Life event classifications and the event-illness relationship.

Several theoretically important and distinct categories of life change are found in most life event scales. These categories can be organized in terms of at least three dimensions: the person's control over the event, the desirability of the event, and whether or not the independent variable of the event is confounded with the dependent variable of illness. It is important to separate conceptually and, to the extent possible, to distinguish empirically among events according to these dimensions, because several different models of the event-illness relationship are implied when events from several categories are combined. A secondary analysis of recently published data shows that the kinds of events associated with illness are undesirable events within the subject's control. It may not be necessary to consider these dimensions in predicting illness, but the prevention and understanding of illness are furthered by their consideration.     

The relationship of life events and stress to neurosis in China: Comparison of 105 neurotic patients to 103 normal controls

Modified versions of Hohnes' Schedule of Recent Experience (SRE) and Social Readjustment Rating Scale (SRRS) are used to compare the stress rating of 43 life events of 105 neurotic patients to 103 normal controls and to compare the quantity of life event changes experienced by the two groups. Life events are divided into three categories on the basis of their frequency of occurrence and the intensity of stress they induce. Significantly higher stress ratings for the neurotic patients are found in 17 of 43 life event items studied. In the year prior to the onset of the neurotic illness, the patient group experienced more life event changes and had significantly higher levels of stress than the control group. The results are compared to Holmes' findings in Japan.     

A prospective controlled study: Minimally invasive stereotactic puncture therapy versus conventional craniotomy in the treatment of acute intracerebral hemorrhage

Background

Young stroke can have devastating consequences with respect to quality of life, the ability to work, plan or run a family, and participate in social life. Better insight into risk factors and the long-term prognosis is extremely important, especially in young stroke patients with a life expectancy of decades. To date, detailed information on risk factors and the long-term prognosis in young stroke patients, and more specific risk of mortality or recurrent vascular events, remains scarce.

Methods/Design

The FUTURE study is a prospective cohort study on risk factors and prognosis of young ischemic and hemorrhagic stroke among 1006 patients, aged 18-50 years, included in our study database between 1-1-1980 and 1-11-2010. Follow-up visits at our research centre take place from the end of 2009 until the end of 2011. Control subjects will be recruited among the patients' spouses, relatives or social environment. Information on mortality and incident vascular events will be retrieved via structured questionnaires. In addition, participants are invited to the research centre to undergo an extensive sub study including MRI.

Discussion

The FUTURE study has the potential to make an important contribution to increase the knowledge on risk factors and long-term prognosis in young stroke patients. Our study differs from previous studies by having a maximal follow-up of more than 30 years, including not only TIA and ischemic stroke but also hemorrhagic stroke, the addition of healthy controls and prospectively collect data during an extensive follow-up visit. Completion of the FUTURE study may provide better information for treating physicians and patients with respect to the prognosis of young stroke.     

Associations between Parent-Adolescent Attachment Relationship Quality,Negative Life Events and Mental Health

Purpose

The aim of this study was to examine the association of negative life events and parent-adolescent attachment relationship quality with mental health problems and to explore an interaction between the parent-adolescent attachment relationship and one or multiple negative life events on the mental health of adolescents.

Methods

A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). The occurrence of life events and the quality of parent-adolescent attachment were assessed at baseline and mental health status at two-year follow-up by means of self-report questionnaires. Binary logistic regression analyses were conducted to assess associations between life events, parent-adolescent attachment and mental health problems. Relative Excess Risk due to Interaction techniques were used to determine the interaction effects on the additive scale.

Results

Life events were related to mental health status, as was parent-adolescent attachment. The combined effect of an unfavourable parent-adolescent attachment with life events on mental health was larger than the sum of the two individual effects. Among adolescents with one life event or multiple life events, an unfavourable parent-adolescent attachment increased the risk of mental health problems at follow-up compared to the group without life events.

Conclusion

Results supported an interaction effect between parent-adolescent attachment and negative life events on mental health. Especially adolescents with one or multiple life events and an unfavourable parent-adolescent attachment seems to be a vulnerable group for mental health problems. Implications for further research are discussed.     

Stress, control beliefs, and psychological distress: the problem of response bias

Research on the buffering effects of locus of control beliefs in the relationship between stressful life events and psychological distress has produced inconclusive findings. The purpose of this study is to examine whether social desirability response set bias may be at least partially responsible for these contradictory results. Analysis of data from a community survey of married women suggests that social desirability can attenuate the interaction effect between stress and control beliefs. It is recommended that researchers include controls for this form of nonrandom measurement error in future studies.     

