A coping self-insight scale for adults: development and preliminary psychometric properties.

BACKGROUND: Self-insights focused on the coping process are implicated in the refinement of capacities for resilience. To advance this research, we must identify key coping self-insights and develop a concise measurement tool. OBJECTIVE: The purpose of this paper is to develop evidence for the construct dimensionality and validity of a measure of coping self-insight. METHODS: Items measuring 13 coping self-insight dimensions were generated via consultation with theoretical work, subject matter experts, and pre-testing items for clarity. Thereafter, the dimensionality of items was assessed with undergraduate students (N = 232) and an online sample (N = 800) via exploratory and confirmatory analyses. Finally, a multi-trait, multi-method approach was used to test discriminant validity in a further sample of students (N = 228). RESULTS: The initial item list was reduced to five key dimensions that balanced data-driven and conceptual considerations. Confirmatory Factor Analysis revealed moderate-to-strong correlations (r = .47-.80) among dimensions. We also demonstrated evidence of internal reliability, convergent, criterion, and discriminant validity. Invariance tests for sub-groups of interest (e.g., sex, sample type) frequently demonstrated metric or scalar invariance, except for age sub-groups. CONCLUSIONS: Findings offer a starting point regarding the types of coping self-insights important for the emergence of resilience and a validated tool for future research.

Validation of the German version of the work and social adjustment scale in a sample of depressed patients.

BACKGROUND: Depression is one of the key factors contributing to difficulties in one's ability to work, and serves as one of the major reasons why employees apply for psychotherapy and receive insurance subsidization of treatments. Hence, an increasing and growing number of studies rely on workability assessment scales as their primary outcome measure. The Work and Social Assessment Scale (WSAS) has been documented as one of the most psychometrically reliable and valid tools especially developed to assess workability and social functioning in patients with mental health problems. Yet, the application of the WSAS in Germany has been limited due to the paucity of a valid questionnaire in the German language. The objective of the present study was to translate the WSAS, as a brief and easy administrable tool into German and test its psychometric properties in a sample of adults with depression. METHODS: Two hundred seventy-seven patients (M = 48.3 years, SD = 11.1) with mild to moderately severe depression were recruited. A multistep translation from English into the German language was performed and the factorial validity, criterion validity, convergent validity, discriminant validity, internal consistency, and floor and ceiling effects were examined. RESULTS: The confirmatory factor analysis results confirmed the one-factor structure of the WSAS. Significant correlations with the WHODAS 2-0 questionnaire, a measure of functionality, demonstrated good convergent validity. Significant correlations with depression and quality of life demonstrated good criterion validity. The WSAS also demonstrated strong internal consistency (α = .89), and the absence of floor and ceiling effects indicated good sensitivity of the instrument. CONCLUSIONS: The results of the present study demonstrated that the German version of the WSAS has good psychometric properties comparable to other international versions of this scale. The findings recommend a global assessment of psychosocial functioning with the sum score of the WSAS. TRIAL REGISTRATION: ISRCTN identifier: ISRCTN28972230 . Date of registration June 26th 2018.

How resilience is strengthened by exposure to stressors: the systematic self-reflection model of resilience strengthening.

BACKGROUND: Exposure to demands is normally considered to drain resources and threaten wellbeing. However, studies have indicated a resilience-strengthening role for stressors. OBJECTIVES: This paper introduces a unifying model, including five testable hypotheses regarding how resilience can be strengthened progressively via exposure to life-stressors. METHODS: We review and synthesize relevant scholarship that underpins the Systematic Self-Reflection model of resilience-strengthening. RESULTS: The model highlights the importance of a specific meta-cognitive skill (self-reflection on one's initial stressor response) as a mechanism for strengthening resilience. The Systematic Self-Reflection model uniquely proposes five self-reflective practices critical in the on-going adaptation of three resilient capacities: (1) coping resources, (2) usage of coping and emotional regulatory repertoire, and (3) resilient beliefs. The self-reflective process is proposed to strengthen a person's resilience by developing insight into their already-present capacities, the limitations of these capacities, and by stimulating the search for person-driven alternative approaches. CONCLUSION: This model extends the existing scholarship by proposing how the experience of stressors and adversity may have resilience-strengthening opportunities. The implication of this model is that engaging with stressors can have positive consequences for longer-term healthy emotional development if scaffolded in adaptive reflective practices.

Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults.

BACKGROUND: Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults. METHOD: A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale. RESULTS: Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder. CONCLUSION: Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.

Assessing rumination in response to illness: the development and validation of the Multidimensional Rumination in Illness Scale (MRIS).

The cognitive style of rumination extends existing cognitive models of emotional response to illness. In the absence of a specific measure, we developed the Multidimensional Rumination in Illness Scale (MRIS). In Study 1, an initial 60-item pool was tested, followed by confirmation of the factor structure in Study 2. In Study 1 participants (n = 185) completed the pilot version of the MRIS, then in Study 2 (n = 163) a reduced 41-item model was tested. Study 1: Exploratory factor analysis of a reduced 32-item scale indicated an initial four-factor solution for the MRIS (Intrusion, Brooding, Instrumental, Preventability), with satisfactory internal consistency and stable factor structure across gender. Study 2: Following scale revision, confirmatory factor analysis substantiated the adequacy of a three-factor MRIS structure, and good internal consistency, test-rest reliability, and concurrent and discriminant validity was demonstrated for the MRIS. The MRIS exhibited good psychometric properties in the current sample, providing a comprehensive assessment of the cognitive style of rumination in the context of physical illness.

Comparison of real-life accidental falls in older people with experimental falls in middle-aged test subjects.

Falling is a common accident among older people. Automatic fall detectors are one method of improving security. However, in most cases, fall detectors are designed and tested with data from experimental falls in younger people. This study is one of the first to provide fall-related acceleration data obtained from real-life falls. Wireless sensors were used to collect acceleration data during a six-month test period in older people. Data from five events representing forward falls, a sideways fall, a backwards fall, and a fall out of bed were collected and compared with experimental falls performed by middle-aged test subjects. The signals from real-life falls had similar features to those from intentional falls. Real-life forward, sideways and backward falls all showed a pre impact phase and an impact phase that were in keeping with the model that was based on experimental falls. In addition, the fall out of bed had a similar acceleration profile as the experimental falls of the same type. However, there were differences in the parameters that were used for the detection of the fall phases. The beginning of the fall was detected in all of the real-life falls starting from a standing posture, whereas the high pre impact velocity was not. In some real-life falls, multiple impacts suggested protective actions. In conclusion, this study demonstrated similarities between real-life falls of older people and experimental falls of middle-aged subjects. However, some fall characteristics detected from experimental falls were not detectable in acceleration signals from corresponding heterogeneous real-life falls.

Multidimensional analytical method based on binary phase shaping of femtosecond pulses.

Multidimensional chemical detection and identification based on phase shaped femtosecond laser pulses coupled to mass spectrometry is demonstrated. The method based on binary phase shaping (BPS) takes into account the accuracy and precision standards required by analytical chemistry. It couples multiphoton intrapulse interference of ultrashort laser pulses with time-of-flight mass spectrometry (TOF-MS). We demonstrate that BPS-MS provides a rigorous multidimensional technique for the detection and identification of analogues to chemical agents and mixtures in real time. Experimental results on dimethyl phosphite and pyridine illustrate the new approach toward the real-time accurate detection and identification of chemical compounds including isomers.

Alkyl-substituted silica gel as a carrier in the controlled release of dexmedetomidine.

The effect of alkyl substitution of the silica xerogel matrix on the release rate of dexmedetomidine was evaluated. Silica sol was processed by either casting or spray drying. When the reaction precursor tetraethylorthosilicate (TEOS) was partially substituted with tri- or dialkoxysilane, the release of dexmedetomidine and degradation of the matrix were decreased compared with 100% TEOS-based gel. Increasing the number or length of the organic groups attached to silicon, modified the silica gel structure and reduced the release rate of dexmedetomidine from monoliths. The release of dexmedetomidine from alkyl-substituted silica gel microparticles, however, showed a burst in drug release. Subcutaneously administered silica xerogel matrices (manufactured by casting, containing 25 mol% dimethyldiethoxysilane at two different doses of dexmedetomidine) were studied in dogs. Sustained delivery of dexmedetomidine was obtained for at least 48 h.

