Forprófun á íslenskri útgáfu Sjálfsmatskvarða Becks fyrir börn og unglinga

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenGerð var forprófun á Sjálfsmatskvörðum Becks fyrir börn á aldrinum 7-14 ára til þess að athuga próffræðilega eiginleika íslenskrar útgáfu af kvörðunum. Þátttakendur voru 293 úr 12 grunnskólum í Reykjavík. Próffræðilegir eiginleikar reyndust sambærilegir við erlendar rannsóknir. Innri áreiðanleiki var hár og fylgni atriða við heildarskor hvers kvarða viðunandi. Samleitni kvarða var athugað með þáttagreiningu og niðurstöður sýndu að þunglyndi, kvíði og hegðunarvandi voru einsleitir kvarðar en atriði sjálfsmyndar og reiði mynduðu tvo þætti. Gerð var þáttagreining á öllum 100 atriðum kvarðanna. Niðurstöður sýndu þrjá þætti sem skýrðu 38,6% dreifingar. Fyrsti þáttur samanstóð af þunglyndi, reiði og kvíða. Á annan þátt lögðust þrjú atriði reiði og 18 atriði hegðunarvanda og á þriðja þátt lögðust 18 atriði sjálfsmyndar. Há fylgni reyndist vera milli kvíða, þunglyndis og reiði en það er sambærilegt niðurstöðum erlendra rannsókna. Réttmæti kvarðanna var athugað með þremur spurningum um líðan í skóla og stríðni. Spurning um líðan í frímínútum hafði hæstu fylgni við þunglyndi sem bendir til þess að nemendur sem sýna þunglyndiseinkenni líður frekar illa í frímínútum. Spurning um líðan í kennslustundum hafði hæstu fylgni við hegðunarvanda og reiði og loks var hæst fylgni milli hegðunarvanda og stríðni. Enginn kynja- eða aldursmunur kom fram á kvörðum fyrir þunglyndi, reiði og kvíða. Hins vegar var meðaltal eldri hóps og drengja hærra á kvarða fyrir hegðunarvanda en hjá yngri hóp og stúlkum. Meðaltal á sjálfsmyndarkvarða var lægra í hópi eldri þáttakenda og meiri munur var á milli yngri og eldri stúlkna sem bendir til að sjálfsmynd verði neikvæðari á unglingsárum og sérstaklega hjá stúlkum. Próffræðilegir eiginleikar reyndust í megindráttum góðir en safna þarf meiri gögnum um áreiðanleika og réttmæti kvarðanna áður en hægt er að mæla með almennri notkun þeirra hér á landi.A pilot study of the Beck Youth Inventories (BYI) for children 7-14 years was undertaken to evaluate the psychometric properties of the Icelandic version. Participants were 293 from 12 elementary schools in Reykjavík. Psychometric properties revealed similar findings as other studies abroad have revealed. The internal consistency reliability was high and item total correlation acceptable. A principal axis factor analysis was conducted to evaluate the homogeneity of the BYI. Depression, anxiety and disruptive behavior were unidimensional but self-concept and anger revealed two factors. Additionally a principal axis factor analysis of all items of the inventories indicated three factors explaining 38,6% of variance. Items of depression, anxiety and anger loaded on the first factor. Disruptive behavior and 3 items of anger loaded on the second factor. Items of self-concept loaded on the third factor. Depression, anxiety and anger correlated highly, consistent with studies abroad and the factor analysis results. The scales´ validity was evaluated by three items assesing emotional well being in school and teasing other pupils. The highest correlation was between emotional well being in school breaks and depression, emotional well being in classrooms and disruptive behavior and anger, and between teasing other pupils and disruptive behavior. No significant age and gender differences were found on depression, anxiety and anger. Mean score for boys was higher than for girls on disruptive behavior and older students scored higher than younger students. Older students´ mean score was lower than younger students´ mean on self-concept and this difference was greater for girls than boys. Psychometric properties were good, but additonal studies need to be undertaken on the scales´ reliability and validity before we can recommend general use of the scales for clinical purposes in Iceland

Visualization of therapeutic angiogenesis with a polymer-based magnetic resonance imaging contrast agent