Effects of life events and stress on neutrophil functions in elderly men

Background

Psychological stress or life events might significantly decrease neutrophil function in elderly individuals and lead to infectious diseases. However, relationships between these factors have not been examined in detail. We investigated the relationships between neutrophil function measured using the nitroblue tetrazolium (NBT) reduction test and measurements of psychological stress and life events among 81 men aged over 60?years.

Results

The numbers and scores for life events were significantly higher (p?Conclusions Chronic psychological stress due to life events decreases neutrophil functions among elderly men.     

The life events stress-performance linkage: an exploratory study

For a long time, the relationship between life events, psychological adjustment, and illness has been a subject of much concern in the medical literature. Very recently, several management theorists have proposed a life events stress-performance linkage. In the present study, such a linkage was tested in a classroom setting. One hundred fifty-nine university students were asked to estimate the degree of readjustment required for each of 43 life events and, subsequently, to identify events that they had experienced during the past year. Weighted and unweighted life event stress scores were later correlated with six indices of classroom performance. As hypothesized, measures of stress collected early in the semester were inversely related to future performance. The predictive ability of the stress scores was not enhanced by using readjustment values to weight life events experienced.     

Which Dimensions of Patient-Centeredness Matter? - Results of a Web-Based Expert Delphi Survey

Background

Present models and definitions of patient-centeredness revealed a lack of conceptual clarity. Based on a prior systematic literature review, we developed an integrative model with 15 dimensions of patient-centeredness. The aims of this study were to 1) validate, and 2) prioritize these dimensions.

Method

A two-round web-based Delphi study was conducted. 297 international experts were invited to participate. In round one they were asked to 1) give an individual rating on a nine-point-scale on relevance and clarity of the dimensions, 2) add missing dimensions, and 3) prioritize the dimensions. In round two, experts received feedback about the results of round one and were asked to reflect and re-rate their own results. The cut-off for the validation of a dimension was a median < 7 on one of the criteria.

Results

105 experts participated in round one and 71 in round two. In round one, one new dimension was suggested and included for discussion in round two. In round two, this dimension did not reach sufficient ratings to be included in the model. Eleven dimensions reached a median ≥ 7 on both criteria (relevance and clarity). Four dimensions had a median < 7 on one or both criteria. The five dimensions rated as most important were: patient as a unique person, patient involvement in care, patient information, clinician-patient communication and patient empowerment.

Discussion

11 out of the 15 dimensions have been validated through experts’ ratings. Further research on the four dimensions that received insufficient ratings is recommended. The priority order of the dimensions can help researchers and clinicians to focus on the most important dimensions of patient-centeredness. Overall, the model provides a useful framework that can be used in the development of measures, interventions, and medical education curricula, as well as the adoption of a new perspective in health policy.     

Towards a Psychological Construct of Being Moved

The emotional state of being moved, though frequently referred to in both classical rhetoric and current language use, is far from established as a well-defined psychological construct. In a series of three studies, we investigated eliciting scenarios, emotional ingredients, appraisal patterns, feeling qualities, and the affective signature of being moved and related emotional states. The great majority of the eliciting scenarios can be assigned to significant relationship and critical life events (especially death, birth, marriage, separation, and reunion). Sadness and joy turned out to be the two preeminent emotions involved in episodes of being moved. Both the sad and the joyful variants of being moved showed a coactivation of positive and negative affect and can thus be ranked among the mixed emotions. Moreover, being moved, while featuring only low-to-mid arousal levels, was experienced as an emotional state of high intensity; this applied to responses to fictional artworks no less than to own-life and other real, but media-represented, events. The most distinctive findings regarding cognitive appraisal dimensions were very low ratings for causation of the event by oneself and for having the power to change its outcome, along with very high ratings for appraisals of compatibility with social norms and self-ideals. Putting together the characteristics identified and discussed throughout the three studies, the paper ends with a sketch of a psychological construct of being moved.     

Ischemic arterial events and atherosclerosis in patients with systemic sclerosis: a population-based case-control study

Introduction

While microvascular disease is well described in systemic sclerosis (SSc), it is still unclear whether the occurrence of ischemic macrovascular events and atherosclerosis is enhanced among patients with SSc.

Methods

In this study, 111 SSc patients (74% of prevalent cases in Stockholm County) and 105 age- and sex-comparable population controls were investigated. Previous ischemic arterial events were tabulated. As surrogate measures of atherosclerosis, plaque occurrence and intima-media thickness (IMT) were determined with carotid ultrasound and the ankle-brachial index (ABI) was calculated. Traditional cardiovascular risk factors were recorded and we also measured biomarkers indicating systemic inflammation and endothelial activation/dysfunction.

