Health Literacy Measure for Adolescents (HELMA): Development and Psychometric Properties

Background

Health literacy refers to personal competencies for the access to, understanding of, appraisal of and application of health information in order to make sound decisions in everyday life. The aim of this study was to develop and evaluate the psychometric properties of an instrument for the measurement of health literacy among adolescents (the Health Literacy Measure for Adolescents-HELMA).

Methods

This study was made up of two phases, qualitative and quantitative, which were carried out in 2012–2014 in Tehran, Iran. In the qualitative part of the study, in-depth interviews with 67 adolescents aged 15–18 were carried out in 4 high schools to generate the initial item pool for the survey. The content validity of the items was then assessed by an expert panel review (n = 13) and face validity was assessed by interviewing adolescents (n = 16). In the quantitative part of the study, in order to describe the psychometric properties of the scale, validity, reliability (internal consistency and test-retest) and factor analysis were assessed.

Results

An item pool made up of 104 items was generated at the qualitative stage. After content validity was considered, this decreased to 47 items. In the quantitative stage, 582 adolescents aged 15–18 participated in the study with a mean age of 16.2 years. 51.2% of participants were females. In principal component factor analysis, 8 factors were loaded, which accounted for 53.37% of the variance observed. Reliability has been approved by α = 0.93 and the test-retest of the scale at two-week intervals indicated an appropriate stability for the scale (ICC = 0.93). The final questionnaire was approved with 44 items split into eight sections. The sections were titled: gain access to, reading, understanding, appraise, use, communication, self-efficacy and numeracy.

Conclusion

The Health Literacy Measure for Adolescents (HELMA) is a valid and reliable tool for the measurement of the health literacy of adolescents aged 15–18 and can be used to evaluate different levels of functional, interactive, and critical health literacy in adolescents.     

Psychometric Properties of Translation of the Child Perception Questionnaire (CPQ11-14) in Telugu Speaking Indian Children

Oral health related quality of life research among children in India is still nascent and no measures have been validated to date. Although CPQ_11-14 has been previously used in studies from the Indian sub-continent, the instrument has never been tested for cross-cultural adaptability. This study aimed to assess the validity and reliability of CPQ_11-14 in Telugu speaking Indian school children. Primary school children of Medak district, Telangana State, India, were recruited by a multi-stage probability sampling method. The translated questionnaire was initially pilot tested on a small subset of children (n = 40). Children with informed consent from parents (N = 1342) were then provided with questionnaires containing the Telugu translation of CPQ_11-14, followed by a clinical examination conducted by a single examiner, using Basic WHO survey methods for dental caries, malocclusion, and Dean’s Fluorosis index. Children (n = 161) in randomly chosen schools were re-administered the same questionnaire after a two week interval to test reliability of CPQ_11-14 on repeated administrations. Internal consistency and test-retest reliability as determined by Cronbach’s alpha and Intra-class correlation coefficient for overall CPQ_11-14 scale were 0.925 and 0.923, respectively. CPQ_11-14 discriminated between the categories of fluorosis and malocclusion while its discriminant validity with respect to dental caries was limited. CPQ_11-14 also demonstrated good construct validity with both overall CPQ_11-14 and its subscales having significant positive correlation with global ratings of oral health and overall wellbeing, even after adjusting for confounding variables. CPQ_11-14 had a correlation of 0.405 with self-evaluated oral health and 0.407 with self-evaluated impact of oral health on overall wellbeing. In conclusion, Telugu translation of CPQ_11-14 demonstrated good internal consistency and excellent reliability on repeated administrations after two weeks. It also exhibited good discriminant and construct validity.     

Children's Separation Anxiety Scale (CSAS): Psychometric Properties

This study describes the psychometric properties of the Children''s Separation Anxiety Scale (CSAS), which assesses separation anxiety symptoms in childhood. Participants in Study 1 were 1,908 schoolchildren aged between 8 and 11. Exploratory factor analysis identified four factors: worry about separation, distress from separation, opposition to separation, and calm at separation, which explained 46.91% of the variance. In Study 2, 6,016 children aged 8–11 participated. The factor model in Study 1 was validated by confirmatory factor analysis. The internal consistency (α = 0.82) and temporal stability (r = 0.83) of the instrument were good. The convergent and discriminant validity were evaluated by means of correlations with other measures of separation anxiety, childhood anxiety, depression and anger. Sensitivity of the scale was 85% and its specificity, 95%. The results support the reliability and validity of the CSAS.     

