Gender differences in fears related to coronary arteriography

OBJECTIVE: To compare levels of fear and the intensity of specific fears in women and men related to coronary arteriography (CA). DESIGN: Prospective survey. SETTING: A 1360-bed university hospital. Data were collected before, during, and after CA, and again 6 months later. SUBJECTS: The sample consisted of 54 women and 166 men undergoing scheduled CA. METHODS: To compare fear levels at different points of evaluation; two analyses of covariance for repeated measures were performed. RESULTS: On average, women had significantly higher mean scores of fear across the points of evaluation on the Visual Analogue Scale than men (P <.001). During the hospital stay, the most intense fear for both women and men was the fear of coronary artery bypass grafting and the uncertainty about the illness, whereas at home it was the fear of myocardial infarction. On average, women reported significantly intense fears more frequently than men across time. On average, men experienced more intensive fear of problems in their sex life than women (P =. 032). The changes in intensity of fears over time were not significantly different by gender, except in fear of pain (P =.013), health care staff not having enough time to care for the patient (P =.039), and health care staff discussing the patient's condition without the patient being present (P =.048). Age and prior CA were found to be significantly related to most of the fears at different points of evaluation, and to the changes of fears over time. CONCLUSION: There existed differences in the tendency to report intensity of fears by gender; however, the intensity of fears changed in a similar way over time. The results suggest that the few gender differences in fears that existed may be explained by the treatment chosen for the patients and the patients' acceptance of it. Therefore, it is important to adapt information and support according to the treatment chosen for the patient.     

The ability to perceive duration: Its relation to the development of the logical concept of time.

Seventy-two children, ages 34 to 73 months, were presented with one of six different relative duration problems that involved judging which of two lights was on longer. In addition to the traditional 4- versus 7-s duration condition, each child was tested on a long (4- vs. 28-s) and a short (1- vs. 7-s) condition. Two of the problems were logically impossible to solve on the basis of nontemporal cues. Results showed that, contrary to predictions based on standard models of the logical time concept, long and short conditions were easier for children to solve than the traditional 4- versus 7-s condition. Furthermore, children were able to solve problems that are logically impossible to solve on the basis of nontemporal information. These results indicate that children have a perceptual experience of duration separate from one derived inferentially from nontemporal knowledge (e.g., start/stop relationships, speed, distance, and brightness) and that they can use this perceptual knowledge to solve relative duration problems. This suggests that the logical time concept involves the capacity to experience duration perceptually and that models of the time concept that do not acknowledge such a capacity (e.g., Piaget's) must be reassessed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring impact of nursing intervention on cancer patients' ability to control symptoms

Cancer patients' ability to control symptoms and to maintain reasonable quality of life is limited due to lack of knowledge, guidance, and instructions from health care providers, who usually refrain from transferring responsibility for the treatment to the patient. The present study describes a measured effect of a structured nursing intervention in which nurses were trained to apply the self-care model to 48 ambulatory cancer patients under chemo- or radiotherapy or both. The intervention included 10 structured home visits to each patient during 3 months, in which the nurse assessed symptoms and advised, guided, supported, and educated the patient in the relevant areas. The symptoms were quantitatively assessed using the Symptom Control Assessment (SCA) instrument, which was developed and validated specifically for this study. The SCA relates to 16 signs, symptoms, and complaints that encompass both the universal and the deviation-from-health needs, in addition to anxiety, body image, and sexuality. The instrument allows either the patient or the nurse to rate the severity of the complaint, the patient's independence in controlling it, the patient's perception of the familial and external help extended to him or her, and the knowledge of the symptom and its control possessed by the patient. Also, the SCA allows comparing the patient's ratings with the professional view of the visiting nurse. The SCA was proven to be a highly reliable and valid instrument. The results indicate that the intensity of the complaints decreased in the experimental group during the 3-month period while they increased in the matched control group, creating a considerable difference between the two groups on multivariate analysis of covariance (MANCOVA). On t-tests, significant improvement was found in 15 out of the 16 symptoms, including pain. The greatest reduction was found in the "psychosocial symptoms," namely anxiety, sociability, body image, and sexuality. Similarly, the patients' independence, knowledge, and perception of familial help increased in the experimental group and declined in the control group. Perhaps the most meaningful change was a significant increase in the ability of the experimental patients to assume responsibility for their own treatment as it is reflected by the increase of the independence ratings for all 16 symptoms. This is in sharp contrast to the decrease in 15 of the 16 symptoms among control patients. The results suggest that the self-care approach is effective also in improving the quality of life for unstable cancer patients by reduction of suffering and increase in controlling capabilities.     