Results

Mean age was 62 ± 12 years for patients and controls. Ischemic arterial events were more common, due to increased occurrence of ischemic heart disease (IHD) and ischemic peripheral vascular disease (IPVD), in the patient group (12% vs. 4%, P = 0.03 and 9% vs. 0%, P = 0.003 respectively). On a group level, there was no difference regarding the occurrence of ischemic cerebrovascular disease, the frequency of plaques, IMT or ABI between SSc patients and controls. Subgroup analyses revealed that patients with anticentromere antibodies (ACA+) had more plaques and more ischemic arterial events compared to other SSc patients (67% vs. 39% and 32% vs. 11%; P = 0.006 and P = 0.01, respectively) and compared to controls (67% vs. 41% and 32% vs. 7%, P = 0.02 and P = 0.0003, respectively). Biomarkers of inflammation/endothelial activation were generally increased among SSc patients.

Conclusions

Patients with SSc are at enhanced risk for IHD and IPVD. The ACA+ SSc subgroup was particularly affected with both ischemic arterial events and premature atherosclerosis. The microvascular vulnerability of ACA+ patients is previously well documented. We demonstrate that ACA+ SSc patients have an enhanced risk of macrovascular injury as well. This group should be followed closely and modifiable cardiovascular risk factors should be treated at an early stage.     

Subjective assessment of chimpanzee (<Emphasis Type="Italic">Pan troglodytes</Emphasis>) personality: reliability and stability of trait ratings

A 46-item rating scale was used to obtain personality ratings from 75 captive chimpanzees (Pan troglodytes) from 7 zoological parks. Factor analysis revealed five personality dimensions similar to those found in previous research on primate personality: Agreeableness, Dominance, Neuroticism, Extraversion and Intellect. There were significant sex and age differences in ratings on these dimensions, with males rated more highly on Dominance and older chimpanzees rated as more agreeable but less extraverted than younger chimpanzees. Interobserver agreement for most individual trait items was high, but tended to be less reliable for trait terms expressing more subtle social or cognitive abilities. Personality ratings for one zoo were found to be largely stable across a 3-year period, but highlighted the effects of environmental factors on the expression of personality in captive chimpanzees.     

Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: a cross sectional study

Background

There is no consensus regarding the optimal approach to assessment of the quality of life of people with dementia. We undertook the present study to describe and determine the factors associated with ratings of the quality of life of a cohort of people with dementia living in a residential care facility.

Methodology/Principal Findings

351 people with dementia living in residential care facilities, and their staff and family informants participated in this cross sectional observational study. Quality of life was measured using self (Quality of Life in Alzheimer''s Disease [QoL-AD] scale), and informant (QoL-AD and Alzheimer''s Disease Related QoL Scale) reports. 226 people (64%) with dementia (median MMSE 17; 12–21) were able to self rate the QoL-AD scale and these subjects'' ratings were compared to ratings by staff and family. Both staff and family informant ratings of the QoL-AD underestimated self ratings (mean difference −7.8, 95% CI −8.8, −6.7 for staff rated QoL-AD; and mean difference −7.2, 95% CI −8.5, −6.0 for family rated QoL-AD). Self ratings of QoL were lower among people who were restrained, had fallen or had pain. Informant ratings of the QoL of the participants with dementia were consistently and significantly lower for people with severe cognitive impairment, who had fallen, had presence of neuropsychiatric symptoms, or where care giver distress was present. Documented restraint, reported pain and neuropsychiatric symptoms were independently associated with lower self rating of the QoL-AD in multivariate models. Cognitive impairment, case conferencing, hospitalizations and neuropsychiatric symptoms were found to be independently associated with staff rated ADRQL.

Conclusions

The majority of people with dementia living in residential care facilities can rate their own QoL. Informant ratings underestimate self ratings of QoL of people with dementia, and appear to be associated with factors which are not associated with self ratings.     

Life events, coping, and posttraumatic stress symptoms among Chinese adolescents exposed to 2008 Wenchuan Earthquake, China

Purpose

To examine the relationship between negative life events, coping styles, and symptoms of post-traumatic stress disorder (PTSD) among adolescent survivors exposed to 2008 Wenchuan Earthquake, China.

Methods

A survey was conducted in a sample of 2250 adolescent students from two schools in Dujiangyan District, a seriously damaged area, 20 kilometers away from the epicenter, 6 months after the earthquake. Participants completed a self-administered questionnaire including demographics, negative life events, coping styles, and PTSD symptoms.

Results

Academic pressure was the strongest predictor of adolescents'' PTSD symptoms among all negative life events. Main effects of negative life events, positive coping and negative coping on PTSD symptoms were significant in both younger adolescents and older adolescents, while the moderator effects of two coping styles were found significant only within older adolescents.

