The purpose of this study was to test the ability of Corah's Dental Anxiety Scale (DAS) and Spielberger's State Anxiety Inventory (STAI-S) to distinguish between fearful (n = 145) and regularly attending (n = 156) Norwegian dental patients. The reliability of both instruments was high (Cronbach's alpha indices > 0.95). With DAS, 90% of the fearful patients and 85% of the reference patients were correctly assigned to their appropriate group. Thus it may be concluded that, when used on a Norwegian population, DAS is a valid instrument for distinguishing fearful patients from those regularly attending dental treatment. The corresponding figures for STAI-S were 80% for the fearful patients and 79% for the reference patients. Although not developed specifically for this purpose, this instrument may therefore still validly be used to distinguish between the groups. The correlation between the instruments was 0.76, indicating that to some extent they measure the same phenomenon.
Drinking alcohol is an essential and commonplace part of life in Russia. Alcohol-related problems in the general population and among adolescents in particular has become a major public health concern. The problem cannot be solely explained by the frequency and quantity of alcohol consumption. The social determinants of drinking alcohol also need to be considered. These are the focus of the present investigation. The social determinants of drinking behaviour were assessed by self-reports (Social Context of Drinking Scale, Adolescent Alcohol Involvement Scale and Rutgers Alcohol Problem Index) in 387 secondary school students in Arkhangelsk, Russia. The factor structure for the Social Context of Drinking Scale was similar to that noted in respect of the original study [Thombs and Beck (1994) Health Education and Research 9, 13-22]. Significant gender differences in problem drinking and the social contexts of drinking were found. High intensity girl drinkers were likely to drink in most social contexts, whereas high intensity drinking boys were more likely to drink in the context of Stress Control. Furthermore, boy problem drinkers were more likely to drink in the context of School Defiance and Peer Acceptance, whereas girl problem drinkers tended to drink in the contexts of School Defiance and Stress Control. In general, the Social Context of Drinking Scale demonstrated a good ability to discriminate high from low intensity drinkers, and high from low problem drinkers. These results may provide useful information for targeted prevention programmes for adolescents.
The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.
A representative population sample was studied to elucidate relationships of arterial pressure (AR) with muscular performance (MP) and arterial hypertension risk factors. Power working capacity (PWCx) was measured by means of exercise tolerance test at rest, under physical loading and after the exercise. The findings were processed using a multivariate step-by-step regression analysis which established independent relations between exercise and postexercise MP and arterial hypertension. In normal and hypertensive males a rise in systolic pressure (SP) after the initial exercise (load 1) was dependent on PWC1 after more intensive exercise (load 2) on relations of MP with heart rate, SP and diastolic pressure (DP). In hypertensive males the SP elevation depended also on the age, B. W. index and heart rate. In normal AP males a DP rise depended on PWC2 and MP, the increment being limited by relationships between MP, DP, heart rate and SP. In hypertensive males the influence of PWC1 is defined through a SP rise after load 1. In normal AP and hypertensive females PWC1 is decisive for a SP rise. In normal AP females growth of DP after load 2 was dependent on PWC2 in relation to heart rate growth after load 2, while in hypertensive females PWC1 resulted in DP elevation after load 1. On comparison of the groups with normal and high AP the degree of AP increment under exercise depended on the relations of MP with heart rate, SP and DP.
The Readiness and Motivation Interview (RMI) is a semistructured interview measure of readiness and motivation to change that can be used for all eating disorder diagnoses. The RMI has demonstrated excellent psychometric properties and has both clinical and predictive utility in adult samples. This study examined the psychometric properties of the RMI in a younger population, namely, 12- to 18-year-old girls with eating disorders. Study participants (N = 65) completed the RMI and measures of convergent, discriminant, and criterion validity. Adolescents with eating disorders were able to conceptualize and articulate their readiness for change and to report the extent to which change efforts were for themselves versus for others. RMI readiness profiles across eating disorder symptom domains in adolescents were comparable to those in adults, with higher reported readiness to change binge eating than to change dietary restriction or compensatory strategies. Differences in internal consistency between adult and adolescent samples are discussed. Interviewing adolescents early in treatment about readiness may assist clinicians in forming an alliance with this difficult-to-engage population, while also providing valuable information for treatment planning.