In vitro release of dexmedetomidine from silica xerogel monoliths: effect of sol-gel synthesis parameters.

Dexmedetomidine, an alpha 2-agonist, was incorporated as a hydrochloride salt into silica xerogel in order to evaluate the effect of sol-gel synthesis parameters: pH of the sol, water/alkoxide molar ratio, drug concentration and size of the device on the drug release rate and degradation rate of the matrix. This study showed that diffusion controlled the release of dexmedetomidine from silica xerogel prepared between pH 1 and pH 5. The drug release was, however, slowest near the zero charge of silica xerogel (pH 2-3). The burst of dexmedetomidine, a lipophilic, but in the form of hydrochloride salt water-soluble drug, was increased from the matrix prepared either below or above the isoelectric point. It follows that the optimum pH for preparing a drug delivery device for dexmedetomidine, is near the zero charge of silica xerogel, where the degradation of the matrix was also slowest. In addition to processing pH, the release rate of drugs can be controlled by changing the water/alkoxide molar ratio of the sol.

Development of the psychological impact of tinnitus interview: a clinician-administered measure of tinnitus-related distress.

The development of valid and reliable methods for assessing psychological aspects of tinnitus continues to be an important goal of research. Such assessment methods are potentially useful in clinical and research contexts. Existing self-report measures have a number of disadvantages, and so a need exists to develop a form of assessment that is less open to response bias and the effects of experimental demand. A new approach, the Psychological Impact of Tinnitus Interview (PITI), is described, and some preliminary data on its psychometric properties are reported. The results suggest that the PITI is capable of providing a measure of separate, relatively independent dimensions of tinnitus-related distress--namely, sleep difficulties, general distress, mood, suicidal aspects, and avoidance of or interference with normal activities. This method may lead to more refined measures of these dimensions of tinnitus-related psychological difficulties. The PITI should be regarded as a promising assessment tool for use in experimental settings, pending further work on its content, coding method, and administration.

In vitro evaluation of sol-gel processed spray dried silica gel microspheres as carrier in controlled drug delivery.

The objective of this study was to evaluate sol-gel-derived spray dried silica gel microspheres as carrier material for dexmedetomidine HCl and toremifene citrate. The drug was dissolved in sol-gel processed silica sol before spray drying with Büchi laboratory scale equipment. Microspheres with a low specific surface area were spherical by shape with a smooth surface without pores on the external surface. The particle size distribution was quite narrow. The in vitro release of toremifene citrate and dexmedetomidine HCl showed a dose-dependent burst followed by a slower release phase, that was proportional to the drug concentration in the concentration range between 3.9 and 15.4 wt.%. The release period for toremifene citrate was approximately 10 days and for dexmedetomidine HCl between 7 and 50 days depending on drug concentration. Spray drying is a promising way to produce spherical silica gel particles with a narrow particle size range for controlled delivery of toremifene citrate and dexmedetomidine HCl.

Structure and chromosomal localization of the human and murine genes for the macrophage MARCO receptor.

The structures of the human and mouse genes for the macrophage receptor with collagenous structure were determined. Both genes have 17 exons, of which exons 4-15 encode the collagenous domain. The transcription initiation sites in the mouse gene were identified using primer extension, SI nuclease mapping, and 5' capturing rapid amplification of cDNA ends assays. All three methods revealed two major initiation sites, one starting 27 bp downstream of a TATA box and another at positions -63 and -66 downstream of an AT-rich region. Several potential binding sites for transcription factors were identified in the promoter region, neither gene has a CAAT box or GC boxes. The human and mouse genes were localized to syntenic regions on chromosomes 2 and 1, respectively, using fluorescence in situ hybridization.

Regulation and functional involvement of macrophage scavenger receptor MARCO in clearance of bacteria in vivo.

