Using a 0-10 Scale for Assessment of Anxiety in Patients With Acute Myocardial Infarction

Patients with acute myocardial infarction (AMI) often experience anxiety, an emotion that predicts adverse physiologic outcomes. The purpose of this study was to determine whether a single-item anxiety assessment instrument, the Anxiety Level Index (ALI), is a valid alternative to the State Anxiety Index (SAI) or the anxiety subscale of the Brief Symptom Inventory (BSI) for assessing state anxiety for patients with AMI. In this prospective multicenter study, 243 inpatients with AMI rated their anxiety using the SAI, the anxiety subscale of the BSI, and the ALI. Anxiety Level Index scores were compared to SAI and BSI anxiety subscale scores. There were moderate, positive correlations between the SAI and the ALI (rs = 0.52, P < .001), and between the ALI and the anxiety subscale of the BSI (rs = 0.45, P < .001). Although ALI scores were moderately and significantly correlated with scores on the SAI and the BSI anxiety subscales, the results of the Bland-Altman method indicate a lack of construct validity of the single-item measure. The quest continues to construct a simple self-report measure of anxiety that is appropriate for critically ill patients with AMI.

Negative thinking and the mental health of low-income single mothers

PURPOSE

To test a conceptual model of predictors of depressive symptoms in low-income single mothers with children from 2 to 6 years of age.

DESIGN

Data were collected from September 2000 to October 2002 as part of the baseline data collection for a larger study in the eastern part of the United States. A volunteer sample of 205 women who were at risk for depression was recruited.

METHODS

Each woman completed a survey that included the Center for Epidemiologic Studies-Depression Scale, the Beck Depression Inventory, the Rosenberg Self-Esteem Scale, the Crandall Cognitions Inventory, and the Everyday Stressors Index.

FINDINGS

More than 75% of the participants scored at least in the mild depressive range on the Beck Depression Inventory or in the high depressive range on the CES-D. Negative thinking mediated the relationship between self-esteem and depressive symptoms and partially mediated the relationship between chronic stressors and depressive symptoms.

CONCLUSIONS

These findings are consistent with earlier research by this team. Negative thinking is an important factor in the development of depressive symptoms in at-risk women. As a symptom, negative thinking might be more amenable to nursing intervention than to interventions focused on reducing chronic stress.

The manuscript option dissertation: multiple perspectives

Based on our experiences at the University of Kentucky, the manuscript option dissertation is clearly a win-win situation from every angle. Other doctoral programs may find this approach invigorating. The ultimate benefit is the rapid dissemination of new knowledge to healthcare professionals for application to practice.

Parental bonding: a key factor for mental health of college women

The purpose of this study was to investigate the relationship of parental bonding to the mental health of college women aged 18 to 24 years. A cross-sectional study of a volunteer sample of 246 college women was conducted. Data on depressive symptoms, negative thinking, self-esteem, and parental bonding were collected via self-report. Maternal care was the strongest predictor of all four mental health indices. Paternal overprotection predicted scores of three of the four mental health measures. Women with optimal maternal and paternal bonding profiles (high care/low overprotection) had fewer depressive symptoms, less negative thinking, and higher self-esteem than women with other bonding profiles. The findings have implications for prevention, screening, and intervention to enhance the mental health of college women.

The archives of the Pioneer Health Centre, Peckham, in the Wellcome Library

This article gives a brief description of this important British experiment in health and community (1926-50) and the historiography relating to it. The archives, which are now in the Wellcome Library, are described. While mention is made of the gaps in the record (and the possible reasons for them), the strengths of the collection are indicated.