Is susceptibility to distraction related to mental ability?

In order to assess the effects of individual differences in attentional focus on measures of mental skills, 272 university undergraduates were tested. Distractibility was determined in a speeded visual search task by comparing performance in the presence and absence of extraneous auditory and visual stimuli. Mental ability was measured using tests of crystallized intelligence and verbal ability. Although mental abilities were measured under normal (no distraction) conditions, high-distractible subjects on average were 9.4 percentile points lower than low-distractible subjects on the cognitive skills measures. This suggests that perceptual/attentional factors are an important aspect of measured intelligence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Towards a gold standard for quantitative coronary arteriography

Densitometric quantification of coronary artery stenoses in angiographic images can be problematic for two reasons: (i) the x-rays are inadequately oriented with respect to the vessel segments of interest at image acquisition; (ii) non-linear effects due for instance to beam hardening, scattered radiation and veiling glare may reduce the accuracy. As a consequence, appreciable discrepancies between degrees of stenosis measured in two different projections can occur. To overcome these limitations, we have designed and tested a combined correction that compensates (at subsequent analysis) for the error contributions due to the cited sources. It implies 3D reconstruction of the vessel segments of interest and consequently requires an appropriate biplane coronary angiogram. In experiments performed with a dedicated phantom, application of the correction improved the correlation between measured and true area reduction percentages (without correction: y = 1.04x - 4%, r = 0.97, SEE = 6%, n = 35; with correction: y = 1.02x - 0%, r = 0.99, SEE = 3%, n = 35). Applied to ten area stenoses measured biplane in patients and exhibiting strong interplane discrepancies, the correction had a comparable effect (without correction: y = 0.83x - 11%, r = 0.86, SEE = 9%, n = 10; with correction: y = 0.83x + 2%, r = 0.98, SEE = 4%, n = 10). The new densitometric method could possibly be used as a gold standard in the objective evaluation of geometric methods in patients.     

To perceive is to know.

"Perceiving is a cognitive process involving knowing, understanding, comprehending, organizing and even cognizing… . [The] factors known in perception are properties of sets of stimuli, not properties of individual stimuli (to say nothing of the elements which make up these individual stimuli)… . [Perceiving] is an active process, 1 in which the perceiver participates fully." The experiments cited illustrate "that to perceive is to know. It is to know and comprehend the nature of a stimulus; it is to know the nature of the alternatives to a stimulus; and it is to know the structure and organization of sets of stimuli." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective coronary arteriography. Risk in a community hospital

Over a 33-month period, selective coronary arteriography was performed in 627 consecutive patients in a 385-bed, non-university-affiliated community hospital. Mortality was 0.16% (one death); there was also one nonfatal myocardial infarction. No deaths or myocardial infarctions occurred in the last 369 consecutive patients in this series when routine systemic heparinization was introduced. Substantially greater risk of mortality (2.6%) and nonfatal myocardial infarction (2.6%) was encountered in an earlier series of 78 consecutive patients for whom a different protocol was used. It included extensive exercise hemodynamic studies with the use of percutaneous arterial angiographic catheters, without systemic heparinization. This indicates that coronary arteriography can be carried out with acceptable risk in a community hospital. Protocols should be designed to minimize the time that catheters are in the arterial system. Systemic heparinization may reduce the risk of procedure-related death and myocardial infarction.     

Spontaneous coronary artery perforation with tamponade. Demonstration by necropsy selective coronary arteriography

Pericardial tamponade in a 51-year-old man after acute anteroseptal myocardial infarction was the result of spontaneous perforation of an atheromatous coronary artery. The value of a simple necropsy technique of selective coronary arteriography in demonstrating the lesion is described.     