The purpose of this study was to refine the Western Consortium for Cancer Nursing Research (WCCNR) stomatitis staging system. Fifty-six adult cancer patients were accrued. Using all eight descriptors, 96.4% of the participants were correctly staged. Using only lesions, colour and bleeding, however, 92.9% of the cases were correctly staged. Based on the findings of this study, the WCCNR stomatitis staging system has been shortened to include only lesions, colour and bleeding.
This paper demonstrates how the Mokken Scaling Model and other statistical tools may be useful in assessing the consistency of psychometric properties of health-related quality of life (HRQoL) scales across various populations. The main focus is the psychometric performance of the scales proposed for the EORTC QLQ-C30 in seven patient groups totalling more than 2,000 cancer patients. All scales performed satisfactorily in the total sample with the exception of the role functioning and cognitive functioning scales, which failed in terms of reliability and item discriminant validity. The descriptive statistics for the scales show that several of them, particularly those that build upon only two items, have discrimination problems at the extremes, visible in the high percentages at the maximum or the minimum observed values. The scalability analysis in the subsamples showed that the essential assumption in the Mokken Scaling Model of equal item step order does not hold for the cognitive functioning, emotional functioning and physical functioning scales. We conclude that the Mokken Scaling Model is well suited to the purpose of examining the generalizability of HRQoL scales across subpopulations although a global statistical test of the fit of the measurement model is not available.
The British Stroke Driver Screening Assessment (SDSA) is a set of four simple cognitive tests to evaluate driving fitness in stroke patients. To evaluate its usefulness in a Scandinavian context, we adapted the tests and assessed a group of 97 stroke patients from Sweden and Norway, using a driving test as the criterion. When results were calculated according to the original method, based on a discriminant function, less than 70% of the participants were correctly classified. To improve the predictive potential, a new discriminant analysis was performed, using the scores of a subsample of 49 patients, and validated on the remaining 48 participants. In total, 78% of the patients were correctly classified, but specificity was superior to sensitivity. We conclude that the Nordic version of the SDSA is a useful instrument, provided that test scores are interpreted in a balanced manner, taking into account the possibility of compensatory traffic behavior.
With the increasing availability of adult cystic fibrosis clinics, pediatric caregivers are faced with deciding whether an adolescent is ready for transfer. Twenty-two pediatric caregivers, ten adult caregivers, and three adult patients were interviewed to determine what behaviors and knowledge they perceived as essential for successful transition to adult care. No differences were noted between the pediatric and adult caregivers' responses. Based on their responses, a 24-item questionnaire was developed to assess readiness for transfer of 36 adolescents with cystic fibrosis. The questionnaire scores were found to be better predictors than age for success in transfer to adult care. The questionnaire allows the pediatric staff to focus on those areas that adolescents may need further preparation.
Species biogeography is a result of complex events and factors associated with climate change, ecological interactions, anthropogenic impacts, physical geography, and evolution. To understand the contemporary biogeography of a species, it is necessary to understand its history. Specimens from areas of localized extinction are important, as extirpation of species from these areas may represent the loss of unique adaptations and a distinctive evolutionary trajectory. The walrus (Odobenus rosmarus) has a discontinuous circumpolar distribution in the arctic and subarctic that once included the southeastern Canadian Maritimes region. However, exploitation of the Maritimes population during the 16th-18th centuries led to extirpation, and the species has not inhabited areas south of 55°N for ~250 years. We examined genetic and morphological characteristics of specimens from the Maritimes, Atlantic (O. r. rosmarus) and Pacific (O. r. divergens) populations to test the hypothesis that the first group was distinctive. Analysis of Atlantic and Maritimes specimens indicated that most skull and mandibular measurements were significantly different between the Maritimes and Atlantic groups and discriminant analysis of principal components confirmed them as distinctive groups, with complete isolation of skull features. The Maritimes walrus appear to have been larger animals, with larger and more robust tusks, skulls and mandibles. The mtDNA control region haplotypes identified in Maritimes specimens were unique to the region and a greater average number of nucleotide differences were found between the regions (Atlantic and Maritimes) than within either group. Levels of diversity (h and p) were lower in the Maritimes, consistent with other studies of species at range margins. Our data suggest that the Maritimes walrus was a morphologically and genetically distinctive group that was on a different evolutionary path from other walrus found in the north Atlantic.