Chronic multisymptom illness affecting Air Force veterans of the Gulf War

CONTEXT: Gulf War (GW) veterans report nonspecific symptoms significantly more often than their nondeployed peers. However, no specific disorder has been identified, and the etiologic basis and clinical significance of their symptoms remain unclear. OBJECTIVES: To organize symptoms reported by US Air Force GW veterans into a case definition, to characterize clinical features, and to evaluate risk factors. DESIGN: Cross-sectional population survey of individual characteristics and symptoms and clinical evaluation (including a structured interview, the Medical Outcomes Study Short Form 36, psychiatric screening, physical examination, clinical laboratory tests, and serologic assays for antibodies against viruses, rickettsia, parasites, and bacteria) conducted in 1995. PARTICIPANTS AND SETTING: The cross-sectional questionnaire survey included 3723 currently active volunteers, irrespective of health status or GW participation, from 4 air force populations. The cross-sectional clinical evaluation included 158 GW veterans from one unit, irrespective of health status. MAIN OUTCOME MEASURES: Symptom-based case definition; case prevalence rate for GW veterans and nondeployed personnel; clinical and laboratory findings among veterans who met the case definition. RESULTS: We defined a case as having 1 or more chronic symptoms from at least 2 of 3 categories (fatigue, mood-cognition, and musculoskeletal). The prevalence of mild-to-moderate and severe cases was 39% and 6%, respectively, among 1155 GW veterans compared with 14% and 0.7% among 2520 nondeployed personnel. Illness was not associated with time or place of deployment or with duties during the war. Fifty-nine clinically evaluated GW veterans (37%) were noncases, 86 (54%) mild-to-moderate cases, and 13 (8%) severe cases. Although no physical examination, laboratory, or serologic findings identified cases, veterans who met the case definition had significantly diminished functioning and well-being. CONCLUSIONS: Among currently active members of 4 Air Force populations, a chronic multisymptom condition was significantly associated with deployment to the GW. The condition was not associated with specific GW exposures and also affected nondeployed personnel.     

Prestige effects in body-sway suggestibility.

The effect of the prestige of E on body-sway suggestibility was assayed by measuring the influence of academic personnel on students. The findings, in general, were that body-sway suggestibility was heightened in response to individuals perceived as being prestigeful, most significantly among Ss already high in suggestibility. From Psyc Abstracts 36:02:2GD87D. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A noncognitive correlate of performance among lower aptitude men.

The Hand Skills Test, a device which measures "persistence beyond minimum standards on tiring tasks," was used to predict school grades and job performance evaluations for higher and lower aptitude Navy personnel. 3 enlisted samples and 1 officer candidate sample were employed. Within each sample men were divided into higher and lower aptitude groups at the median of their aptitude test scores. Principal findings were: (a) the Hand Skills Test significantly predicted school grades of the 2 lower aptitude enlisted samples (grades were not available for the 3rd enlisted samples) but did not predict for higher aptitude enlisted men or for officer candidates, and (b) the Hand Skills Test significantly predicted job performance evaluations among lower aptitude men in all 4 samples, but again validities were not significantly different from zero among the 4 higher aptitude samples. From Psyc Abstracts 36:05:5LD76K. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential self-perceptions of management personnel and line workers.

"A 64-pair forced-choice adjective check-list was filled out by 463 management personnel and 320 line workers. The responses of the individuals in the two groups were analyzed for each of the pairs of adjectives, and it was found that 25 pairs differentiated the two groups at the .05 level of confidence or better. From these differentiating adjectives, integrated pictures of the self-perceptions of the two groups were developed. Management personnel tended more often to describe themselves in terms of leadership-type traits, whereas line workers relatively more often pictured themselves in cooperative-follower terms. These findings were discussed as to their implications for understanding organizational structure and functioning and for labor-management relations." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supervision of pharmacy personnel

OBJECTIVE: To review legal, acceptable, and optimal personnel practices. DATA SOURCES: A general literature search was conducted to identify appropriate material. In addition, the personnel manuals of several organizations (large and small) were reviewed for alternative ways to address similar problems. DATA SYNTHESIS: The cost of personnel is often the largest single non-drug expense in a pharmacy's operating budget. Pharmacists rarely receive comprehensive training during their professional training to address the unique issues of supervision. A review of the basics of supervision, and some topics unique to pharmacy, is presented. CONCLUSION: Familiarity with appropriate supervisory practices can enhance productivity, improve morale, and create a better practice environment.     

