Legal abortion in Denmark during the past 25 years: aspects of public health and ethics

The present study was designed to investigate the relationship between self-reported oral handicap as measured by socio-dental indicators and both dental state and felt need for dental treatment in a group of frail and functionally dependent older adults. A total of 263 housebound adults over the age of 60 years were investigated with regard to their self-reported dental handicap using the socio-dental indices derived by Locker (Community Dent Health 1992;9:109-24). Of these, 117 were in long-stay residential facilities, 67 in sheltered housing and 79 in private housing. The majority were female (76%) and the largest age group comprised 81-90-year-olds (44%), while only 8% were in the youngest group of 60-70-year-olds. A high level of handicap was recorded. In the previous 4 weeks, 74% of the group experienced difficulty in chewing, 54% some other functional handicap, 22% oral pain, 72% some incident of discomfort and 30% some social problem related to their oral condition. The socio-dental indices related more to the number of teeth than to age or gender. Ability to chew five index foods was related directly to the number of teeth present (P<0.001) but unless there were more than 20 teeth present, subjects with natural teeth were more dissatisfied with their appearance than those with complete dentures (P=0.002). The 57 subjects (29%) who expressed a desire for treatment had significantly higher handicap scores (P<0.001). Thus the results indicate that there are high levels of oral handicap in frail and functionally dependent older adults that are related to both the number of natural teeth retained and desire for treatment.     

Cognitive strategies, expectancy, and coping style in the control of pain.

Measures of tolerance, self-reported pain threshold, and overall discomfort of cold-pressor pain were obtained from 114 male undergraduates in a pretest–training–posttest experiment. Training consisted of brief practice in 1 of 4 cognitive strategies: rational thinking, compatible imagery, incompatible imagery, and task-irrelevant cognition. Analyses of covariance indicated that (a) cognitive-imaginal strategies facilitated endurance of pain and raised self-reported threshold, (b) rational thinking and compatible imagery were generally the most effective treatments, (c) expectancy alone was not a significant pain-attenuating factor, (d) treatments did not affect discomfort ratings, and (e) individual differences in imaginal ability and coping style did not correlate with changes in any of the dependent measures. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of patient-controlled transcutaneous electronic nerve stimulation (TENS) to decrease the discomfort of regional anaesthesia in dentistry: a randomised controlled clinical trial

OBJECTIVE: To compare the use of topical anaesthesia and transcutaneous electronic nerve stimulation (TENS) as means of reducing the discomfort of inferior dental block injections. METHODS: One hundred adult dental patients received 2% lignocaine with 1:80,000 adrenaline for long buccal and inferior dental block anaesthesia. The long buccal injections were given first with no prior mucosal preparation. Patients received inferior dental blocks after one of the following mucosal preparations: (1) no pretreatment; (2) a 2 min application of 20% benzocaine topical anaesthetic; (3) application of patient-controlled TENS at the injection site. Patients scored injection discomfort after each administration on a 100 mm visual analogue scale. RESULTS: The discomfort of the long buccal injection did not differ between the three groups of patients (F2,97 = 1.0). There were significant differences in the pain scores for the inferior dental block injections (F2,97 = 5.3; p < 0.01). Injection discomfort following TENS was less than that following no pretreatment (p < 0.01) and after topical anaesthetic application (p < 0.05). The use of topical anaesthesia did not produce a significant change in injection discomfort compared with no pretreatment. CONCLUSION: The use of TENS reduces injection discomfort during inferior dental block anaesthesia.     

