Preliminary validation of a self-efficacy scale for pediatric chronic illness.

BACKGROUND: Tracking self-efficacy may be useful for identifying children at risk for medical noncompliance. We created the Pediatric Rating of Chronic Illness Self-Efficacy (PRCISE) to measure self-efficacy in youth dealing with a chronic illness. METHOD: Data were collected from 217 families where one child aged 7-20 (Mage  = 13.62, SDage  = 2.92; 62.7% Latino, 58.1% female) had a chronic illness. Parent participants provided demographic information. Youth completed a depression measure, the Patient Health Questionnaire for Adolescents and the PRCISE. To determine the underlying latent structure of the scale, an exploratory factor analysis was conducted using parallel analysis. We also carried out two multiple linear regressions to explore the data and establish preliminary predictive validity. RESULTS: The measure was reduced to 15 items, demonstrating a one-factor solution with strong reliability. Predictors of lower self-efficacy included having parents who had not attended college, being African American, and having higher Patient Health Questionnaire for Adolescents scores, R2  = .23, F(11, 174) = 5.62, p < .001. Main effects were qualified by a two-way interaction, such that the decrease in PRCISE scores associated with depressive symptoms was attenuated in children with less educated parents. In terms of predictive validity, higher PRCISE scores unexpectedly predicted more number of emergency room visits, R2  = .12, F(9, 113) = 2.73, p < .01. CONCLUSIONS: The PRCISE appears to be a reliable measure of a single self-efficacy construct. Secondary analyses revealed important health disparities in pediatric chronic illness self-efficacy. Next steps may include validation of the PRCISE using confirmatory factor analysis.

Effects of an employee exercise programme on mental health.

BACKGROUND: Prior research indicates that workplace wellness programmes (WWPs) are generally associated with lowered healthcare costs and improved employee health. Despite the importance of mental well-being in workplace productivity and attendance, few WWP studies have focused on improvements in psychological well-being. AIMS: To examine the effects of the Bruin Health Improvement Program (BHIP), a 3-month exercise and nutrition WWP, on seven domains of health: physical and mental health, stress, energy level, social satisfaction, self-efficacy and quality of life. METHODS: Using data from BHIP completers, we conducted multiple one-way multivariate analyses of variance and follow-up univariate t-tests to examine changes in physical and mental health, stress, energy level, social satisfaction, self-efficacy and quality of life. Effect sizes were also calculated post hoc to determine the magnitude of each effect. RESULTS: Results for the 281 participants reveal significant improvements across all seven domains (P < 0.001). Effect sizes ranged from 0.19 to 0.67. CONCLUSIONS: This study is unique in revealing the effects of a WWP on multiple domains of psychological well-being. Given rising healthcare costs associated with mental health, targeting mental health through WWP may be an effective strategy for reducing indirect healthcare costs associated with absenteeism and presenteeism.

40 Gb/s silicon photonics modulator for TE and TM polarisations.

A key device in future high speed short reach interconnect technology will be the optical modulator. These devices, in silicon, have experienced dramatic improvements over the last 6 years and the modulation bandwidth has increased from a few tens of MHz to over 30 GHz. However, the demands of optical interconnects are significant. Here we describe an approach based on a self-aligned wrap around p-n junction structure embedded in a silicon waveguide that can produce high-speed optical phase modulation, whilst at the same time, capable of a high extinction ratio. An all-silicon optical modulator using a CMOS compatible fabrication process with a data rate of 40 Gb/s and extinction ratio up to approximately 6.5 dB for TE and TM polarisations is demonstrated. This technology is not only compatible with conventional complementary MOS (CMOS) processing, but is also intended to simplify and improve the reliability of, the fabrication process.

Vigilance behaviors and EEG activity in sustained attention may affect acute pain.

During Sustained Attention to stimuli across many modalities neural activity often decreases over time on task, while Errors in task performance increase (Vigilance Decrement). Sustained Attention to pain has rarely been investigated experimentally despite its clinical significance. We have employed a Sustained Attention protocol (Continuous Performance Task, CPT) in which the subject counts painful laser stimuli (targets) when they occur randomly in a prolonged train of nonpainful nontargets. We hypothesize that the magnitude of the poststimulus oscillatory power divided by baseline power (Event-Related Spectral Perturbation, ERSP - scalp EEG) over Frontoparietal structures will decrease at all frequencies with time on task, while Beta ERSP (14-30Hz) will be correlated with Error Rates in performance of the CPT. During the CPT with a painful target ERSP was found in four separate Windows, as defined by both their frequency band and the time after the stimulus. A Vigilance Decrement was found which confirms that Sustained Attention to pain was produced by this CPT. In addition, Error Rates was correlated inversely with laser energy, and with ratings of pain unpleasantness and salience. Error Rates also were related directly to the Beta ERSP Window at scalp EEG electrodes over the central sulcus. Over time on task, the ERSP magnitude decreased in Alpha (8-14Hz) Window, was unchanged in early and late Delta/Theta Windows (0-8Hz), and increased in the Beta Window. The increase in Beta ERSP and a decrease in the Alpha ERSP occurred at the same EEG electrode over the parietal lobe to a significant degree across subjects. Overall, Beta activity increases with time on task, and with higher Error Rates as in the case of other modalities. In the case of pain increased Errors correspond to misidentification of painful and nonpainful stimuli and so modulate the sensation of pain under the influence of Sustained Attention.

Characterization of resolution, sensitivity, and shielding of a gamma-probe for sentinel lymph node localization: an experimental study.

