The causes, phenomenology, and consequences of hurt feelings.

One hundred sixty-four participants recounted situations in which their feelings had been hurt (victim accounts) or in which they had hurt another person's feelings (perpetrator accounts) and then completed a questionnaire. Hurt feelings were precipitated by events that connoted relational devaluation, and the victims' distress correlated strongly with feelings of rejection. Victims were typically hurt by people whom they knew well, suggesting that familiarity or closeness played a role. Analyses of the subjective experience revealed that hurt feelings are characterized by undifferentiated negative affect that is often accompanied by emotions such as anxiety and hostility. Victims' responses to the event were related to their attributions for the perpetrators' actions, and hurtful episodes typically had negative repercussions for the relationships between perpetrators and victims. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Product differentiation among health maintenance organizations: causes and consequences of offering open-ended products

Open-ended products that allow an HMO enrollee to use providers who are not affiliated with the HMO have become an important component of the Clinton administration's health reform proposal, because these products maintain consumer freedom of choice of any provider. However, little is known about the consequences of offering an open-ended product from an organizational standpoint. This paper uses a theory of "spatial competition" to examine the decisions of health maintenance organizations to offer an open-ended product and the effect of offering an open-ended product on their enrollment.     

Epilepsy in older adults: causes, consequences and treatment

OBJECTIVES: Seizures and epilepsy are common problems in older adults. Although, the highest incidence of seizures and epilepsy occurs in individuals more than 65 years of age, the magnitude of this public health problem, and its consequences on the quality of life of older adults, are not appreciated. Moreover, there is no consensus on the most appropriate way to diagnose or manage epilepsy in this population. This report reviews the current literature on all aspects of epilepsy in older people. DESIGN/METHODS: The medical literature was reviewed for all articles pertaining to pathophysiology, diagnosis, and treatment of epilepsy in older people. RESULTS: Epidemiology, etiology, diagnosis, use of diagnostic tests including EEG and imaging, new medical and surgical treatments, and psychosocial issues as they relate to older epilepsy patient are discussed. Several questions that merit future systematic investigation are presented. CONCLUSION: Seizures and epilepsy in older people are much more common than is generally known. There are unique issues related to this population with regard to diagnosis and treatment. Several new medical and surgical therapies are now available for all epilepsy patients, some of which may be helpful for the older epilepsy patient.     

Lipid peroxidation: a review of causes, consequences, measurement and dietary influences

In this review the process of lipid peroxidation and the atherogenicity of peroxidied lipids are discussed. Recent findings with regard to the effect of selected dietary factors on susceptibility of lipids to oxidative stress and on antioxidant defences are analysed with particular reference to their potential use in the prevention and treatment of atherogenesis and, by extension, coronary heart disease. Laboratory methods of assessing antioxidant defences, lipid peroxidation and the effects of lipid peroxidation are also reviewed and discussed with particular reference to their ability to assess in vivo oxidative stress and lipid peroxidation status. A range of oxidative stress indices are presented and their limitations discussed, but the main focus is on the most commonly used laboratory test for lipid peroxidation, the thiobarbituric acid reacting substances (TBARS) test. Finally, the influence of selected dietary factors on measured peroxidation status is discussed, with particular reference to the antioxidant vitamins C (ascorbic acid) and E (alpha tocopherol) and the type of fatty acids (mono- and poly-unsaturated) in the diet.     

Malaria vaccine: roadblocks and possible solutions

Malaria remains the most prevalent and devastating parasitic disease worldwide. Vaccination is considered to be an approach that will complement other strategies for prevention and control of the disease in the future. In the last 10 years, intense studies aimed at the development of a malaria vaccine have provided important knowledge of the nature of the host immunological mechanisms of protection and their respective target antigens. It became well established that protective immune responses can be generated against the distinct stages of Plasmodium. However, in general, protective immune responses are directed at stage-specific antigens. The elucidation of the primary structure of these antigens made possible the generation of synthetic and recombinant proteins that are being extensively used in experimental immunizations against the infection. Today, several epitopes of limited polymorphism have been described and protective immunity can be generated by immunization with them. These epitopes are being tested as primary candidates for a subunit vaccine against malaria. Here we critically review the major roadblocks for the development of a malaria vaccine and provide some insight on how these problems are being solved.     

