Representations of self and other: a semantic space model

This article describes a semantic space model of personality. According to the model, representations of facets of the self (e.g., actual self, ideal self) and of others are arrayed in a semantic space, with proximities among representations predicted to be associated with mood, self-evaluation, and broad personality dimensions. The relation of proximities among pairs of representations to personality and mood measures was found to be mediated by the spatial proximity of other representations, indicating that the representations constitute dynamic systems. Proximities among representations were shown to predict self-esteem and self-evaluative moods even after controlling for the contribution of the personality dimensions of Neuroticism, Extraversion, and Agreeableness. Generally, the semantic space model led to better predictions than did several related models concerning representations of self and other.

The relation of childhood personality types to adolescent behavior and development: a longitudinal study of Icelandic children

The relation of childhood personality types, or configurations of personality traits, to adolescent development was examined. Three personality types were identified in an inverse factor analysis of California Child Q-Sort data on 128 Icelandic 7-year-olds: resilient, overcontrolled, and undercontrolled. Growth curve analyses demonstrated that in comparison to children of the other 2 types, children of the resilient personality type had higher levels of academic achievement and lower levels of concentration problems throughout adolescence; resilient children also developed sophisticated friendship reasoning and an internal locus of control more quickly. Children of the overcontrolled type were found to be more prone to social withdrawal and low levels of self-esteem during adolescence than children of the other 2 types. In contrast to the other 2 types, children classified as undercontrolled showed an increase in aggressive behavior in adolescence. Implications of the findings for research on personality development are discussed.

Hemodynamic and renal excretory effects of human brain natriuretic peptide infusion in patients with congestive heart failure. A double-blind, placebo-controlled, randomized crossover trial

BACKGROUND

The pharmacological effects of infusion of human brain natriuretic peptide (hBNP) in patients with severe congestive heart failure have not been characterized previously.

METHODS AND RESULTS

Twenty patients with severe congestive heart failure were randomized in a double-blind, placebo-controlled, crossover trial to receive incremental 90-minute infusions of hBNP (0.003, 0.01, 0.03, and 0.1 microgram/kg per minute) or placebo on 2 consecutive days. At the highest completed dose of the hBNP, mean pulmonary artery pressure decreased from 38.3 +/- 1.6 to 25.9 +/- 1.7 mm Hg; mean pulmonary capillary wedge pressure decreased from 25.1 +/- 1.1 to 13.2 +/- 1.3 mm Hg; mean right atrial pressure decreased from 10.9 +/- 1 to 4.8 +/- 1.0 mm Hg; mean arterial pressure decreased from 85.2 +/- 2.0 to 74.9 +/- 1.7 mm Hg; and cardiac index increased from 2.0 +/- 0.1 to 2.5 +/- 0.1 L/min per square meter (all P < .01 versus placebo). Urine volume and urine sodium excretion increased significantly during hBNP infusion when compared with placebo infusion (90 +/- 38 versus 67 +/- 27 mL/h and 2.6 +/- 2.4 versus 1.4 +/- 1.2 mEq/h, respectively, both P < .05 versus placebo), whereas creatinine clearance and urinary potassium excretion did not change.

CONCLUSIONS

Infusion of incremental doses of hBNP is associated with favorable hemodynamic and natriuretic effects in patients with severe congestive heart failure.

[Therapeutic trials in oncology. Legal aspects]

