Factor Structure of the Neurocognitive Tests: An Application of the Confirmative Factor Analysis in Stabilized Schizophrenia Patients

The purpose of the present study was to identify the factor structure of neurocognitive tests used on schizophrenia patients by using the confirmative factor analysis, and to assess the factor score differences of schizophrenia patients and healthy controls. Comprehensive neurocognitive tests were administered to stabilized schizophrenia patients (N=114) and healthy controls (N=120). In the results of factor analyses on patients, the multifactorial-6-factor model, which included the speed of processing, working memory, verbal learning and memory, visual learning and memory, attention/vigilance, and reasoning/problem solving as suggested by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS), showed the better goodness of fit than any of the other models tested. And assessing the group differences of factor scores, we found the patients performed worse than the controls in all factors, but the result showed meaningful variations of impairments across the cognitive factors. Our study identifies the six major domains with multifactorial structure of cognitive abilities in schizophrenia patients and confirms the distinctive impairment patterns of each cognitive domain. These results may have utility in better understanding the pathology of schizophrenia as well as in genetic studies.     

Correlates of DSM-III personality disorder in obsessive-compulsive disorder

Forty-three patients with primary obsessive-compulsive disorder (OCD) completed the Personality Diagnostic Questionnaire (PDQ), a self-rating scale designed to assess axis II personality disorders (PD) from DSM-III. Results showed that 53% of the patients received at least one PD diagnosis. The most frequent diagnoses were avoidant (30%), histrionic (26%), dependent (19%), and schizotypal (16%). Consideration of the personality traits irrespective of diagnostic category showed that in addition to avoidant and dependent personality characteristics, the sample had strong passive aggressive and compulsive tendencies and substantial histrionic, paranoid, and schizotypal traits. Patients exhibiting a greater number of personality traits were also significantly more symptomatic. However, anxiety, phobic, and obsessive-compulsive symptoms were not selected as unique predictors of any personality variables in the regression analyses. Rather, the most important correlate of PD in these patients consisted of dysphoric mood as assessed by the Beck Depression Inventory (BDI) and, to a lesser degree, younger age or shorter duration of illness. These findings do not support a specific link between OCD and PD in general and compulsive PD in particular.     

Adolescent mothers and breastfeeding: experiences and support needs--an exploratory study.

The experiences and support needs of adolescent mothers who commenced breastfeeding were elicited using focus groups and in-depth semistructured interviews. The study took place in the North West of England, UK. The qualitative data were analyzed using thematic networks analysis. Five themes related to experiences emerged: feeling watched and judged, lacking confidence, tiredness, discomfort, and sharing accountability. A further 5 themes were developed to describe the adolescents' support needs: emotional support, esteem support, instrumental support, informational support, and network support. These forms of support were most effective when provided together in a synergistic way and within a trusting relationship. Key supporters identified were the mother's mother, the partner, and the midwife employed in a teenage pregnancy coordinator role. Health professionals need to further explore the ways in which relationships may be developed and sustained that provide the range of support required by adolescent mothers to enable them to continue breastfeeding.     

Perivascular paclitaxel wraps block arteriovenous graft stenosis in a pig model.

BACKGROUND: Haemodialysis vascular access dysfunction is currently a huge clinical problem. In an attempt to reduce the morbidity associated with haemodialysis vascular access dysfunction, we have previously developed and validated a local perivascular paclitaxel release system that has been shown to release paclitaxel for at least 3 weeks. The aim of the current study was to evaluate the in vivo use of these perivascular wraps (for both safety and efficacy) at different time points in our pig model of arteriovenous graft stenosis. METHODS: Paclitaxel-loaded ethylene vinyl acetate wraps were placed around the graft-vein anastomosis on one side, with control polymers being placed on the contralateral side in our pig model of arteriovenous graft stenosis. Animals were sacrificed at early (10-11 days), middle (23-24 days) and late (32-38 days) time points. The entire graft-vein anastomosis was removed at the time of sacrifice and assessed for the extent of luminal stenosis using histomorphometric techniques. RESULT: Graft-vein anastomoses treated with the paclitaxel-loaded polymers had an almost complete absence of luminal stenosis at the middle (23-24 days) and late (32-38 days) time points (when one would expect the development of neointimal hyperplasia) as compared with the contralateral control graft-vein anastomoses (37.90% luminal stenosis in the controls vs 0.10% in the paclitaxel group). There were minimal local side effects from this procedure. CONCLUSIONS: Our results demonstrate the safety and efficacy of paclitaxel-loaded perivascular wraps in the setting of a pig model of arteriovenous graft stenosis. We believe that such a local approach which could be easily applied at the time of surgery is ideally suited for use in the clinical setting of haemodialysis vascular access dysfunction. It is likely that this novel approach could result in a significant reduction in the huge economic and health morbidity costs currently associated with this recalcitrant clinical problem.     

Process of behavioral change as it relates to intentional physical activity.

During the past 100 years, America has changed from an agrarian society, where the intent of physical activity was to produce needed materials, to a postindustrial society, where 60% of American adults are not regularly physically active and 25% are not active at all. With sedentary lifestyle and its attendant consequences on the rise, the occupational health nurse can increase individuals' knowledge, facilitate their decision making, and motivate them to try new behaviors and change existing behaviors. The occupational health nurse can use a model to organize individual workers' information and clarify strategies to promote behavior change. The goal is to decrease the morbidity and mortality associated with sedentary lifestyles of American workers by using the model when individuals present to the occupational health service. Individuals benefit from health care professionals who understand personal risks and communicate strategies to address barriers and concerns when they consider behavior changes such as increasing physical activity.