The effectiveness of a new method for assessing induration

OBJECTIVE: To examine the correlation among the National Board of Medical Examiners subject examination, the US Medical Licensure Examination step 1 scores, and grade point average and to determine if poor performance could be predicted by the US Medical Licensure Examination step 1 score and grade point average. METHODS: The subject examination scores of 148 third-year medical students were compared with their US Medical Licensure Examination step 1 scores and grade point averages. Scores below the 20th percentile were defined as poor performance. RESULTS: There was a significant correlation between the US Medical Licensure Examination score and the subject examination score (r = .6, P < .001). The correlation with grade point average was also significant (r = .57, P < .001). CONCLUSION: The US Medical Licensure Examination step 1 performance, grade point average, and performance on the subject examination are all correlated. However, use of the US Medical Licensure Examination step 1 scores and grade point averages to identify all students at risk was associated with a high false-positive rate at our institution.     

Studies on the role of urinary macromolecules in urolithiasis: review of methodologies and a proposal for a standard reference crystallization system

In this study, urine from a calcium oxalate kidney stone former was ultrafiltered (10 kD cut-off). Crystallization was induced in the ultrafiltrate and retentate fractions as well as in a sample of the whole urine. The progress of crystallization was monitored by Coulter Counter and flow cytometry techniques. (The latter has not been used in studies of the role of urinary macromolecules in urolithiasis). Deposited crystals were examined by scanning electron microscopy. Results indicated that urinary macromolecules in this subject are inhibitors of nucleation and aggregation. These results agree with the findings of some workers but disagree with those of others. Indeed, studies on the role played by urinary macromolecules in promoting or inhibiting urolithiasis have failed to produce consistent findings. Examination of the literature reveals that a wide variety of experimental techniques and crystallization systems have been used in these studies and that this might be the cause of the inconsistencies. Based on reported experiences and those of the present study, a standard reference crystallization system is proposed. The key elements of this system involve the use of real urine, ultrafiltration, continuous crystallizer equipment, Coulter Counter procedures and scanning electron microscopy.     

Experimental aneurysms: proposal for a new technic

The authors present a critical analysis of the various methods of experimental production of aneurysms and report their own method in which saccular aneurysms were produced at the bifurcation of the common carotid artery in dogs with vein patch grafts. The objective point of this study was the creation of an experimental model to evaluate the efficacy of a therapeutic procedure. These aneurysms have a low incidence of thrombosis and a tendency to enlarge and to become spherical. They closely simulate the saccular aneurysms developing spontaneously in the cerebral arteries of man, and as such are useful models for experimental purposes.     

Measuring causal attributions for success and failure: A comparison of methodologies for assessing causal dimensions.

This study evaluated the reliability and validity of three commonly used procedures for assessing the dimensional properties of causal attributions for success and failure. These methods of assessment were based on open-ended attributions for performance, importance ratings of different causes of success and failure, and the attributor's perception of his or her causal attribution for performance as assessed by the Causal Dimension Scale. Data were collected on causal attributions, expected and actual performance, subjective evaluations of performance, and affective reactions from a group of students before and after their midterm examination. Analyses were conducted to evaluate the reliability, convergent and discriminant validity, and construct validity of the attribution measures. The results generally supported the use of the Causal Dimension Scale over the other methods of assessing causal dimensions. Implications of these findings for attribution research and possible improvements in the Causal Dimension Scale are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A proposal for a new direction to treat cancer