Construction Personnel Role and Information Needs

In management practice, personnel functions and personnel information needs are the very first areas that are systematically tackled. This is because a manager or supervisor cannot perform his∕her functions efficiently without proper information on which to base decisions. However, construction industry studies and researchers do not emphasize these areas. Thus, there is a lack of information in the construction industry regarding functions, responsibilities, and information needs of construction personnel. Results are presented of a field study conducted to determine: (a) The primary role of the key individuals at the various management levels (i.e., their functions, responsibilities and authorities); and (b) the type of information these personnel require in order to effectivery perform their functions. The management level grouping approach is used to present the role and information needs of the key construction personnel identified in the study.     

Prevalence of aspirin use among patients calling 9-1-1 for chest pain

OBJECTIVE: Early aspirin administration during an acute myocardial infarction (AMI) decreases morbidity and mortality. This investigation examined the extent to which patients with a complaint of chest pain, the symptom most identified with AMI by the general population, self-administer aspirin before the arrival of emergency medical services (EMS) personnel. METHODS: In this prospective, cross-sectional prevalence study, data were derived through the analysis of EMS incident reports for patients with a complaint of chest pain from June 1, 1997, to August 31, 1997. RESULTS: The study included 694 subjects. One hundred two (15%) took aspirin for their chest pain before the arrival of EMS personnel. Of the 322 subjects who reported taking aspirin on a regular basis, 82 (26%) took additional aspirin for their acute chest pain. Only 20 (5%) of the 370 patients who were not using regular aspirin therapy self-administered aspirin acutely (p<0.001). In addition, patients with lower intensity of chest pain (p = 0.03) were more likely to take aspirin for their chest pain. CONCLUSION: Only a relatively small fraction of individuals calling 9-1-1 with acute chest pain take aspirin prior to the arrival of EMS personnel. These individuals are more likely to self-administer aspirin if they are already taking it on a regular basis. It is also possible that they are less likely to take aspirin if their chest pain is more severe.     

Licensure, use, and training of paramedical personnel to perform screening flexible sigmoidoscopy

BACKGROUND: The purpose of this study was to assess the state board of nursing guidelines about the performance of flexible sigmoidoscopy by nurses and to determine the current use and training of paramedical personnel in flexible sigmoidoscopy at gastroenterology fellowship programs in the United States. METHODS: Separate one-page questionnaires were sent to state boards of nursing and directors of endoscopy at gastroenterology fellowship programs in the United States. RESULTS: Twenty percent (10 of 50) of state boards of nursing explicitly approve the performance of sigmoidoscopy by registered nurses, and 50% (25 of 50) explicitly approve the practice by nurse practitioners. Forty-six percent (23 of 50) of state boards of nursing have no written policy but allow nurses to use a "decision making model" to determine whether the performance of sigmoidoscopy is allowed. Fifteen percent (24 of 164) of gastroenterology fellowship programs in the United States use paramedical personnel to perform flexible sigmoidoscopy. Sixty-three percent (15 of 24) of these programs started since 1995, and 67% (16 of 24) require that the paramedical personnel perform 50 or more supervised sigmoidoscopies during their training. Forty-five percent (5 of 11) of programs with physician assistants/nurse practitioners use these personnel to perform colonoscopy or endoscopy. CONCLUSIONS: Nurses are allowed to perform flexible sigmoidoscopy in most states based on current state board of nursing guidelines. The use of paramedical personnel to perform endoscopic procedures is increasing rapidly.     

Quality assurance today and some future perspectives

The purpose of this article is to describe the developmental level of QA in Finland. Working unit, regional and national level QA activities are reflected. The major effort to study the current situation of nursing QA was taken by STAKES (The National Research and Development Centre for Welfare and Health) in the beginning of 1993. Over 1200 institutions received a questionnaires where their QA activities were inquired. The increasing need for multiprofessional cooperation, better information and participation of nursing care personnel are discussed. To utilize research findings and to increase resources and skills of nursing care personnel to perform small scale studies are seen essential for QA advancement. To receive good quality care is a right of all patients. The nursing care personnel is responsible to deliver that kind of care. QA is a means to provide it. Accountability is demanded by both public and profession itself. Nurses have taken the leadership in providing good quality nursing care.     

State psychological associations, licensing criteria, and the "master's issue."