A "remarkable collection": The Papers of Frederick Parkes Weber FRCP (1863-1962)

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Preventing depression in high-risk college women: a report of an 18-month follow-up

The authors tested the long-term effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in 92 college women aged 18 to 24 years who ere at risk for clinical depression. The women were randomly assigned to either an experimental or a no-treatment control group. The experimental group participated in a 6-week cognitive-behavioral intervention that targeted identification and reduction of negative thinking, using such techniques as thought stopping and affirmations. Data on depressive symptoms, self-esteem, and negative thinking were collected before the intervention and at intervals of 1, 6, and 18 months postintervention. The women in the intervention group experienced a greater decrease in depressive symptoms and negative thinking and a greater increase in self-esteem than those in the control group. The beneficial effects continued over an 18-month follow-up period. These findings support the importance of thought stopping and affirmations as prevention interventions with at-risk college women.

Regulation of gene expression and cell growth in vivo by tetracycline using the hollow fiber assay

The hollow fiber assay presents a potentially unique tool to study the effects of regulated gene expression in cell lines that do not form tumors in vivo. The hollow fibers allow small molecules to pass freely through while keeping the cells within the fibers and segregated from host cells. OSp16.1 cells, derived from the U24 clone of the U2-OS osteogenic sarcoma tumor line, express the p16INK4a tumor suppressor under the regulation of tetracycline (tet) (Mitra J et al. Mol Cell Bio 19:3916, 1999). The in vitro induction of p16 in the OSp16.1 cell line is regulated by tet. The hollow fiber assay was used to determine whether the regulation of the p16 gene could be achieved in vivo, since these cells did not grow in the xenograft model. There were no differences in the in vivo growth pattern of U24 cells loaded into the hollow fibers with and without tet: 807% and 839% net growth, respectively. OSp16.1 cells in fibers in mice receiving 3.33 mg/kg/day tet had a 644% net growth after 21 days. There was a 194% net growth without tet. Immunoblotting of extracts prepared from the hollow fibers confirmed that p16 was induced in the absence of tet. These data demonstrate this assay is a useful tool for studying the effects of regulated gene expression in vivo.

Effects of the quality of dyadic relationships on the psychological well-being of elderly care-recipients

The purpose of this study was to examine the association of the quality of caregiver relationships with the psychological well-being of elderly care-recipients. Sociodemographic variables and characteristics of the care-recipient situation (e.g., self-rated physical health, amount of instrumental support needed) were explored as potential predictors of the psychological well-being of elderly individuals. A secondary analysis of data collected during in-home interviews with 37 community-dwelling older adults revealed no significant correlations between the quality of the primary intimate relationship and any dimension of psychological well-being. However, better self-rated health was associated with fewer depressive symptoms, higher morale, greater life satisfaction, and better quality of life. The more instrumental support needed by an individual, the greater their depressive symptoms and the lower their morale. The findings also revealed that the older the individual was, the greater the depressive symptoms were and the lower life satisfaction became. Self-rated physical health predicted each dimension of psychological well-being. The findings suggest that age, the amount of instrumental support needed, and perceptions of physical health are important indicators of the psychological well-being of elderly care-recipients.

Synthesis and structures of polymeric Mn, Co, Cu, and Zn complexes of 3-diphenylamino-4-hydroxycyclobut-3-ene-1,2-dione (diphenylaminosquarate) and of the salt [Ni(H2O)6][(C6H5)2NC4O3]2.2H2O