A new approach is proposed that has the potential to be a successful therapy for most disseminated cancers because it can circumvent the problems posed by three characteristics which are universally expressed by cancer cells: heterogeneity, plasticity, and the lack of a cancer specific or cancer associated characteristic which is not also shared by some normal cells. Analysis shows that almost all current and research approaches for treating disseminated cancers have the same fundamental strategy: they rely on an agent interacting individually and effectively with each cancer cell. We call all these approaches "lock and key" strategies to emphasize the need for this individual agent to cell interaction. The three characteristics preclude current approaches from successfully treating most disseminated cancers because they operate by a "lock and key" strategy which (a) only kills cancer cells expressing a single particular trait, (b) allows other cancer cells to adapt and survive the treatment, and (c) also kills the normal cells which express the same particular trait. The heterogeneity and plasticity of cancer cells can only be circumvented by an attack which is microregional (not cell by cell) and destructive (not killed by conventional endogenous or exogenous cytotoxic agents). All cells in each microregion must be destroyed, including those which do not express an exploitable trait. The proposed approach can achieve such microregional destruction by the delivery to, and long term immobilization of, a large number of radio-isotopes. The proposed approach exploits the additive contribution of multiple mechanisms to enhance tumor specificity of the microregions. Given that all targeting and killing agents are "imperfect", this is the only way specificity can be enhanced. The biological basis of these specificity enhancing mechanisms are well-known. However, they are ignored by current therapies because most of them can only be exploited in the context of the proposed approach. Some of the mechanisms reflect characteristics, such as heterogeneity, genetic instability, and tumor progression which are the result of the micro-evolutionary process of tumor development. These are virtually always present in, and virtually specific to, cancer. Others reflect the somewhat "imperfect" cancer associated characteristics of structures, including cancer cells, extracellular structures, and non-malignant cells within the tumor mass. The additive contribution of the multiple mechanisms gives the process the potential to destroy all the cancer cells with minimal non-tumor toxicity. The cornerstone of the proposed approach is a novel class of soluble chemicals. They can be administered intravenously to subjects, circulate throughout body fluids and are enzymatically converted into an insoluble material when the chemicals reach targeted sites. In this paper, these chemicals are called "soluble precipitable reagents" (SPR) to describe their ability to be converted from a soluble to an insoluble material. The insoluble material is called platform to indicate that it has the ability to bind various agents. The SPR chemicals enable a three-step process to be constructed which can deliver and retain a large number of radio-isotope atoms in tumor tissue. In step 1, a binary reagent comprised of an SPR attached to an imperfect cancer targeting agent is administered. The binary reagent is endocytosed and transported into lysosomes where the targeting agent moiety is digested and the detached SPR is converted by natural intracellular lysosomal enzymes into a platform. As will be discussed, a very large number of platform molecules can be made to accumulate inside targeted cells. In step 2, a supersensitive fraction of the cancer cells, including some which had accumulated platform in step 1, are killed by the administration of a very low dose of an anti-cancer agent. Very few, if any, normal cells will be killed by the very low dose. The death of the ce     

The challenge of environmental psychology: A proposal for a new functionalism.

Argues that the hardship conditions under which man evolved put a high premium on rapid and efficient information handling. Currently maladaptive behavior with respect to overpopulation and environmental decline may be in part the result of an inadequate conception of what the future holds. The missing knowledge is unlikely to be verbal. Substitutes for experience that enhance imagery of alternative futures may be pivotal. A few of the multitude of researchable topics that arise in this context are presented. It is concluded that a broad functional psychology could find much to learn, study, and contribute in the environmental area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new method for assessing the interpersonal behavior of psychopathic individuals: Preliminary validation studies.

Two studies examined whether increased attention to interpersonal behaviors would improve assessments of the personality core underlying psychopathy. After item analysis, 21 items measuring interpersonal interactions and nonverbal behaviors associated with psychopathy were retained as the Interpersonal Measure of Psychopathy (IM-P). Federal prison inmates (Study 1, N?=?98) and undergraduates (Study 2, N?=?92) were rated on occurrence of these behaviors during an interview conducted to complete either Hare's Psychopathy Checklist—Revised (PCL-R) or Psychopathy Checklist: Screening Version (PCL: SV). In both studies, IM-P scores correlated more highly with PCL Factor 1 than with PCL Factor 2 scores. Regression analyses indicated that, after controlling for demographic variables and PCL factor scores, IM-P scores predicted interviewer emotional responses and participants' adult fighting (Study 1) and ratings of participants' interpersonal dominance (Study 2). Thus, measurement of interpersonal behavior appears to permit improved prediction of several criteria linked to the personality core of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Culture and health-related schemas: A review and proposal for interdisciplinary integration.

Presents a comprehensive review of anthropological, sociological, and psychological theory and data on the structure, content, and function of health-related schemas. Health psychology's need to integrate specific variables and principles from the other disciplines is highlighted. The importance of cultural factors in health beliefs is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A review of instruments for assessing family history

The influence of family history on one's development has long been a focus of psychological theory, research, and practice. In recent years, however, conceptualizations of family influences on development have evolved considerably, and there has also been increased concern about the reliability of individuals' memory for their childhoods in general. Current knowledge regarding these and other issues are applied to reviewing the instruments that have been developed to assess aspects of family history. The complexity of this type of assessment is emphasized, and a variety of problems with the reliability and validity of the currently available instruments are discussed. Suggestions for future research are also offered.     

A review of the groupware literature: Theories, methodologies, and a research agenda.

This paper brings the groupware literature to the attention of researchers and practitioners in order to validate it in terms of delivering computer technologies that actively facilitate groups of collaborating users. It reviews the theoretical perspectives and assumptions of group performance that are driving the present research. Also, the extant literature and outcome measures will be reviewed with an emphasis on the type of research conducted. The authors found that the theoretical frameworks used in the groupware research do not reflect recent developments in Industrial-Organizational Psychology (e.g., groupware research does not generally include critical contextual variables). Based on this review, the authors propose a comprehensive and integrated research agenda for future work in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multisystemic therapy for child abuse and neglect: A randomized effectiveness trial.