Type II diabetics with macrovascular complications: polymorphonuclear leukocyte (PMN) filtration, PMN membrane fluidity and cytosolic Ca2+ content after activation

OBJECTIVE: To perform a sensitivity analysis using a decision model for simulating opportunistic screening for oral cancer and precancer in order to obtain an estimate of health gain from screening high risk dental patients, identified with the aid of artificial intelligence. DESIGN: A hypothetical opportunistic screening programme based on preselection of high risk patients was compared with screening all eligible patients and with a 'do nothing' scenario. The basic assumptions and data used in the model have been described previously. SETTING: Screening would be carried out in dental practices. PARTICIPANTS: A notional population of 100,000 adults of average age 55 years and 20 years life expectancy. INTERVENTIONS: Systematic clinical examination of the oral mucosa of high risk individuals identified by artificial intelligence on the basis of personal characteristics and life style. OUTCOME MEASURES: QALYs and equivalent lives saved RESULTS: The following estimates of health gain were obtained: the preselected screened group (n = 25,000) would achieve 1,993,294 QALYs. Without preselection, screening an unselected population of 100,000 eligible adults would result in 1,993,094 QALYs. Under the 'do nothing' scenario, 100,000 unscreened individuals would achieve 1,992,982 QALYs. Selective screening could avoid the equivalent of 15 deaths per 100,000 subjects examined. Screening preselected subjects at heightened risk would save the equivalent of two to three times the number of healthy lives compared with non-selective screening. Only one quarter of the population would need to be examined. CONCLUSIONS: Opportunistic screening of preselected dental patients for oral cancer and precancer appears to be a promising health promotion strategy and should be subject to formal economic appraisal.     

Subjectively reported oral health status in an adult population

This study describes the subjectively reported oral health status of an adult population aged 18 yr and over. The study used measures of the functional, social and psychological impact of oral disorders, originally developed for surveys of older adults, and aimed to determine whether or not they were sensitive to the oral health concerns of younger adults. It compared four age groups (18-29 yr; 30-49 yr; 50-64 yr; 65 yr and over) in terms of the following subjective oral health indicators: ability to chew, problems speaking, oral and facial pain; other oral symptoms; problems eating; problems with communication-social relations; limitations in activities of daily living and worry and concern. The initial hypothesis that few younger subjects would report the kinds of problems documented by these indicators was not supported. On all measures except ability to chew, younger subjects were as likely to be compromised by oral conditions as older subjects.     

Electrochemical assay of proteinase inhibitors using polycation-sensitive membrane electrode detection

OBJECTIVE: Past research has shown response biases to influence the accuracy of results from self-report measures. In pain assessment, where a percentage of patients have financial and other reasons to minimize or exaggerate psychological disturbance, it becomes especially important to identify the influence of response bias in self-report of adjustment. This study investigated the susceptibility of three commonly used self-report pain assessment measures to response bias. DESIGN: This study used a within-subjects (asymptomatic subjects) design with two experimental conditions and nonequivalent control group (chronic pain patients). SUBJECTS: Experimental group: 40 students enrolled in an occupational therapy program at a major southeastern United States university. Control group: 200 subjects referred to a multidisciplinary pain clinic at a major teaching hospital. MEASURES: Coping Strategies Questionnaire, Multidimensional Pain Inventory, and Pain Beliefs and Perceptions Inventory. RESULTS: With few exceptions, asymptomatic subjects scored significantly differently on these measures while portraying themselves as either coping well or coping poorly. In addition, when using the "coping poorly" response set, asymptomatic subjects reproduced scores similar to those of symptomatic chronic pain patients. CONCLUSION: The susceptibility to manipulation appeared constant across the three measures, a finding that highlighted the difficulties clinicians and researchers encounter in accurate interpretation of results from these measures in the absence of validity indicators. This study also emphasizes the ease with which subjects with sufficient motivation can present themselves in an untruthful and manipulative manner and can generate scores that are, on their own, difficult to distinguish from those of a group of typical chronic pain patients.     

Heredity links natural hazards and human health: Apolipoprotein E gene moderates the health of earthquake survivors.

