Multiple injuries in peacetime and wartime estimate of severity of injury by the Injury Severity Score and Polytraumaschlüssel

The aim of this study was to evaluate the efficacy and tolerability of valsartan, a new angiotensin II receptor antagonist, versus atenolol in the treatment of severe primary hypertension. A total of 103 adult out-patients were randomised to receive either valsartan 160 mg or atenolol 100 mg once daily for 6 weeks. If necessary, additional blood pressure (BP) control could be provided as add-on therapy. Both valsartan and atenolol decreased mean sitting diastolic BP (DBP) and mean sitting systolic BP (SBP): least squares mean change from baseline in DBP; valsartan, -20.0 mm Hg; atenolol, -20.4 mm Hg: in SBP; valsartan, -30.0 mm Hg; atenolol, -25.5 mm Hg. There was no statistically significant difference between the treatment groups. Add-on hydrochlorothiazide (HCTZ) 25 mg was required by 97.2% of patients receiving atenolol and 83.6% of patients receiving valsartan; additional verapamil SR 240 mg was also required by 58.3% of patients receiving atenolol and 64.2% receiving valsartan. Valsartan was well tolerated, with a comparable incidence of treatment-related adverse experiences in both groups. In conclusion valsartan 160 mg is as well tolerated and effective as atenolol 100 mg in lowering BP in severely hypertensive patients.     

Personality Factors and Injury Severity in the Prediction of Early and Late Traumatic Brain Injury Outcomes.

Objective: To identify personality features predicting early and late outcome after traumatic brain injury (TBI). Design: Multiple regression analyses of data from an inception cohort. Participants: Sixty-nine persons with moderate to severe TBI and significant others (SOs). Outcome Measures: Rasch measure of supervision, independent living, and work (Participation and Independence Measure) at hospital discharge and at 1-year follow-up. Predictor Variables: Duration of posttraumatic amnesia (PTA) and NEO Personality Inventory-Revised completed by participants and SOs to describe participant's preinjury personality. Results: Overall personality variables were within normal limits. Only self-reported Neuroticism, specifically Depression, added significantly to PTA in predicting early outcome. Conclusions: Although self-reported depression negatively affects TBI outcome, other personality features reported by people with TBI and SOs during early recovery are normal and do not affect outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Score discrepancies between the 1981 and 1985 editions of the Strong-Campbell Interest Inventory.

In the 1985 revision of the Strong-Campbell Interest Inventory (SCII), all occupational scales are scored with scoring procedures that are different from those used with the 1981 revision. The changes resulted from a new general reference sample and a substantial number of new criterion samples. In this study, SCII answer sheets for 300 male university freshmen were scored via both the 1981 and 1985 scoring systems. Seventy-seven scales yielded 23,100 differences for this group. A comparison of the 1981 and 1985 scores for these matched occupational scales demonstrated standard score differences as large as 39 points. There were 2,486 discrepancies greater than 10 points and 8,456 greater than 5 points. The maximum and average discrepancies as well as standard errors are given for each occupational scale. The communalities of the profiles generated by the two scoring systems indicate considerable profile variance. Implications of the results are discussed, and counselors are advised to thoroughly understand the changes that have been made in the new instrument. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

关于中国式英语和中国英语的看法

中国英语目前正作为一种使用具有一定语言特色的人数最多的＂使用型国别变体＂被国内外语言学家重视。中国式英语是中国的英语学习者在英语语言习得过程中的一种中介语现象。其成因受多种因素相互作用,包括语言迁移、跨文化交际等。但中国英语成为一种受目的语影响的中介语变异体,在中国式英语考核标准影响下,它以标准英语的规范形式,带来了越来越严重的本土化问题。但随着英语的全球化普及,它的传播也更加区域化。尤其是在反对语言殖民化,保护本土语言的吁求声中,未来的英语一定是全球化与本土化的结合。     

Severity of perinatal cerebral injury and developmental outcome: A dose-response relationship.

The purpose of this study was to establish a dose–response relationship between extent of perinatal cerebral injury and quality of developmental outcome in childhood. To attain this goal, 54 school and preschool-age children who had incurred perinatal intracranial hemorrhage were recruited. The main index of hemorrhage severity—the degree of acute ventriculomegaly observed on the cranial ultrasonogram during the neonatal period—was significantly associated with outcome in all measured domains. These included verbal and nonverbal intelligence, motor skills, and behavioral problems associated with the externalizing and internalizing syndromal groupings. The putative neurobiological mechanisms underlying the observed dose–response relationship between perinatal lesion severity and developmental outcome are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Severity of homelessness and adverse birth outcomes.

