Reliability and validity of Women's Health Initiative Insomnia Rating Scale.

The reliability and construct validity of the 5-item Women's Health Initiative Insomnia Rating Scale (WHIIRS) were evaluated in 2 studies. In Study 1, using a sample of 66,269 postmenopausal women, validity of the WHIIRS was assessed by examining its relationship to other measures known to be related to sleep quality. Reliability of the WHIIRS was estimated using a resampling approach; the mean alpha coefficient was .78. Test-retest reliability coefficients were .96 for same-day administration and .66 after a year or more. Correlations of the WHIIRS with the other measures were in the predicted directions. Study 2 used a sample of 459 women and compared the WHIIRS with objective indicators of sleep quality. Results showed that differences in the objective indicators could be detected by the WHIIRS. Findings suggest that a between-group mean difference of approximately 0.50 of a standard deviation on the WHIIRS may be clinically meaningful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of stressors on breast cancer incidence in the Women's Health Initiative.

Objective: To examine associations among life events stress, social support, and breast cancer incidence in a cohort of postmenopausal women. Design and main outcome measure: Women's Health Initiative observational study participants, breast cancer free at entry, who provided assessment of stressful life events, social support, and breast cancer risk factors, were prospectively followed for breast cancer incidence (n = 84,334). Results: During an average of 7.6 years of follow-up, 2,481 invasive breast cancers were diagnosed. In age-adjusted proportional hazards models, 1 stressful life event was associated with increased risk, but risk decreased with each additional stressful life event. After adjustment for confounders the decreasing risk was not significant. Stressful life events and social support appeared to interact in relation to breast cancer risk such that women who had greater number of stressful life events and low social support had a decreased risk of breast cancer. Conclusions: This study found no independent association between stressful life events and breast cancer risk. The results are compatible with a more complex model of psychosocial factors interacting in relation to breast cancer risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women's Health Initiative: Why now? What is it? What's new?

Studies collectively named the Women's Health Initiative (WHI) are currently enrolling 164,500 postmenopausal women in several overlapping clinical trials and an observational study. The overall goals of WHI are to understand the determinants of postmenopausal women's health and to evaluate the efficacy of practical interventions in preventing the major causes of morbidity and mortality in older women. This article reviews the research leading to the WHI studies; describes the study designs and protocols, with an emphasis on what's new about WHI from a psychological perspective; and outlines the major psychosocial hypotheses under investigation and the major challenges WHI presents to psychological science. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure and measurement invariance of the Women's Health Initiative Insomnia Rating Scale.

As part of the Women's Health Initiative Study, the 5-item Women's Health Initiative Insomnia Rating Scale (WHIIRS) was developed. This article summarizes the development of the scale through the use of responses from 66,269 postmenopausal women (mean age=62.07 years, SD=7.41 years). All women completed a 10-item questionnaire concerning sleep. A novel resampling technique was introduced as part of the data analysis. Principal-axes factor analysis without iteration and rotation to a varimax solution was conducted for 120,000 random samples of 1,000 women each. Use of this strategy led to the development of a scale with a highly stable factor structure. Structural equation modeling revealed no major differences in factor structure across age and race-ethnic groups. WHIIRS norms for race-ethnicity and age subgroups are detailed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of Social Support and Social Burden to Repeated Breast Cancer Screening in the Women's Health Initiative.

Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps     

Woman-centered information on menopause for health care providers: findings from the Midlife Women's Health Survey

Despite their growing numbers, midlife women continue to feel marginalized by a health care system that is unresponsive to their needs for current information about the perimenopausal experience and for egalitarian, woman-centered care. In this article, the authors call upon physicians, health educators, nurses, counselors, and other health providers to meet the consumer needs of this ever-growing clientele. To this end, they provide data-based information derived from the responses of more than 400 middle-aged women from across the United States to annual Midlife Women's Health Surveys from 1990 to 1993. The authors focus on enhancing the sensitivity of health care providers toward their midlife clients by offering data describing the normal menopausal transition and the feelings and concerns of this group.     

The Impact of Rape on Women's Sexual Health Risk Behaviors.

This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N=102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and/or drugs during sex. The 2nd cluster (moderate risk) reported increases in frequency of sexual activity and number of partners but mitigated that risk with increased condom use. Survivors in the 3rd cluster (low risk) indicated that their sexual health behaviors had become much less risky postrape. An ecological model predicting cluster membership revealed that individual-level and contextual factors predict patterns of risk behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care reform: The 1993–1994 evolution.

Health care costs in the US continue to increase, as does the number of individuals who lack health care coverage. The magnitude of these critical problems assures that reform of the health care system will continue to be debated over the next decade. Increasing health care costs are associated with increased complexity of services and a greater number of health care providers. As health costs increase and the number of individuals covered by private insurance decreases, states will face increasing pressure to develop effective methods of providing coverage for those without health insurance. Employer mandates will be viewed as one method of extending health coverage. Psychologists must be involved in policy issues so as to ensure the utilization of psychological knowledge and attention to psychological and behavioral health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolution of groundwater quality in France: perspectives for enduring use for human consumption

France is rich in groundwater. It has many aquifers with renewable resources which are estimated at 100 billion m3/year, of which 3.5 billion m3, or 60% of the water used in France for human consumption, are withdrawn each year. This practice is justified by the often naturally pure quality of the water and by the regularity of the resource. Nevertheless, free aquifers, in spite of natural physical and geochemical barriers, are not sufficiently protected from anthropic surface contamination and when pollutants reach them, the consequences are never negligible, be it from a sanitary, economic or natural heritage point of view. The most extensive pollution is nitrate contamination. Nitrate concentrations have been increasing constantly over the last 30 years and in some regions have gone over the critical threshold of 50 mg/l which is the European standard, and concentrations of 100 mg/l have been measured in some places. The gravity of other types of pollution--mining, industrial or domestic--is determined by the mineral or organic products involved. The cumulative effect of all of this pollution is serious from various standpoints: from an economic and environmental point of view because aquifers contribute to the maintenance of aquatic life, and for our natural heritage because of the long-term degradation of vast aquifers in some very urban and industrial regions. We might, therefore, question the possible long-term use of aquifers as a source of drinking water.     

