bluuebunny/crossref_metadata_2025 huggingface dataset:
Same… same but different: expectations of graduates from two midwifery education courses in Australia
Authors: Hammond Athena , Gray Joanne , Smith Rachel , Fenwick Jennifer , Homer Caroline SE
Published: June 2011

Aims and objectives.  To identify the expectations and workforce intentions of new graduate midwives from two different pre‐registration educational courses at one Australian university.

Background.  In Australia there are two different educational pathways to midwifery qualification, one offered for registered nurses, commonly at a postgraduate level and the other for non‐nurses, at an undergraduate level. The knowledge about midwifery graduates in general is reasonably limited and there is no specific research that examines the similarities and differences between graduates from the two different courses.

Design.  A cross‐sectional design was used.

Method.  Data were collected by questionnaire from both undergraduate and postgraduate midwifery graduates in 2007 and 2008 at one Australian university. Data were analysed using descriptive statistics.

Results.  Almost all the graduates from the two different pre‐registration courses intended to enter the midwifery workforce with both groups rating the factors that influenced this decision similarly. There were, however, significant differences in graduates age and their intention to work part time. Their views of their ideal roles and subsequent uptake into formal new graduate transition programmes differed. Graduates from the two courses also reported philosophical differences regarding their concepts of job satisfaction and ways their jobs could be improved.

Conclusions.  The graduates from the two different courses showed sufficient significant differences to warrant consideration in current workforce planning for midwifery.

Relevance to clinical practice.  The factors that influence the career decisions of new graduate midwives can positively impact educational and workforce planning. The findings may be able to help inform strategies to address turnover and attrition in midwifery.
Reception of Kraepelin's ideas 1900–1960
Authors: Palm Ulrich , Möller Hans‐Jürgen
Published: June 2011

Kraepelin's system of mental diseases has contributed substantially to the foundation of modern psychiatric diagnosis in the DSM‐IV and ICD‐10. Considering Kraepelin's influence in the creation of these diagnostic tools, the question arises as to how Kraepelin's contemporaries and successors reacted to his nosology. Historical libraries and archives in Munich, Berlin and Paris were searched for European and American psychiatric literature using the keywords ‘Kraepelin’, ‘dichotomy’ and ‘manic‐depressive disorder’. Literature from 1900 to 1960 was examined and compared to the current literature regarding Kraepelin's impact on modern classification systems. The sixth edition of Kraepelin's ‘Lehrbuch’ (1899) presented the dichotomy in its entirety and led to three different periods of critical comment on dichotomy and methodology between 1900 and 1960. But on the whole, Kraepelin's system was quickly and completely adopted in clinical diagnosis. The publications appearing on and following Kraepelin's centenary in 1956 represent his work as generally being the foundation of modern psychiatry. The neo‐Kraepelinian movement, beginning in the late 1960s, developed more differentiated views of Kraepelin's scientific background and methodology. Notwithstanding all the criticism of Kraepelin's dichotomy, it remains more than ever the basis of psychiatric diagnosis. The criticism today shows parallels to the statements made during Kraepelin's era, mainly concerning the issue of diagnostic overlapping of the two disease entities, manic‐depressive disorder and schizophrenia, and includes the question of syndromatology.
Survey of bilingualism in autism spectrum disorders
Authors: Kay‐Raining Bird Elizabeth , Lamond Erin , Holden Jeanette
Published: June 2011

This survey study investigates issues related to bilingualism and autism. Bilingualism is common around the world but there is little published information to guide professionals and parents in making decisions about bilingualism for children with autism. Participants were 49 parents or guardians of children with autism who were members of a bilingual family; 75% were raising their child with autism spectrum disorders (ASD) to be bilingual or multilingual. Professionals did not always support this choice. Parents reported that living in a bilingual community and the need to communicate with various people in a variety of venues supported a bilingual choice along with the enrichment and job opportunities that bilingualism afforded. Parents also reported concerns around choosing bilingualism for their children with ASD, such as lack of services and supports and concerns about whether their children would be able to learn two languages. Children with ASD exposed to two languages were often reported to be acquiring their languages of exposure, albeit to varying degrees. Given the small sample size and the exploratory nature of the study, the need for more research is emphasized.
How to Contribute to the Development of a Global Understanding of Corporate Governance? Reflections from Submitted and Published Articles in CGIR
Authors: Zattoni Alessandro , Van Ees Hans
Published: June 2011

Manuscript Type: Review

Research Question/Issue: The article starts as a reflection on the criteria that articles submitted to CGIR should respect in order to pass the screening and referee procedures. Beyond that, the article explores the characteristics of all articles, and particularly of best paper and runner up articles, published recently in the journal. As such the article may be a guide for publishing in the journal and for contributing to the development of a global theory of corporate governance.

