Controlling for occasion-specific effects when assessing the test–retest reliability of self-report health questionnaires

OBJECTIVE: This study proposes a method for self-report health questionnaires to adjust test-retest reliability for changes during the test-retest interval based on an external measure, and to distinguish such changes from random response errors. METHODS: In our application, eighty participants completed the Symptoms of Illness Checklist (SIC) on two occasions, two weeks apart, immediately before interviews given on each occasion by one of two physicians in a crossover design. The physician interview scores served as external measures, and structural equation modeling was used to estimate the parameters of a model that corrected for the occasion-specific effect of participants' responses using information from the interviews. RESULTS: Correcting for changes in symptoms during the test-retest interval increased SIC test-retest reliability from .744 to .804 and significantly improved model fit (chi2(diff)(1) = 30.78, p < .001). CONCLUSIONS: The results suggest methods that can improve the evaluation of self-report health questionnaire test-retest reliability by identifying changes using an external measure, and distinguishing these from random response errors; these increased the estimated SIC test-retest reliability and indicated that the SIC was indeed able to measure changes over the studied time interval. This method can be applied across a broad range of questionnaires.     

Investigation of tinnitus induced by sound and its relationship to ongoing tinnitus

Tinnitus was temporarily induced by monaurally presented sound, and its level monitored using a dichotic loudness-matching task. The first experiment found no effect of varying the level, bandwidth, or center frequency of an inducing noise on the level or duration of the induced tinnitus; nor was there any difference when tones or different noises were used to induce tinnitus. The rated loudness of the tinnitus, however, increased with the level and decreased with the center frequency of the noise. The second experiment investigated tinnitus induced by a 1-kHz, 95-dB SPL tone in 53 subjects with thresholds in the normal range, but with varying degrees of ongoing tinnitus that ranged from no discernible sound sensation at all, through an apparently normal but usually inaudible noise or ringing, to constant or near-constant tinnitus. Individual differences in induced tinnitus were found that were related to differences in ongoing tinnitus; for example, the levels of induced and ongoing tinnitus were positively correlated. The results suggest that some kinds of ongoing tinnitus may arise from the auditory process responsible for induced tinnitus.     

Tetrahymena extract protects Paramecium from oxygen-free radicals

Cells of Paramecium tetraurelia will age and die, while cells of Tetrahymena thermophilia are immortal. Both are free-living, ciliated protozoa. Whole cells and homogenates of both Paramecium and Tetrahymena were treated with iron(+2) to induce peroxidation of membrane lipids and other cellular constituents. Paramecium is far more susceptible to such peroxidative damage than Tetrahymena. Indeed, addition of Tetrahymena extract protects Paramecium from peroxidative damage. Tetrahymena’s protective molecules block the initial attack of oxygen-free radicals on Paramecium constituents. A portion of the protective molecules are high molecular weight and temperature sensitive, but others are of small size. Some of the protective molecules are tightly bound to membranes or cytoskeletal elements pelleted from Tetrahymena sonicates.     

Increased incidence of gap junctional coupling between spinal motoneurones following transient blockade of NMDA receptors in neonatal rats

Neonatal rat motoneurones are electrically coupled via gap junctions and the incidence of this coupling declines during postnatal development. The mechanisms involved in this developmental regulation of gap junctional communication are largely unknown. Here we have studied the role of NMDA receptor-mediated glutamatergic synaptic activity in the regulation of motoneurone coupling. Gap junctional coupling was demonstrated by the presence of graded, short latency depolarising potentials following ventral root stimulation, and by the transfer of the low molecular weight tracer Neurobiotin to neighbouring motoneurones. Sites of close apposition between the somata and/or dendrites of the dye-coupled motoneurones were identified as potential sites of gap junctional coupling. Early postnatal blockade of the NMDA subtype of glutamate receptors using the non-competitive antagonist dizocilpine maleate (MK801) arrested the developmental decrease in electrotonic and dye coupling during the first postnatal week. These results suggest that the postnatal increase in glutamatergic synaptic activity associated with the onset of locomotion promote the loss of gap junctional connections between developing motoneurones.     

In vivo vs in vitro anticariogenic behavior of glass-ionomer and resin composite restorative materials.

OBJECTIVE: To evaluate the in vivo vs the in vitro anticariogenic potential of glass-ionomer and resin composite restoratives, utilizing a standardized interfacial gap model. METHODS: (a) In vitro study. Box shaped cavities were prepared at the buccal surfaces of extracted premolars limited to enamel. The incisal cavity walls received no treatment and were covered with 40 microm-thick metal spacers. The cavities were restored with a glass-ionomer (Ketac-Fil, n=8) and a fluoride-free resin composite (Scotchbond MP Plus/Z100, n=8). After 4 weeks immersion in an acidic gel (pH 4), thin sections were produced and examined under polarized-light microscopy.(b) In vivo study. Four low caries activity volunteers, with first four premolars, each planned to be extracted for orthodontic reasons, participated in the study. Cavities were prepared as before and filled contralaterally per patient with glass-ionomer (n=8) and resin composite (n=8). After 6 months in vivo, the teeth were extracted, sectioned and investigated by polarized-light microscopy, Raman microspectroscopy and SEM-EDS X-ray microanalysis. Unpaired t-test (lesion dimensions) and one-way ANOVA and Newman-Keuls tests (Ca, P wt%, Ca/P ratios) were used to identify statistically significant differences in lesion analysis (alpha=0.05). RESULTS: (a) In vitro study. All restorations developed lesions at incisal and cervical margins. At gap-free regions glass-ionomers showed reduced lesion dimensions compared to those of composites (p<0.05). At regions with gaps, no significant differences were found in lesion depth between the restorative groups tested. Lesion length was increased in composite, and decreased in glass-ionomer, whereas lesion depth in both restorative groups was increased in comparison to gap-free regions (p<0.05).(b) In vivo study. No lesions were observed at gap-free regions. At gap regions, 75.5% of glass-ionomer and 62.5% of composite restorations developed lesions. The lesion dimensions were significantly greater in glass-ionomer (p<0.05). A reduction in PO4(3-), CO3(2-), Ca and P was found in lesions compared to intact tissues. No F was detected and no CaF2 lattice vibrations were found at the enamel margins facing the gap adjacent to glass-ionomers. SIGNIFICANCE: In the presence of a standardized interfacial gap, no preventive effect was exerted in vivo from the glass-ionomer to protect the adjacent enamel wall from secondary caries attack. The lack of any correlation between the in vivo and in vitro models tested implies that artificial caries experiments have a negligible clinical relevance in predicting the in vivo effect.     

Problems with a ‘target’ approach to access in primary care: a qualitative study

We report an analysis of the qualitative phase of a study of patients' and carers' views of primary care services, focusing on their experiences of access to face-to-face general practitioner (GP) consultations during the period when new access policies were being implemented. Practices interpreted the new policy in various ways; restricted interpretations, including restriction of access to telephone booking, could cause distress to patients. Patients and carers welcomed flexible interpretations of the policy that offered choice, such as a choice of GP, or of booking in advance.