The scavenger receptors expressed by macrophages are thought to play an important role in the immune response against bacteria by mediating binding and phagocytosis. A novel member of the class A scavenger receptor family, macrophage receptor with collagenous structure (MARCO), has recently been identified. In this study we have generated a panel of mAbs with specificities for different domains of this receptor. Two of those reacting with the C-terminal cysteine-rich domain block ligand binding of MARCO. The in vivo expression of this murine receptor is normally restricted to distinct populations of macrophages in the spleen and lymph nodes. During bacillus Calmette-Guérin (BCG) infection, during bacterial sepsis, or after the injection of purified LPS, however, the expression of MARCO is rapidly induced on macrophages in other tissues, including Kupffer cells in the liver. Using the mouse macrophage cell line J774.2, it was shown that LPS stimulation up-regulates surface expression of MARCO in a dose- and time-dependent fashion. The proinflammatory cytokines IL-1, IL-6, TNF-alpha, and IFN-gamma had little or no effect. Using inhibitory mAbs, the relevance of MARCO for the clearance of circulating bacteria in vivo was determined. Although the overall elimination of live Escherichia coli and Staphylococcus aureus from the blood did not appear to be affected by treatment with these Abs, the capturing of heat-killed bacteria by macrophages in the marginal zone areas of the spleen was clearly inhibited. This study suggests a role for MARCO in the host antibacterial defense.

Taste, temperature, and presentation predict satisfaction with foodservices in a Canadian continuing-care hospital.

OBJECTIVE: To identify food, service, and patient variables associated with high satisfaction with foodservices in a continuing-care hospital that serves, primarily, geriatric patients and patients undergoing physical rehabilitation. DESIGN: Survey questionnaire concerning eight aspects of food and foodservice as well as type of diet and major patient descriptors. SUBJECTS: All patients from geriatric continuing-care units, geriatric rehabilitation units, and physical rehabilitation units at Saint-Vincent Pavilion were considered potential respondents. A convenience sample of 65 clients met the established inclusion criteria and were willing to participate. Patients had to be able to communicate their views, and the clinical nursing staff judged all respondents to be cognitively able to provide opinions concerning food and foodservice. The mean age of subjects was 67 years, the mean length of stay in the hospital was 2 years, and 60% of the subjects were women (n = 39). STATISTICAL ANALYSES: Spearman rank correlations, univariate analyses (t tests for continuously distributed data, chi 2 tests for categorical data), and multivariate analyses (regular and logistic regression). RESULTS: In general, patients questioned were extremely positive about the quality and quantity of food and foodservices at this continuing-care/rehabilitation hospital. Type of diet and patient characteristics were not differentially associated with high levels of overall satisfaction with foodservices (as assessed by a general satisfaction question). Univariate analyses revealed that all aspects of foodservices (except quantity of food) were significantly correlated with overall satisfaction. Multivariate analyses showed that satisfaction with presentation of meal was the best predictor of overall satisfaction and that clients who were very satisfied with the taste of food and were very satisfied that cold food was cold enough were the most satisfied overall. Knowledge of key variables as assessed by multivariate analyses (ie, taste and coldness) predicted whether clients were very satisfied overall 80% of the time. APPLICATIONS: Surveys are usefull tools for assessing the ways in which clients view the food and services provided by dietitians. Dietitians in continuing-care settings need to focus on a few specific characteristics related to what is eaten and how food is presented, rather than on patient-specific variables, when trying to maximize satisfaction with hospital food. The information in this study can be used as a baseline against which future data can be compared. The survey contributes to a continuing quality assurance process that allows dietitians to track the effect of changes that are made to food and foodservices and to monitor areas that require modification.

Cloning of a novel bacteria-binding receptor structurally related to scavenger receptors and expressed in a subset of macrophages.

