Interpersonal stress and style as predictors of biofeedback/relaxation training outcome: preliminary findings

Although the data base describing clinical outcome following biofeedback/relaxation training is accumulating, there have been relatively few attempts to predict short-term outcome, and even fewer for long-term outcome. Significant short-term outcome predictors have been identified, and they often allude to the level of psychological distress as a major factor affecting outcome. To investigate further the role of psychological variables in outcome prediction, this project presents preliminary findings that demonstrate the relationship involving interpersonal psychological stress, interpersonal style of behavior, and outcome. With a very heterogeneous group of patients (N = 39), measures of interpersonal style of behavior were used to discriminate correctly 80% of cases by outcome at the 3-month postadmission evaluation. With a more homogeneous group having somatic disorders alone (headache, Raynaud's, etc.), the accuracy of prediction at 3 months was 90%. No measures were capable of predicting long-term outcome with accuracies even moderately greater than chance. The results indicate that style of interpersonal behavior (e.g., managerial, dependent) and, to a lesser extent, interpersonal stress is predictive of short-term outcome following biofeedback/relaxation training. Individuals who tend to like responsibility and who are more executive and independent generally benefited more than doubtful, obedient, and depressed individuals. While the resulting prediction rates were only slightly more accurate than MMPI D and Pt subscales alone, the procedures provide additional information regarding the personality characteristics of successful and unsuccessful biofeedback clients, and may also provide the clinician with information regarding treatment choice if biofeedback is provided as an adjunct to psychotherapy.     

Interpersonal stress and style as predictors of biofeedback/relaxation training outcome: Preliminary findings

Although the data base describing clinical outcome following biofeedback/relaxation training is accumulating, there have been relatively few attempts to predict short-term outcome, and even fewer for long-term outcome. Significant short-term outcome predictors have been identified, and they often allude to the level of psychological distress as a major factor affecting outcome. To investigate further the role of psychological variables in outcome prediction, this project presents preliminary findings that demonstrate the relationship involving interpersonal psychological stress, interpersonal style of behavior, and outcome. With a very heterogenous group of patients (N=39), measures of interpersonal style of behavior were used to discriminate correctly 80% of cases by outcome at the 3-month postadmission evaluation. With a more homogeneous group having somatic disorders alone (headache, Raynaud's, etc.), the accuracy of prediction at 3 months was 90%. No measures were capable of predicting long-term outcome with accuracies even moderately greater than chance. The results indicate that style of interpersonal behavior (e.g., managerial, dependent) and, to a lesser extent, interpersonal stress is predictive of short-term outcome following biofeedback/relaxation training. Individuals who tend to like responsibility and who are more executive and independent generally benefited more than doubtful, obedient, and depressed individuals. While the resulting prediction rates were only slightly more accurate than MMPI D and Pt subscales alone, the procedures provide additional information regarding the personality characteristics of successful and unsuccessful biofeedback clients, and may also provide the clinician with information regarding treatment choice if biofeedback is provided as an adjunct to psychotherapy.     

Female Goldeneye Ducks (Bucephala clangula) Do Not Discriminate among Male Precopulatory Display Patterns

Female goldeneyes remain motionless on the surface of the water while single males circle them performing a series of highly stereotyped displays. After performing between eight and 90 of these displays the male either copulates or attempts to copulate with the female. However, females allow only 58% of males to mount them, while rejecting 42%. We have examined 804 of these precopulatory sequences containing 11,841 actions in an effort to determine why females find some display sequences of males unsuitable, while others are accepted. Males have an extraordinarily varied sequence of actions, and sequence variation leading to successful and unsuccessful copulation attempts was similar. Most surprising was the tendency of males to eliminate one of the five actions, whether in successful or unsuccessful attempts. As unlikely as we think it might be as the result of natural selection, the only statistically significant difference we found between successful and unsuccessful attempts was the reduction in the frequency of expression of one or more of the behaviors in successful attempts. These observations, coupled with the large variation seen in most sequences, suggest that there is not a correct sequence, or even a correct set of actions leading to copulation. The male must, however, perform goldeneye species-specific precopulatory behavior as performed by adult males, although it apparently can be performed in a wide variety of patterns.     