The psychological associations in the 50 states and the District of Columbia were surveyed with regard to their membership structure and the status of master's-level members. Most (31) of these associations closely follow the membership criteria established by the American Psychological Association, allowing associate membership for master's-level personnel, whereas 15 associations provide full membership for such personnel. A minority (17) of the state psychology boards provide some form of licensing or certification for master's-level personnel, and 5 more states provide for registration of such personnel. It is argued that the structures of state psychological associations reflect a tension between two views of psychology: as a scientific discipline or as a profession. The scientific emphasis encourages associations to include all individuals interested in a field of scientific endeavor; the professional perspective motivates associations to exclude those ineligible to join a profession of self-regulated, highly qualified, health service providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of the acceptability of a needleless vascular-access system by nurses

BACKGROUND: Needleless intravenous-access devices have been introduced in an effort to reduce needlestick injuries and possible transmission of blood-borne pathogens to health care workers. However, there are no data on the acceptance of these devices by nursing personnel. METHODS: A survey of nursing personnel was taken at Indiana University Medical Center after introduction of a needleless intravenous device to determine their opinion after use of the needleless device. RESULTS: The majority of the nurses (72 of 94, 70%) had a favorable overall opinion of the device. Among those with a favorable opinion, 76% (55/72) responded that reduced risk of needlestick injury was the most important reason. Among those who had a negative opinion about the needleless-device system, 32% (7/22) reported that contamination risk was their major concern. Those who were trained before device use were more likely to properly use and maintain the needleless intravenous-access system. Of 89 respondents, 75.3% (67/89) believed that the initial training was adequate; however, 43% (29/67) thought that additional training after using the device for some time would have been beneficial. CONCLUSIONS: Comprehensive education programs that include training before and after device use are necessary if new needleless intravenous-access systems are to be successfully introduced and accepted by nursing personnel.     

Psychological coping with stillbirth. Course of grief response, influential factors, treatment satisfaction, patient management needs]

Course of Grief Response, influencing Factors, Satisfaction with treatment, Need for Psychotherapeutic Support: The emotional response to a late miscarriage or a stillbirth was examined retrospectively in a systematic study involving 51 patients. The women had lost a child either by stillbirth (beyond the 20th week of gestation) or shortly after delivery. We assessed the long-term course of possible determinants of grief, a complicated grief response, as well as the patients' satisfaction with the treatment and their need for further psychotherapeutic support. The mourning response was complicated by a depressive reaction in 22%. Major risk factors were individual disposition, lack of partner and professional support. The findings reveal that the course of the grief response is positively influenced by: 1. open discussion (thematisation) with the skilled personnel and the patients' families, 2. direct or indirect contact with the deceased child (concretisation) and 3. the patients concerned being extensively informed as to place and circumstances of the funeral (whereabouts of the child).     

Selection and evaluation procedure for operating room personnel.

16 surgeons and supervisors of operating room (OR) personnel rated 100 behavioral statements pertaining to OR performance on a 1-7 importance scale. 42 statements were retained and incorporated into a final criterion list on the basis of mean rated importance and agreement among raters as measured by their standard deviations. 163 OR personnel were then rated by their supervisors and 40 were administered the Wonderlic, O'Connor Finger Dexterity Test, Press Test, and 3 scales of the CPI. Factor analysis of the criterion variables revealed that 54% of the variance could be accounted for by 4 factors: general technical knowledge, attention to detail, patient awareness, and social interaction. The 1st 3 factors were significantly related to 1 or more of the predictor variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multigroup evaluation of the models and functions of university counseling centers.

The appropriateness of 4 counseling center models (traditional, consultation, vocational guidance, and psychotherapy) and 15 specific counseling center functions for universities with enrollments of 10,000-plus were evaluated by 28 counselors, 16 student personnel administrators, 84 resident assistants, faculty, 187 students, and 21 university administrators. Ss were drawn from a large public university in the East. The traditional model was evaluated most positively by 5 of the subgroups. The most salient findings were (a) in both the models and functions phases of the study, student personnel subgroups rated consultation-related activities as appreciably more appropriate, both in a relative and absolute sense, than did nonstudent personnel subgroups; (b) while the psychotherapy model consistently received the lowest ratings, certain types of personal adjustment counseling received consistently positive ratings; (c) educational-vocational counseling was seen as highly appropriate by all groups, but counselors and student personnel administrators did not feel enough of it was being done, a finding consistent with earlier research. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors influencing the success of applied research.