Conclusions

Coping may play a role to moderate the relationship between post-earthquake negative life events and PTSD symptom, but the function seems to depend on the age of participants. Psychosocial coping skills training may be important in the prevention and intervention of mental health problems in adolescent survivors of traumatic earthquake.     

Comparison of postural and motor components in instrumental defense learning in dogs

In 6 dogs, during the period of a complete formation of the "co-ordination" program of defensive reflex associated with maintaining flexion of the left hind-limb, the diagonal pattern of posture readjustment occurred very infrequently. Only during the period of a complete automation of the motor habit, a constant occurrence of the diagonal pattern of posture readjustment was observed in all realisations. These findings suggest that the diagonal pattern of posture readjustment occurs much later than the motor pattern necessary for solving the instrumental task.     

Legal Professionals' Knowledge of Eyewitness Testimony in China: A Cross-Sectional Survey

Purpose

To examine legal professionals’ knowledge of a wide range of factors that affect eyewitness accuracy in China.

Methods

A total of 812 participants, including 210 judges, 244 prosecutors, 202 police officers, and 156 defense attorneys, were asked to respond to 12 statements about eyewitness testimony and 3 basic demographic questions (i.e., gender, age, and prior experience).

Results

Although the judges and the defense attorneys had a somewhat higher number of correct responses than the other two groups, all groups showed limited knowledge of eyewitness testimony. In addition, the participants’ responses to only four items (i.e., weapon focus, attitude and expectations, child suggestibility, and the impact of stress) were roughly unanimous within the four legal professional groups. Legal professionals’ gender showed no significant correlations with their knowledge of eyewitness testimony. Prior experiences were significantly and negatively correlated with the item on the knowledge of forgetting curve among judges but positively correlated with two items (i.e., attitudes and exposure time) among defense attorneys and with 4 statements (i.e., the knowledge of attitudes and expectations, impact of stress, child witness accuracy, and exposure time) among prosecutors.

Conclusions

The findings suggest that knowledge of the factors that influence eyewitness accuracy must be more effectively communicated to legal professionals in the future.     

Hazard ratings of pine forests to a pine wilt disease at two spatial scales (individual trees and stands) using self-organizing map and random forest

Pine wilt disease (PWD) caused by the pine wood nematode is the most serious global threat to pine forests. Hazard ratings of trees and forests to pest attacks provide important information to efficiently identify current or future hazardous conditions. However, in spite of the importance of hazard ratings for managing PWD, there are few studies on hazard ratings in this system. In this study, we evaluated the hazard ratings of pine trees and pine stands to PWD by considering environmental factors at the level of the stand and the individual tree. Our results showed that trees with larger diameter at breast height (DBH) showed a higher risk rate than those with smaller DBH, indicating that large trees have an increased probability of exposure to vector beetles because they are tall and have a large crown volume. We also found that reduced tree vigour could be related to susceptibility to PWD. In pine stands, geographical factors showed a high correlation with the occurrence of PWD. PWD occurrence was rare at high altitudes, but was more common on steep and south-facing slopes. These patterns were consistently observed in the results from 2 computational approaches: self-organizing map (SOM) and random forest models. The combination of SOM and random forest was effective to extract ecological information from the dataset. The SOM efficiently characterized relations among variables, and the random forest model was effective at predicting ecological variables, including the hazard rating of trees to disturbances.     

Cell sociology and the problem of position effect: Pattern formation,origin and role of gradients

The control of pattern formation and the significance of gradients is reconsidered on the basis of the concept of cell sociology (which takes into account continuous exchange of information between cells and the possibility of autonomous progression in differentiation). Not all traits of a pattern are imposed by a single prepattern, which would be an organized molecular framework or a gradient. Patterns are unfolded in steps; these are readjustments of a cell population to intrinsic and extrinsic changes in cell activities. Prepatterns are the various components of the programme of every readjustment and are established by information of various origins, which can be dissociated experimentally: determination (elementary social prepattern), pre-existing organization (antecedent pp.), surrounding cell populations (environmental pp.), position among other tissues (positional pp.) and the organization of inducers (imprinting pp.). Every transitory pattern formed during a readjustment serves as antecedent pp. during the next readjustment. Covert graded patterns result from various aspects of the social behaviour of cells (growth, aggregation, induction, cell renewal) and may serve as antecedent or imprinting prepatterns. They appear as water marks in the final patterns, or generate overt graded patterns. They also manifest themselves in temporal patterns, particularly in gradients of relative growth.Dedicated to Professor P. D. Nieuwkoop on the occasion of his 60th birthday.