Research Findings/Insights: The article is based on both personal reflections of the two screening editors of the journal, and the analysis of all screening decisions taken in 2009, all articles published in the journal in 2008–10, and best papers and runner up articles in 2007–09. Results shows that (1) the most important reasons for desk rejection are the failure to build the paper on the extant literature addressing international corporate governance, a problematic structure of the paper together with substantial editing problems, and the quality of the data collection procedure; (2) the majority of articles published in the journal use both a legal, finance, and economic theoretical framework, and a quantitative research method to analyze how governance mechanisms control value distribution at firm level; (3) best papers and runner up articles have richer theoretical frameworks, more eclectic research methods, and pay explicit attention to the relevance for theory and practice.

Theoretical/Academic Implications: The article emphasizes the importance to balance rigor and relevance to enhance the global understanding of corporate governance.

Practitioner/Policy Implications: The results of the study may be of practical importance for the scholars of various disciplines that want to submit articles to the journal. The ideas contained in this article can help them to refine their articles before the submission to increase the rate of acceptance in the review process and hopefully the publication in the journal. Moreover, we underline that moving forward a global theory of corporate governance could assist practitioners and/or policy makers in developing more efficient governance mechanisms.
Focus groups for allied health professionals and professions allied to technical services in the NHS – marketing opportunities, lessons learnt and recommendations
Authors: Chamberlain David , Brook Richard
Published: June 2011

Background:  Worcestershire Health Libraries provides services to all NHS and social care staff in Worcestershire. Despite intensive marketing, statistics showed low usage of the library service for professions allied to technical services and allied health professionals.

Objectives:  To discover why there was low usage of the library services using qualitative techniques and to use focus groups as a marketing opportunity. This article also aims to outline the processes involved in delivering focus groups, the results gained, and the actions taken in response to the results.

Methods:  Focus groups were conducted in two departments, Pathology and Occupational Therapy. The Biochemistry department (part of Pathology) had two focus groups. An additional focus group was conducted for all the Pathology education leads. Occupational Therapy had two meetings, one for hospital based staff, and the other for community staff.

Results:  Issues centred on registration, inductions, time, library ambience, multi‐disciplinary service and resources. The findings raised marketing opportunities and the process identified potential candidates for the role of team knowledge officer, to act as library champions within departments. It also identified areas in which the library service was not meeting user needs and expectations, and helped focus service development.

Conclusions:  Focus groups allowed an opportunity to speak to non‐users face to face and to discover, and where appropriate challenge both their, and library staff’s pre‐conceived ideas about the service. The information revealed gave an opportunity to market services based on user needs.
Comparison of cardiac output determined by arterial pulse pressure waveform analysis method (FloTrac/Vigileo) versus lithium dilution method in anesthetized dogs
Authors: Valverde Alexander , Gianotti Giacomo , Rioja Eva , Hathway Amanda
Published: June 2011

Objective
–
To compare the determination of cardiac output (CO) via arterial pulse pressure waveform analysis (FloTrac/Vigileo) versus lithium dilution method.

Design
–
Prospective study.

Setting
–
University teaching hospital.

Animals
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Six adult dogs.

Interventions
–
Dogs were instrumented for CO determinations using lithium dilution (LiDCO) and FloTrac/Vigileo methods. Direct blood pressure, heart rate, arterial blood gases, and end‐tidal isoflurane (ETIso) and CO2 concentrations were measured throughout the study while CO was manipulated with different depth of anesthesia and rapid administration of isotonic crystalloids at 60 mL/kg/h.

Measurements and Main Results
–
Baseline CO measurements were obtained at 1.3% ETIso and were lowered by 3% ETIso. Measurements were obtained in duplicate or triplicate with LiDCO and averaged for comparison with corresponding values measured continuously with the FloTrac/Vigileo method. For 30 comparisons between methods, a mean bias of −100 mL/kg/min and 95% limits of agreement between −311 and +112 mL/kg/min (212 mL/kg/min) was determined. The mean (mL/kg/min) of the differences of LiDCO−Vigileo=62.0402+−0.8383 × Vigileo, and the correlation coefficient (r) between the 2 methods 0.70 for all CO determinations. The repeatability coefficients for the individual LiDCO and FloTrac/Vigileo methods were 187 and 400 mL/kg/min, respectively. Mean LiDCO and FloTrac/Vigileo values from all measurements were 145 ± 68 mL/kg/min (range, 64–354) and 244 ± 144 mL/kg/min (range, 89–624), respectively. The overall mean relative error was 48 ± 14%.

Conclusion
–
The FloTrac/Vigileo overestimated CO values compared with LiDCO and the relative error was high, which makes this method unreliable for use in dogs.
Influence of Liver Pathology on Markers of Postmortem Brain Tissue Quality
Authors: Sheedy Donna , Say Meichien , Stevens Julia , Harper Clive G. , Kril Jillian J.
Published: June 2011

Background:  Postmortem brain tissue provides an important resource to investigate various brain disorders, including those resulting from the effects of alcohol abuse. Unlike the traditionally recognized confounders to tissue quality (e.g., coma, hypoxia), our understanding of the effects of liver disease is incomplete. The aim of this study was to determine the effects of liver pathology, and in particular cirrhosis resulting in hepatic encephalopathy (HE), on 2 postmortem brain tissue quality markers, brain pH and RNA integrity.