Therapeutic trials in the field of oncology regularly serve the dual purpose of expanding existing knowledge and meeting the doctor's obligation to provide medical care. Their objective is to check, modify or establish standards of treatment. In the form of clinical trials, they investigate the effects (efficacy, risks and other properties) of medicinal drugs. This applies both to new, as yet unapproved, drugs and also to drugs already in use, but now to be tested for an indication other than that for which they were originally approved. This applies to trials sponsored by the pharmaceutical industry and to studies not so sponsored. These clinical trials are subject to the regulations of pharmaceutical law (AMG), while others are assessed in accordance with the exemplary principles expressed in sec. 40 AMG. All therapeutic studies are required by pharmaceutical law or professional law to be reviewed by ethics committees (approval/advising). All such studies must comply with strict legitimation requirements of liability law. They may be carried out only when there has been a positive benefit/-risk assessment that promises results that are at least equal to those obtainable with standard treatment. Patient information requirements are strict and include the provision of information about alternative forms of treatment as well as about the absence of health insurance funding-where this applies- and the future funding of further treatment on termination of the study. Documentation obligations are extensive, and organizational requirements include the establishment of quality management. In the case of clinical trials, the conclusion of an insurance contract for the participants is mandatory, and in the case of other therapeutic studies urgently recommended. Therapeutic studies may be funded by statutory health insurance carriers within the framework of study regulations or quality assurance measures. This does not apply to clinical trials of drugs on behalf of the pharmaceutical industry.

Nicotine enhances expression of the neutrophil elastase gene and protein in a human myeloblast/promyelocyte cell line

The pathogenesis of emphysema is considered to be an imbalance of protease and antiprotease activity in the lower respiratory tract leading to uninhibited degradation of lung interstitium by elastolytic enzymes. An increased amount of the serine protease neutrophil elastase (NE) is though to play a major role in this degradation. Because the expression of NE is limited to neutrophil precursors in the bone marrow, we hypothesized that nicotine, which is readily absorbed from lung and distributed to tissue, including bone marrow, would increase expression of the NE gene and protein. HL-60 cells, a myeloblast/promyelocyte cell line, were cultured in the presence or absence of 0.06 and 0.8 microM nicotine for 5 d. Both concentrations of nicotine caused a 2.4- to 3.3-fold increase, respectively, in NE gene expression over unstimulated cells, and NE protein increased 4.8- to 3.4-fold over unstimulated cells, respectively, similar to our positive control DMSO. Nicotine did not induce upregulation of the NE gene by initiating cell differentiation. Both low and high nicotine concentrations upregulate the NE gene in HL-60 cells leading to increased NE protein concentration per cell suggesting a pathophysiologic mechanism for emphysema.

Complete nucleotide sequence and transcriptional analysis of snakehead fish retrovirus

The complete genome of the snakehead fish retrovirus has been cloned and sequenced, and its transcriptional profile in cell culture has been determined. The 11.2-kb provirus displays a complex expression pattern capable of encoding accessory proteins and is unique in the predicted location of the env initiation codon and signal peptide upstream of gag and the common splice donor site. The virus is distinguishable from all known retrovirus groups by the presence of an arginine tRNA primer binding site. The coding regions are highly divergent and show a number of unusual characteristics, including a large Gag coiled-coil region, a Pol domain of unknown function, and a long, lentiviral-like, Env cytoplasmic domain. Phylogenetic analysis of the Pol sequence emphasizes the divergent nature of the virus from the avian and mammalian retroviruses. The snakehead virus is also distinct from a previously characterized complex fish retrovirus, suggesting that discrete groups of these viruses have yet to be identified in the lower vertebrates.

Genetic influences on osteoarthritis in women: a twin study

OBJECTIVES

To assess the relative contribution of genetic and environmental factors to common forms of osteoarthritis of the hands and knees.

DESIGN

Classic twin study with unselected twins who were screened radiologically for osteoarthritis.

SUBJECTS

130 identical and 120 non-identical female twins aged 48-70 recruited from a London based twin register and through a national media campaign.

MAIN OUTCOME MEASURES

Similarity in identical compared with non-identical twin pairs for radiographic changes at the interphalangeal and first carpometacarpal joints of the hands and the tibiofemoral joint and patellofemoral joint of the knee expressed as intraclass correlations.

RESULTS

The intraclass correlations of radiographic osteophytes and narrowing at most sites and the presence of Heberden's nodes and knee pain were higher in the identical pairs. The intraclass correlation of the total radiographic osteoarthritis score in identical pairs (rMZ) was 0.64 (SE 0.05) compared with 0.38 (0.08) in non-identical pairs. The proportion of genetic variance of total osteoarthritis score (osteophytes and narrowing) with modelling techniques was estimated at 0.54 (95% confidence interval 0.43 to 0.65) and ranged from 0.39 to 0.65 for different sites and features (p < 0.001) after adjustment for age and weight.

