3,097 research outputs found
The Relation of Certain Factors in Farm Family Life to Personality Development in Adolescents
Although the family has been much written about, and studied from many points of view in the past, relatively little attention has been given by investigators to the problem of determining the factors which make for successful family life. The need for information of this sort is obvious, and in recent years a few studies have been made from this point of view. The present study was undertaken for the purpose of gathering further information about normal families and some of the home-environmental factors which are thought to contribute to, or hinder, the achievement of successful family life
A Study of Relief Activities in Seven Nebraska Counties, 1927-1934
In the present study, an attempt was made to investigate the relief situation in Nebraska. The aim was (1) to determine how public relief funds were administered in the various counties of the state before the beginning of federal participation in relief, and what changes, if any, had come about after the federal relief agencies began to function, and also what volunteer relief agencies were available to supplement county relief in each case; (2) to determine, so far as possible, the actual amounts that were spent and for what purposes, and also the amounts of goods distributed by each county and by these various agencies during the years 1927 to 1934; and (3) to obtain information concerning the extent to which relief was extended to families actually engaged in farming. It also seemed desirable to learn something of the general attitude and personal opinions of the county officials and relief workers concerning the problem in general and concerning the relief clients themselves. Some attempt was therefore made to determine whether the relief clients were urban, small town, or farm people, what conditions placed them on relief, and how they were regarded by officials and others
Personality Development in Farm, Small-Town, and City Children
One purpose of the present research project was to contribute further toward an adequate knowledge of the relative merits of urban and rural environments. In this bulletin the three general home settings already mentioned, namely the farm in the open country, the small town (600 to 1,300 in population), and the city, are compared as to their favorableness in regard to the personality development of the children who grow up in them. The data for the comparisons are the average scores made by representative samples of young people from each environment on a set of tests and scales designed to measure certain aspects of character and personality. Certain home environmental factors and influences concerning which data were obtained, as well as other factors external to the home, are discussed in relation to some of the group differences in test performance which appeared
The Relation of Certain Factors in Farm Family Life to Personality Development in Adolescents
Although the family has been much written about, and studied from many points of view in the past, relatively little attention has been given by investigators to the problem of determining the factors which make for successful family life. The need for information of this sort is obvious, and in recent years a few studies have been made from this point of view. The present study was undertaken for the purpose of gathering further information about normal families and some of the home-environmental factors which are thought to contribute to, or hinder, the achievement of successful family life
Risk factors for chest infection in acute stroke: a prospective cohort study
<p><b>Background and Purpose:</b> Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.</p>
<p><b>Methods:</b> We studied a series of consecutive patients with acute stroke who were admitted to hospital. Detailed evaluation included the modified National Institutes of Health Stroke Scale; the Abbreviated Mental Test; and measures of swallow, respiratory, and oral health status. Pneumonia was diagnosed by set criteria. Patients were followed up at 3 months after stroke.</p>
<p><b>Results:</b> We studied 412 patients, 391 (94.9%) with ischemic stroke and 21 (5.1%) with hemorrhagic stroke; 78 (18.9%) met the study criteria for pneumonia. Subjects who developed pneumonia were older (mean±SD age, 75.9±11.4 vs 64.9±13.9 years), had higher modified National Institutes of Health Stroke Scale scores, a history of chronic obstructive pulmonary disease, lower Abbreviated Mental Test scores, and a higher oral cavity score, and a greater proportion tested positive for bacterial cultures from oral swabs. In binary logistic-regression analysis, independent predictors (P<0.05) of pneumonia were age >65 years, dysarthria or no speech due to aphasia, a modified Rankin Scale score ≥4, an Abbreviated Mental Test score <8, and failure on the water swallow test. The presence of 2 or more of these risk factors carried 90.9% sensitivity and 75.6% specificity for the development of pneumonia.</p>
<p><b>Conclusions:</b> Pneumonia after stroke is associated with older age, dysarthria/no speech due to aphasia, severity of poststroke disability, cognitive impairment, and an abnormal water swallow test result. Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.</p>
Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the diagnosis of dementia within community dwelling populations
<b>Background</b><p></p>