Methods:  We measured tissue quality markers in a cohort of alcohol abuse and control cases collected by the NSW Tissue Resource Centre. Cerebellar tissue was used to evaluate both brain pH and RNA quality (as indicated by the RNA integrity number: RIN). A histological assessment was performed on each case to exclude coexisting pathologies (e.g., cerebrovascular disease, hypoxic encephalopathy, neurodegenerative disease) and to assess the presence or absence of HE. Autopsy reports were reviewed for liver pathology and toxicology.

Results:  Analysis revealed that cases of alcohol abuse had a lower mean (±SD) brain pH, 6.46 (±0.3) as compared with the control mean 6.64 (±0.2). The mean RIN for the alcohol abuse group was 6.97 (±1.3) and controls 7.66 (±0.5). The severity of liver pathology affected both brain pH (p < 0.0001) and RIN (p < 0.0001). The comparison between cirrhotic cases highlighted increased degradation of RNA in cases with cirrhosis resulting in HE (p = 0.0095). A similar effect was seen on brain pH (p = 0.0019).

Conclusions:  The results show that the presence of cirrhosis and, more so, HE reduces the pH and RIN of postmortem brain tissue.
On Estimation in Relative Survival
Authors: Perme Maja Pohar , Stare Janez , Estève Jacques
Published: June 2011

Summary Estimation of relative survival has become the first and the most basic step when reporting cancer survival statistics. Standard estimators are in routine use by all cancer registries. However, it has been recently noted that these estimators do not provide information on cancer mortality that is independent of the national general population mortality. Thus they are not suitable for comparison between countries. Furthermore, the commonly used interpretation of the relative survival curve is vague and misleading. The present article attempts to remedy these basic problems. The population quantities of the traditional estimators are carefully described and their interpretation discussed. We then propose a new estimator of net survival probability that enables the desired comparability between countries. The new estimator requires no modeling and is accompanied with a straightforward variance estimate. The methods are described on real as well as simulated data.
Where Neuroimaging and Lesion Studies Meet
Authors: Kwok Sze Chai
Published: June 2011

Lesion studies (both patients and nonhuman animals) and functional neuroimaging studies of normal, healthy subjects provide complementary, but different types of information. This article suggests that both study types are necessary for deriving inferentially sound conclusions regarding the neural basis of cognition.
Innate immunity in allergic disease
Authors: Minnicozzi Michael , Sawyer Richard T. , Fenton Matthew J.
Published: June 2011

Summary: The innate immune system consists of multiple cell types that express germline‐encoded pattern recognition receptors that recognize pathogen‐associated molecular patterns (PAMPs) or danger‐associated molecular patterns (DAMPs). Allergens are frequently found in forms and mixtures that contain PAMPs and DAMPs. The innate immune system is interposed between the external environment and the internal acquired immune system. It is also an integral part of the airways, gut, and skin. These tissues face continuous exposure to allergens, PAMPs, and DAMPs. Interaction of allergens with the innate immune system normally results in immune tolerance but, in the case of allergic disease, this interaction induces recurring and/or chronic inflammation as well as the loss of immunologic tolerance. Upon activation by allergens, the innate immune response commits the acquired immune response to a variety of outcomes mediated by distinct T‐cell subsets, such as T‐helper 2, regulatory T, or T‐helper 17 cells. New studies highlighted in this review underscore the close relationship between allergens, the innate immune system, and the acquired immune system that promotes homeostasis versus allergic disease.
Eosinophils: multifaceted biological properties and roles in health and disease
Authors: Kita Hirohito
Published: June 2011

Summary:  Eosinophils are leukocytes resident in mucosal tissues. During T‐helper 2 (Th2)‐type inflammation, eosinophils are recruited from bone marrow and blood to the sites of immune response. While eosinophils have been considered end‐stage cells involved in host protection against parasite infection and immunopathology in hypersensitivity disease, recent studies changed this perspective. Eosinophils are now considered multifunctional leukocytes involved in tissue homeostasis, modulation of adaptive immune responses, and innate immunity to certain microbes. Eosinophils are capable of producing immunoregulatory cytokines and are actively involved in regulation of Th2‐type immune responses. However, such new information does not preclude earlier observations showing that eosinophils, in particular human eosinophils, are also effector cells with proinflammatory and destructive capabilities. Eosinophils with activation phenotypes are observed in biological specimens from patients with disease, and deposition of eosinophil products is readily seen in the affected tissues from these patients. Therefore, it would be reasonable to consider the eosinophil a multifaceted leukocyte that contributes to various physiological and pathological processes depending on their location and activation status. This review summarizes the emerging concept of the multifaceted immunobiology of eosinophils and discusses the roles of eosinophils in health and disease and the challenges and perspectives in the field.
The genetics of asthma and allergic disease: a 21st century perspective
Authors: Ober Carole , Yao Tsung‐Chieh
Published: June 2011