The evolution of the Hox cluster: insights from outgroups

When a tumor or other heterogeneous cell population is acutely exposed to ionizing radiation (or, for that matter, to chemotherapeutic agents or hyperthermia), cells that happen to be more sensitive will be preferentially removed, leaving behind a population more resistant as a whole. However, under broadly applicable assumptions, we here demonstrate mathematically that there is a natural tendency of the postirradiation population to recover from the irradiation in such a manner as to restore its original sensitivity composition, i.e. to undergo "resensitization". An important consequence in radiotherapy is that, if a fixed total radiation dose is delivered in a more protracted manner, e.g. as several fractions or as a continuous dose at low dose rate, resensitization occurring over the course of dose delivery will result in greater cell killing than would otherwise have occurred. That is, for a cell population with any form of diversity in radiosensitivity, the influence of redistribution is to make any prolonged dose more damaging than an acute dose of the same magnitude. This tendency toward an "inverse dose-rate effect" may be masked in practice by countervailing effects, such as repair of sublethal damage, but the tendency is demonstrated to hold under very general circumstances, being a consequence of cell-cell diversity and the dynamic response of the cell population to treatment.     

The treatment of conduct disorder: perspectives from across Canada

OBJECTIVE: To provide a synopsis of treatment programs for conduct-disordered children in Canada. METHOD: Five groups of authors from British Columbia, Ontario, Quebec, and New Brunswick describe their approaches to the treatment of children with conduct disorder. RESULTS: All programs emphasize the needs to use multimodal treatment schemes, including day and short-term residential care, and to base programs on identified factors associated with the development of conduct disorder. CONCLUSION: Specific forms of treatment of conduct disorder are promising but are often hampered by social and political agendas.     

Segregation analysis of breast cancer in a population-based sample of postmenopausal probands: The Iowa Women's Health Study

Inheritance of a major susceptibility gene for breast cancer has been primarily investigated in families with early-onset disease. However, familial clustering of late-onset breast cancer is well documented, and genetic factors may also be relevant. In the Iowa Women's Health Study, we evaluated evidence for a major gene after allowing for measured environmental risk factors. Two hundred sixty-five incident breast cancer probands were identified from a prospective cohort study of 41,837 women aged 55 to 69 years at baseline in 1986. A pedigree development form was mailed to the probands to ascertain all first-degree female relatives. A questionnaire and body measurement protocol were mailed to identified living relatives or surrogates. Segregation analyses were conducted on a total of 1,145 women in 251 families using regressive models as implemented in S.A.G.E. Mendelian codominant inheritance of an allele that produced an earlier-age-at-onset provided the best fit to the data. Incorporation of measured environmental risk factors as covariates yielded no significant improvements in the likelihoods. Approximately 50% of this population could be expected to carry a late-onset breast cancer susceptibility gene, and 23% of the population is susceptible because of the environment in which they live. Homozygous gene carriers are predicted to have a mean age-at-onset of 48 years, over 20 years earlier than heterozygotes; few cases would be expected among non-gene carriers. In conclusion, the transmission pattern of late-onset breast cancer may be determined by a common susceptibility gene.     

The Impact of Breast Cancer on the Lives of Middle-Aged Women: Results From the Australian Longitudinal Study of Women's Health.

This article investigated the impact of breast cancer (BC) in middle-aged Australian women (45-50 years). Two waves of data collected 2 years apart from a longitudinal survey of 12,177 women identified 3 groups: (a) 11,933 (98%) who reported never having had BC, (b) 181 (1.5%) who reported a diagnosis of BC at Time 1, and (c) 63 (0.5%) who reported onset of BC between Time 1 and Time 2. Repeated measures analysis of variance was used to compare the 3 groups. Women with recent onset of BC experienced significant changes across a range of functioning compared with the other 2 groups. Compared with women with no BC, women with longer established onset of BC had significantly worse health and social outcomes, but these were associated with small effect sizes. Both groups of women with BC reported less impact on mental and emotional health than on other areas of functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Nutritional Screening Initiative: meeting the nutritional needs of elders

Nutritional factors are associated with at least 5 of the 10 leading causes of death in the United States. Older persons are especially vulnerable for nutritional problems, usually resulting from inappropriate (usually inadequate) intake of nutrients or increased need for nutrients. Nutritional assessment and interventions are sometimes overlooked in the focus on more complicated medical care. Yet there are many ways in which nurses can intervene to improve patients' nutritional status. One resource for organizing nutritional assessment and interventions is the Nutrition Screening Initiative. This multidisciplinary initiative provides useful guidelines and tools for assessing nutritional status and for planning the most appropriate interventions.     

创新是企业的灵魂

在经济全球化的形势下，企业发展的关键在于创新．企业的生产、研发与经营系统都要有利于技术创新．企业需要制定正确利益分配制度、正确处理人才和资本的关系，采用创新战略应对经济全球化带来的挑战和机遇．