INTRODUCTION:With the recent progress of tissue engineering technology, the effects of regeneration-induction therapy of various tissues have been experimentally demonstrated in animal models. Furthermore, some clinical trials have also been successfully performed. Under these circumstances, it is strongly required to develop a non-invasive imaging method that can accurately evaluate the process of tissue regeneration and healing. Among various imaging modalities, magnetic resonance imaging (MRI), having a high spatial resolution and tissue contrast, is expected to be an optimal modality for this purpose. For the application of MRI for the monitoring of tissue regeneration, effective delivery of MRI contrast agents to the region being regenerated or repaired is essential. In this study, a new polymer-based MRI contrast agent has been designed to evaluate the therapeutic angiogenesis.METHODS:Gadolinium ions (Gd) and cyclic peptides containing an arginine-glycine-aspartic acid (RGD) sequence (cRGD) with an inherent affinity for the v3 integrin expressed on activated endothelial cells during angiogenesis were chemically introduced to dextran (cRGD-dextran-Gd). The amount of Gd and cRGD to dextran and the longitudinal relaxivity of cRGD-dextran-Gd were evaluated. To examine the interaction between the cyclic RGD and the v3 integrin, the fluorescein-labeled dextrans with or without the cRGD were cultured with human umbilical vein endothelial cells (HUVEC) expressing the v3 integrin.Right femoral, external iliac, and deep femoral and circumflex arteries and veins were surgically ligated to prepare a mouse model of hindlimb ischemia. A laser Doppler analysis and histological evaluation revealed that the hindlimb ischemia was naturally healed accompanied with angiogenesis in the ischemic region without any treatments. In this study, mice 7 days after the vascular ligation were used as an angiogenesis model. MRI (T1-weighted image (T1WI)) was performed after intravenous injection of cRGD-dextran-Gd into the mice.RESULTS AND DISCUSSION:The amount of Gd and cRGD introduced was calculated to be 25 and 3.7 molecules for one dextran molecule, respectively. The longitudinal relaxivity of cRGD-dextran-Gd was calculated to be 5.3 sec-1mM-1, which is higher than that of Magnevist® (4.7 sec-1mM-1). The fluorescein-labeled cRGD-dextran was internalized into HUVEC to a greater extent than dextran-Gd. It is likely that the affinity of cRGD for the v3 integrin on the HUVEC surface enabled the fluorescein-labeled cRGD-dextran to strongly interact with the cells, resulting in the enhanced internalization by a receptor-mediated fashion.The ischemic-angiogenic region was clearly enhanced in T1WI after the intravenous injection of cRGD-dextran-Gd. It was also found that the fluorescein-labeled cRGD-dextran was co-localized in the integrinv3-positive region in the ischemic-angiogenic region after the intravenous injection. Therefore, it is clearly demonstrated that the affinity of cRGD for the integrinv3 enabled the cRGD-dextran conjugates to be selectively delivered to the ischemic-angiogenic region of mice with hindlimb ischemia.2012　World Molecular Imaging Congres

Tracking of Manganese Labeled Mononuclear Cells and Evaluation of Cardiac Function in Rat Model Using Self-Gating Cine Magnetic Resonance Imaging

第75回日本循環器学

Cardiopulmonary resuscitation in adults over 80 : outcome and the perception of appropriateness by clinicians

OBJECTIVES: To determine the prevalence of clinician perception of inappropriate cardiopulmonary resuscitation (CPR) regarding the last out‐of‐hospital cardiac arrest (OHCA) encountered in an adult 80 years or older and its relationship to patient outcome. DESIGN: Subanalysis of an international multicenter cross‐sectional survey (REAPPROPRIATE). SETTING: Out‐of‐hospital CPR attempts registered in Europe, Israel, Japan, and the United States in adults 80 years or older. PARTICIPANTS: A total of 611 clinicians of whom 176 (28.8%) were doctors, 123 (20.1%) were nurses, and 312 (51.1%) were emergency medical technicians/paramedics. RESULTS AND MEASUREMENTS: The last CPR attempt among patients 80 years or older was perceived as appropriate by 320 (52.4%) of the clinicians; 178 (29.1%) were uncertain about the appropriateness, and 113 (18.5%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the “appropriate” subgroup was 8 of 265 (3.0%), 1 of 164 (.6%) in the “uncertain” subgroup, and 2 of 107 (1.9%) in the “inappropriate” subgroup (P = .23); 503 of 564 (89.2%) CPR attempts involved non‐shockable rhythms. CPR attempts in nursing homes accounted for 124 of 590 (21.0%) of the patients and were perceived as appropriate by 44 (35.5%) of the clinicians; 45 (36.3%) were uncertain about the appropriateness; and 35 (28.2%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the nursing home patients was 0 of 107 (0%); 104 of 111 (93.7%) CPR attempts involved non‐shockable rhythms. Overall, 36 of 543 (6.6%) CPR attempts were undertaken despite a known written do not attempt resuscitation decision; 14 of 36 (38.9%) clinicians considered this appropriate, 9 of 36 (25.0%) were uncertain about its appropriateness, and 13 of 36 (36.1%) considered this inappropriate. CONCLUSION: Our findings show that despite generally poor outcomes for older patients undergoing CPR, many emergency clinicians do not consider these attempts at resuscitation to be inappropriate. A professional and societal debate is urgently needed to ensure that first we do not harm older patients by futile CPR attempts. J Am Geriatr Soc 68:39–45, 201