Predictors and the prevalence of adverse birth outcomes among 237 homeless women interviewed at 78 shelters and meal programs in Los Angeles in 1997 were assessed. It was hypothesized that they would report worse outcomes than national norms, that African Americans would report the worst outcomes because of their greater risk in the general population, and that homelessness severity would independently predict poorer outcomes beyond its association with other adverse conditions. Other predictors included reproductive history, behavioral and health-related variables, psychological trauma and distress, ethnicity, and income. African Americans and Hispanics reported worse outcomes than are found nationally, and African Americans reported the worst outcomes. In a predictive structural equation model, severity of homelessness significantly predicted low birth weight and preterm births beyond its relationship with prenatal care and other risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Severity of prescribed penalty and mock jurors' verdicts.

An analogy between the process of reaching a verdict by an individual juror and the testing of a statistical hypothesis leads to the predictions that as the severity of the prescribed penalty for an offense is increased, the amount of evidence required by jurors to convict will also increase and the probability of conviction will decrease. A review of the literature suggests that while historical, anecdotal, and field evidence seems to favor the latter prediction, the extant experimental work has offered little support. A study was performed with 449 undergraduates to experimentally test the predictions. The conviction rate for individual mock jurors was inversely related to the severity of the prescribed penalty, as predicted. A previous failure to confirm this prediction was attributed to an inappropriate choice of response scale. An analysis employing E. Thomas and A. Hogue's (1976) model confirmed the prediction that more evidence of guilt would be required for conviction when the prescribed penalty was severe. Thus, increasing penalties for criminal offenses may actually lower the percentage of convictions for those offenses. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Injury control. A crucial aspect of emergency medicine

We have briefly described the theoretic and strategic concepts of injury control and suggested ways for emergency medicine to be more broadly involved. It is not enough for emergency physicians to be active solely in the acute management of injured patients. Emergency physicians need to "look upstream" and balance their focus on the acute management of injuries with a focus on the prevention of injuries.     

Severity of psychosocial stress and outcome of alcoholism treatment.

Examined the relation between stressful life events and drinking outcome among 129 male alcoholics (aged 22–70 yrs) who had completed an alcohol treatment program. Life events were assessed for the year prior to treatment and for the 3 mo after treatment and were rated on a modified version of the Psychiatric Epidemiology Research Interview and the Contextual Rating System (G. W. Brown and T. O. Harris, 1982). Approximately 40% of the pretreatment stressors were found to be directly or indirectly related to alcohol use. When stressors related to drinking were excluded from consideration, men who returned to drinking after treatment were found to experience more severe or highly threatening stress before their relapse than men who remained abstinent during the follow-up period. These data suggest that although less severe stress may not increase risk for relapse, acute severe stressors and highly threatening chronic difficulties may be associated with elevated relapse risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic quality in hysterosalpingography. Comparison between iodixanol and iotrolan

PURPOSE: To compare the diagnostic quality and adverse events of the water-soluble, non-ionic, iso-osmolar, dimeric contrast media iodixanol and iotrolan in hysterosalpingography (HSG). MATERIAL AND METHODS: One hundred and twenty patients participated in a double-blind randomized parallel-group phase-III study. Questionnaires and patient interviews were used. Diagnostic quality was assessed using a visual analogue scale and the quality in specific regions was rated using a categorical scale. RESULTS: Overall diagnostic quality was equal for the two groups. There was no statistically significant difference between the two groups in diagnostic quality in the specific regions of interest. No differences between the contrast media were found with regard to adverse events. CONCLUSION: Both contrast media provided images of high diagnostic quality in HSG.     

Polyposis coli. Comparison between the familial and non-familial form

Since 1970 16 patients with polyposis coli have been treated at the Department of Surgery, Medical School, Hannover. Of these, 9 patients showed the classic type of familial polyposis, while 7 patients denied a positive family history. Comparing both groups, the nonfamilial type of polyposis coli can be separated as well from the familial polyposis as from multiple adenomas of the large bowel. Operative treatment in both groups of polyposis coli and management of nonfamilial polyposis coli are discussed.     

A Descriptive Epidemiology of Lifetime Trauma and the Physical Health Status of Older Adults.

Three issues are evaluated in this study. The 1st involves examining the relationship between exposure to trauma over the life course and physical health status in old age. The 2nd has to do with seeing whether the relationship between trauma and health varies across 3 cohorts of older adults: the young-old (ages 65-74), the old-old (ages 75-84), and the oldest old (age 85 and over). The 3rd issue involves seeing whether the age at which a trauma was encountered is related to health in late life. Data from a nationwide survey of older people (N = 1,518) reveal that trauma is associated with worse health. Moreover, the young-old appear to be at greatest risk. Finally, data suggest that trauma arising between the ages of 18 and 30 years, as well as ages 31 to 64 years, has the strongest relationship with current health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attention, Heart Rate, and Startle Response During Exposure to Trauma-Relevant Pictures: A Comparison of Recent Trauma Victims and Patients With Posttraumatic Stress Disorder.