CONCLUSIONS

These results demonstrate for the first time a clear genetic effect for radiographic osteoarthritis of the hand and knee in women, with a genetic influence ranging from 39-65%, independent of known environmental or demographic confounders. The results of this study should lead to further work on isolating the gene or genes involved in the pathogenesis of the common disabling disease.

The psychological outcome of breast reconstruction

My first experience with breast cancer as a nurse was in 1974. I was a 23-year-old nursing student and working as an operating room technician. A radical mastectomy was being performed on a 52-year-old woman. As I passed clamps and scissors to the two surgeons, I struggled to conceal the shock I was experiencing. "Is it really necessary to remove so much tissue for such a small lump?" "Yes," the doctor replied, "It's either this or she'll die." It was 10 years later that I would begin my work with patients undergoing breast reconstruction. During the 7-1/2 years that I worked as an operating room supervisor and assistant to a plastic surgeon, I responded to the needs of a number of women during their time of crisis. We would see each other every week or two for a year, become friends, and treatment would come to an end. Their lives would go on, and I would continue my work with a new patient, then another and another. My work with reconstruction patients continues as Patient Information Coordinator for Mentor H/S, a breast implant manufacturer. Hundreds of women who have had breast cancer call me each year. I provide information, answer questions, and help educate. Etched in my memories are emotion-filled faces and voices of shock, fear, confusion, sorrow, and resignation followed by acceptance. Individual women of various lifestyles and personalities as well as different levels of financial and social status, all have one thing in common--breast cancer, mastectomy, decisions, and reconstruction. Many were experiencing an interruption in their lives, a stress on their relationships and a drain on their finances. But the even greater challenge they faced was the life and death crisis of an illness that is both life threatening an disfiguring. Researchers such as Schain, Goldberg and Kasper have documented the psychological effects of breast-loss for women and their relationships (Schain, 1991; Goldberg, Stoltzman, & Goldberg, 1984; Kasper, 1995). Jones, Matheson, and Rowland looked at psychological adjustment, counseling needs and patients' response to their altered body image (Jones & Reznikoff, 1989; Matheson & Drever, 1990; Rowland, Holland, Chaglassian, & Kinner, 1993). The alteration of body image first occurs with mastectomy and continues with reconstruction. Goin, Cederna and Wellisch provide insight into the effects of various types of reconstruction (Goin & Goin, 1988; Cederna, Yates, Chang, Cram, & Ricciardelli, 1995; Wellisch, Schain, Noone, & Little, 1987). The following article is a compilation of my personal experience, and excerpts from literature presented as an overview of the psychological effects of mastectomy and reconstruction.

Differential macrophage responses in the peripheral and central nervous system during wallerian degeneration of axons

We characterized quantitatively the macrophage response following axonal injury in both the peripheral (PNS) and central nervous system (CNS) of adult mammals. A monoclonal antibody (ED-1) which stains monocytes, macrophages, and activated microglia was employed. In one model, Wallerian degeneration of the sciatic nerve was studied. An increase in the number of macrophages was seen as early as 1 day following nerve transection. Macrophage number increased synchronously along the length of degenerating nerve over a 21-day period. In a second model, transection of a spinal dorsal sensory root allowed us to compare and contrast the macrophage response along the PNS and CNS portions of a single axonal pathway. An increased number of macrophages restricted to the PNS portion of this pathway was seen by 3 days and continued to increase over a 14-day period. Myelin breakdown occurred in association with an increase in the number of macrophages by 3 days in the PNS but not the CNS portion of the degenerating dorsal root axon pathway. Low-affinity nerve growth factor receptor immunohistochemical staining increased by Day 1 in the PNS but not the CNS portion of this pathway, occurring prior to the invasion of macrophages. In both models, the morphology of infiltrating macrophages changed over time from small slender ramified cells to large elongated multivacuolated cells. In conclusion, our results demonstrate that the macrophage response during Wallerian degeneration of axons in adult mammals is much more rapid and robust in the PNS, where axonal regeneration occurs, than in the CNS, where axonal regeneration is far more limited.