OBJECTIVE: The aim of this study was to evaluate angular, spatial, and energy resolution, sensitivity, and shielding of a gamma-probe. MATERIALS AND METHODS: The EUROPROBE II gamma-probe (EuroRad) with sources of technetium-99m was assessed according to NEMA NU-3-2004. Resolution tests were evaluated considering the full width at half maximum (FWHM). The following parameters were evaluated: angular resolution in air, spatial resolution with a scattering medium and in air, energy resolution, and sensitivity and shielding. The collimator was used to evaluate angular and spatial resolution, sensitivity, and shielding. Background radiation was considered and did not affect the counts. RESULTS: FWHM of angular resolution (at 3/30 cm) was 39.17°/33.13° with the collimator and 74.08°/71.51° without the collimator; FWHM of spatial resolution in air at 10 mm was 13.32 mm with the collimator and 21.23 mm without the collimator. Energy resolution (%FWHM) was 20.51%. Sensitivity at 10 mm was 4.642±5 cps/MBq without the collimator and 1.063±2 cps/MBq with the collimator; shielding effectiveness of the probe tip was 99.52%. Background was not relevant to the counts. CONCLUSION: We showed that the collimator improved angular and spatial resolution to the detriment of sensitivity. Feasible results of energy resolution, sensitivity, and shielding were achieved.

A sub-micron depletion-type photonic modulator in Silicon On Insulator.

We provide detailed analysis of a four terminal p+pnn+ optical modulator integrated into a silicon-on-insulator (SOI) rib waveguide. The proposed depletion device has been designed to approach birefringence free operation. The modulation mechanism is the carrier depletion effect in a pn junction; carrier losses induced are minimised in our design and because we use a depletion device, the device is insensitive to carrier lifetime. The rise time and fall time of the proposed device have both been calculated to be 7 ps for a reverse bias of only 5 volts. A maximum excess loss of 2 dB is predicted for TE and TM due to the presence of p type and n type carriers in the waveguide.

A mutant of Listeria monocytogenes LO28 unable to induce an acid tolerance response displays diminished virulence in a murine model.

Exposing Listeria monocytogenes LO28 to sublethal pH induces protection against normally lethal pH conditions, a phenomenon known as the acid tolerance response. We identified a mutant, L. monocytogenes ATR1, which is incapable of inducing such tolerance, either against low pH or against any other stress tested. The virulence of this mutant was considerably decreased, suggesting that the acid tolerance response contributes to in vivo survival of L. monocytogenes.

Dimethylsulfoxide enhances CNS neuronal plasma membrane resealing after injury in low temperature or low calcium.

The inability to repair the damaged membrane may be one of the key mechanisms underlying the severe neuronal degeneration and overall functional loss seen in in vivo spinal cord injury and traumatic axonal injury in blunt head trauma. Promoting membrane resealing following damage may therefore constitute a potential effective therapeutic intervention in treating head trauma and spinal cord injuries. In our previous studies, we have shown that the axolemma failed to reseal following transection in clinically related situations, such as low extracellular calcium and low temperature. Our current studies indicate that DMSO is capable of rendering significant improvement in guinea pig axonal membrane resealing following transection in both 0.5 mM [Ca(2+)](0) and 25 degrees C situations. This was demonstrated physiologically by monitoring membrane potential recovery and anatomically by conducting HRP-exclusion assays 60 minutes after injury. Further, we have shown that the addition of DMSO in normal Krebs' solution (2 mM [Ca(2+)](0) and 37 degrees C) resulted in a decrease in membrane repair following injury. This indicates that DMSO-mediated membrane repair is sensitive to temperature and calcium. This study suggests the role of DMSO in axonal membrane resealing in clinically relevant conditions and raises the possibility of using DMSO in combination with other more established therapies in spinal cord injury treatment.

Identification and disruption of lisRK, a genetic locus encoding a two-component signal transduction system involved in stress tolerance and virulence in Listeria monocytogenes.

lisRK encodes a two-component regulatory system in the food pathogen Listeria monocytogenes LO28. Following identification of the operon in an acid-tolerant Tn917 mutant, a deletion in the histidine kinase component was shown to result in a growth phase variation in acid tolerance, an ability to grow in high ethanol concentrations, and a significant reduction in virulence.

Ventilatory effects of the nonimmobilizer 1,2-dichlorohexafluorocyclobutane (2N) in swine.

UNLABELLED: Nonimmobilizers (inhaled compounds that do not suppress movement in response to a noxious stimulus) resemble anesthetics in their capacity to suppress memory, but unlike anesthetics, they can cause convulsions. Higher concentrations of nonimmobilizers may cause death, even with apparent suppression of convulsions by the concurrent administration of conventional inhaled anesthetics. We hypothesized that nonimmobilizers can depress ventilation and can cause death by adding to the depression of ventilation produced by conventional anesthetics. To test these hypotheses, we administered 1,2-dichlorohexafluorocyclobutane (2N) to four pigs anesthetized with desflurane. The addition of 2N decreased PaCO2 and tended to increase the slope of the ventilatory response to imposed increases in PETCO2. Limited results from study of two other nonimmobilizers (2,3-dichlorooctafluorobutane and perfluoropentane), in two pigs each, were consistent with the findings for 2N. However, experimental limitations (e.g., toxicity of 2,3-dichlorooctafluorobutane, and hypoxia from perfluoropentane) confound interpretation of these latter results. Our findings do not support our hypotheses--2N (and presumably all nonimmobilizers) seems to be a respiratory stimulant, not a depressant. IMPLICATIONS: A new class of inhaled compounds, nonimmobilizers, allow tests of how inhaled anesthetics act. Nonimmobilizers may act like anesthetics (e.g., impair learning) or may not (e.g., do not prevent movement in response to a noxious stimulus). The present work shows that, unlike anesthetics,nonimmobilizers do not depress breathing.