Victims of a recent trauma were compared with posttraumatic stress disorder (PTSD) patients and healthy controls to assess whether a specific anxiety response and an attentional bias were evident initially or only in chronic PTSD. Heart rate (HR) and startle response were measured, and a dot-probe task was carried out using trauma-relevant pictures. Severely affected recent trauma victims and chronic PTSD patients showed HR acceleration to trauma-related material, which was the only significant group difference. A bias away from trauma-related material was related to severity of intrusions in recent trauma victims, and the bias toward trauma-related material increased with amplitude of the HR response in PTSD patients. A specific anxiety reaction is present initially in severely affected trauma victims. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Refugee survivors of torture: Trauma and treatment.

It is increasingly likely that psychologists may be faced with clients who have been tortured, although the significance of this background can be easily unrecognized or mishandled. With the growing incidence of refugees to the United States escaping from organized violence and human rights violations in many parts of the world, the need for psychological assistance in the recovery from torture is well documented. By integrating principles from trauma theory and multicultural theory with a conceptual analysis of power and liberation theory, the author offers an understanding of both the nature of the damage inflicted by politically based torture and strategies to help overcome that damage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingent Leadership and Effectiveness of Trauma Resuscitation Teams.

This research investigated leadership and effectiveness of teams operating in a high-velocity environment, specifically trauma resuscitation teams. On the basis of the literature and their own ethnographic work, the authors proposed and tested a contingency model in which the influence of leadership on team effectiveness during trauma resuscitation differs according to the situation. Results indicated that empowering leadership was more effective when trauma severity was low and when team experience was high. Directive leadership was more effective when trauma severity was high or when the team was inexperienced. Findings also suggested that an empowering leader provided more learning opportunities than did a directive leader. The major contribution of this article is the linkage of leadership to team effectiveness, as moderated by relatively specific situational contingencies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Severity of heroin dependence and HIV risk. II. Sharing injecting equipment

One of the most conspicuous risks of HIV transmission among drug injectors involves sharing injecting equipment which has been contaminated by infected blood. The present study investigates the relationship between severity of dependence upon heroin and the sharing of previously used injecting equipment (passive sharing). Four-hundred-and-eight heroin users were contacted and interviewed. Two-hundred-and-eighty-one (69% of the total heroin sample) had injected drugs on at least one occasion, and 204 of the 281 injectors (73%) had shared injecting equipment on at least one occasion after it had been used by someone else. The more severely dependent heroin injectors were more likely to have shared injecting equipment. As users become more dependent upon heroin, the types of factors which predispose them towards sharing may change. Less dependent users were more likely to use in public and 'social' settings, and they may be more likely to share injecting equipment with people they do not know well. The more dependent users appear to use heroin in private settings and to be at greater risk of sharing with dealers, perhaps because of the urgency of their need for drugs at times when they are in withdrawal. One of the most frequently cited reasons for sharing was that sterile injecting equipment was difficult to obtain. It is a matter for some concern that many of the sharers in our sample (24%) reported having shared used injecting equipment while in custody. There was good overall awareness of the risks of health problems associated with injecting among our subjects. However, awareness of risk was not associated with avoidance of sharing behaviour.     

Reliability and validity of the Yale Global Tic Severity Scale.

To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports of depression and anxiety. All children participated in a 2nd YGTSS administration by the same rater 48 days later. Good internal consistency and stability were found for the YGTSS scores. YGTSS scores demonstrated strong correlations with parent-rated tic severity (r = .58-.68). YGTSS scores were not significantly related to measures of clinician ratings of OCD severity (r = .01-.15), parent ratings of externalizing and internalizing behavior (r = -.07-.20), and child ratings of depression (r = .02-.26) and anxiety (r = -.06 -.28). Findings suggest that the YGTSS is a reliable and valid instrument for the assessment of pediatric TS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison between one-session psychological treatment and benzodiazepine in dental phobia.

To compare the effects of a single session of psychological treatment and acute administration of benzodiazepine, 50 dental phobic patients were allocated either to psychological treatment, benzodiazepine, or no treatment for anxiety. Psychological treatment consisted of stress management training and imaginal exposure to phobic stimuli with homework assignments. Benzodiazepine was administered 30 min before dental treatment. Both treatment conditions led to less anxiety during dental surgery than did the control condition. Phobic patients in the benzodiazepine condition showed a relapse after dental treatment, whereas those in the psychological treatment condition showed further improvement until the follow-up 2 months later. Of the latter group, 70% continued dental treatment; only 20% and 10% returned in the benzodiazepine and control conditions, respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)