Conducted an intensive follow-up of 10 projects rated by the National Institute of Mental Health as very high or relatively low in successfully reaching their objectives or suitable modifications thereof, in writing clear and complete reports suitable for replication, and in disseminating findings. Key personnel associated with each project completed a comprehensive interview schedule concerning idea development, project design, funding, research, development and dissemination of findings, and utilization of findings. Profiles of the successful and less successful projects were then formulated. The successful projects showed high levels of communication and involvement with the individuals involved in research and practice. The principle investigator designed and devoted his full time to the project. Potential consumers were involved and informed of project development, processes, and findings. Higher levels of dissemination and utilization of findings resulted. The less successful projects, while calm during the early stages of idea development, design, and funding, developed difficulties during research associated with limited and ineffective communication among the researchers and between researchers and practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Meta-Analytic Study of General Mental Ability Validity for Different Occupations in the European Community.

A comprehensive meta-analysis of the validity of general mental ability (GMA) measures across 12 occupational categories in the European Community (EC) is presented. GMA measures showed that there is validity generalization and large operational validities for job performance and training success in 11 occupational groups. Results also showed that job complexity moderated the magnitude of the operational validity of GMA tests across three levels of job complexity: low, medium, and high. In general, results were similar to those found in the United States, although the European findings showed a slightly larger magnitude of operational validity in some cases. Theoretical and practical implications of these findings for personnel selection are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Educators' attitudes toward working mothers.

In an exploratory study of educators' sex-role perceptions, 411 teachers, administrators, and pupil personnel workers were administered the Attitudes Toward Working Mothers Scale. Administrators and teachers were found to have significantly less positive attitudes toward working mothers than did pupil personnel workers. Within each of the groups, males had the least positive attitudes. Marital status, maternal employment history, and child-bearing status were unrelated to these attitudes. Replication on a second sample (330 Ss) produced similar findings. (58 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epidemiology of hepatitis C virus infection in Nepal

The impact of the Prehospital Trauma Life Support (PHTLS) programme, introduced in Trinidad and Tobago in 1992, was assessed by questionnaires completed by 26 medical personnel (MP); 71 ambulance personnel (AP); and 50 non ambulance paramedical personnel (NAP). Of the 23 MP, 45 AP and 38 NAP who were aware of the programme, 19 (82.6%) MP, 40 (88.9%) AP and 25 (65.8%) NAP were able to differentiate personnel that had taken the PHTLS programme based on their performance. 32 (71.1%) of the AP were PHTLS trained. 24 (53.3%) and 4 (9%) of the AP identified poor equipment and poor supervision, respectively, as reasons for difficulty in applying PHTLS principles. Improvements observed among those completing the PHTLS programme were: improved resuscitation techniques by 20 (86.9%) MP, 38 (84.4%) AP and 27 (71.1%) NAP; better vital signs recording by 8 (34.8%) MP, 27 (60%) AP and 8 (21.1%) NAP; improved immobilization by 23 (100%) MP, 40 (88.9%) AP and 33 (86.8%) NAP; better haemorrhage control by 22 (95.6%) MP, 40 (88.9%) AP and 24 (63.2%) NAP; appropriate splinting of fractures by 23 (100%) MP, 40 (88.9%) AP and 32 (84.2%) NAP; and increased utilization of oxygen by 15 (65.2%) MP, 31 (68.9%) AP and 21 (55.3%) NAP. 32 (71.1%) AP with PHTLS training indicated improvement in their ability to resuscitate and transport trauma victims, with 42 (93.3%) reporting improvement in overall prehospital care. Medical, paramedical and ambulance personnel all perceive a significant positive impact of PHTLS training on prehospital trauma care. Although improvements in supervision, documentation and equipment are still required, improved trauma resuscitative techniques after PHTLS training should improve trauma patient outcome in Trinidad and Tobago.     

Employment testing: Old theories and new research findings.

Claims that cognitive ability tests of the kind generally used in personnel selection are valid predictors of successful performance for jobs in all settings. This controversial stance is supported by analyses that recast findings of invalid tests as instances of Type I error. Ideally, if an employer has large enough samples, perfectly reliable tests, and an unrestricted range of ability in the applicant pool, the most widely used types of standardized tests should be valid in all job situations, and the notion of job-specific validity would no longer hold. The authors argue against previous reservations about the suitability of cognitive ability tests for employee selection that were made on the basis of their supposed limited applicability, their bias, and their ultimate contribution to workforce productivity. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)