Summary:  Asthma and allergy are common conditions with complex etiologies involving both genetic and environmental contributions. Recent genome‐wide association studies (GWAS) and meta‐analyses of GWAS have begun to shed light on both common and distinct pathways that contribute to asthma and allergic diseases. Associations with variation in genes encoding the epithelial cell‐derived cytokines, interleukin‐33 (IL‐33) and thymic stromal lymphopoietin (TSLP), and the IL1RL1 gene encoding the IL‐33 receptor, ST2, highlight the central roles for innate immune response pathways that promote the activation and differentiation of T‐helper 2 cells in the pathogenesis of both asthma and allergic diseases. In contrast, variation at the 17q21 asthma locus, encoding the ORMDL3 and GSDML genes, is specifically associated with risk for childhood onset asthma. These and other genetic findings are providing a list of well‐validated asthma and allergy susceptibility genes that are expanding our understanding of the common and unique biological pathways that are dysregulated in these related conditions. Ongoing studies will continue to broaden our understanding of asthma and allergy and unravel the mechanisms for the development of these complex traits.
The sentinel role of the airway epithelium in asthma pathogenesis
Authors: Holgate Stephen T.
Published: June 2011

Summary:  The adoption of the concept that asthma is primarily a disease most frequently associated with elaboration of T‐helper 2 (Th2)‐type inflammation has led to the widely held concept that its origins, exacerbation, and persistence are allergen driven. Taking aside the asthma that is expressed in non‐allergic individuals leaves the great proportion of asthma that is associated with allergy (or atopy) and that often has its onset in early childhood. Evidence is presented that asthma is primarily an epithelial disorder and that its origin as well as its clinical manifestations have more to do with altered epithelial physical and functional barrier properties than being purely linked to allergic pathways. In genetically susceptible individuals, impaired epithelial barrier function renders the airways vulnerable to early life virus infection, and this in turn provides the stimulus to prime immature dendritic cells toward directing a Th2 response and local allergen sensitization. Continued epithelial susceptibility to environmental insults such as viral, allergen, and pollutant exposure and impaired repair responses leads to asthma persistence and provides the mediator and growth factor microenvironment for persistence of inflammation and airway wall remodeling. Increased deposition of matrix in the epithelial lamina reticularis provides evidence for ongoing epithelial barrier dysfunction, while physical distortion of the epithelium consequent upon repeated bronchoconstriction provides additional stimuli for remodeling. This latter response initially serves a protective function but, if exaggerated, may lead to fixed airflow obstruction associated with more severe and chronic disease. Dual pathways in the origins, persistence, and progression of asthma help explain why anti‐inflammatory treatments fail to influence the natural history of asthma in childhood and only partially does so in chronic severe disease. Positioning the airway epithelium as fundamental to the origins and persistence of asthma provides a rationale for pursuit of therapeutics that increase the resistance of the airways to environmental insults rather than concentrating all effort on suppressing inflammation.
CORRELATION OF ULTRASOUND FINDINGS, LIVER AND SPLEEN CYTOLOGY, AND PROGNOSIS IN THE CLINICAL STAGING OF HIGH METASTATIC RISK CANINE MAST CELL TUMORS
Authors: BOOK ALISON P. , FIDEL JANEAN , WILLS TAMARA , BRYAN JEFFREY , SELLON RANCE , MATTOON JOHN
Published: June 2011

Cytologic sampling of the ultrasonographically normal spleen and liver is not implemented routinely in the clinical staging of canine cutaneous mast cell tumors and normal ultrasound findings are often accepted as sufficient evidence for ruling out splenic or liver metastasis. Our objective was to define the specificity and sensitivity of ultrasound findings for diagnosis of mast cell infiltration when verified with cytologic evaluation, and to define the prognostic role of cytologic evaluation of liver and splenic aspirates. Dogs with a diagnosis of clinically aggressive grade II, or grade III mast cell tumor treated with a combination vinblastine/CCNU chemotherapy protocol, were selected retrospectively based on availability of cytologic evaluation of spleen plus or minus liver for staging. Out of 19 dogs, 10 dogs had a grade II tumor and nine a grade III tumor. Seven dogs had mast cell infiltration of the spleen, liver, or both. The sensitivity of ultrasound for detecting mast cell infiltration was 43% for the spleen and 0% for the liver. Dogs with positive cytologic evidence of mast cell infiltration to spleen, liver, or both had significantly shorter survival (100 vs. 291 days) than dogs without evidence of mast cell infiltration (P<0.0001). Routine splenic aspiration should be performed regardless of ultrasonographic appearance in dogs with a clinically aggressive mast cell tumor.
LISTENING AS EMBRACING THE OTHER: MARTIN BUBER'S PHILOSOPHY OF DIALOGUE
Authors: Gordon Mordechai
Published: June 2011