Development and Validation of the Keele Musculoskeletal Patient Reported Outcome Measure (MSK-PROM)

Objective

To develop and validate a patient report outcome measure (PROM) for clinical practice that can monitor health status of patients with a range of musculoskeletal (MSK) disorders.

Methods

Constructs for inclusion in the MSK-PROM were identified from a consensus process involving patients with musculoskeletal conditions, clinicians, purchasers of healthcare services, and primary care researchers. Psychometric properties of the brief tool, including face and construct validity, repeatability and responsiveness were assessed in a sample of patients with musculoskeletal pain consulting physiotherapy services in the United Kingdom (n=425).

Results

The consensus process identified 10 prioritised domains for monitoring musculoskeletal health status: pain intensity, quality of life, physical capacity, interference with social/leisure activities, emotional well-being, severity of most difficult thing, activities and roles, understanding independence, and overall impact. As the EuroQol (EQ-5D-5L) is a widely adopted PROMs tool and covers the first four domains listed, to reduce patient burden to a minimum the MSK-PROM was designed to capture the remaining six prioritised domains which are not measured by the EQ-5D-5L. The tool demonstrated excellent reliability, construct validity, responsiveness and acceptability to patients and clinicians for use in clinical practice.

Conclusion

We have validated a brief patient reported outcome measure (MSK-PROM) for use in clinical practice to measure musculoskeletal health status and monitor outcomes over time using domains that are meaningful to patients and sensitive to change. Further work will establish whether the MSK-PROM is useful in other musculoskeletal healthcare settings.     

Psychometric Properties of the Problem Areas in Diabetes (PAID) Instrument in Singapore

Background

Emotional distress is an important dimension in diabetes, and several instruments have been developed to measure this aspect. The Problem Areas in Diabetes (PAID) scale is one such instrument which has demonstrated validity and reliability in Western populations, but its psychometric properties in Asian populations have not been examined.

Methods

This was a secondary analysis of data from patients with Type 2 diabetes mellitus recruited through convenience sampling from a diabetes specialist outpatient clinic in Singapore. The following psychometric properties were assessed: Construct validity through confirmatory factor analysis (CFA) and Rasch analysis, concurrent validity through correlation with related scales (Kessler Psychological Distress Scale, Diabetes Health Profile—psychological distress, Audit of Diabetes Dependent Quality of Life), reliability through assessment of internal consistency and floor and ceiling effects, and sensitivity by estimating effect sizes for known clinical and social functioning groups.

Results

203 patients with mean age of 45±12 years were analysed. None of the previously published model structures achieved a good fit on CFA. On Rasch analysis, four items showed poor fit and were removed. The abridged 16-item PAID mapped to a single latent trait, with a high degree of internal consistency (Cronbach ɑ 0.95), but significant floor effect (24.6% scoring at floor). Both 20-item and 16-item PAID scores were moderately correlated with scores of related scales, and sensitive to differences in clinical and social functioning groups, with large effect sizes for glycemic control and diabetes related complications, nephropathy and neuropathy.

Conclusion

The abridged 16-item PAID measures a single latent trait of emotional distress due to diabetes whereas the 20-item PAID appears to measures more than one latent trait. However, both the 16-item and 20-item PAID versions are valid, reliable and sensitive for use among Singaporean patients with diabetes.     

Psychometric Properties of the Lexington Attachment to Pets Scale: Mexican Version (LAPS-M)

The Lexington Attachment to Pets Scale (LAPS) is perhaps the most widely used instrument to assess human emotional attachments to pets and is suitable for both dog and cat owners. However, this instrument has not been translated into Spanish. Thus, the present study aimed to assess the psychometric properties of the Mexican version of the Lexington Attachment to Pets Scale (LAPS-M), which was translated into Spanish and adapted for dog owners. We analyzed the internal consistency and factor structure in a convenience sample of 152 people; 56.6% were women and 43.4% were men, with a mean age of 32.4 years (SD = 10.9 years), who had, on average, two dogs for a period of 3.8 years. The results indicate that the scale has excellent internal consistency in its complete version, with a Cronbach's alpha of 0.96, and also in its three subscales, with Cronbach's alpha coefficients ranging from 0.83 to 0.94. Factor analysis suggests a unifactorial structure is appropriate. However, the goodness-of-fit indicated by confirmatory factor analysis statistics would likely improve with a larger sample size. When we compared the central tendency measures of the LAPS-M according to the type of relationship with the dog, we found higher scores among people who considered dogs to be family members than among those who considered dogs to be pets. Furthermore, people who reported that the relationship with their dog was burdensome or stressful had lower scores. We conclude that the Mexican version of the LAPS is adequate and that further studies with larger sample sizes will contribute to the evidence regarding its psychometric properties     