Reaction of M(NO3)2.xH2O (M = Mn, Co, Ni, Cu, Zn) with 3-diphenylamino-4-hydroxycyclobut-3-ene-1,2-dione (diphenylaminosquarate) produces the neutral polymeric species (M[mu-(C6H5)2NC4O3]2[H2O]2)n [M = Mn (1), Cu (2)]; (M[mu-(C6H5)2NC4O3][(C6H5)2NC4O3][H2O]3)n [M = Co (3), Zn (4)]; and in the case of Ni, the salt [Ni(H2O)6][(C6H5)2NC4O3]2.2H2O (5). Complexes 1 and 2 are isomorphous and crystallize in the monoclinic space group P2(1)/c with, for 1, a = 13.138(1) A, b = 10.900(2) A, c = 9.269(2) A, beta = 96.07(1) degrees, and Z = 2. Complexes 3 and 4 are also isomorphous and crystallize in the space group P2(1)/c with, for 3, a = 13.211(1) A, b = 11.038(1) A, c = 18.748(1) A, beta = 97.75(1) degrees, and Z = 4. The nickel salt, 5, crystallizes in the triclinic space group P1 with a = 6.181(1) A, b = 9.417(1) A, c = 15.486(1) A, alpha = 101.37(1) degrees, beta = 95.51(1) degrees, gamma = 107.57(1) degrees, and Z = 1. In 1 and 2, the metal coordination is octahedral, comprising four mu-1,3-bridging diphenylaminosquarate ligands and two trans aqua ligands. In 3 and 4, the metal coordination is again octahedral, comprising two mu-1,3-bridging and one pendant diphenylaminosquarate ligands, the octahedron being completed by three aqua ligands in a meridional configuration. In 5, the hexaaquanickel(II) ion is linked by O-H...O hydrogen bonds to a pair of diphenylaminosquarate anions. These anion-cation units are linked via included water molecules to form hydrogen-bonded chains. The diphenylaminosquarate ligands in the polymeric complexes 1-4 display multiple-bond localization, a feature which is absent in 5. Complex 1 exhibits weak antiferromagnetic coupling, whereas 2 shows no significant magnetic interactions.

Somites in zebrafish doubly mutant for knypek and trilobite form without internal mesenchymal cells or compaction

In vertebrates, paraxial mesoderm is partitioned into repeating units called somites. It is thought that the mechanical forces arising from compaction of the presumptive internal cells of prospective somites cause them to detach from the unsegmented presomitic mesoderm [1-3]. To determine how prospective somites physically segregate from each other, we used time-lapse microscopy to analyze the mechanics underlying early somitogenesis in wild-type zebrafish and in the mutants trilobite(m209) (tri), knypek(m119) (kny), and kny;tri, which are defective in convergent extension during gastrulation. Formation of somite boundaries in all of these embryos involved segregation, local alignment, and cell-shape changes of presumptive epitheloid border cells along nascent intersomitic boundaries. Although kny;tri somites formed without convergence of the presomitic mesoderm and were composed of only two cells in their anteroposterior (AP) dimension, they still exhibited AP intrasegmental polarity. Furthermore, morphogenesis of somite boundaries in these embryos proceeded in a manner similar to that in wild-type embryos. Thus, intersomitic boundary formation in zebrafish involves short-range movements of presumptive border cells that do not require mechanical forces generated by internal cells or compaction of the presomitic mesoderm.

Reducing negative thinking and depressive symptoms in college women

PURPOSE

Although cognitive-behavioral interventions have been successful in treating depression, no studies were found that focused solely on reducing negative thinking via group intervention as a means of preventing depression in at-risk groups. The purpose of this randomized controlled trial was to test the effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in young women at risk for depression.

DESIGN

A randomized controlled trial with 92 college women ages 18 to 24 who were at risk for depression was conducted.

METHOD

Participants were randomly assigned to either the control or experimental group. The experimental group participated in a 6-week cognitive-behavioral group intervention. Data on self-esteem, depressive symptoms, and negative thinking were collected via self-report questionnaires from control and experimental groups at baseline, 1 month after the intervention, and at 6-month follow-up. Data were analyzed using mixed-model methodology and the Cochran-Mantel-Haenszel chi-square test.

FINDINGS

Compared to those in the control group, women who received the intervention had a greater decrease in depressive symptoms and negative thinking and a greater increase in self-esteem, and these beneficial effects were maintained over 6-months.

CONCLUSIONS

The findings document the effectiveness of this cognitive-behavioral group intervention and indicate empirical support for the beneficial effects of reducing negative thinking by the use of affirmations and thought-stopping techniques on women's mental health.

Negative thinking mediates the effect of self-esteem on depressive symptoms in college women

BACKGROUND

One of every three women between 18 and 24 years of age may be significantly depressed. Younger women have shown increasing rates of unipolar depression since the 1950s, and the average age of onset continues to decline.