Composition of free fatty acids at the end of pregnancy and inducibility of labor

The concentrations of free fatty acids which included prostaglandin precursors were investigated in a group of 54 healthy women coming to elective induction of labor. There were no differences between the concentrations of the fatty acids when the mothers were divided in two groups according to whether induction was successful or not. There were slightly more mothers with successful induction, who had the total prostaglandin precursor level above average than among mothers with unsuccessful induction (p < 0.05). The rates of false positives or false negatives were so high, however, that this determination can not be clinically used in predicting the outcome of labor induction.     

A comparison of outcomes using three different methods of breast reconstruction.

In a review of 325 postmastectomy breast reconstructions, the aesthetic quality of the result and the risk of unsuccessful outcome were compared for three techniques: tissue expansion (105 breasts), latissimus dorsi myocutaneous flap (47 breasts), and TRAM flap (173 breasts). The aesthetic successes achievable with the three methods were similar, and some excellent results were achieved with each of them. The failure rate after tissue expansion (21 percent) was significantly higher than those observed with the TRAM (3 percent) and latissimus (9 percent) flaps. Tissue expansion also was not as aesthetically successful as other techniques in obese patients. For immediate breast reconstruction, the TRAM flap was the most aesthetically successful technique. Although tissue expansion has advantages and may be the best choice for some patients, methods that used autogenous tissue provided more consistent success.     

Evolution of Polaskia chichipe (Cactaceae) under domestication in the Tehuacan Valley, central Mexico: reproductive biology

Polaskia chichipe, a columnar cactus, is cultivated for its edible fruits in central Mexico. This study analyzed whether artificial selection has modified its reproduction patterns and caused barriers to pollen exchange between wild, managed in situ, and cultivated populations. Anthesis was diurnal (～16 h in winter, ～10 h in spring) as well as partly nocturnal (～12 h in winter, ～3 h in spring), and flowers were pollinated by bees, hummingbirds, and hawk moths. Manual cross-pollination was ～37-49% effective in all populations. Self-pollination was ～12% successful in the wild, but twice as successful (～22-27%) in managed and cultivated populations. Diurnal pollination was ～35-55% effective in winter and 100% in spring. Nocturnal pollination was successful only in winter (15%). Crosses among individuals were more effective within populations than among populations, including populations under a similar management regimen. The least successful crosses were between wild and cultivated populations. Flowers were produced in all populations from January to March, but flowering peaks differed by 1 mo among wild, managed, and cultivated populations and by 2 mo between wild and cultivated populations. The latter interrupted pollen exchange in May. Seeds from managed and cultivated populations germinated faster than those from wild individuals. Domestication has seemingly favored self-compatible P. chichipe plants with higher fruit yield, a longer period of fruit production, and faster seed germination, attributes that have resulted in partial reproductive barriers between wild and manipulated populations.     

Susceptibility of Helicobacter pylori Isolates against Agents Commonly Administered for Eradication Therapy and the Efficacy of Chemotherapy

Although chemotherapy has been documented to be effective in the treatment of Helicobacter pylori-associated gastritis and gastroduodenal ulcers, some cases are known to have been unsuccessful in the attempt to eradicate this species. In this study, we examined the relation between the susceptibility of H. pylori isolates and the efficacy of chemotherapy. We utilized the modified agar plate dilution method to determine the minimum inhibitory concentrations (MICs) of 63 H. pylori strains isolated before treatment with several drugs routinely used during eradication chemotherapy. Among the drugs tested, amoxicillin (AMPC) and clarithromycin (CAM) demonstrated high degrees of activity with MIC₉₀, 0.39 and 0.2 μg/ml, respectively. No highly resistant strain against AMPC was detected among the strains examined, while for CAM and metronidazole (MTZ), 9.5% and 7.9% of the strains, respectively, were resistant before treatment. It should be noted that all of the MICs of the strains from patients with successful therapy were lower than those from patients with unsuccessful therapy. These findings indicate that susceptibility tests should be carried out prior to the commencement of drug administration in order to provide safer and more effective chemotherapy.     