Objective: This study aimed to investigate the role of the apolipoprotein ε4 allele in moderating the influence of an exogenous stressor, an earthquake, on health. Design: A “natural experiment” design was used where the interaction between the presence of the apolipoprotein ε4 allele and the level of subjective and objective exposure to a devastating earthquake was examined in a population-based cohort of elderly Taiwanese (N = 718). Main Outcome Measures: The cognitive-affective dimension of health was assessed by measures of perceived control and depression and functional limitations were assessed using measures of instrumental activities of daily living and mobility. Overall health status was gauged using a single-item measure of self-rated health. Results: Those who experienced damage to their property or were forced to move from their homes (high objective exposure) demonstrated low levels of self-rated health and somewhat lower perceived control a year later, only if they were apolipoprotein ε4 carriers. Similarly, those who found the earthquake severely distressing (high subjective exposure) were shown to have low levels of functioning and low self-rated health a year later, only if they possessed the ε4 allele. Conclusion: Our findings suggest that genetic variation in the apolipoprotein E gene may modify the health effects of the exogenous stress of natural disaster exposure. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Affects separable and inseparable: On the hierarchical arrangement of the negative affects.

D. Watson and A. Tellegen (1985) proposed a hierarchical model of self-rated affect in which 2 broad, general dimensions (negative affect [NA] and positive affect) are each composed of several correlated yet ultimately distinguished emotions. As a partial test of this model, 4 studies examining relations among measures of fear, sadness, hostility, and guilt through a series of multitrait–multimethod matrixes were conducted. Consistent with a hierarchical model, all 4 NAs showed significant convergent validity and adequate discriminant validity, indicating that they represent meaningful and differentiable psychological constructs. However, the measures were also consistently and substantially interrelated, thereby demonstrating the existence of a strong higher order NA factor in self-report data. Results demonstrate the importance of assessing both levels of the hierarchical structure in studies of self-rated affect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A proposed 30-45 minute 4 page standard protocol to evaluate rheumatoid arthritis (SPERA) that includes measures of inflammatory activity, joint damage, and longterm outcomes

A proposed 4 page, 30-45 minute standard protocol to assess rheumatoid arthritis (SPERA) is described that includes all relevant measures of inflammatory activity such as joint swelling, measures of joint damage such as joint deformity, and outcomes such as joint replacement surgery, to monitor patients in longterm observational studies. Forms are included: (1) a patient self-report modified health assessment questionnaire (MHAQ) to assess function, pain, fatigue, psychological distress, symptoms, and drugs used; (2) assessor-completed forms: "RA clinical features" --criteria for RA, functional class, family history, extraarticular disease, comorbidities, joint surgery, radiographic score, and laboratory findings. (3) A 32 joint count with 5 variables: (a) a "shorthand" normal/abnormal so that normal joints require no further detailed assessment; (b) tenderness or pain on motion; (c) swelling; (d) limited motion or deformity; (e) previous surgeries; physical measures of function, i.e., grip strength, walk time, and button test. (4) Medication review of previous disease modifying antirheumatic drugs (DMARD), work history, and years of education. The forms allow cost effective acquisition of all relevant measures of activity, damage, and outcomes in routine clinical care, and allow recognition that measures of activity may show similar or improved values over 5-10 years, while measures of damage and outcomes indicate severe progression in the same patients. The SPERA is feasible to acquire most known relevant measures of activity, damage, and outcomes in RA in 30-45 min in usual clinical settings, to provide a complete database for analyses of longterm outcomes.     