In this essay, Mordechai Gordon interprets Martin Buber's ideas on dialogue, presence, and especially his notion of embracing in an attempt to shed some light on Buber's understanding of listening. Gordon argues that in order to understand Buber's conception of listening, one needs to examine this concept in the context of his philosophy of dialogue. More specifically, his contention is that closely examining Buber's notion of embracing the other is critical to making sense of his conception of listening. Gordon's analysis suggests that, in Buber's model, listening involves a kind of active attentiveness to another's words or actions, engaging them as though they are directed specifically at us. Gordon's discussion of dialogue and listening also indicates that the relation between speaking and listening is one of reciprocity and mutual dependence and that listening plays an essential role in initiating many dialogues by creating a space in which two people can embrace each other as complete individuals.
Association of Cerebrospinal Fluid Analysis Findings with Clinical Signs and Outcome in Acute Nonambulatory Thoracolumbar Disc Disease in Dogs
Authors: Srugo I. , Aroch I. , Christopher M.M. , Chai O. , Goralnik L. , Bdolah‐Abram T. , Shamir M.H.
Published: June 2011

Background:Cerebrospinal fluid (CSF) pleocytosis recently was associated with the severity of neurologic signs in dogs with intervertebral disc disease (IVDD).

Hypothesis/Objectives:To look for an association among CSF cell counts, total protein concentration, and severity of neurologic signs at presentation with outcome in dogs with acute thoracolumbar IVDD. Our hypothesis was that CSF total nucleated cell count (TNCC) and percentage cell types would be associated with the severity of spinal cord damage and therefore with both the presenting clinical signs and the prognosis of affected dogs.

Animals:Fifty‐four dogs with acute nonambulatory thoracolumbar IVDD were evaluated.

Methods:Retrospective study. Signalment, neurologic grade, CSF TNCC, protein concentration, red blood cells count and differential cell percentages, and short‐ and long‐term outcomes were evaluated.

Results:CSF pleocytosis (>5 cells/μL) was present in 54% of dogs and was positively associated with neurologic grade at presentation and with postoperative time to regaining ambulation. Neutrophils were observed most frequently. The percentage of CSF macrophages and macrophage to monocyte ratio were higher (P= .001, for both) in dogs presented without deep pain sensation (DPS) that did not regain ambulation. Receiver operator characteristics curve analysis yielded a cut‐off point of 13% macrophages with a sensitivity and specificity of 100 and 83%, respectively, for prediction of a negative outcome.

Conclusions and Clinical Importance:CSF pleocytosis is positively associated with the severity of spinal cord damage in dogs with thoracolumbar IVDD. The percentage of CSF macrophages can be used as a prognostic indicator for regaining ambulation in dogs that have lost DPS.
Recurrent Demyelination and Remyelination in 37 Young Bengal Cats with Polyneuropathy
Authors: Bensfield A.C. , Evans J. , Pesayco J.P. , Mizisin A.P. , Shelton G.D.
Published: June 2011

Background:With the exception of diabetic neuropathy, polyneuropathy associated with hyperchylomicronemia, and a few inherited polyneuropathies, peripheral neuropathies are poorly characterized in cats. A chronic polyneuropathy is described in a cohort of young Bengal cats.

Objective:To characterize the clinical and histopathological features of a chronic‐relapsing peripheral neuropathy in young Bengal cats.

Animals:Thirty‐seven young Bengal cats with clinical weakness consistent with peripheral neuropathy.

Methods:Bengal cats were included in this study after a diagnosis of polyneuropathy was confirmed by muscle and peripheral nerve biopsy specimens. Pathological changes were characterized at the light and electron microscopic level and by morphometry. Clinical information and long‐term outcome from case records of Bengal cats with histologically confirmed peripheral neuropathy were then assessed.

Results:Nerve fiber loss within distal intramuscular nerve branches was a consistent finding in young Bengal cats with polyneuropathy. The most common abnormalities in peripheral nerve biopsies included inappropriately thin myelin sheaths and thinly myelinated fibers surrounded by supernumerary Schwann cell processes, indicative of repeated cycles of demyelination and remyelination. Recovery was common. Response to treatment could not be determined.

Conclusions and Clinical Importance:A chronic‐relapsing form of polyneuropathy associated primarily with episodes of demyelination and remyelination was identified in young Bengal cats. The prognosis for recovery is good, although relapses are possible and there can be residual motor deficits.
Psychological consequences of medical accidents in personal litigants
Authors: Church John , Vincent Charles
Published: June 2011

Long‐term distress was assessed in 29 patients who had suffered an injury during surgery, a failure of diagnosis or other incorrect treatment, and who had taken legal action as a result. Psychological distress reported over four years after the incident was severe: 38 per cent of those interviewed were identified as ‘cases’ for anxiety, 41 per cent for depression and 55 per cent for both on the Hospital Anxiety and Depression Scale, using the conservative cut‐off criteria of 11 for caseness. Scores on the Impact of Events Scale indicated higher levels of intrusive memories and posttraumatic distress than have been previously reported for serious life‐events and other accidents. Early and ongoing psychosocial interventions would benefit many victims of medical accidents. Clinical psychologists have an important role to play in providing psychological treatment where appropriate and in re‐establishing a relationship of trust and confidence in health care professionals.
Reducing anxiety in women referred for colposcopy using an information booklet
Authors: Marteau Theresa M. , Kidd Jane , Cuddeford Lisa , Walker Patrick
Published: June 2011