Various tools exist for initial assessment of possible dementia with no consensus on the optimal assessment method. Instruments that use collateral sources to assess change in cognitive function over time may have particular utility. The most commonly used informant dementia assessment is the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).<p></p>
A synthesis of the available data regarding IQCODE accuracy will help inform cognitive assessment strategies for clinical practice, research and policy.<p></p>
<b>Objectives</b><p></p>
Our primary objective was to determine the diagnostic accuracy of the informant based questionnaire IQCODE, for detection of all cause (undifferentiated) dementia in community-dwelling adults with no previous cognitive assessment. We sought to describe the accuracy of IQCODE (the index test) against a clinical diagnosis of dementia (the reference standard).<p></p>
Our secondary objective was to describe the effect of heterogeneity on the summary estimates. We were particularly interested in the traditional 26-item scale versus the 16-item short form; and language of administration. We explored the effect of varying the threshold IQCODE score used to define 'test positivity'.<p></p>
<b>Search methods</b><p></p>
We searched the following sources on 28 January 2013: ALOIS (Cochrane Dementia and Cognitive Improvement Group), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), BIOSIS Previews (ISI Web of Knowledge), Web of Science with Conference Proceedings (ISI Web of Knowledge), LILACS (BIREME). We also searched sources relevant or specific to diagnostic test accuracy: MEDION (Universities of Maastrict and Leuven); DARE (York University); ARIF (Birmingham University). We used sensitive search terms based on MeSH terms and other controlled vocabulary.<p></p>
<b>Selection criteria</b><p></p>
We selected those studies performed in community settings that used (not necessarily exclusively) the IQCODE to assess for presence of dementia and, where dementia diagnosis was confirmed, with clinical assessment. Our intention with limiting the search to a 'community' setting was to include those studies closest to population level assessment. Within our predefined community inclusion criteria, there were relevant papers that fulfilled our definition of community dwelling but represented a selected population, for example stroke survivors. We included these studies but performed sensitivity analyses to assess the effects of these less representative populations on the summary results.<p></p>
<b>Data collection and analysis</b><p></p>
We screened all titles generated by the electronic database searches and abstracts of all potentially relevant studies were reviewed. Full papers were assessed for eligibility and data extracted by two independent assessors. For quality assessment (risk of bias and applicability) we used the QUADAS 2 tool. We included test accuracy data on the IQCODE used at predefined diagnostic thresholds. Where data allowed, we performed meta-analyses to calculate summary values of sensitivity and specificity with corresponding 95% confidence intervals (CIs). We pre-specified analyses to describe the effect of IQCODE format (traditional or short form) and language of administration for the IQCODE.<p></p>
<b>Main results</b><p></p>
From 16,144 citations, 71 papers described IQCODE test accuracy. We included 10 papers (11 independent datasets) representing data from 2644 individuals (n = 379 (14%) with dementia). Using IQCODE cut-offs commonly employed in clinical practice (3.3, 3.4, 3.5, 3.6) the sensitivity and specificity of IQCODE for diagnosis of dementia across the studies were generally above 75%.<p></p>
Taking an IQCODE threshold of 3.3 (or closest available) the sensitivity was 0.80 (95% CI 0.75 to 0.85); specificity was 0.84 (95% CI 0.78 to 0.90); positive likelihood ratio was 5.2 (95% CI 3.7 to 7.5) and the negative likelihood ratio was 0.23 (95% CI 0.19 to 0.29).<p></p>
Comparative analysis suggested no significant difference in the test accuracy of the 16 and 26-item IQCODE tests and no significant difference in test accuracy by language of administration. There was little difference in sensitivity across our predefined diagnostic cut-points.<p></p>
There was substantial heterogeneity in the included studies. Sensitivity analyses removing potentially unrepresentative populations in these studies made little difference to the pooled data estimates.
The majority of included papers had potential for bias, particularly around participant selection and sampling. The quality of reporting was suboptimal particularly regarding timing of assessments and descriptors of reproducibility and inter-observer variability.<p></p>
<b>Authors' conclusions</b><p></p>
Published data suggest that if using the IQCODE for community dwelling older adults, the 16 item IQCODE may be preferable to the traditional scale due to lesser test burden and no obvious difference in accuracy. Although IQCODE test accuracy is in a range that many would consider 'reasonable', in the context of community or population settings the use of the IQCODE alone would result in substantial misdiagnosis and false reassurance. Across the included studies there were issues with heterogeneity, several potential biases and suboptimal reporting quality
Complement-Mediated Virus Infectivity Neutralisation by HLA Antibodies Is Associated with Sterilising Immunity to SIV Challenge in the Macaque Model for HIV/AIDS.