Two-dimensional intravenous coronary arteriography using above-K-edge monochromatic synchrotron X-ray

RATIONALE AND OBJECTIVES: For intravenous (i.v.) coronary arteriography, a real-time two-dimensional (2D) imaging system is being developed using above-K-edge monochromatic X-rays alone. The potential diagnostic value of this system was examined in the current study. METHODS: The angiographic system consisted of an asymmetric silicon (311) monocrystal, an image intensifier, and a charged-coupled device camera. It was constructed at the beam line of the Tristan Accumulation Ring. Monochromatic X-rays of 33.32 keV were used, and each image was recorded over 2 msec. RESULTS: Ventricular wall motion and the anatomy of the coronary arteries could be seen in dogs by sequential images obtained without subtraction. The left anterior descending coronary artery, left circumflex coronary artery, and right coronary artery and the branches of these vessels were observed. The parts of the coronary arteries overlapping the aorta and left ventricle were revealed somewhat during washout of the contrast material. CONCLUSION: For a 2D imaging system, monochromatic i.v. coronary angiography using an energy above the iodine K-edge might be able to image the coronary arteries without subtraction. However, the image quality needs to be improved by increasing the X-ray flux, decreasing background radiation scatter from the object, and decreasing contamination with 99-keV X-rays.     

Nurses' reactions to change

Some nurses adjust well to change, others do not. This study compares age, education, experience, and specialty as they relate to change behaviors of awareness, choice, freedom to act intentionally, and involvement in creating change. According to the study, nurses who are most influential in creating positive change are managers and educators.     

Is diagnostic ability related to relevant training and experience?

We examined the relationship of presumably relevant education and experience to the diagnosis of psychopathology, a relationship that has been elusive in earlier research. On the basis of the argument that earlier studies may have suffered from a restricted range of relevant education and experience (because most participants have been graduate students and practicing psychologists), we focused on participants at lower levels on these variables. Participants were undergraduate and graduate students in psychology with varying amounts of experience in working in a human service setting, and a few paraprofessionals. Accuracy of clinical diagnosis was measured via a test devised for that purpose; ratings of perceived severity of psychopathology were also obtained for the case histories used in the test. The results indicated that diagnostic accuracy increased significantly in the sampled population with relevant education and with relevant experience. Perceived severity of pathology displayed complex curvilinear relationships with amount of experience and with amount of presumably relevant education. The findings show that if lower levels of education and experience are sampled, a robust relationship between accuracy of diagnostic categorization and both relevant education and experience can indeed be demonstrated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Divergent thinking ability is related to faster relatedness judgments.

Creativity is commonly defined as the novel and useful combination of concepts previously thought to be unrelated. Fundamentally, this process rests on the ability to judge relatedness between concepts. The authors conducted an experiment to test the connection between divergent thinking ability and the speed of judging relatedness. Our results demonstrated that people with higher divergent thinking ability are faster in judging whether two concepts are related or unrelated. In real life, this can lead to a substantial advantage in the number of potentially useful relationships that could be assessed per unit of time. Equally important, there was no link between IQ and speed of judging relatedness. These results are interpreted in relation to a recently proposed model of creative cognition suggesting that creative people are faster in information processing under conditions of low ambiguity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dyslipidemia and coronary artery disease. Prevalence and treatment in patients referred for coronary arteriography

We report a case with adult respiratory distress syndrome (ARDS) associated with increased levels of squamous cell carcinoma-related antigen (SCC) in the serum and bronchoalveolar lavage fluid (BALF). ARDS was likely induced by ibuprofen, based on the presence of pancytopenia and a weakly positive drug lymphocyte stimulating test (DLST). High serum and BALF levels of interleukin (IL)-8, neutrophil elastase as well as SCC were detected. Corticosteroid therapy resulted in clinical improvement, resolution of pulmonary infiltrates on chest roentgenogram and normalization of serum and BALF levels of IL-8, neutrophil elastase and SCC.     

Arterial blood supply to a left artrial myxoma diagnosed by coronary arteriography: report of a case

A patient with left atrial myxoma is described. Selective coronary arteriography visualized a cluster of abnormal vessels representing the vascularization of the tumoral mass localized in the left atrium.