Youth, race, and labor: working kids and historical ambivalence in twentieth century America

As a society, we share assumptions that exhibit a profound historical ambivalence regarding young people at work. On the one hand, we all acknowledge that there is something socially and morally reprehensible about forcing children to toil. Many of us see child labor as a vestigial remnant of the harshest aspects of the Industrial Revolution. On the other hand, we also continue to see work as a sign of the moral and social health of a community and hence, we see employment among the young as a stabilizing and redemptive activity. Especially when addressing the nation's poor, urban and African-American populations, youth unemployment is almost universally understood as a root cause of social unrest and community breakdown. This paper outlines some of the historical arguments about children in the work force and raises the question about the national resolve to seriously address this issue.     

Hypertension two years after renal transplantation: causes and consequences

The incidence of hypertension 2 years after renal transplantation and the possible causes of hypertension were studied retrospectively. A group of 93 patients treated with cyclosporin (CyA), azathioprine (Aza), and/or prednisolone (Pred) were compared to a group of 31 patients treated with Aza and Pred. There were more patients with hypertension in the CyA group (73%) than in the Aza group (58%). Hypertension before transplantation predisposed to hypertension after transplantation. After transplantation, hypertension was most common among patients with polycystic kidney disease (46%), chronic glomerulonephritis (67%), and diabetes (71%). The accumulated immunosuppressive medication (CyA/Pred) did not affect the occurrence of hypertension. Hypertensive patients had significantly poorer graft function than did normotensive patients (serum creatinine level 229 mumol/l vs 162 mumol/l, P < 0.01). The 10-year graft survival was markedly impaired in the group with hypertension (42% vs 65% for normotensives, P < 0.05). The 10-year patient survival was 59% vs 79% (P = NS). The study further confirms the frequent finding that hypertension has a negative effect on graft and patient survival rates.     

Many hands make light the work: The causes and consequences of social loafing.

As reported in summary form by W. Moede (1927), an unpublished study found that in a rope-pulling task, while collective group performance increased somewhat with group size, it was less than the sum of the individual efforts (IE). IE decreased as group size increased. The present 2 experiments with 84 undergraduates investigated this effect using clapping and shouting tasks. Results replicate the earlier findings. The decrease in IE, which is here called social loafing, is in addition to losses due to faulty coordination of group efforts. The experimental generality, theoretical importance, widespread occurrence, and negative social consequences of social loafing are examined, along with ways of minimizing it. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer victimization among schoolchildren: Correlations, causes, consequences, and considerations in assessment and intervention.

Peer victimization among schoolchildren is a common problem that predicts serious maladjustment. In this article, the authors define peer victimization, provide a brief overview of the history of research on the topic, and review prevalence rates, common measurement approaches, and the correlates of peer victimization. This review leads to recommendations for empirically based assessment and intervention. Finally, the authors highlight directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The consequences of universalizing health services: children's use of health services in Catalonia

The purpose of this study was to assess the role of needs and social factors in the use of health services among children under age 15 in Catalonia, Spain, where health care reform was explicitly designed to facilitate universal access to primary care according to health needs. Data from the Catalan Health Interview Survey of 1994, a multistage probability sample (2,433 children under 15 years old), were analyzed. Multiple regression examined the relationship between health needs and number of visits in the last year, controlling for the effect of sociodemographic characteristics. Two logistic regression equations were selected to predict heavy (more than seven visits per year) and light (less than two visits) utilization of services. The multiple regression model explained 14.3 percent of the variance in number of visits, with health status perception, disability, reported chronic condition, restriction of activities, and having had a recent accident by far the most important determinants. No familial socioeconomic characteristics, including social class, education, or family size, influenced the extent of use. In contrast to health systems not designed to achieve either universal access according to need or strong primary care, universal access to health services in Catalonia appears to enhance the use of services among children with health needs, regardless of socioeconomic characteristics.     