Sterilising immunity is a desired outcome for vaccination against human immunodeficiency virus (HIV) and has been observed in the macaque model using inactivated simian immunodeficiency virus (SIV). This protection was attributed to antibodies specific for cell proteins including human leucocyte antigens (HLA) class I and II incorporated into virions during vaccine and challenge virus preparation. We show here, using HLA bead arrays, that vaccinated macaques protected from virus challenge had higher serum antibody reactivity compared with non-protected animals. Moreover, reactivity was shown to be directed against HLA framework determinants. Previous studies failed to correlate serum antibody mediated virus neutralisation with protection and were confounded by cytotoxic effects. Using a virus entry assay based on TZM-bl cells we now report that, in the presence of complement, serum antibody titres that neutralise virus infectivity were higher in protected animals. We propose that complement-augmented virus neutralisation is a key factor in inducing sterilising immunity and may be difficult to achieve with HIV/SIV Env-based vaccines. Understanding how to overcome the apparent block of inactivated SIV vaccines to elicit anti-envelope protein antibodies that effectively engage the complement system could enable novel anti-HIV antibody vaccines that induce potent, virolytic serological response to be developed
Lineage tree analysis of immunoglobulin variable-region gene mutations in autoimmune diseases: chronic activation, normal selection
Autoimmune diseases show high diversity in the affected organs, clinical manifestations and disease dynamics. Yet they all share common features, such as the ectopic germinal centers found in many affected tissues. Lineage trees depict the diversification, via somatic hypermutation (SHM), of immunoglobulin variable-region (IGV) genes. We previously developed an algorithm for quantifying the graphical properties of IGV gene lineage trees, allowing evaluation of the dynamical interplay between SHM and antigen-driven selection in different lymphoid tissues, species, and disease situations. Here, we apply this method to ectopic GC B cell clones from patients with Myasthenia Gravis, Rheumatoid Arthritis, and Sjögren’s Syndrome, using data scaling to minimize the effects of the large variability due to methodological differences between groups. Autoimmune trees were found to be significantly larger relative to normal controls. In contrast, comparison of the measurements for tree branching indicated that similar selection pressure operates on autoimmune and normal control clones
Octilinear Force-Directed Layout with Mental Map Preservation for Schematic Diagrams
We present an algorithm for automatically laying out metro map style schematics using a force-directed approach, where we use a localized version of the standard spring embedder forces combined with an octilinear magnetic force. The two types of forces used during layout are naturally conflicting, and the existing method of simply combining these to generate a resultant force does not give satisfactory results. Hence we vary the forces, emphasizing the standard forces in the beginning to produce a well distributed graph, with the octilinear forces
becoming prevalent at the end of the layout, to ensure that the key requirement of line angles at intervals of 45? is obtained. Our method is considerably faster than the more commonly used search-based approaches, and we believe the results are superior to the previous force-directed approach. We have further developed this technique to address the issues of dynamic schematic layout. We use a Delaunay triangulation to construct a schematic “frame”, which is used to retain relative node positions and permits full control of the level of mental map preservation.
This technique is the first to combine mental map preservation techniques with the additional layout criteria of schematic diagrams. To conclude, we present the results of a study to investigate the relationship between the level of mental map preservation and the user response time and accuracy
5-year follow-up of cytotoxic chemotherapy as an adjuvant to surgery in carcinoma of the bronchus.
This report gives the 5-year findings of a double-blind study of long-term cytotoxic chemotherapy as an adjuvant to surgery in patients receiving busulphan or cyclophosphamide for carcinoma of the bronchus compared with a group receiving a placebo. Of 243 patients initially allocated busulphan, 234 cyclophosphamide and 249 placebo, 28%, 27% and 34% respectively were alive at 5 years. There were significant associations between mortality from bronchial carcinoma and histological involvement of the resected intrathoracic nodes and the histology of the tumour. Haematological toxicity, especially thrombocytopenia, was frequent and severe in the busulphan series, and low platelet counts continued long after chemotherapy was stopped
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