Measuring disadvantage: changes in the underprivileged area, Townsend, and Carstairs scores 1981-91

OBJECTIVE

To compare the intercensal change for each of the underprivileged area (UPA), Townsend, and Carstairs scores calculated from 1981 and 1991 census data.

SETTING

England and Wales.

METHODS

The method described enables comparison of change in composite scores such as the UPA, Townsend, and Carstairs scores which are derived from normalised variables. The national values of equivalent variables derived from the censuses are calculated and normalised on the same baseline of the 1981 electoral ward mean and SD values. The resultant change in composite scores for different censuses can then be compared directly.

MAIN OUTCOME MEASURE

Change in the composite score values for the 1991 census when compared with the 1981 census.

RESULTS

For England and Wales, the UPA score increased by 5.62 units (0.35 of the SD) but the Townsend and Carstairs scores fell by 2.39 and 1.13 units respectively (0.71 and 0.33 of the SDs).

CONCLUSION

The Townsend and Carstairs scores are good measures of material deprivation and show a general improvement as such between 1981 and 1991. The UPA score, however, includes additional factors relating to family structure, social deprivation, and health need and shows a decline in the overall situation.

Technical note: potentially higher patient radiation doses using digital equipment for barium studies

Digital fluorography offers several advantages over conventional radiographic systems. The general expectation of digital equipment has been of a lower radiation dose to the patient. A series of dose-area product measurements on two digital sets during barium meal and barium enema examinations has shown that this expectation is not necessarily correct, particularly when the dose from the fluoroscopic part of the examination is considered. Users of digital fluorography sets are advised to check the performance of their equipment by suitable dose measurements.

Prosocial behavior and caring in adolescence: relations to self-understanding and social judgment

The relation of self-understanding and moral judgment to dedicated prosocial behavior is investigated. Participants were African-American and Latin-American adolescents who had been nominated by community leaders for having demonstrated unusual commitments to care for others or the community (care exemplars). The care exemplars, and matched comparison adolescents, were extensively interviewed over the course of 4-6 sessions in order to elicit self-understanding, moral judgment, and implicit personality theories. The care exemplars were more likely than the comparison adolescents to: (1) describe themselves in terms of moral personality traits and goals, (2) view themselves as having closer continuity to their pasts and futures, (3) think of themselves as incorporating their ideals and parental images, and (4) articulate theories of self in which personal beliefs and philosophies are important. There were no differences between the care exemplars and the comparison adolescents in developmental stages of moral judgment nor in the abstractness of their implicit personality theories.

The experience of self in the bottlenose dolphin

Marten and Psarakos have presented some evidence which suggests that objective self-awareness and possibly representations of self may characterize the dolphins' experience of self. Their research demonstrates the possibility of similarities in the sense of self between primate species and dolphins, although whether dolphins have subjective self-awareness, personal memories, and theories of self--all important facets of the sense of self in humans--was not examined. Clearly, even this limited evidence was difficult to achieve; the difficulties in adapting methods and coding behavior are quite apparent in their report. Future progress, however, may depend upon clarification of what are the necessary components for a sense of self and an explication of how these might be reflected in dolphin behavior. We are mindful of the authors' point (pp. 219 and 220) that the dolphin lives more in an acoustic than a visual environment. Thus, while tasks relying upon vision may reveal the presence or absence of the sense of self in primates, it might well be the case that in dolphins self-related experiences might be better revealed in auditory tasks. But then, what is the nature of human self-awareness in terms of audition? While both conceptual and methodological hurdles remain, Marten and Psarakos have demonstrated that important questions can be asked about the minds and phenomenal worlds of nonanthropoid species.

Women and saline breast implant surgery

Since clinical studies are ongoing relative to breast implants, keeping up with the most current information is an important aspect of nursing practice. This article will provide answers to five basic questions that arise in regards to breast implantation and nurses' roles in the process.

