The effects of the hypothalamus on hemodynamic changes elicited by vagal nerve stimulation.
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To investigate the means by which neurogenic shock or syncope occur in dentistry, we determined the hemodynamic response to the activation of vagal tone in cats while they were under emotional stress. The hypothalamus and the vagal nerve were electrically stimulated to produce emotional stress and to activate vagal tone, respectively. Hemodynamic changes were recorded during vagal stimulation (Va group) and during vagal stimulation preceded by hypothalamic stimulation (AH + Va group). Although blood pressure decreased in both groups, the degree of hypotensive response in the AH + Va group was greater than the response in the Va group. Total peripheral resistance (TPR) was reduced in the AH + Va group but was increased in the Va group. The blood flow to the skeletal muscles in the AH + Va group was greater than that of the Va group. Reduced TPR, which could be due to vasodilation in the skeletal muscles, was the cause of intensified hypotension in the AH + Va group. Clearly, the hypotension produced by vagal stimulation was worsened when it was preceded by hypothalamic stimulation; this occurrence could be related to the tendency of blood to flow to the skeletal muscles. (+info)
Questionnaire survey of interpreter use in accident and emergency departments in the UK.
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OBJECTIVE: To determine the support for a national telephone interpreter service from accident and emergency (A&E) departments across the UK, and the factors that may influence that support. To determine the nature of interpreter needs for these departments. METHODS: Postal questionnaire survey of 255 A&E departments in the UK. RESULTS: A total of 197 replies were received, a response rate of 77.3%. Altogether 186 respondents answered the question on support for a national telephone interpreter service and 124 (66.7%) would support one. Those departments in favour were no more likely to have required an interpreter in the last seven days (chi 2 = 0.16, df = 1, p = 0.69), be in the inner city (Fisher's exact test, two sided probability, p = 1), have predominantly local population needs compared with tourist needs (chi 2 = 0.65, df = 1, p = 0.42), or be current users of a telephone interpreter service (chi 2 = 0.01, df = 1, p = 0.93). Seventy-nine of 180 (42.9%) departments had used some form of interpreter in the seven days preceding completion of the survey. Seventy-six of 86 (88.4%) of those departments using face to face interpreters had experienced difficulty obtaining an interpreter out of hours. Nationally, the following proportion of all A&E departments listed the named language as occurring among the three most common languages requiring interpretation: French 0.46 (95% confidence interval 0.42 to 0.50), Urdu 0.30 (0.26 to 0.34), and German 0.24 (0.21 to 0.27). CONCLUSIONS: There is widespread need and support for a national telephone interpreter service that would match the requirements of 24 hour emergency health care provision. (+info)
Evaluation of the Turkish translation of a disease activity form for Behcet's syndrome.
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OBJECTIVE: This study examined the interobserver and intra-observer reliability of the Turkish version of the Behcet's Disease Current Activity Form (BDCAF), which was obtained by a translation and back-translation process. METHODS: Fifty Behcet's syndrome (BS) patients were assessed by four rheumatologists in separate morning and afternoon sessions. RESULTS: The results showed good intra- and interobserver agreement for the oro-genital ulcers and eye involvement of BS, but there was poor agreement between (kappa score = 0.14) and within observers (range for kappa scores 0.09-0.25) for their overall impression of disease activity. Individual low kappa scores were also noted for erythema nodosum, vascular involvement, central nervous system involvement and gastrointestinal involvement. CONCLUSION: These results suggest that the Turkish version of BDCAF may be useful for assessing the classic triad of BS (oro-genital ulceration and eye involvement), but more experience is needed for its other parts. (+info)
German version of the Epworth Sleepiness Scale.
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BACKGROUND: The Epworth Sleepiness Scale (ESS) is a questionnaire widely used in English speaking countries for assessment of subjective daytime sleepiness. OBJECTIVE: Our purpose was to translate and validate the ESS for use in German-speaking countries. METHODS: A German translation of the ESS was administered to 159 healthy German-speaking Swiss and to 174 patients with various sleep disorders. RESULTS: The mean +/- SD of ESS scores in normals was 5.7+/-3.0, in patients it was 13.0+/-5.1 (p<0.001). Scores were not correlated with age or gender but with the percentage of time spent at an oxygen saturation <90% (R = 0.35, p<0.001), and the respiratory disturbance index (R = 0.26, p<0.001) in primary snorers and sleep apnea patients. Item analysis confirmed internal consistency of the scale (Cronbach alpha = 0.60 in normals, and 0.83 in patients). Follow-up scores in 25 sleep apnea patients on treatment showed a reduction by 7+/-5 points (p<0.05). CONCLUSIONS: Our data validate the ESS for application in German-speaking populations. The simplicity, reliability and the apparent lack of relevant influences of language and cultural background on performance of the ESS makes it a valuable tool for clinical management and research. (+info)
The central relationship questionnaire (CRQ): psychometric properties in a Swedish sample and cross-cultural studies.