OBJECTIVES

To examine the prevalence and correlates of high depressive symptoms in single college women 18 to 24 years of age. Negative thinking was posited to mediate the relationship between self-esteem and depressive symptoms.

METHODS

A sample of 246 women was recruited from a university student body. Each woman completed a survey that included the Center for Epidemiologic Studies-Depression Scale, the Beck Depression Inventory, the Rosenberg Self-esteem Scale, the Crandell Cognitions Inventory, and the Automatic Thoughts Questionnaire.

RESULTS

Of the women, 35% had high depressive symptoms. Negative thinking mediated the relationship between self-esteem and depressive symptoms. However, self-esteem also showed a weak direct effect on depressive symptoms.

CONCLUSION

The findings suggest that negative thinking may play an important role in the development of depressive symptoms in college women.

The hollow fiber assay: continued characterization with novel approaches

The hollow fiber assay, a unique in vivo model, permits the simultaneous evaluation of compound efficacy against multiple cell lines in two physiological compartments. This assay has been used to characterize in vivo activity of cytotoxic compounds. The purpose of the present study was to characterize and optimize this assay for compounds with a defined mechanism of action, specifically cell cycle inhibition. Two human tumor cell lines and one normal human cell line were loaded into polyvinylidene fluoride hollow fibers at two or more cell concentrations and grown in mice for 3-10 days. The data demonstrate the importance of characterizing the initial loading density of various cell lines in the evaluation of compounds. All studies were performed with cells in the linear part of the cell growth curves. Initial loading densities of 1-2 x 10(4) cells/fiber gave the greatest opportunity for growth in the three human cell lines tested (HCT116 colon carcinoma, NCI-H460 non-small cell carcinoma, and AG 1523 normal fibroblast). Utilizing the MTT assay, standard curves were constructed to correlate the final number of cells with optical density (OD) readings at 540 nm in order to calculate cell numbers in the fibers. Insights into the mechanism of action of cisplatin have been gained using Western blot analysis of the cell cycle markers PCNA (a protein present throughout the cell cycle) and Rb (a protein that acts as a tumor suppressor gene product) from the hollow fiber cells. In cisplatin-treated NCI-H460 cells both PCNA and Rb phosphorylation decreased, suggesting the arrest of the cells prior to the S phase. Standard therapeutic agents, cisplatin, racemic flavopiridol, cyclophosphamide and mitomycin C, were evaluated independently in the hollow fiber assay and the xenograft model. The data demonstrate that compounds active in the hollow fiber assay are also active in the xenograft.

Kindergarten children's knowledge and perceptions of alcohol, tobacco, and other drugs

Kindergarten children's knowledge and perceptions of alcohol, tobacco, and other drugs (ATODs) were assessed and the congruence between parent ATOD use and children's knowledge of ATODs was examined. Data were collected during the pre-intervention phase of an ATOD prevention trial with 5- and 6-year-old children and their parents. Three elementary schools were randomly selected from a population of 15 high-risk elementary schools in Lexington, Ky., (n = 126 parent-child dyads). Children were interviewed about their knowledge, feelings, and attitudes toward ATODs using the Child Drug Awareness Inventory. Parents self-reported ATOD use. Almost all (95%) kindergarten children recognized cigarettes; 56% correctly identified alcoholic beverages; and 17% recognized at least one illicit drug. Minority children were almost four times more likely to recognize illicit drugs than were non-minority children. Children's knowledge of ATODs was not correlated with the parents' reported drug use. ATOD prevention programs for young children merit greater emphasis.

The physical health of rural mothers and their low birth weight children

The purpose of this research was to examine the physical health of rural mothers and their low birth weight children (< 2,500 gm). The health of rural mothers is of concern because rural families have poorer health than urban ones, and as the primary caregiver for the low birth weight child, mother's health affects the child's care and potentially the child's health. In this cross-sectional, exploratory study, in-home interviews were conducted with 48 mothers between 2 weeks and 18 months after their children were discharged from their birth hospitalization. Mothers' physical health and their perceptions of their children's health were assessed. The mothers were more concerned about their children's health than their own (p = .0005). The concerns included uncertainty about the children's future health, growth, and development. Suggestions for community health care providers are addressed.