Psychometric Properties of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) in Chilean Children and Adolescents

In recent years, there has been a considerable increase in the development of assessment tools for obsessive-compulsive symptomatology in children and adolescents. The Obsessive Compulsive Inventory-Child Version (OCI-CV) is a well-established assessment self-report, with special interest for the assessment of dimensions of Obsessive Compulsive Disorder (OCD). This instrument has shown to be useful for clinical and non-clinical populations in two languages (English and European Spanish). Thus, the aim of this study was to analyze the psychometric properties of the OCI-CV in a Chilean community sample. The sample consisted of 816 children and adolescents with a mean age of 14.54 years (SD = 2.21; range = 10–18 years). Factor structure, internal consistency, test-retest reliability, convergent/divergent validity, and gender/age differences were examined. Confirmatory factor analysis showed a 6-factor structure (Doubting/Checking, Obsessing, Hoarding, Washing, Ordering, and Neutralizing) with one second-order factor. Good estimates of reliability (including internal consistency and test-retest), evidence supporting the validity, and small age and gender differences (higher levels of OCD symptomatology among older participants and women, respectively) are found. The OCI-CV is also an adequate scale for the assessment of obsessions and compulsions in a general population of Chilean children and adolescents.     

Activation of RhoA by association of Galpha(13) with Dbl

RhoA is a small G protein that is implicated in the regulation of the actin cytoskeleton, gene expression, and cell cycle progression. It is activated by many agonists whose receptors are linked to heterotrimeric G proteins, but the mechanisms are incompletely understood. In this study, we show that the constitutively active alpha-subunit of the heterotrimeric G protein G(13) associated with the Rho family guanine nucleotide exchange factor Dbl in NIH 3T3 cells and that this resulted in activation of RhoA. This activation was not seen with wild-type Galpha(13) or if Dbl and active Galpha(13) were expressed separately and mixed. In contrast, coexpression of constitutively active Galpha(q) with Dbl did not lead to their association and caused a weak activation of RhoA that was no greater than that observed with wild-type Galpha(q). These findings illustrate that activated Galpha(13) and Dbl can associate in vivo and that this leads to Rho activation.     

The Unknown Vygotsky: On the Experience of a Literary Translation from Hebrew

Following is the first publication of a previously unknown translation by L.S. Vygotsky from Hebrew of a fictional short story by M.J. Berdyczewski, a Jewish writer popular at the beginning of the twentieth century. The commentary by the authors of this article reconstructs the context of Vygotsky’s life situation during the prerevolutionary period. Particular attention is focused on the questions of ethnic and cultural self-determination that were confronting him. The cultural contexts essential for an understanding and interpretation of the artistic and world-view features of the text of the short story are explored. A comparison is drawn to show the connection between the themes addressed in the story and the substantive problems that Vygotsky would subsequently deal with as a professional psychology: the artistic inner experience, moral choice, and cultural mediation.     

Reviewing the Psychometric Properties of Contemporary Circadian Typology Measures