Dipole source localization by the mottled sculpin II. The role of lateral line excitation patterns

Extracellular, single unit recording techniques were used to measure the responses of posterior lateral line nerve fibers to a 50-Hz dipole source that slowly changed its location along the length of the fish. The flow-field equations for a dipole source were used to model the pressure gradient pattern and thus, the expected excitation pattern along a linear array of lateral line receptor organs for different source locations. Finally, excitation patterns were similarly modeled along the left and right side of the fish's head for actual steps taken by sculpin in approach pathways to the 50-Hz dipole source. Spatial histograms of posterior lateral line nerve fiber responses to different locations of the dipole source could be predicted from pressure gradient patterns modeled from the flow-field equations, confirming that the modeling approach applied to behavioral results was a good predictor of excitation patterns likely to be encoded by the lateral line periphery. An examination of how modeled excitation patterns changed from one position to the next in typical approach pathways and how patterns differed between positions from which successful and unsuccessful strikes were launched suggests that approach and strike strategies can indeed be explained by the information available in excitation patterns. In particular, changes in the spatial distribution of pressure gradient directions (polarities), available only when the source is lateral (as opposed to directly in front of the fish), appear to enhance the ability of sculpin to determine source distance. Without such information, misses are more likely to occur and successful strikes are more likely to be launched from short distances only. Accepted: 23 October 1996     

Seasonal interactions in the black-legged kittiwake, Rissa tridactyla: links between breeding performance and winter distribution

Relationships between events in one period of the annual cycle and behaviour in subsequent seasons are key determinants of individual life histories and population dynamics. However, studying such associations is challenging, given the difficulties in following individuals across seasons, particularly in migratory species. Relationships between breeding performance and subsequent winter ecology are particularly poorly understood, yet are likely to be profoundly important because of the costs of reproduction. Using geolocation technology, we show that black-legged kittiwakes that experienced breeding failure left their colony in southeast Scotland earlier than successful breeders. Moreover, a greater proportion of unsuccessful breeders (94% versus 53% successful) travelled over 3000 km to the West Atlantic, whereas fewer visited the East Atlantic (31% versus 80% successful), less than 1000 km from the colony. The two groups did not differ in the timing of return to the colony the following spring. However, 58 per cent of males made a previously undescribed long-distance pre-breeding movement to the central Atlantic. Our results demonstrate important links between reproductive performance and winter distribution, with significant implications for population dynamics. Furthermore, macro-scale segregation associated with breeding outcome is relevant to defining important wintering areas, in particular among declining species experiencing increasingly regular breeding failure.     

Nest‐site selection by Blue‐black Grassquits in a Neotropical savanna: do choices influence nest success?

ABSTRACT.   Nest-site choice affects individual fitness and possibly reflects natural selection of the capacity of individuals to select appropriate microhabitat features. From 2003 to 2005, we examined nest-site characteristics and nesting success of Blue-black Grassquits ( Volatinia jacarina ) in central Brazil. We compared the characteristics of nest sites and nonused sites, as well as the characteristics of successful and unsuccessful nests. Grassquit nest sites were structurally more complex than nonused sites. Shrub height and the interaction between vegetation height and percentage of ground coverage were the most important predictors of nest placement. Grassquits used only four (20%) of the 20 grass species in the study area, with Paspalum pectinatum used less than expected based on availability and Melinis minutiflora more than expected. The only variable that differed between unsuccessful and successful nests was the distance to nearest conspecific nest; the latter were about twice as far from neighboring nests as unsuccessful nests. The evaluation of microhabitat candidate models indicated that the daily survival probability of nests varied chiefly as a function of the interaction between their external height and inner depth. Greater survival occurred when the external height was minimized in combination with augmentation of internal depth of the nest cup. The link between nest success and the inverse association of external height and internal depth suggests that minimizing the visual cues of nest presence while maintaining a viable incubation chamber can positively affect nest success. Thus, we suggest that nest concealment is the most critical attribute associated with nest site choice for Blue-black Grassquits in the study area. Vegetation cover above the nest seems to be particularly important, perhaps as a strategy to deter visually oriented aerial predators.     