A novel murine plasma membrane protein has been identified in subpopulations of macrophages. It has an intracellular N-terminal domain, a transmembrane domain, and an extracellular region with a short spacer, an 89 Gly-Xaa-Yaa repeat-containing collagenous domain, and a C-terminal cysteine-rich domain. In situ hybridization and immunohistochemical staining have localized the protein to a subset of macrophages in the marginal zone of the spleen and the medullary cord of lymph nodes. No expression was observed in macrophages of liver or lung. Transfected COS cells synthesized a native trimeric plasma membrane protein that bound labeled bacteria and acetylated LDL, but not yeast or Ficoll. The results suggest that the novel protein is a macrophage-specific membrane receptor with a role in host defense, as it shows postnatal expression in macrophages, which are considered responsible for the binding of bacterial antigens and phagocytosis.

Rapid antimicrobial susceptibility testing of gram-negative bacilli using Baxter MicroScan rapid fluorogenic panels and autoSCAN-W/A.

The MicroScan Rapid Neg MIC/Combo panels and autoSCAN-W/A (Walk Away) system utilize automated fluorescence technology for rapid antimicrobial susceptibility testing of Gram-negative bacilli. In a three site clinical study eleven antimicrobial agents were evaluated by comparing results obtained with 741 clinical isolates, using rapid fluorogenic expanded dilution MIC panels and corresponding frozen microdilution reference panels determined visually. Results for 31%, 40%, 12% and 9% of the isolates were available within 3.5, 4.5, 5.5 and 7.0 hours respectively. Results for 7.3% were not available within that time period. For the seven drugs analyzed using a Minimum Inhibitory Concentration range of dilutions, overall agreement (+/- 1 dilution) was 94%, with 1.5% very major, 0.9% major and 2.5% minor errors. For the four drugs analyzed using a Breakpoint range of dilutions, overall agreement (+/- 1 dilution) was 97%, with two percent very major, and one percent major errors. The MicroScan Rapid Neg MIC system is an accurate and rapid method for same day determination of susceptibility of Gram-negative bacilli.

Rapid antimicrobial susceptibility testing of gram-positive cocci using Baxter MicroScan rapid fluorogenic panels and autoSCAN-W/A.

The Microscan Rapid Pos MIC/Combo panels and autoSCAN-W/A (Walk Away) system utilize automated fluorescence technology for rapid antimicrobial susceptibility testing of staphylococci, streptococci, and Listeria. In a three site clinical study, panels containing 26 antimicrobial agents were evaluated by comparing results obtained with 605 clinically significant isolates, using rapid fluorogenic expanded dilution MIC panels and corresponding frozen microdilution reference panels. Results for 16%, 40%, 13%, 9%, 8%, 11% and 1% of the isolates were available within 3.5, 4.5, 5.5, 7.0, 8, 11 and 15 h respectively. Results for 2% were not available within that time period. Overall agreement (+/- 1 dilution) for the 14,609 efficacy comparisons was 96%, with 1% each for very major, major and minor errors. Interlaboratory reproducibility testing of 25 isolates in triplicate in each site, showed an overall essential agreement of 97%. The MicroScan Rapid Pos MIC System is an accurate, reproducible and rapid method for same-day determination of susceptibility of Gram-positive cocci.

Buffering effect of antacids in the mouth--a new treatment of dental erosion?

Antacids are drugs of choice in the treatment of reflux esophagitis and peptic ulcer disease, where acid regurgitation may cause dental erosion. Since there are no specific preventive measures or effective treatment for erosions, the present study was made to assess whether the keeping of antacids in the mouth before swallowing would be beneficial with regard to their effect on mouth pH, after acidic challenge. Five healthy subjects formed the test panel. After measuring the acid binding capacity of all the antacid preparations in the Finnish market, the two most effective were selected for testing, one in emulsion form (Novaluzid), the other a tablet (Link). Acid regurgitation was mimicked by consuming a low-pH (3.2) drink immediately before the antacid. Control series were made with the acidic drink only. Both the antacids were found to counteract totally the pH fall caused by the drink, when measured as changes in the tongue surface pH. The Novaluzid preparation was more effective than the Link preparation but the difference was not significant. It may be anticipated that patients suffering from acid regurgitations would benefit if they are counseled to keep their antacids in the mouth for a while before swallowing.