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The Core Conflictual Relationship Theme (CCRT) method is one of the most widely used and tested instruments developed within a psychoanalytic context for assessing central relationship patterns or characteristic patterns of relating to others. The Swedish version of the Central Relationship Questionnaire (CRQ), a recently developed self-report instrument based on the CCRT, was tested in a sample of Swedish psychology students (31 men, 60 women) and compared with responses of Swedish outpatients (15 men, 15 women) and North American students (49 men, 49 women). The subscales of the Swedish CRQ showed acceptable internal consistency and correlated with each other in a predictable fashion, displaying a pattern of intercorrelations similar to the English version. The CRQ showed meaningful patterns of correspondence with self-reported interpersonal problems as well as meaningful differences between the Swedish students and Swedish outpatients, indicating preliminary convergent and divergent validity. (+info)
An English and Spanish quality of life measure for rheumatoid arthritis.
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OBJECTIVE: To develop a rheumatoid arthritis-specific health-related quality of life instrument, translate the English instrument into Spanish, and test the scaling assumptions, reliability, validity, and feasibility of both the English and Spanish versions. METHODS: The development of the Quality of Life-Rheumatoid Arthritis Scale (QOL-RA Scale) involved literature review, consultations with experts, 40 face-to-face interviews, and 5 focus group discussions with multiethnic and multilingual women with rheumatoid arthritis (RA). Translation design facilitated conceptual and linguistic equivalence. Data for the psychometrics came from telephone interviews of a sample of 107 Caucasian/English and 80 Hispanic/Spanish women with RA. The instruments were (a) the Arthritis Impact Measurement Scales 2 (AIMS2), (b) the Lubben Social Network Scale (LSNS), (c) the Center for Epidemiologic Studies-Depression Scale (CES-D), and (d) the QOL-RA Scale. Descriptive statistics, significance tests, Cronbach's alpha technique, correlation, and factor analysis were used. RESULTS: The QOL-RA Scale, an 8-item scale, took 2 to 3 minutes to administer. Psychometric analysis revealed that the psychometric attributes and constructs of both English and Spanish questionnaires are comparable (i.e., equivalent). Both versions demonstrated the following: (a) normal distribution of the QOL-RA Scale, roughly symmetrical distributions of the items, equivalent means and standard deviations across items, and less than 10% floor and ceiling effects, (b) Cronbach's alpha coefficients of 0.87-0.90, (c) significant correlations of the QOL-RA Scale with the AIMS2 subscales, LSNS, and CES-D, ranging from 0.25 to 0.66 (P < or = 0.01), and (d) extraction of 2 factors, namely physio-psychological and socio-psychological, that explained 65% to 73% of the variance in the scale scores. CONCLUSION: The QOL-RA Scale, in both English and Spanish versions, appears to meet the assumptions of a summated rating scale and the criteria of relevance, reliability, validity, feasibility, and adaptability to several languages. (+info)
Reliability, validity and psychometric properties of the Greek translation of the Center for Epidemiological Studies-Depression (CES-D) Scale.
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INTRODUCTION: The aim of the current study was to assess the reliability, validity and psychometric properties of the Greek translation of the Center for Epidemiological Studies- Depression Scale (CES-D). METHODS: 40 depressed patients 29.65 +/- 9.38 years old, and 120 normal controls 27.23 +/- 10.62 years old entered the study. In 20 of them (12 patients and 8 controls) the instrument was re-applied 1-2 days later. Translation and Back Translation was made. Clinical Diagnosis was reached by consensus of two examiners with the use of the SCAN v.2.0 and the IPDE. Statistical Analysis included ANOVA, the Pearson Product Moment Correlation Coefficient, Principal Components Analysis and Discriminant Function Analysis and the calculation of Cronbach's alpha (alpha) RESULTS: Both Sensitivity and specificity exceed 90.00 at 23/24, Chronbach's alpha for the total scale was equal to 0.95. Factor analysis revealed three factors (positive affect, irritability and interpersonal relationships, depressed affect and somatic complains). The test-retest reliability was satisfactory (Pearson's R between 0.45 and 0.95 for individual items and 0.71 for total score). CONCLUSION: The Greek translation of the CES-D scale is both reliable and valid and is suitable for clinical and research use with satisfactory properties. Its properties are similar to those reported in the international literature. However one should always have in mind the limitations inherent in the use of self-report scales. (+info)
Translational selection shapes codon usage in the GC-rich genome of Chlamydomonas reinhardtii.
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In unicellular species codon usage is determined by mutational biases and natural selection. Among prokaryotes, the influence of these factors is different if the genome is skewed towards AT or GC, since in AT-rich organisms translational selection is absent. On the other hand, in AT-rich unicellular eukaryotes the two factors are present. In order to understand if GC-rich genomes display a similar behavior, the case of Chlamydomonas reinhardtii was studied. Since we found that translational selection strongly influences codon usage in this species, we conclude that there is not a common pattern among unicellular organisms. (+info)