The partnership model: working with individuals, families, and communities toward a new vision of health

A novel irreversible 5-HT1A receptor binding ligand, NCS-MPP (4-(2'- methoxy-phenyl)-1-[2'-(N-2"-pyridyl)-p-isothiocyanobenzamido]- ethyl-piperazine), based on the new 5-HT1A receptor antagonist p-MPPI (4-(2'-methoxy-phenyl)-1-[2'-(N-2"-pyridyl)-p-iodobenzamido]-ethyl -piperazine ), was synthesized, and its binding characteristics were evaluated using in vitro homogenate binding with rat hippocampal membranes. The Ki value of NCS-MPP was estimated to be 1.8 +_ 0.2 nM using analysis of concentration-dependent inhibition for the binding of [125I]p-MPPI to 5-HT1A receptors. NovaScreen of NCS-MPP showed low to moderate binding affinities to alpha-1, alpha-2-adrenergic and 5-HT2 receptors, with Ki values of 350, 420, and 103 nM, respectively. These data strongly suggest that the ligand bound to 5-HT1A receptors with high affinity and high selectivity. Irreversible inhibition of [125I]p-MPPI binding by NCS-MPP following a 5 min incubation at room temperature was concentration dependent; the inhibition increased to 50% at a concentration less than 10 nM, and became more pronounced (90%) at 400 nM. Under similar assay conditions, NCS-MPP was significantly less efficient in irreversibly inhibiting agonist ligand [125I]8-OH-PIPAT binding to 5-HT1A receptors at lower concentrations (<10nM). After pretreatment of membranes with a low concentration of NCS-MPP (2nM), there was an apparent loss of [125I]p-MPPI binding sites, as expected, but no change in the binding affinity (Kd) was observed. However, the significant increase in Kd at a higher concentration of NCS-MPP (50 nM) indicated that there may be a secondary alkylation site, which may not be directly involved in p-MPPI binding to receptors; nevertheless, it would lead to an increased Kd value. The availability of an irreversible ligand, NCS-MPP, may provide a useful tool for studies of 5-HT1A receptors in the central nervous system.     

Occupational stress: Its causes and consequences for job performance.

Examined occupational stress and its relation with individual characteristics, job conditions, stressful events, affect, and job performance. Study 1, in which 104 nurses participated in group discussions and 96 nurses (mean age 36 yrs) completed a questionnaire, identified 45 stressful events (appended) for nurses. In Study 2, 171 nurses (mean age 34.6 yrs) completed another questionnaire and were rated by a supervisor and/or a coworker. Findings show that ratings of interpersonal aspects of job performance (i.e., sensitivity, warmth, consideration, tolerance) and cognitive/motivational aspects (i.e., concentration, composure, perseverance, adaptability) correlated significantly with self-reported perceptions of stressful events, subjective stress, depression, and hostility. Models developed through path analysis suggest that the frequency and subjective intensity of the 45 events identified in Study 1 caused feelings of stress, leading to depression and causing decrements in interpersonal and cognitive/motivational aspects of job performance. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol expectancies, problem drinking, and adverse health consequences

This study evaluated a measure of positive and negative expected effects of alcohol and their subjective evaluation in the identification of college freshmen at high risk for problem drinking and associated morbidities. It was hypothesized that greater expectations of positive outcomes and fewer negative evaluations of negative outcomes would be associated with reports of heavier drinking and more alcohol-related health problems. College freshmen (n = 328) completed a standardized measure of expectations and subjective evaluations of positive and negative outcomes associated with drinking, and a questionnaire assessing drinking patterns and common alcohol-related health problems. Fifty-two percent of students were male and the mean age was 17.9 years (SD = 0.5). Students' expectations of positive outcomes and their subjective evaluations of both positive and negative outcomes from drinking were significantly correlated with drinking and alcohol-related health problems indices (p < 0.001). Gender, expectation of positive outcomes, and evaluation of negative outcomes explained 29% of the variance in drinking and 15% of the variance in alcohol-related health problems indices. Heavier-drinking students and those reporting more health problems expected more positive effects on their sociability and sexuality (p < 0.03) and were less concerned about cognitive and behavioral impairment as a result of drinking (p < 0.001). Students with more health problems were less concerned that drinking would lead to risk-taking or aggressive behavior (p < 0.003). Positive and negative outcome expectancies and their subjective evaluations accounted for a significant portion of the variability in drinking and alcohol-related health problems.(ABSTRACT TRUNCATED AT 250 WORDS)     

The health care market: what possible competition?

The subject of competition in health care exceeds the scientific journals being discussed in almost each public debate on the health care system. In this paper the elements characterising economic competition will be defined in comparison with the particular characteristics of the health care market. The peculiar features of that market require attention to be paid to the equity of the system, to the competitive mechanisms which are not completely evaluated and to the failures of the public bureaucracy still operating. The principal models of competition found in the literature are illustrated and some experiences as UK and Sweden are shown. Some elements of competition are proposed for the Italian National Health Service (INHS) with some rules for the possible implementation.