The accurate measurement of circadian typology (CT) is critical because the construct has implications for a number of health disorders. In this review, we focus on the evidence to support the reliability and validity of the more commonly used CT scales: the Morningness-Eveningness Questionnaire (MEQ), reduced Morningness-Eveningness Questionnaire (rMEQ), the Composite Scale of Morningness (CSM), and the Preferences Scale (PS). In addition, we also consider the Munich ChronoType Questionnaire (MCTQ). In terms of reliability, the MEQ, CSM, and PS consistently report high levels of reliability (>0.80), whereas the reliability of the rMEQ is satisfactory. The stability of these scales is sound at follow-up periods up to 13 mos. The MCTQ is not a scale; therefore, its reliability cannot be assessed. Although it is possible to determine the stability of the MCTQ, these data are yet to be reported. Validity must be given equal weight in assessing the measurement properties of CT instruments. Most commonly reported is convergent and construct validity. The MEQ, rMEQ, and CSM are highly correlated and this is to be expected, given that these scales share common items. The level of agreement between the MCTQ and the MEQ is satisfactory, but the correlation between these two constructs decreases in line with the number of “corrections” applied to the MCTQ. The interesting question is whether CT is best represented by a psychological preference for behavior or by using a biomarker such as sleep midpoint. Good-quality subjective and objective data suggest adequate construct validity for each of the CT instruments, but a major limitation of this literature is studies that assess the predictive validity of these instruments. We make a number of recommendations with the aim of advancing science. Future studies need to (1) focus on collecting data from representative samples that consider a number of environmental factors; (2) employ longitudinal designs to allow the predictive validity of CT measures to be assessed and preferably make use of objective data; (3) employ contemporary statistical approaches, including structural equation modeling and item-response models; and (4) provide better information concerning sample selection and a rationale for choosing cutoff points.     

Activation of Double-stranded RNA-activated Protein Kinase (PKR) by Interferon-stimulated Gene 15 (ISG15) Modification Down-regulates Protein Translation

The ubiquitin-like molecule ISG15 (UCRP) and protein modification by ISG15 (ISGylation) are strongly induced by interferon, genotoxic stress, and pathogen infection, suggesting that ISG15 plays an important role in innate immune responses. However, how ISGylation contributes to innate immune responses is not clear. The dsRNA-dependent protein kinase (PKR) inhibits translation by phosphorylating eIF2α to exert its anti-viral effect. ISG15 and PKR are induced by interferon, suggesting that a relationship exists between ISGylation and translational regulation. Here, we report that PKR is ISGylated at lysines 69 and 159. ISG15-modified PKR is active in the absence of virus infection and phosphorylates eIF2α to down-regulate protein translation. The present study describes a novel pathway for the activation of PKR and the regulation of protein translation.     

A Psychometric Measure of Working Memory Capacity for Configured Body Movement

Working memory (WM) models have traditionally assumed at least two domain-specific storage systems for verbal and visuo-spatial information. We review data that suggest the existence of an additional slave system devoted to the temporary storage of body movements, and present a novel instrument for its assessment: the movement span task. The movement span task assesses individuals'' ability to remember and reproduce meaningless configurations of the body. During the encoding phase of a trial, participants watch short videos of meaningless movements presented in sets varying in size from one to five items. Immediately after encoding, they are prompted to reenact as many items as possible. The movement span task was administered to 90 participants along with standard tests of verbal WM, visuo-spatial WM, and a gesture classification test in which participants judged whether a speaker''s gestures were congruent or incongruent with his accompanying speech. Performance on the gesture classification task was not related to standard measures of verbal or visuo-spatial working memory capacity, but was predicted by scores on the movement span task. Results suggest the movement span task can serve as an assessment of individual differences in WM capacity for body-centric information.     

Measuring Cognitive Errors Using the Cognitive Distortions Scale (CDS): Psychometric Properties in Clinical and Non-Clinical Samples

The Cognitive Distortions Scale was developed to assess thinking errors using case examples in two domains: interpersonal and personal achievement. Although its validity and reliability has been previously demonstrated in non-clinical samples, its psychometric properties and scoring has not yet been evaluated. The aim of the current study was to evaluate the psychometric properties of the Cognitive Distortions Scale in two Turkish samples and to examine the usefulness of the categorical scoring system. A total of 325 individuals (Sample 1 and Sample 2) were enrolled in this study to assess those psychometric properties. Our Sample 1 consisted of 225 individuals working as interns at the Diskapi Yildirim Beyazit Teaching and Research Hospital and Sample 2 consisted of 100 patients diagnosed with depression presenting to the outpatient unit of the same Hospital. Construct validity was assessed using the Beck Depression Inventory, the State Trait Anxiety Inventory, the Dysfunctional Attitude Scale, and the Automatic Thought Questionnaire. Factor analyses supported a one-factor model in these clinical and non-clinical samples. Cronbach''s α values were excellent in both the non-clinical and clinical samples (0.933 and 0.918 respectively). Cognitive Distortions Scale scores showed significant correlation with relevant clinical measures. Study Cognitive Distortions Scale scores were stable over a time span of two weeks. This study showed that the Cognitive Distortions Scale is a valid and reliable measure in clinical and non-clinical populations. In addition, it shows that the categorical exists/does not exist scoring system is relevant and could be used in clinical settings.     