Women referred for colposcopy following abnormal cervical smears are extremely anxious. The purpose of the current study is to compare the effectiveness of two booklets in reducing this anxiety. One booklet was brief, simply written to provide procedural information, behavioural instructions and outcome information. The other booklet was longer and more complex focusing largely upon procedural and outcome information. Women referred for colposcopy for the first time following abnormal cervical smears were randomly allocated to one of four groups: Group 1 received the appointment letter, Group 2 received the appointment letter and the simple booklet, Group 3 received the appointment letter and the more complex booklet, Group 4 received the appointment letter and both booklets. While receipt of either booklet increased women's knowledge about cervical abnormalities and colposcopy, women who received the simpler booklet were less anxious shortly after receipt of their appointments than women receiving no information or the complex booklet, and were also less anxious than those not receiving this booklet when they attended the hospital for colposcopy. There was also some evidence that these women were more reassured from this consultation than those who had not received this booklet. Receiving the more complex booklet increased knowledge but did not reduce anxiety. The aspects of the simple booklet that led to reduced anxiety, and how, remain to be determined.
Personality, cancer and coronary heart disease: Further evidence on a controversial issue
Authors: Amelang Manfred , Schmidt‐Rathjens Claudia , Matthews Gerald
Published: June 2011

Controversy surrounds the contention that certain psychological factors correlate highly with cancer and coronary heart disease (CHD). This study provides further empirical evidence on this issue. Special consideration is given to Grossarth‐Maticek's theory of personality types, according to which Type 1 personalities are more susceptible to cancer and Type 2 personalities to CHD. A total of 1858 participants of both sexes between the ages of 39 and 68 responded to a battery of personality scales including our own R(evised)‐Scales. Designed to measure the Grossarth‐Maticek's personality types, these R‐Scales proved to be internally highly consistent, but R‐Scales 1 and 2 were intercorrelated at the level of their reliability. Factor analyses indicated that Grossarth‐Maticek's predictors of illness do not measure any unique constructs, i.e. constructs not also tapped by other personality scales included in the test battery. Participants suffering from cancer or from CHD differed in personality from healthy participants, but not in the direction predicted. These results suggest that the claimed discriminant validity of the Grossarth‐Maticek illness predictors is highly improbable.
Health behaviours reported as coping strategies: A factor analytical study
Authors: Ingledew David K. , Hardy Lew , Cooper Cary L. , Jemal Hatice
Published: June 2011

Objectives. This study aimed to explore the relationships between health behaviours which participants reported using as coping strategies, and other, more documented, coping strategies.

Design. The relationships were examined using exploratory factor analysis of questionnaire data.

Methods. Items reflecting the use of health behaviours as ways of coping with stressful situations were developed. Behaviours included relaxation, eating and weight control, preventive medicine, exercise and fitness, safety, sleep, use of caffeine, alcohol use, smoking and general self‐care. These 30 items were intermingled with Carver, Scheier & Weintraub's (1989) COPE items. The whole was administered with COPE instructions to 256 adults. Principal‐axis factoring with oblique rotation was employed.

Results. Factor analysis of the health behaviour items along with 13 COPE scales eventuated in a six‐factor solution, explaining 47.8 per cent of the variance. Three factors reflected problem‐focused coping, emotion‐focused coping and avoidance, and three quite distinct factors reflected exercise, eating and self‐care. Women compared with men tended more towards emotion‐focused coping and eating. Older individuals compared with younger tended more towards problem‐focused coping and self‐care, and less towards eating.

Conclusions. Because the health behaviours formed quite distinct factors, it is suggested that health behaviours may serve coping functions other than the previously well documented functions of problem‐focused, emotion‐focused or avoidance. It is speculated that exercise and self‐care may function in a preventive fashion as resources for coping. Other possible interpretations of the results are discussed.
Depression in patients undergoing cardiac surgery: A comment
Authors: Duits A. A. , Boeke S. , Duivenvoorden H. J. , Passchier J. , Erdman R. A. M.
Published: June 2011

A recent article by Burker et al. reported a high prevalence of depression in patients (N = 114) both before (47 per cent) and after (61 per cent) cardiac surgery. Prevalence in the present study (N = 133), on the other hand, was low: between 7.5 and 16.5 per cent pre‐operatively and 4.5 and 14.3 per cent post‐opcratively, depending on the assessment instrument used. We recommend using a combination of self‐report inventories and expert clinical judgment to determine the prevalence of depression in cardiac surgery patients.
Vital exhaustion, neuroticism and symptom reporting in patients with cardiac and non‐cardiac chest pain
Authors: Bennett Paul , Smith Paula , Gallacher John E. J.
Published: June 2011