腹腔镜联合GnRH-a治疗后Ⅲ-Ⅳ期子宫内膜异位症患者妊娠情况与阴道微生态的相关性

探讨腹腔镜联合GnRH-a治疗后Ⅲ-Ⅳ期子宫内膜异位症（EMS）患者妊娠情况与阴道微生态的相关性。

经腹腔镜联合GnRH-a治疗后的196例EMS患者根据妊娠情况分为妊娠组（n = 98）和未妊娠组（n = 98）,比较两组阴道微生态差异。将已成功妊娠的患者按照阴道微生态情况分组探讨阴道微生态对妊娠结局的影响和相关性。

治疗前未妊娠组与妊娠组的pH值、H₂O₂值、菌群密集度、菌群多样性、Nugent评分、AV评分差异无统计学意义（P＞0.05）,但治疗后未妊娠组上述指标异常的病例比例显著高于妊娠组（P＜0.05）。在已成功妊娠的EMS患者中,阴道微生态异常的患者发生不良妊娠结局的比例显著高于阴道微生态正常的患者（P＜0.05）。pH值、H₂O₂值、菌群密集度和多样性、Nugent评分和AV评分的异常可导致不良妊娠结局。

阴道微生态失衡是经腹腔镜和GnRH-a联合治疗后的Ⅲ-Ⅳ期EMS患者不能成功妊娠或妊娠后发生不良妊娠结局的重要原因。

     

Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study

Tuberculosis (TB) is one of the major public health and socio-economic issues in the 21^st century globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS) are among the major indicators of the performance of a national TB control program. Hence, this institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate factors associated with unsuccessful outcome at Dilla University Referral Hospital, southern Ethiopia. Five years (2008 to 2013) TB record of TB clinic of the hospital was reviewed. A total 1537 registered TB patients with complete information were included. Of these, 942 (61.3%) were male, 1015 (66%) were from rural areas, 544 (35.4%) were smear positive pulmonary TB (PTB+), 816 (53.1%) were smear negative pulmonary TB (PTB-) and 177(11.5%) were extra pulmonary TB (EPTB) patients. Records of the 1537 TB patients showed that 181 (11.8%) were cured, 1129(73.5%) completed treatment, 171 (11.1%) defaulted, 52 (3.4%) died and 4 (0.3%) had treatment failure. The overall mean treatment success rate of the TB patients was 85.2%. The treatment success rate of the TB patients increased from 80.5% in September 2008-August 2009 to 84.8% in September 2012–May 2013. Tuberculosis type, age, residence and year of treatment were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly higher among TB patients from rural areas (AOR = 1.63, 95% CI: 1.21–2.20) compared to their urban counterparts. Unsuccessful treatment outcome was also observed in PTB- patients (AOR = 1.77, 95% CI: 1.26–2.50) and EPTB (AOR = 2.07, 95% CI: 1.28–3.37) compared to the PTB+ patients. In conclusion, it appears that DOTS have improved treatment success in the hospital during five years. Regular follow-up of patients with poor treatment outcome and provision of health information on TB treatment to patients from rural area is recommended.     

