Socioeconomic status and health in women with systemic lupus erythematosus

OBJECTIVE: Health outcomes of patients with chronic illnesses are commonly worse in people of lower socioeconomic status (SES). We investigated psychosocial factors that may mediate the relationship between SES and measures of morbidity in women with systemic lupus erythematosus (SLE). METHODS: We collected information on SES, psychosocial factors, and health status in a cross sectional survey of 100 women with SLE. SES was rated using the Hollingshead Two-Factor Index, a weighted average of years of formal education and occupational prestige (higher Hollingshead Index=lower SES). Health status measures included the Health Assessment Questionnaire Disability Index (HAQ), the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR), the Systemic Lupus Activity Measure (SLAM), and the SLE Disease Activity Index (SLEDAI). Potential mediators consisted of 18 environmental, medical care, social, psychological, and behavioral factors. RESULTS: Patients with higher Hollingshead Indexes (lower SES) had more functional disability as measured by the HAQ (r=0.22: p=0.03) and more cumulative organ damage as measured by the SLICC/ACR Damage Index (r = 0.19; p=0.06). SES was not related to either the SLAM or SLEDAI. Significant univariate associations were present between the Hollingshead Index and 10 potential mediating variables: household crowding, insurance status, organizational barriers to medical care, depression, health locus of control by powerful others, SLE knowledge, social support, marital status, body mass index, and regular alcohol use. However, in multiple linear regression analyses, only 3 of these variables modified the relationship between Hollingshead Index and the HAQ: more severe depression scores, higher body mass index, and more restricted access to medical care. More severe depression and greater locus of control by powerful others tended to mediate the relationship between low SES and greater organ damage. CONCLUSION: SES is related to morbidity in women with SLE. There are identifiable and potentially modifiable mediators of this relationship.     

Creep and recovery of ultra high modulus polyethylene

The creep and recovery behaviour of ultra high modulus polyethylene has been studied over the temperature range 20–70°C. Four types of material were examined; low molecular weight and intermediate molecular weight homopolymer, an ethylene hexene-1 copolymer, and a sample prepared by γ-irradiation of isotropic low molecular weight polymer prior to drawing. With the exception of the low molecular weight homopolymer, the materials showed an apparent critical stress below which there was no detectable permanent creep. It is proposed that the behaviour of all the materials can be described to a good approximation by a simple model, where two activated processes are coupled in parallel. Tentative structural explanations of the results are also given.     

Fast discrete cosine transform algorithm for systolic arrays

A fast algorithm for an N-point discrete cosine transform (DCT) is derived from a 4N-point Winograd Fourier transform algorithm (WFTA). This algorithm, which has the same form as Winograd's Fourier transform and convolution algorithms, is suitable for a high-speed implementation using one-bit systolic arrays.     

A recipe for sintering submicron silver powders

A process for sintering submicron silver powders is described. The process allows for a reasonable surface area (determined by the BET adsorption isotherm technique) whilst maintaining a strong mechanical contact between the sinter and silver foils or silver plated copper plates.     

Design of flexible coaxial cores for ac superconducting cables

The phase (inner) and neutral (outer) tubular conductors are each formed from two layers of niobium-clad copper strips laid in helices of opposite sense. The dielectric is lapped high density polyethylene tape impregnated with helium. The lay angles of the conductor strips are chosen to meet the requirements of thermal contraction and magnetic pressure from large fault currents.The main advantage of using twin, instead of single conductor layers is that there is no axial magnetic flux within the core and hence the associated problems are avoided. A further advantage is that when the thickness of the two copper layers is optimized there is a useful reduction in power dissipation when the superconductor is normal. This improves both the cable's ability to carry fault currents and the stability of the conductor against reversion to the normal state when carrying the rated current. Since the optimum thickness of each layer (～0.5 mm) is about half that in a single layer cable, the double layer would not be significantly more expensive.     

Molecular structure and morphology of glycogen isolated from the cestode, Moniezia expansa

Intravenous administration of 125I-hCG to 7-8 day pseudopregnant rats resulted in maximum uptake of radioactivity to corpora lutea 2 hours after treatment. At this time tissue/plasma radioactivity ratios on an equal weight basis were: corpora lutea, 70.2 +/- 12.8; ovarian interstitium, 4.6 +/- 0.2; kidney, 2.2 +/- 0.1. No appreciable uptake was seen by adrenals or liver. Radioactivity in corpora lutea was associated primarily with membranes which sedimented at 2000g and when released by heat it was more than 63% bound to luteal LH receptor preparation in vitro. Radioactivity in renal tissue was associated primarily with the 100,000g supernatant fraction and was bound less than 1% to luteal LH receptors in vitro. PGF2alpha significantly reduced uptake (p less than .001) of 125I-hCG by corpora lutea within 30 minutes (-63%) as well as at 1 (-64%), 2 (-75%), 4 (-68%) and 24 hours (-85%). No clear effect of PGF2alpha on uptake of 125I-hCG by ovarian interstitial tissue was seen. Plasma progesterone was significantly decreased (p less than .001) within 30 minutes (-47%; p less than .01) after PGF2alpha treatment and also at 1 (-65%), 2 (-82%), 4 (-68%) and 24 hours (-92%). Two hours after PGF2alpha treatment the content of progesterone in corpora lutea was depressed (-46%; p less than .001). It is suggested that the rapid inhibition of luteal progesterone production induced by PGF2alpha in vivo occurs through a block in gonadotropin uptake by corpora lutea.     

Posthyperventilation isocapnic hyperpnea

From the results of this study, it appears that whole blood alone or red blood cells reconstituted with saline solution do not adequately replace the loss of albumin and concomitant decrease in colloid oncotic pressure that occur during extensive intraabdominal and intrathoracic operations. Since colloid oncotic pressure is a major factor in the restitution of intravascular volume from stores of interstitial fluid and since it may also play a role in the development of postoperative pulmonary problems, it is important to maintain a relatively normal colloid oncotic pressure during the operation and in the immediate postoperative period. Although dextran can be used for this purpose, its short half-life of four to six hours and associated coagulation problems militate against its use in large quantities. This leaves purified protein fraction or salt-poor albumin as the main sources of protein for the maintenance of colloid oncotic pressure. Both of these products are expensive and short in supply. The oncometer in present use is a clinically feasible and rapid, one to three minutes, means of determining the colloid oncotic pressure. It permits a rational approach to the use of albumin products, avoiding the pitfalls of under or excess administration in the operative and postoperative periods.     

Occupational differences in computer-related anxiety: implications for the implementation of a computerized patient management information system

The present investigation was concerned with the implementation of an information system within a health care setting. A large number of staff required training on a new patient management information system (MIS). The aim of this study was to assess occupational differences on a number of psychological variables associated with MIS success. Computer anxiety was of primary concern due to its relationship to avoidance of computers. A total of 175 questionnaires were distributed, with 103 questionnaires being completed and returned for analysis (61.1%). It was found that clerical/administrative staff had significantly higher self-efficacy regarding computer use and more experience with computers. The nursing group experienced significantly more, computer anxiety, negative attitudes, and negative expectations than the clerical group. Self-efficacy was found to be the best predictor of computer related anxiety. The results have implications for MIS implementation strategies particularly in the areas of training and resource allocation.     

Comments on "The Paramorphic Representation of Clinical Judgment."

Hoffman's (see 34: 7779) position concerning the independent contribution of a variable in the judgment process is examined by presenting several empirical examples. It is concluded that the concept of relative weight will not provide any information about the independent contribution of a predictor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)