In a case control study, 60 participants matched for age and gender were identified in three conditions: patients admitted with confirmed first myocardial infarction (MI), patients admitted with chest pain but with no evidence of MI, and a ‘normal’ control group. Amongst a number of measures, they completed the Pennebaker Inventory of Linguid Languidness (PILL) and Maastricht Questionnaire (MQ). Both MQ and PILL, alone and in combination, failed to discriminate between cardiac and non‐cardiac patients, only between patients and controls. The implications of these results are discussed.
Evaluation of cognitive—behavioural counselling for the distress associated with an abnormal cervical smear result
Authors: Richardson P. H. , Doherty I. , Wolfe C. D. A. , Carman N. , Chamberlain F. , Holtom R. , Raju K. S.
Published: June 2011

A prospective randomized controlled trial was conducted to examine the relative effects of the provision of information and of cognitive–behavioural counselling on the psychological adjustment of women who had previously been informed of an abnormal cervical smear result and subsequently required a further diagnostic procedure (colposcopy examination) and treatment. Altogether, 219 women were randomized to one of two groups: (a) counselling plus the provision of an information leaflet, and (b) information leaflet only. Patients in both groups received an information leaflet with their first colposcopy appointment. Patients in the counselling group also attended a counselling interview prior to their colposcopy examination. The Abnormal Smears Questionnaire (a measure of specific concerns relating to the smear result and subsequent diagnostic and treatment procedures), together with the Spielberger State Anxiety Inventory (STAI‐Y1), the General Health Questionnaire (GHQ‐30), and the Profile of Mood States (POMS‐36) were administered pre‐colposcopy, post‐colposcopy, pre‐treatment, post‐treatment and at three‐ and six‐month follow‐ups. Additionally a counselling evaluation questionnaire was completed by women in the counselling group after their colposcopy examination.

High levels of distress were reported by both groups of patients on all measures prior to the colposcopy examination, with a subsequent highly significant post‐colposcopy reduction, again in both groups. There were no significant differences in psychological functioning between the two groups at post‐colposcopy assessment. Some minor differences emerged between the two groups at treatment and follow‐up assessments but following analysis of covariance these were interpreted as artifacts of baseline differences between the two groups on the measures concerned. Therefore, the hypothesis that cognitive‐behavioural counselling plus information would have an incremental benefit over the simple provision of an information leaflet was not supported. Possible interpretations of these results are discussed.
The Functional Dimensions of Coping scale: Theory, reliability and validity
Authors: Ferguson Eamonn , Cox Tom
Published: June 2011

Objectives. This paper details the theoretical position that coping function is transactionally defined. It details the psychometric development of an instrument to assess coping function transactionally: Functional Dimensions of Coping (FDC) scale. The FDC scale permits individuals to define for themselves what functions they believe their coping behaviours/styles perform. Four functions are used: approach, avoidance, reappraisal and emotional regulation. It was hypothesized that a four‐factor model would be a better fit to the data than other more parsimonious models (e.g. approach‐avoidance). Validity was assessed in terms of associations with health anxieties (hypochondriasis) and it was hypothesized that those who report health anxieties should perceive their coping behaviours in terms of the avoidance and reappraisal functions.

Design. Two retrospective questionnaire studies (Ns = 333, 101) are reported.

Methods. Survey questionnaires were distributed to two samples of undergraduate students. The data were analysed using a mixture of LISREL modelling and multiple linear regression analyses.

Results. The FDC was shown to: (1) have excellent factorial validity (the four‐factor model was the best fit to the data), (2) have excellent internal psychometric properties, (3) have no significant associations with social desirability and (4) covary in predicted ways with a number of health anxieties.

Conclusions. These results indicate that coping function can be assessed usefully in a transactional way.
Self‐help treatment of chronic fatigue in the community: A randomized controlled trial
Authors: Chalder T. , Wallace P. , Wessely S.
Published: June 2011

Objectives. To evaluate the efficacy of a self‐help booklet and specific advice in reducing chronic fatigue in a primary care population aged 18–34 years.

Design. A randomized controlled trial.

Methods. A self‐help intervention (N = 70) was compared with no treatment (N = 80). The main outcome measures were a fatigue questionnaire and the 12‐item General Health Questionnaire. Follow‐up was completed on 127 patients.

Results. The self‐help group showed significantly greater improvements in fatigue (p = .01) and psychological distress (p < .01) than controls. At follow‐up, 63 per cent of the self‐help completers achieved a good outcome (scored less than 4 on the fatigue questionnaire) compared with 39 per cent of the control group.

Conclusions. The provision of a self‐help booklet and specific advice during a consultation with a research nurse was more effective than no treatment at improving fatigue and psychological distress. General practitioners should be encouraged to use self‐help literature in the management of patients with chronic fatigue.
The development of an anger expression and control scale
Authors: van Elderen Thérèse , Maes Stan , Komproe Ivan , van der Kamp Leo
Published: June 2011

Objectives. The Self‐Expression and Control Scale (SECS) has been constructed to investigate the role of anger expression and anger control in the aetiology and progression of hypertension, coronary heart disease and other chronic diseases.