The primary purpose of this study was to conduct a randomized effectiveness trial of Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) for physically abused youth (mean age = 13.88 years, 55.8% female, 68.6% Black) and their families. Eighty-six families being followed by Child Protective Services due to physical abuse were randomly assigned to MST-CAN or Enhanced Outpatient Treatment (EOT), with both interventions delivered by therapists employed at a community mental health center. Across five assessments extending 16 months post baseline, intent-to-treat analyses showed that MST-CAN was significantly more effective than EOT in reducing youth mental health symptoms, parent psychiatric distress, parenting behaviors associated with maltreatment, youth out-of-home placements, and changes in youth placement. Also, MST-CAN was significantly more effective at improving natural social support for parents. Effect sizes were in the medium to large range for most outcomes examined. Although fewer children in the MST-CAN condition experienced an incident of reabuse than did counterparts in the EOT condition, base rates were low and this difference was not statistically significant. The findings of this study demonstrate the potential for broad-based treatments of child physical abuse to be effectively transported and implemented in community treatment settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Opisthorchiasis control in northeast Thailand: proposal for a new approach

In a prospective study 102 patients with malignant tumors of the tongue, oropharynx, hypopharynx, and larynx were staged by means of MRI. Special attention was directed at those tumour extensions that could influence the treatment strategy. The MR findings were correlated with the results of palpation, endoscopy, ultrasound, computerised tomography and histopathological findings. MRI showed a good delineation of pT2 to pT4 tumours. However, visualisation of small tumours in the soft palate, the tonsils, the pyriform sinuses and vocal cords was difficult. In conclusion our results suggest that in addition to endoscopy MRI is a valuable tool for the examination of tumours of tongue, oropharynx, hypopharynx and larynx.     

A prospective comparison of four study designs used in assessing safety and effectiveness of drug therapy in hypertension management

The objective of the study was to compare prospectively the impact of study design on drug therapy safety and effectiveness data obtained in hypertension management. The main study was a randomized controlled clinical trial of four different prospective study designs used in postmarketing assessment involving 1008 primary care practices in nine Canadian provinces. Two thousand nine hundred sixty-four patients with mild to moderate hypertension received an angiotensin converting enzyme (ACE) inhibitor daily for 14 weeks in one of four postmarketing studies--a randomized double-blind clinical trial (RCT) (10 to 40 mg fosinopril daily v 5 to 20 mg enalapril daily), two structured open label trials of 10 to 40 mg fosinopril daily (one with free drugs), or an unstructured open label trial of 10 to 40 mg fosinopril daily. Patient demographic and baseline characteristics, systolic and diastolic blood pressures, adverse events reported, and data quality were recorded as the outcome measures. The results showed that the RCT patients were titrated to higher doses of ACE inhibitor than patients in the open studies, P < .008; patients in the open studies were more likely to receive adjuvant diuretic therapy, P < .008. The decrease in blood pressure was similar for patients in all four studies, mean decrease in systolic BP was between 18 and 20 mm Hg, mean decrease in diastolic BP was between 11 and 13 mm Hg. Fewer patients in the unstructured open trial reported adverse events than patients in the RCT; a 55% relative reduction in reported adverse events (P < .008) was associated with the unstructured trial. There were also fewer drug-related adverse events per patient reported in the unstructured study (17 per 100 patients) than in the other studies (27 to 41 per 100 patients), P < .008. Physician preference for rounding off blood pressure measurements to 0 or 5 occurred most often in the unstructured open trial (P < .008). In conclusion, despite differences in dose titration and in the use of adjuvant therapy, antihypertensive drug therapy effectiveness observed in an RCT may be similar to uncontrolled postmarketing studies. Open trials with scheduled follow-up visits are as effective in detecting severe adverse events as RCT, but postmarketing studies with unstructured schedules of follow-up are insufficient in identifying drug-related adverse events and have poorer quality data.     

A proposal for a new (third) genus within the family Adenoviridae

This article presents a proposal for the establishment of a new adenovirus genus to accommodate certain bovine, ovine, and avian adenoviruses with special characteristics which differentiate them from members of the existing genera Mastadenovirus and Aviadenovirus. This proposal has been developed from earlier versions with advice from the Adenovirus Study Group of the International Committee on Taxonomy of Viruses (ICTV).     

A review of methods and instruments for assessing externalizing disorders: theoretical and practical considerations in rendering a diagnosis

This review addresses the most current and widely used methods of assessing childhood and adolescent externalizing disorders. Interviews, rating scales, and self-report instruments are described, and their strengths and weaknesses are discussed. Direct observational techniques in naturalistic and analogue settings are also reviewed. Throughout the article, commentary is offered regarding the psychometric adequacy and clinical validity of these instruments. It is suggested that, although the instruments presently used to assist in diagnosing externalizing disorders generally possess adequate reliability and representational validity, evidence of elaborative validity is lacking. Clinicians and researchers are encouraged to adopt a broader conceptualization of the diagnostic process, to question existing standards for establishing validity, and to consider alternative means of demonstrating diagnostic utility.