redirection, the report of a Task Force on the Allocation of Health Care Resources. The task force, headed by Joan Watson, the former hostess of CBC's "Marketplace," included the Honourable Pauline McGibbon, former lieutenant-governor of Ontario, Roy Romanow, former NDP attorney general of Saskatchewan, and two physicians, John O'Brien-Bell and Leon Richard. The purpose of the task force was to examine the allocation of health care resources in the face of an increasing elderly population and the explosion of new technology. The report could help shape the future of the health care system. The report makes it clear that the health system is in crisis and the reform of the health system needs us all, as both active professionals and critical consumers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in gradients of stimulus generalization as a function of "Abstract" and "Concrete" attitude.

Goldstein's concept of the loss of abstract attitude in psychopathology, was related to stimulus generalization along a visual-spatial dimension, with an apparatus requiring a voluntary response. Measurement was made of the gradient of stimulus generalization (GSG) of 34 "abstract" Ss, and 34 "concrete" Ss. These Ss were selected on the basis of their performance on 2 abstraction tasks (i.e., the Weigl-Goldstein-Scheerer Color Form Sorting Test, and the Wechsler-Bellevue block design subtest). The hypothesis that "concrete" Ss would have a lower GSG than "abstract" Ss, was tested and supported. The prediction that any differences observed would be independent of diagnostic category, was also substantiated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The "second gas effect" is not a valid concept

To determine whether the "second gas effect" is valid, we determined the pharmacokinetics of 0.2% enflurane with or without 80% N2) (n = 7 each) under controlled constant volume ventilation in 14 young healthy male patients before their operations. The alveolar (end-tidal) concentration (FA) and inspired concentration (FI) at the mouthpiece and the arterial blood concentration of enflurane were measured, and the ratio of FA to FI was calculated. The FA/FI of enflurane increased rapidly during the first few minutes of administration and then increased slowly. No significant difference was found in the FA/FI between the two groups at any time point (P > 0.05). The arterial blood concentrations of enflurane increased progressively and were not significantly different between the two groups at any time point (P > 0.05). The results indicate that, at high concentrations, N2O neither facilitated the increase of FA nor enhanced the uptake of a companion gas. The second gas effect is a nonexistent phenomenon in clinical practice because the concentrating effect is very weak and the augmentation effect is nonexistent under controlled ventilation. IMPLICATIONS: We studied the effects of N2O on the ratio of alveolar (end-tidal) concentration to inspired concentration of the second gas (enflurane) and on its blood concentration in humans. Nitrous oxide did not affect the alveolar or blood concentration of the second gas under controlled constant volume ventilation. The "second gas effect" is not a valid concept.     

Presence of multiple "Helicobacter heilmannii" strains in an individual suffering from ulcers and in his two cats

Circumstantial evidence suggests that "Helicobacter heilmannii" infection is an example of zoonosis. The presence of "H. heilmannii" strains in a human subject with acute gastric erosions, in his two cats, and in two unrelated cats was analyzed, and the genetic relatedness of the human and feline strains was assessed. A 580-bp, PCR-amplified sequence of "H. heilmannii" urease B gene (ureB) obtained from biopsies from the human subject and his two cats was restricted with AluI and cloned for sequencing. Analysis of the restriction fragment length polymorphism of the ureB-amplified product suggested the presence of different individual "H. heilmannii" strains in the cats and of three distinct strains in the human subject. One of the "H. heilmannii" ureB sequences amplified from the human subject's biopsies was identical to that derived from one of his cats. The degree of similarity between the other "H. heilmannii" human and feline nucleotide sequences was higher than 97%. Most of the base substitutions were conservative. We conclude that human and animal "H. heilmannii" strains are closely related and that humans can be infected by more than one "H. heilmannii" strain, as has been observed for Helicobacter pylori.     

The enigma of "hidden" traumatic brain injury

OBJECTIVE: To examine individuals with "hidden" traumatic brain injury (TBI), defined in this study as those who sustained a blow to the head, with altered mental status, and experienced a substantial number of the cognitive, behavioral, and emotional sequelae typically associated with brain injury but did not make the causal connection between the injury and its consequences. DESIGN: Comparison of four groups of individuals matched for age, gender, years of education, and duration of loss of consciousness. SETTING: This study of hidden TBI followed the identification of 143 individuals who, within a larger study of people with TBI who live in the community, identified themselves as "nondisabled" (they were to be part of the comparison sample) but who had experienced a blow to the head that left them at minimum dazed and confused. PARTICIPANTS: 21 of these 143 individuals also reported large numbers of symptoms (eg, headaches, memory problems) associated with TBI. This group (Hidden TBI-High Symptoms group) was compared to three other matched samples: one with known TBI (Known Mild TBI group) and one with no disability (No Disability group) (both of which were drawn from the larger study), and one group of individuals who identified themselves as having no disability but who had experienced a blow to the head that resulted in a few symptoms (Head Trauma-Low Symptoms group). MAIN OUTCOME MEASURES: All study participants were administered an interview that incorporated several existing instruments documenting levels of reported symptoms, emotional well-being/distress, and vocational/social handicaps. RESULTS: The Hidden TBI-High Symptoms group was found to be similar to the Known Mild TBI group in terms of the number and types of symptoms experienced, whereas the Head Trauma-Low Symptoms group was similar in this respect to the No Disability group. The two former groups also evidenced high levels of emotional distress, whereas the two latter groups did not. However, on measures of handicap, the Hidden TBI-High Symptoms and Head Trauma-Low Symptoms groups were similar to the No Disability group and dissimilar from the Known Mild TBI group in that the last group experienced vocational handicap, in particular, whereas the other groups did not. Conclusions: We conclude that hidden TBI occurs at a nontrivial level (7% of our nondisabled sample). Also, individuals with hidden TBI (with persistent symptoms), unlike those with known mild TBI, are likely to experience emotional distress but not vocational handicap following injury.     

"Two solitudes" in psychology.

Used frequency of citation in a 6-yr sample of the journal literature (143,260 citations referring to the work of 48,903 authors) to identify a group of "visible" psychologists. A sample of 300 authors, out of 3,056 with 6 or more citations was used. A principal component factor analysis of the correlation matrix across journals showed a bipolar factor suggesting that there were 2 groups of journals in the sample: a general-experimental group and a personality-social group. It was found that most "visible" psychologists are cited frequently in only 1 of these groups of journals, and that very few are cited frequently in both groups. (french summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

双线电渣炉电极“冻结”机理及“防冻”研究

对双线电渣炉自耗电极“冻结”现象做了生产观察、实验,分析了“冻结”机理,找出了主要影响因素,提出“理想状态”重熔和“准理想状态”重熔措施,彻底克服了电极“冻结”问题,经两年多生产证明措施切实可行。