Prognosis for South Asian and white patients newly admitted to hospital with heart failure in the United Kingdom: historical cohort study

Objectives To compare patterns of admission to hospital and prognosis in white and South Asian patients newly admitted with heart failure, and to evaluate the effect of personal characteristics and comorbidity on outcome.Design Historical cohort study.Setting UK district health authority (population 960 000).Participants 5789 consecutive patients newly admitted with heart failure.Main outcome measures Population admission rates, incidence rates for first admission with heart failure, survival, and readmission rates.Results When compared with the white population, South Asian patients had significantly higher age adjusted admission rates (rate ratio 3.8 for men and 5.2 for women) and hospital incidence rates (2.2 and 2.9). Among 5789 incident cases of heart failure, South Asian patients were younger and more often male than white patients (70 (SD 0.6) v 78 (SD 0.1) years and 56.5% (190/336) v 49.3% (2494/5057)). South Asian patients were also more likely to have previous myocardial infarction (10.1% (n = 34) v 5.5% (n = 278)) or concomitant myocardial infarction (18.8% (n = 63) v 10.7% (n = 539)) or diabetes (45.8% (n = 154) v 16.2% (n = 817), all P < 0.001). A trend was shown to longer unadjusted survival for both sexes among South Asian patients. After adjustment for covariables, South Asian patients had a significantly lower risk of death (hazard ratio 0.82, 95% confidence interval 0.68 to 0.99) and a similar probability of death or readmission (0.96, 0.81 to 1.09) compared with white patients.Conclusions Population admission rates for heart failure are higher among South Asian patients than white patients in Leicestershire. At first admission South Asian patients were younger and more often had concomitant diabetes or acute ischaemic heart disease than white patients. Despite major differences in personal characteristics and risk factors between white and South Asian patients, outcome was similar, if not better, in South Asian patients.     

Fluctuating asymmetries and reproductive success in the peacock blenny

In an investigation of the relationship between reproductive success and fluctuating asymmetry (FA) in the peacock blenny Salaria pavo , FA was measured in four bilaterally paired characters in successful and unsuccessful males during the breeding season. Reproductive success among successful males was assessed by calculating the number of eggs the males were defending. Absolute FA values relative to trait size were high for all characters and it is suggested that this could be a consequence of sub-optimal environmental conditions. Two of the traits presented higher absolute FA values suggesting a lower canalization during ontogeny. No difference in FA between successful and unsuccessful males was found and no relationship between FA and number of eggs among the successful males occurred for any of the measured traits. A composite index of FA, that should better reflect overall developmental competence, was also unrelated to reproductive success. These results indicate that FA is not associated with reproductive success among males of S. pavo . Successful males were larger than unsuccessful males and a strong positive correlation was detected between the body length of the parental males and the number of eggs they had in the nest, even when controlling for the internal nest area. Body size may give males a reproductive advantage by being preferred by females and by having an advantage in male-male competition for nests of higher quality.     

Treatment of presumed prolactinoma by transsphenoidal operation: early and late results.

Seventy seven patients who were presumed to have a prolactinoma on the basis of biochemical findings underwent transsphenoidal operation between October 1977 and September 1983. Sixty one patients were found to have a microadenoma, and hyperprolactinaemia was cured in 46 of these, amenorrhoea in 39 (80% of those with the symptom), galactorrhoea in 32 (80%), and infertility in 31 (82%). Four of eight patients found to have a macroadenoma were also satisfactorily treated with surgery. Two patients had a lesion other than a prolactinoma, and in six a tumour could not be found at operation; four of these last eight patients had a normal serum prolactin concentration after operation. Recurrent hyperprolactinaemia was rare, occurring in only three patients in the series overall; among the 32 patients followed up for more than five years only two of the 22 whose operation had initially been successful developed recurrent hyperprolactinaemia.     

Appraisal of pediatric cardiopulmonary resuscitation.

Sixty-six patients more than 30 days and less thant 16 years of age suffering an unexpected cardiac arrest in an 18-month period were included in a study of resuscitative measures in children. Six children survived to be discharged from hospital. Respiratory disease accounted for most (29%) of the cardiac arrests, but it also had the most favourable prognosis, 21% of the 19 patients surviving. None of the patients survived whose cardiac arrest was secondary to sepsis or trauma, even when the resuscitative efforts were initially successful. Only 1 of the 41 patients who had a cardiac arrest outside of hospital survived, and only 1 of the 34 patients who presented with asystole survived, and then with considerable damage to the central nervous system. The interval between cardiac arrest and application of basic life support was substantially shorter among the survivors. Also, most of the survivors did not present with asystole. The results of this study suggest that survival among resuscitated children is no better than that among adults but can be improved with early recognition and monitoring of children at risk. earlier application of basic and advanced life support, improved education of medical and lay personnel, and further research into pediatric resuscitative techniques.     