Patient radiation doses from enteroclysis examinations

Data relating to patient dose have been acquired for enteroclysis examinations (small bowel enemas) performed at the John Radcliffe Hospital, Oxford, on 23 adult patients. Dose-area products, fluoroscopy times and the number of radiographs taken are used to compare the examination procedure at the John Radcliffe Hospital with enteroclysis and barium follow-throughs performed elsewhere. The mean dose-area product for the 23 examinations was 6.8 Gy cm2 and the mean effective dose was estimated to be 1.5 mSv. These doses are intermediate between those arising from barium meals and barium enemas performed in the same room.

Educational audit of postgraduate medical education

This project examined the academic audit of postgraduate medical education, and went on to research, design and implement an educational audit system for use in Mersey Region, UK. Issues found to be significant included ownership of both standards and results, norming, and the levels of aggregation of data. The project has demonstrated that designing and implementing a system of feedback which is effective and sustainable is feasible, but requires the agreement and support of tutors as to its objectives and use. The resulting system has now been tested across a range of courses and programmes of meetings in Mersey Region, and has been accepted by the Postgraduate Office as the basis for future development.

Estimation of effective dose from dose-area product measurements for barium meals and barium enemas

The International Commission on Radiological Protection has recommended the use of a new dose quantity "effective dose". The doses to 22 organs of the human body are required for a formal calculation of this quantity. This paper shows that a quick estimate of the effective dose received by a patient from a barium meal or a barium enema can be made by multiplying the measured dose-area product for the complete examination by an appropriate conversion coefficient. Despite the varied techniques used for barium examinations, such an estimate is unlikely to be in error by more than 25%.

Defining osteoarthritis of the hand for epidemiological studies: the Chingford Study

OBJECTIVES

To explore the relative merits of clinical and radiological examination in defining hand osteoarthritis (OA) for epidemiological purposes.

METHODS

A total of 976 women aged 45-64 years were selected from the general population and underwent a structured interview, clinical examination of the hand joints and radiography of the hands and knees. The inter-relationship of the clinical and radiological findings was examined, and also the association of each with hand symptoms and the presence of knee OA.

RESULTS

Clinical and radiographic signs of hand OA generally correlated with each other, and each was associated with hand symptoms to a similar degree. When analysed in combination, they were only marginally better at predicting symptoms than when tested individually. However, when they were examined in relation to radiographic features of knee OA, there was a significantly stronger association with radiographic features of hand OA than with clinical features.

CONCLUSIONS

Hand radiology provides a better overall assessment of osteoarthritis than physical examination of the interphalangeal joints or carpo-metacarpal joint; in situations where radiology is not available clinical examination is a viable substitute.

The plasma interleukin-6 and stress hormone responses to acute pyelonephritis

The relationships between the "stress hormones" corticotrophin (ACTH), vasopressin (AVP), corticotrophin releasing hormone (CRH) and cortisol, and the cytokines, interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor were studied during an acute infection. Ten patients (7 female, 3 male, age range 16-56 years) with acute pyelonephritis and normal renal function were studied during the first 72 hours following hospital admission. Peptide hormones were measured by radioimmunoassay, cortisol and cytokines by ELISA. Reference ranges for all hormones were from samples donated by 40 or more volunteers from the electoral roll. The reference data for IL-6 was obtained from 20 normal donor sera. The mean plasma IL-6, AVP and CRH concentrations on admission to hospital were significantly raised above the mean 08:00h values of the normal volunteers (p < 0.001 for AVP and CRH, p < 0.01 for IL-6), but mean plasma ACTH and cortisol were not. Mean plasma IL-6 and AVP were raised more than two standard deviations above the mean of the reference range for 72 hours, although IL-6 tended to fall after 24 hours. No change in plasma IL-1 and tumour necrosis factor was observed in three patients. The correlation between plasma IL-6 and cortisol concentrations at all sampling times and in all subjects was highly significant (p < 0.001). Significant correlations between plasma IL-6 and AVP (p < 0.005), and IL-6 and ACTH (p < 0.05) were also observed. No correlation between IL-6 and CRH could be demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