Potential for abusive parenting by rural mothers with low-birth-weight children

PURPOSE

To describe factors influencing the potential for abusive parenting by rural mothers of low-birth-weight children (< 2,500 gm). Low-birth-weight (LBW) children are at risk for child abuse. However, little is known about the added risks created for these children by rural residency.

DESIGN

Data for this descriptive and exploratory study were collected using a cross-sectional design. A convenience sample of 48 rural mothers delivering LBW children participated in 1994.

METHODS

In-home interviews were conducted using structured questionnaires to assess mothers' everyday stressors, depressive symptoms, social resources, and child abuse potential.

FINDINGS

The prevalence of high depressive symptoms among the mothers was 54%. Higher everyday stressors and less functional social support predicted greater depressive symptoms. Everyday stressors had a direct effect on the mothers' potential for child abuse and an indirect effect via maternal depressive symptoms.

CONCLUSIONS

Rural mothers of LBW children are at risk for abusive parenting. Health care providers should pay particular attention to the mental health of mothers living in rural, isolated areas. Assistance with mobilization of community resources, including social support and child care, may provide needed help for these mothers to improve parenting and thus child health outcomes.

Psychometrics for two short forms of the Center for Epidemiologic Studies-Depression Scale

The Center for Epidemiologic Studies-Depression Scale (CES-D; L. S. Radloff, 1977) assesses the presence and severity of depressive symptoms occurring over the past week. Although it contains only 20 items, its length may preclude its use in a variety of clinical populations. This study evaluated psychometric properties of 2 shorter forms of the CES-D developed by F. J. Kohout, L. F. Berkman, D. A. Evans, and J. Cornoni-Huntley (1993): the Iowa form and the Boston form. Data were pooled from 832 women representing 6 populations. Internal consistency estimates, correlations with the original version of the CES-D, and omitted-included item correlations supported use of the Iowa form over the Boston form when a shortened version of the scale is desired. Regression statistics are provided for use in estimating scores on the original CES-D when either shortened form is used. Factor analytic results from two populations support a single-factor structure for the original CES-D as well as the short forms.

Mothers' potential for child abuse: the roles of childhood abuse and social resources

BACKGROUND

The mechanism by which some victims of childhood abuse become abusive parents, whereas others do not, is not well understood. Previous empirical evidence indicates that social resources may modify the cycle of abuse or maladaptive parenting; however, the effects of different dimensions of social resources have not been compared.

OBJECTIVES

To determine whether a measure of mothers' potential for physical child abuse was related to their retrospective reports of physical and sexual abuse before 18 years of age and to investigate the potential buffering effects of multiple dimensions of social resources on the relationship between childhood abuse and mothers' potential for physical child abuse.

METHODS

The potential role of social resources as a moderator of the relationship between a history of childhood abuse and potential for physical child abuse was investigated in 206 low-income single mothers of young children.

RESULTS

The levels of physical and sexual abuse in childhood were positively associated with the mothers' child abuse potential; sexual abuse displayed the strongest association. Compared with mothers who were not sexually abused in childhood, those reporting violent sexual abuse as children were almost six times more likely to have high potential for physically abusing their children. There was no evidence that any of the social resources modified the relationship of either type of childhood abuse with the mothers' potential for abuse. However, all four dimensions of social resources demonstrated significant main effects on child abuse potential.

CONCLUSIONS

Low-income mothers face many stressors because of their lack of economic resources. This, coupled with a lack of social resources and a history of childhood abuse, makes low-income, single mothers particularly at risk for abusive parenting. The lives of these women and their children may be enhanced by assisting the women to improve their social resources which, ultimately, may reduce their potential for child abuse. Future research should focus on identifying factors that predict and/or modify the potential for abusive parenting as well as actual abuse.