Serosurveillance for Pseudomonas pseudomallei infection in Thailand.

A nation-wide survey was conducted to see the prevalence of serosensitivity to Pseudomonas pseudomallei antigens by indirect hemagglutination (IHA) and indirect immunofluorescent assay (IFA) for IgG and IgM. Serum samples were collected from blood donors in eight selected areas and bacteriologically confirmed melioidosis patients in Ubon Ratchathani province. The distribution patterns of antibody titers were compared among the survey areas with cut-off points set at 1:160 for IHA, 1:4 for IFA-IgM and 1:32 for IFA-IgG. These cut-off points were decided by ROC (Receiver Operating Characteristics) analysis. The specificity (% true negative reactions) of each serological test in the general population differed significantly among survey areas, possibly reflecting the extent of inapparent infection in each community. IFA was more successful than IHA in differentiating between negative from positive reactions. The survey classified the areas into endemic (Khon Kaen, Ubon Ratchathani), transported (Bangkok), and non-endemic (other provinces) types.     

Fitness consequences of egg-size variation in the lesser snow goose

We investigated the relationship between eggsize variation and (a) egg hatching success, (b) chick survival to fledging and recruitment, and (c) adult female survival, over 12 years in the lesser snow goose (Anser caerulescens caerulescens). By comparing the means and variances of egg size for successful and unsuccessful eggs, our aim was to assess the relative fitness of eggs of different sizes and to determine the type of selection operating on egg size in this species. As both egg size and reproductive success vary with age in the lesser snow goose we controlled for the effects of female age. Egg-size variation is very marked in this population, varying by up to 52% for eggs hatching successfully. However, there was no relationship between egg size and post-hatching survival of goslings to fledging or recruitment, either within or between broods, pooling across years. Egg size varied significantly between successful and unsuccessful clutches in only 2 of 33 individual year comparisons. First-laid eggs surviving to onset of incubation, and eggs hatching successfully, were on average larger than unsuccessful eggs, but this was probably due to the confounding effects of female age-specific and sequence-specific egg survival. Variance of egg size differed significantly between successful and unsuccessful eggs in only 3 of 24, and 0 of 21, individual year comparisons for pre- and post-hatching survival respectively. We therefore found little evidence for a relationship between egg-size variation and offspring fitness, or for strong directional, normalising or diversifying selection operating on egg size, in the lesser snow goose. In addition, there was only weak support for the hypothesis that egg-size variation is maintained by temporal variation in selection pressure (sensu Ankney and Bisset 1973). It is likely that egg-size variation represents the pleiotropic expression of alleles affecting more general physiological or metabolic processes. While this does not rule out the existence of alleles with more direct effects on egg size we suggest that their contribution to heritable egg size is small.     

Costs of parasites in common eiders: effects of antiparasite treatment

Parasites are exploiting their host for the resources required for the parasite's reproduction and survival. The effects of antiparasitic treatment during incubation on body mass and return rate in female common eiders Somateria mollissima were examined in a two year study (1998 and 1999) . There was no effect of treatment on nest success, but unsuccessful females had lower body mass. Treatment had no effect on incubation time, mass-loss during incubation or return rate among successful birds. However, treatment lead to higher return rate among unsuccessful birds (treated=69%, n=13; controls=18%, n=11). This pattern remained significant also after including the birds that returned two years after the experiment. We suggest that the unsuccessful females are of lower quality and had higher costs from parasite infections than birds which completed incubation, and that the higher return rate for treated unsuccessful females may mean that costs of parasites are substantial, and that the potential fitness gain from investment in parasite defense and avoidance is large.