Self-reported fears of hospitalized school-age children

This research examines the fears of 82 hospitalized school-age children 8 to 11 years of age as self-reported on the Child Medical Fear Scale (CMFS) (Broome, Hellier, Wilson, Dale, & Glanville, 1988). The variables of age, gender, yearly income level, health status (acute or chronic), and the score on the Trait scale of the State-Trait Anxiety Inventory for Children (STAIC), (Spielberger, Edwards, Lushene, Montuori & Platzek, 1973) were examined. Fear of separation from the family, having shots and finger sticks, having to stay in the hospital for a long time, and being told that something was wrong with them were the fears with highest mean scores. Children with higher trait anxiety and from families with lower yearly income reported a higher amount of fear. Pediatric nurses are encouraged to perform fear assessments and provide individualized interventions that anticipate fear reactions in order to assist school-age children to cope with sources of fears during hospitalization.

Mechanism of endothelin activation of phospholipase A2 in rat renal medullary interstitial cells

Previous studies from this laboratory have demonstrated that endothelin-1 (ET) stimulates phosphatidylinositol (PI) hydrolysis, activates dihydropyridine-insensitive Ca2+ channels, and promotes prostaglandin E2 (PGE2) accumulation in cultured rat renal medullary interstitial cells (RMIC). The mechanism whereby ET augments PGE2 production was explored in the current study. ET-evoked PGE2 accumulation proceeded independent of large increments in cytosolic free Ca2+ concentration ([Ca2+]i), derived from either extracellular or intracellular sources. Chelation of intracellular Ca2+ with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid eliminated ET-evoked PGE2 production, indicating that eicosanoid production was nonetheless a Ca(2+)-requiring process. Nanomolar concentrations of phorbol 12-myristate 13-acetate (PMA) alone did not stimulate PGE2 production, nor did PMA alter ET-stimulated PGE2 accumulation. Furthermore, downregulation of protein kinase C (PKC) by prolonged exposure of cells to PMA did not mitigate ET-mediated PGE2 production, demonstrating that PKC stimulation was not required for PGE2 production. ET stimulated PGE2 accumulation despite PI-specific phospholipase C (PI-PLC) inhibition by nanomolar concentrations of PMA, indicating that eicosanoid production was not a downstream event of PI hydrolysis. ET stimulated arachidonic acid metabolite release in parallel with a loss of label from membrane phospholipids. Phosphatidylethanolamine was the preferred substrate for ET-mediated activation of phospholipase A2 (PLA2). Immunocytochemical studies including immunostaining, immunoblotting, and immunoprecipitation confirmed the presence of cytosolic PLA2 (cPLA2) in RMIC. In summary, ET stimulation of PGE2 production in RMIC is mediated via agonist activation of cPLA2 independent of activation of PI-PLC, suggesting direct coupling to the ET receptor. Constitutive levels of [Ca2+]i rather than abrupt increments in [Ca2+]i are sufficient for activation of this receptor-effector system, with no obligatory requirement for PKC.

Knee immobilization inhibits biomechanical maturation of the rabbit medial collateral ligament

In this investigation, the effect of immobilization on the structural biomechanical properties of the immature rabbit medial collateral ligament (MCL) was quantified. The right hindlimbs of ten, three-month-old female New Zealand White rabbits were immobilized. The hindlimbs of the first group (n = 5) were immobilized for one month, until the rabbits were four months of age. The hindlimbs of the second group (n = 5) were immobilized for three months, until the rabbits were six months of age. Left hindlimbs were not surgically treated and served as contralateral controls. Fifteen normal animals were kept in similar cages until they were killed in subgroups at three, four, or six months of age. Biomechanical investigations after the animals were killed included the testing of a number of MCL structural properties, including prefailure and strength tests. Results showed that the maturation of MCL structural properties were inhibited during immobilization with signs of structural degradation becoming more obvious at the longer period of immobilization. Results also demonstrated that the structural mechanical properties of the contralateral MCLs were significantly altered. These results suggest that knee mobility is essential to the normal maturation of MCL mechanical properties and that contralateral MCLs cannot be used as normal controls in this immature rabbit model of immobility.