Design and methods. This questionnaire was presented to a Dutch community sample (N = 946). A first version of the questionnaire with 64 items was reduced to 40 items on the basis of principal component analyses and analyses of internal consistency. This final 40‐item version of the questionnaire consists of four subscales of 10 items each. The subscales are: anger‐in (AI, the internationalization of anger), anger‐out (AO, the externalization of anger), control‐anger‐in (CAI, control over the internalization of anger) and control‐anger‐out (CAO, control over the externalization of anger). Additionally, differences between the community sample of Dutch residents and a sample of coronary heart disease patients (N = 257) on the four subscales were examined.

Results. The psychometric properties of the SECS proved to be highly acceptable, and the convergent and discriminant validity quite promising. Males and older persons scored statistically significantly lower on AO and higher on CAI and CAO than females and younger persons. The community sample of Dutch residents scored significantly higher on AO than a population of coronary heart disease patients.

Conclusions. The anger control scales seem to allow a more differentiated assessment of anger, which may be of crucial importance for future research on anger and health.
Perceived risk and vulnerability as predictors of precautionary behaviour
Authors: van der Pligt Joop
Published: June 2011

Virtually all major theories of health‐related behaviours are based on the assumption that people estimate their perceived susceptibility to a disease and evaluate the costs and benefits of precautionary behaviour before taking action. Generally, perceived risk or susceptibility is seen as an important determinant of preventive action. First I briefly summarize the literature on the accuracy of perceived risk or susceptibility. Next I turn to the relation between perceived risk and precautionary behaviour. This article reviews the evidence concerning the assumption that perceived risk or vulnerability is an important determinant of precautionary behaviour and points at some shortcomings of the existing literature. Comparative optimism or unrealistic optimism (i.e. the belief that risks apply more to others than to oneself) is also assumed to be related to preventive behaviour. This field of research is briefly reviewed and it is concluded that there is hardly any evidence for the presumed detrimental effect of optimism on preventive behaviour. This is followed by some methodological considerations about how to measure perceived risk and investigate its role as a behavioural determinant. It is recommended to reduce the diversity in which perceived risk is measured and to focus on conditional risk as opposed to unconditional risk. It will be argued that perceived vulnerability is a necessary but not a sufficient condition for preventive action. Other more proximal antecedents of preventive behaviour will be briefly discussed, followed by a brief discussion of the implications for health education practice.
Relationship between locus of control beliefs and metabolic control in insulin‐dependent diabetes mellitus
Authors: Stenström Ulf , Wikby Anders , Andersson Per‐Olof , Rydén Olof
Published: June 2011

Objectives. To examine the relationship between diabetes‐specific health locus of control patterns and metabolic control (HbA1C). The validity and reliability of the Diabetes Locus of Control Scale (DLOC) used were also examined.

Methods. Study participants were 312 consecutive adult Swedish out‐patients with insulin‐dependent diabetes mellitus (IDDM). The participants completed the DLOC at their regular clinic visit and data on metabolic control (HbA1C) and background factors were gathered.

Results. The Diabetes Locus of Control Scale was found to have adequate psychometric properties. Participants with strong beliefs that their own behaviour is responsible for the course of the disease and weak beliefs in chance and luck were metabolically better regulated than participants who exhibited other health locus of control patterns.

Conclusions. The diabetes locus of control patterns examined appear to have explanatory power in accounting for metabolic control. The data suggest that, in planning treatment of IDDM patients, clinicians could make use of knowledge concerning the patients' health locus of control patterns.
Food for thought: Cognitive regulation of food intake
Authors: Boon Brigitte , Stroebe Wolfgang , Schut Henk , Jansen Anita
Published: June 2011

Objectives. Two studies examined the cognitive regulation of restrained eaters' eating behaviour. It was hypothesized that restrained dieters should have more restraint‐related cognitions in the presence of food stimuli than unrestrained eaters, whereas restrained non‐dieters should occupy an intermediate position. The correlation between cognition and consumption should be zero for unrestrained eaters and negative for restrained eaters.

Design. Participants currently dieting or not dieting and of high or low restraint status (median split) were presented in Study 1 with high and low calorie food words and asked to list their thoughts. In Study 2, participants listed thoughts following a taste test. In both studies diet and restraint status were related to restraint relevant thoughts. In Study 2 thoughts were also related to actual consumption.

Methods. Participants were female students; restraint status was measured with the Restraint Scale; current diet status was assessed with one question. Fifty‐two unrestrained eaters, 38 restrained non‐dieters and 18 restrained dieters participated in Study 1; 33 unrestrained eaters, 19 restrained non‐dieters and 11 restrained dieters participated in Study 2.

Results. Food stimuli elicited more eating control, weight‐ and shape‐related thoughts in restrained dieters than in unrestrained eaters, with the restrained non‐dieters occupying an intermediate position. Consistent with predictions, the cognition‐consumption correlation was zero for unrestrained eaters and negative (trend) for restrained dieters. Contrary to prediction, this correlation was positive for restrained non‐dieters.

Conclusions. Results show that cognitions play an important role in the regulation of the eating behaviour of restrained individuals. They further suggest that the cognitive regulation of food intake in restrained eaters may be based on different mechanisms in dieters as compared to non‐dieters.