Investigating the relationship between pain and discomfort and quality of life, using the WHOQOL

The aim of this study was to examine the impact of pain on quality of life and its components in a representative sample of 320 well people, and patients selected from all major categories of illness. Quality of life was assessed using a new, multidimensional, multilingual, generic profile designed for cross-cultural use in health care, i.e. the WHOQOL. Within the WHOQOL, pain and discomfort is one of 29 areas or facets of quality of life, grouped into six domains. It was found that pain and discomfort made a significant impact on perceptions of general quality of life related to health. Furthermore, the presence of pain affected perceptions of five of the six domains of quality of life; the domain of spirituality, religion and personal beliefs being the exception. When quality of life is assessed, negative feelings are most closely associated with reports of pain and discomfort than any other facet. But quality of life surrounding pain and discomfort is more fully explained by the inclusion of six additional facets; the availability of social care, mobility, activities of daily living, positive mood and to a lesser extent, sleep and dependence on medication. Together, these seven facets represent criteria against which the success of pain treatments may be evaluated. As predicted, those who were pain-free had significantly better quality of life than those in pain. A longer duration of pain is associated with increasingly poorer quality of life. Intense affective pain is particularly detrimental to a good quality of life. The psychometric properties of the pain and discomfort facet of the WHOQOL and WHOQOL-100 were assessed. Internal consistency (reliability), discriminant and criterion/concurrent validity were found to be good to excellent, justifying the use of this instrument with a range of chronic and acute pain patients.     

Development and validation of a multidimensional scale of perceived work-family positive spillover.

Although the benefits of participating in both work and family have been recognized for more than 30 years (Sieber, 1974), limited empirical research exists. One reason for this oversight is the absence of a well-established scale to measure these benefits. We present a new multidimensional scale of perceived work-family positive spillover. We conducted two studies that aided the development and validation of this scale. Our scale measures three types of work-family positive spillover: behavior-based instrumental positive spillover, value-based instrumental positive spillover, and affective positive spillover. Each of these three types of positive spillover occurs in two directions: from work to family and from family to work. We further evaluate the scale's construct validity in relation to role satisfaction and self-reported mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development and validation of a questionnaire designed to measure foot-health status

The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.     

Clinical results and perceived health among patients with hip prosthesis

BACKGROUND: Assessment of total hip replacement has been performed without careful attention to the patients' perceived health. The objective of this study is to assess, in a standardized way, the benefit of hip replacement in terms of hip pain, mobility, and function and as an increase in general perceived health. And to quantify clinical complications of the procedure. PATIENTS AND METHODS: Observational study of a series of 131 consecutive patients of a tertiary hospital to whom two health questionnaires (one specific and the other generic) were administered before and one year after total hip replacement. The specific instrument, the Hip Pain and Function (HPF) scale, measures the functional capacity of the hip gathering information on pain, function and mobility. Scores for the HPF range from 0 (maximal limitation of functional capacity) to 85 (no limitation). The generic instrument used, the Nottingham Health Profile (NHP) measures perceived health and scores range from 0 (best health status) to 100 (worse). RESULTS: Mean age of patients was 63 years; ostheo-arthritis was the most frequent diagnosis (78%), with 42% of the patients with associated pathology. An improvement in both hip functional capacity and perceived general health was observed after one year. HPF scores increased from 26.6 at baseline to 69.9 (p < 0.001). Improvements was important and statistically significant in each of the three dimensions of the specific instrument: Pain, Function and Mobility. Overall score for the NHP changed from 50.9 (at baseline) to 18.1 (p < 0.001). Regression analysis showed only two variables associated with improvement: a higher improvement hip function for patients with no other joints affected; and a higher improvement of perceived health in patients over 70 years with cemented prosthesis, that had a worse initial perceived health status. CONCLUSION: Total hip replacement decreases pain and significantly improves hip mobility and function, as well as the general perceived health. The improvement of perceived health was higher in patients over 70 years.     

Toward the formulation of sociodental indicators

The bases for the construction of sociodental indicators is discussed in the paper, considering several available indexes of oral health status (dental caries, periodontal disease, malocclusion, oral hygiene, and other oral conditions) as well as measures of quality of services. Very little research exists relating any of the above measures to social indicators such as personal life-style or cultural and ecological factors. Such expansion would enable dental indicators to be useful for purposes of policy decisions. Combining any dental indicators or set of indicators with a potential global social health index is discussed in terms of potential problems obscuring dentistry's cost to society. Dentistry, in addition, is offered as a system in microcosm-one which can be useful for purposes of polishing methodology for the social health indicator movement.     