Psychometric properties of the Nurses Work Functioning Questionnaire (NWFQ)

Objectives

The Nurses Work Functioning Questionnaire (NWFQ) is a 50-item self-report questionnaire specifically developed for nurses and allied health professionals. Its seven subscales measure impairments in the work functioning due to common mental disorders. Aim of this study is to evaluate the psychometric properties of the NWFQ, by assessing reproducibility and construct validity.

Methods

The questionnaire was administered to 314 nurses and allied health professionals with a re-test in 112 subjects. Reproducibility was assessed by the intraclass correlations coefficients (ICC) and the standard error of measurement (SEM). For construct validity, correlations were calculated with a general work functioning scale, the Endicott Work Productivity Scale (EWPS) (convergent validity) and with a physical functioning scale (divergent validity). For discriminative validity, a Mann Whitney U test was performed testing for significant differences between subjects with mental health complaints and without.

Results

All subscales showed good reliability (ICC: 0.72–0.86), except for one (ICC = 0.16). Convergent validity was good in six subscales, correlations ranged from 0.38–0.62. However, in one subscale the correlation with the EWPS was too low (0.22). Divergent validity was good in all subscales based on correlations ranged from (−0.06)–(−0.23). Discriminative validity was good in all subscales, based on significant differences between subjects with and without mental health complaints (p<0.001–p = 0.003).

Conclusion

The NWFQ demonstrates good psychometric properties, for six of the seven subscales. Subscale “impaired decision making” needs improvement before further use.     

Properties of the promoter region of theT18 d (T13 c )Tla gene

The T18^d (formerlyT13 ^c) gene of BALB/c mice belongs to the category ofTla genes which is expressed by both thymocytes and TL⁺ T-cell leukemias. To elucidate the regulation of T18^d, different restriction fragments of the 5' flanking region between -457 and⁺ 146 were linked to the chloramphenicol acetyltransferase (CAT) gene and transfected into TL⁺ and TL- cells. By comparison of transiently expresssedCAT activity among cells transfected with differentCAT constructs, the results suggest that determination of TL⁺ vs TL phenotypes is located within the region -105 to - 33, and that an element essential to T18 d expression resides within the region - 33 to + 54. Putative DNA-binding factors characterizing particular cell types and displaying selective affinity for particular TI 8^d restriction fragments were identified by electrophoretic mobility shift assays with nuclear extracts (NEs). Two factors (or complexes) which bound specifically to the T18^d fragment-105 to - 33 were expressed preferentially in TL⁺ cells and thus may be involved in determining the tissue-selective expression of TI8^d. The close proximity of negative and positive cis-acting elements within the promoter region is consistent with regulation of T18^d gene expression by a variety of trans-acting factors whose production is attuned to development and differentiation. The data provided may serve as a guide to study the regulation of other categories of Tla genes that are normally silent in thymocytes but may become expressed by leukemia cells.     

Psychometric Properties of the Chinese Version of the Fear of Negative Evaluation Scale-Brief (BFNE) and the BFNE-Straightforward for Middle School Students

Background

The 12-item brief version of the Fear of Negative Evaluation Scale (BFNE) is one of the most widely used instruments to assess fear of negative evaluation. Recent evidence strongly supports the version composed of 8 straightforward items (BFNE-S), which possessesstronger psychometric properties. The purpose of the current study is to examine the psychometric prop-erties of the Chinese versions of the BFNE and BFNE-S for middle school students.

Methodology

A total of 1009 middle school students were recruited in this study. The BFNE, the BFNE-S, the Friedman-Bendas Text Anxiety Scale (FBTAS), and the Social Anxiety Scale (SAS) were administered to 497 participants, and 52 participants were re-tested after four weeks. The BFNE, the BFNE-S, the Rosenberg Self-Esteem Scale (RSES), and the Balanced Inventory of Desirable Responding (BIDR) wereadministered to 492 participants. The BFNE and BFNE-S significantly cor-related with all the scales, supporting their convergent, divergent and concurrent validity.

