The preventive services use self-efficacy (PRESS) scale in older women: Development and psychometric properties

Background: Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits. Individuals with low self-efficacy in accessing these services need to be identified and provided self-efficacy enhancing interventions. Scales measuring self-efficacy in the management of chronic diseases exist, but do not cover the broad spectrum of preventive services and behaviors that can improve the health of older adults, particularly older women who are vulnerable to poorer health and lesser utilization of preventive services. This study aimed to evaluate the psychometric properties of a new preventive services use self-efficacy scale, by measuring its internal consistency reliability, assessing internal construct validity by exploring factor structure, and examining differences in self-efficacy scores according to participant characteristics. Methods: The Preventive Services Use Self-Efficacy (PRESS) Scale was developed by an expert panel at the University of Pittsburgh Center for Aging and Population Health - Prevention Research Center. It was administered to 242 women participating in an ongoing trial and the data were analyzed to assess its psychometric properties. An exploratory factor analysis with a principal axis factoring approach and orthogonal varimax rotation was used to explore the underlying structure of the items in the scale. The internal consistency of the subscales was assessed using Cronbach's alpha coefficient. Results: The exploratory factor analysis defined five self-efficacy factors (self-efficacy for exercise, communication with physicians, self-management of chronic disease, obtaining screening tests, and getting vaccinations regularly) formed by 16 items from the scale. The internal consistency of the subscales ranged from.81 to.94. Participants who accessed a preventive service had higher self-efficacy scores in the corresponding sub-scale than those who did not. Conclusions: The 16-item PRESS scale demonstrates preliminary validity and reliability in measuring self-efficacy in the use of preventive services among older women. It can potentially be used to evaluate the impact of interventions designed to improve self-efficacy in the use of preventive services in community-dwelling older women

Gallstones, cholecystectomy, and the risk for developing pancreatic cancer

We examined the relation between gallstones, cholecystectomy, and the development of pancreatic cancer in the Nurses' Health Study and the Health Professionals Follow-up Study. Among 104 856 women and 48 928 men without cancer at baseline, we documented 349 cases of pancreatic cancer during up to 16 years of follow-up. Participants were classified according to a history of gallstones or cholecystectomy. The age-adjusted relative risk of pancreatic cancer following cholecystectomy or diagnosis of gallstones was 1.31 (95% CI, 0.93–1.83). However, adjustment for other pancreatic cancer risk factors attenuated the association (RR=1.11, 95% CI, 0.78–1.56); this risk did not increase with increasing time following cholecystectomy or gallstones. Gallstones or cholecystectomy do not appear to be significant risk factors for pancreatic cancer

The Formation of the First Massive Black Holes

Supermassive black holes (SMBHs) are common in local galactic nuclei, and SMBHs as massive as several billion solar masses already exist at redshift z=6. These earliest SMBHs may grow by the combination of radiation-pressure-limited accretion and mergers of stellar-mass seed BHs, left behind by the first generation of metal-free stars, or may be formed by more rapid direct collapse of gas in rare special environments where dense gas can accumulate without first fragmenting into stars. This chapter offers a review of these two competing scenarios, as well as some more exotic alternative ideas. It also briefly discusses how the different models may be distinguished in the future by observations with JWST, (e)LISA and other instruments.Comment: 47 pages with 306 references; this review is a chapter in "The First Galaxies - Theoretical Predictions and Observational Clues", Springer Astrophysics and Space Science Library, Eds. T. Wiklind, V. Bromm & B. Mobasher, in pres

Long-Term Health Outcomes in Children Born to Mothers with Diabetes: A Population-Based Cohort Study

BACKGROUND: To examine whether prenatal exposure to parental type 1 diabetes, type 2 diabetes, or gestational diabetes is associated with an increased risk of malignant neoplasm or diseases of the circulatory system in the offspring. METHODS/PRINCIPAL FINDINGS: We conducted a population-based cohort study of 1,781,576 singletons born in Denmark from 1977 to 2008. Children were followed for up to 30 years from the day of birth until the onset of the outcomes under study, death, emigration, or December 31, 2009, whichever came first. We used Cox proportional hazards model to estimate hazard ratios (HR) with 95% confidence intervals (95% CI) for the outcomes under study while adjusting for potential confounders. An increased risk of malignant neoplasm was found in children prenatally exposed to maternal type 2 diabetes (HR = 2.2, 95%CI: 1.5-3.2). An increased risk of diseases of the circulatory system was found in children exposed to maternal type 1 diabetes (HR = 2.2, 95%CI: 1.6-3.0), type 2 diabetes (HR = 1.4, 95%CI: 1.1-1.7), and gestational diabetes (HR = 1.3, 95%CI: 1.1-1.6), but results were attenuated after excluding children with congenital malformations. An increased risk of diseases of the circulatory system was also found in children exposed to paternal type 2 diabetes (HR = 1.5, 95%CI: 1.1-2.2) and the elevated risk remained after excluding children with congenital malformations. CONCLUSIONS: This study suggests that susceptibility to malignant neoplasm is modified partly by fetal programming. Diseases of the circulatory system may be modified by genetic factors, other time-stable family factors, or fetal programming

Optical and near-infrared observations of SN 2013dx associated with GRB 130702A

We present optical and near-infrared light curves and optical spectra of SN 2013dx, associated with the nearby (redshift 0.145) gamma-ray burst GRB 130702A. The prompt isotropic gamma-ray energy released from GRB 130702A is measured to be $E_{\gamma,\mathrm{iso}} = 6.4_{-1.0}^{+1.3} \times 10^{50}$erg (1keV to 10MeV in the rest frame), placing it intermediate between low-luminosity GRBs like GRB 980425/SN 1998bw and the broader cosmological population. We compare the observed $g^{\prime}r^{\prime}i^{\prime}z^{\prime}$ light curves of SN 2013dx to a SN 1998bw template, finding that SN 2013dx evolves $\sim20$% faster (steeper rise time), with a comparable peak luminosity. Spectroscopically, SN 2013dx resembles other broad-lined Type Ic supernovae, both associated with (SN 2006aj and SN 1998bw) and lacking (SN 1997ef, SN 2007I, and SN 2010ah) gamma-ray emission, with photospheric velocities around peak of $\sim$21,000 km s$^{-1}$. We construct a quasi-bolometric ($g^{\prime}r^{\prime}i^{\prime}z^{\prime}yJH$) light curve for SN 2013dx, and, together with the photospheric velocity, we derive basic explosion parameters using simple analytic models. We infer a $^{56}$Ni mass of $M_{\mathrm{Ni}} = 0.38\pm 0.01$M$_{\odot}$, an ejecta mass of $M_{\mathrm{ej}} = 3.0 \pm 0.1$ M$_{\odot}$, and a kinetic energy of $E_{\mathrm{K}} = (8.2 \pm 0.40) \times 10^{51}$erg (statistical uncertainties only), consistent with previous GRB-associated SNe. When considering the ensemble population of GRB-associated SNe, we find no correlation between the mass of synthesized $^{56}$Ni and high-energy properties, despite clear predictions from numerical simulations that $M_{\mathrm{Ni}}$ should correlate with the degree of asymmetry. On the other hand, $M_{\mathrm{Ni}}$ clearly correlates with the kinetic energy of the supernova ejecta across a wide range of core-collapse events