Validity of self-reports of alcohol and other drug use: A multitrait-multimethod assessment.

Used 4 methods (self-reported rating, self-reported intake, peer-reported rating, and peer-reported intake) and multiple analytical criteria to assess the construct validity of reports of 3 types of substance use (alcohol, marihuana, and cigarettes) in a study of 194 college students who were members of friendship pairs. Ss answered questions about their own use and their friend's use of substances, classified their own and their friend's use of each substance according to 6 categories, and completed scales measuring the negative consequences of marihuana and alcohol. The resulting multitrait-multimethod matrix was analyzed in the traditional fashion as well as with confirmatory factor analysis. Convergent and discriminant validity for the 3 substance use traits were quite adequate, although the validity of the peer-reported intake measure of alcohol use may be considered inadequate according to some criteria. Results demonstrate the usefulness of multimethod assessment and confirmatory factor analysis for research on construct validity and for derivation of more accurate measures of drug use. (47 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measures of functional status in community-dwelling elders

OBJECTIVE: To evaluate two performance-based measures of functional status and assess their correlation with self-report measures. DESIGN: Cross-sectional study. PARTICIPANTS: Of the 363 community-dwelling elders enrolled in a trial of comprehensive geriatric assessment who participated, all had at least one of four target conditions (urinary incontinence, depression, impaired functional status, or history of falling). MEASUREMENTS: Two performance-based measures, National Institute on Aging (NIA) Battery, and Physical Performance Test (PPT), and three self-report functional status measures, basic and intermediate activities of daily living and the Short-Form-36 (SF-36) physical functioning subscale, were used. Measures of restricted activity days, patient satisfaction and perceived efficacy were also used. MAIN RESULTS: All measures were internally consistent. There was a high correlation between the NIA and PPT (kappa = 0.71), while correlations between the performance-based and self-report measures ranged from 0.37 to 0.50. When patients with values above the median on the two performance-based measures were compared with those below, there were significant differences (p 相似文献   

Cell behavior and signal molecule involvement in a case study of malignant histiocytosis: a negative model of morphine as an immunoregulator

OBJECTIVE: This paper identifies specific data items for use by state and local agencies in a maternal and child oral health needs assessment model. METHODS: A modified Delphi approach was used to develop consensus on items for inclusion in the data set and their relative importance. Initially, 31 data items were chosen from several national sources. All state dental directors, along with other selected administrators and advisory committee members for this process, were asked to categorize each of the data items as core (essential), important but optional, or of lesser importance. Short comments about each data item were accepted, as were additions to the list of data items. Two rounds of comments were held. RESULTS: Eleven data items/types of information were selected as core items to be included in all needs assessments. All but one of these items were determined by the scores of the respondents. The advisory committee strongly recommended that at least one core item relate to the public's perception of oral health. Some differences in perceived importance of several items existed among the state dental directors, local dental directors, and the advisory committee. Twenty-one items were identified as being important, but optional, and seven were considered less than important and not included in the model data set. CONCLUSIONS: A modified Delphi approach facilitated the development of core and optional data items for a model oral health needs assessment. This model has potential for a common reporting mechanism so that states and local dental programs can share data.     

Construct validity of interpersonal personality measures: The interpersonal circumplex as a nomological net.

To understand a construct means to set it within an appropriate "nomological net" of lawful relations. For measures of interpersonal constructs, the interpersonal circumplex provides a nomological system of great potential for validating constructs and their measures. Three multidimensional measures (dependency, empathy, and narcissism) were subjected to an interpersonal analysis, and construct parameters and similarities were estimated by using formulas derived from the circumplex model. The results offer a distinctly interpersonal perspective on the construct validity of the respective measures. Expanded uses for the interpersonal circumplex are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)