Principal Findings

The Cronbach''s alpha of the BFNE (BFNE-S) was 0.864 (0.867) with 497 par-ticipants and 0.886 (0.844) with 492 participants, and the test-retest reliability coefficient was 0.791 (0.855) (ICC). Although the EFA identified a two-factor solution in which the 8 straightfor-ward items loaded on one factor and the 4 reversed items loaded on the other, the CFA, using a random intercept model to control the wording effect, supported a unidimensional factor struc-ture of the BFNE. Both EFA and CFA supported the unidimensional assumption of the BFNE-S. The correlations of the BFNE and BFNE-S were 0.929 and 0.952 in two samples.

Conclusions

The Chinese versions of the BFNE and BFNE-S demonstrate adequate psychometric properties for assessing fear of negative evaluation. The results support their use among the Chinese middle school students. Considering its greater parsimony and excellent reliability and validity, the BFNE-S is a better tool.     

Psychometric assessment of the Chinese adolescent daytime sleepiness scale (CADSS)

Sleep and Biological Rhythms - Daytime sleepiness is common in adolescents. The daytime sleepiness scales developed for western adolescents may not be applicable to Chinese adolescents. This study...     

Psychometric Evaluation of the Lexington Attachment to Pets Scale (Laps)

Abstract

This paper reports on the development and psychometric evaluation of a scale for assessing emotional attachment of individuals to their pets. Previous attachment scales have suffered variously from low internal consistency and reliance on small or nonrepresentative samples for their development. Telephone interviews of a random, representative sample of 412 pet owners in Fayette County, Kentucky, were completed in September 1990; a 69.5 percent response rate was achieved. From a preliminary set of 42 questions, a final 23-question instrument, the Lexington Attachment to Pets Scale (LAPS), was developed, having excellent psychometric properties. The scale is suitable for use with dog and cat owners. Data on internal consistency, factor structure, and item response theory (IRT) modeling are presented, along with correlations between the LAPS and several domains of variables known to relate to pet attachment.     

公立医院医疗服务质量病人满意度测评量表研究

以Carey等研制的医疗服务质量监测量表为基础,通过专家咨询和病人问卷调查,构建了符合上海市公立医院医疗服务质量实际状况的病人满意度测评量表。分析显示,医疗服务质量病人满意度测评量表具有较好的结构效度、内部信度,并弥补了上海市现有医疗机构医疗服务质量病人满意度测评工具的不足,对上海市公立医院改善服务质量和卫生行政部门加强服务质量监管提供了有价值的信息。     

Post-Spaceflight (STS-135) Mouse Splenocytes Demonstrate Altered Activation Properties and Surface Molecule Expression

Alterations in immune function have been documented during or post-spaceflight and in ground based models of microgravity. Identification of immune parameters that are dysregulated during spaceflight is an important step in mitigating crew health risks during deep space missions. The in vitro analysis of leukocyte activity post-spaceflight in both human and animal species is primarily focused on lymphocytic function. This report completes a broader spectrum analysis of mouse lymphocyte and monocyte changes post 13 days orbital flight (mission STS-135). Analysis includes an examination in surface markers for cell activation, and antigen presentation and co-stimulatory molecules. Cytokine production was measured after stimulation with T-cell mitogen or TLR-2, TLR-4, or TLR-5 agonists. Splenocyte surface marker analysis immediate post-spaceflight and after in vitro culture demonstrated unique changes in phenotypic populations between the flight mice and matched treatment ground controls. Post-spaceflight splenocytes (flight splenocytes) had lower expression intensity of CD4⁺CD25⁺ and CD8⁺CD25⁺ cells, lower percentage of CD11c⁺MHC II⁺ cells, and higher percentage of CD11c⁺MHC I⁺ populations compared to ground controls. The flight splenocytes demonstrated an increase in phagocytic activity. Stimulation with ConA led to decrease in CD4⁺ population but increased CD4⁺CD25⁺ cells compared to ground controls. Culturing with TLR agonists led to a decrease in CD11c⁺ population in splenocytes isolated from flight mice compared to ground controls. Consequently, flight splenocytes with or without TLR-agonist stimulation showed a decrease in CD11c⁺MHC I⁺, CD11c⁺MHC II⁺, and CD11c⁺CD86⁺ cells compared to ground controls. Production of IFN-γ was decreased and IL-2 was increased from ConA stimulated flight splenocytes. This study demonstrated that expression of surface molecules can be affected by conditions of spaceflight and impaired responsiveness persists under culture conditions in vitro.