Validation of the Greek version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+, version 3)

Objectives: There is a growing need for evaluation of the results of mental health services and clinical treatment in older people, but evidence for effectiveness is limited in Greece. The Health of the Nations Outcome Scales for Elderly People (HoNOS65+) are promising instruments for the assessment of mental, physical and social health in older persons. They have been translated into the Greek language but have not been validated. The aim was to assess the inter-rater reliability, intraclass correlation, concurrent validity, internal consistency and sensitivity to change of HoNOS65+ in a Greek sample of older people with mental health problems.

Method: Two samples, one of inpatients in a psychiatric hospital and the other of older people living in the community were used. In order to test the extent to which the HoNOS65+ were sensitive to change the first sample was reassessed after two months and the second after three months. For each participant HoNOS65+ were completed by two independent raters, and the clinician rated blindly each participant on the Stockton Geriatric Rating Scale and a scale which measured behavioural, physical, cognitive and emotional status.

Results: In both groups (inpatients n?=?50, community n?=?65), the inter-rater reliability, intraclass correlation and concurrent validity were high while internal consistency of the scales taken together was low. At reassessment in 98 participants, HoNOS65+ showed changes comparable to clinician ratings.

Conclusion: The Greek version of HoNOS65+ can achieve high levels of reliability, validity and sensitivity to change for measuring outcomes in older people with mental health problems.     

Robotically Assisted Revision of Bariatric Surgeries Is Safe and Effective to Achieve Further Weight Loss

Background

As more bariatric operations are being performed in the USA every year, the number of revisions has increased. These operations are challenging and have a higher morbidity than the initial operation. We have reviewed our series of robotically assisted revisions.

Methods

At the University of Texas Medical School at Houston, we reviewed robotic revision cases from 2004 through 2011 and found 99 bariatric revisions using robotic assistance. Selected endpoints included body mass index (BMI) at follow-up, percent excess weight loss (%EWL), complications, intubation time, operative time, and length of hospital stay.

Results

The average BMI at the time of revision was 44.8 kg/m² and fell to 29 kg/m² after 3 years. BMI was significantly lower at all time intervals (3, 12, 24, and 36 months) compared to initial BMI (p < 0.001). The %EWL was also significant at 1, 3, 12, 24, and 36 months post-revision (p < 0.001). There was a 24 % (13/55) 90-day readmission rate. The overall complication rate was 17 %, with each individual complication rate between 2 and 4 %. There were no deaths. The average operative time was 204 min, and the average length of hospital stay was 2.3 days.

Conclusions

Revising previous bariatric operations to gastric bypass is difficult and time consuming. Although robotically assisted revision can be done safely and can result in effective further weight loss, the high postoperative complication rate is an issue that warrants further attention.     

The shape- and weight-based self-esteem inventory in adolescent girls with eating disorders and adolescent controls

Abstract

This study aimed to determine the validity and psychometric properties of the Shape- and Weight-Based Self-Esteem (SAWBS) Inventory in British adolescent girls with and without eating disorders. Sixty patients and 60 age-matched controls completed the SAWBS Inventory and measures of eating disorder symptoms, body shape concerns, and depression. Patients also completed the Eating Disorders Examination. Adolescents with eating disorders attributed more of their self-esteem to weight and shape than those without eating disorders. The combination of weight and shape was the most important component of self-esteem for 28% of eating-disordered individuals compared with only 10% of controls. The measure showed acceptable validity in this sample. The SAWBS Inventory appears to be valid in British adolescent girls and is able to differentiate between those with and without eating disorders. The measure is likely to be a useful tool in both clinical and research settings with eating-disordered young people.     

Measuring the Impact of Bilingualism on Executive Functioning Via Inhibitory Control Abilities in Autistic Children

Journal of Autism and Developmental Disorders - One factor that may influence how executive functions develop is exposure to more than one language in childhood. This study explored the impact of...     

Anti-phospholipid antibodies in diabetes mellitus.

The presence of autoantibodies to phospholipids may be associated with various pathological disorders; diabetes could be one of them because of the changes occurring in lipid metabolism but there are only few reports examining this question, and they are not always leading to the same conclusions because of the differences in the procedures or in the phospholipids tested. We carried out a systematic comparative study of diabetic serum antibody binding to all phospholipids, anionic and zwitterionic, by a quantitative ELISA. The implication of the hydrophobic moiety of the lipids was also studied: the presence of autoantibodies to the fatty acyl chains was investigated. Our results show the presence of anti-phospholipid antibodies in diabetic sera, particularly anti-phosphatidylinositol and anti-phosphatidylcholine which have never been tested before, and appear to be associated with macroangiopathic complications. The antigenic epitopes are mainly the polar heads as no antibody binding to the hydrophobic moiety was observed. We discuss the relation of those antibodies to the angiopathic complications and to the direct effects of hyperglycemia on lipid antigenicity.     

Associations Between Sexual Trauma and Sexual Relationship Power Among Latina Immigrant Farmworkers: The Moderating Role of Gender Norms

Sexual trauma is a national public health concern due to the alarming rates at which it occurs and decades of research supporting its long-term deleterious effects on health outcomes. We assessed the impact of gender norms and sexual trauma on power within sexual relationships among Latina immigrant farmworkers. At baseline, participants (N  = 175) completed a survey examining demographic information, sexual trauma history, and gender norms; a follow-up was administered 6 months later. Past sexual trauma was associated with less power in sexual relationships, r  = −.25, p < .001, as was endorsement of traditional Latina gender norms (i.e., marianismo): sexual relationship control, r  = −.38, p < .001; sexual decision-making dominance, r  = −.21, p  = .005. In contrast, egalitarian gender norm endorsement was associated with higher levels of sexual relationship control, r  = .37, p < .001, and sexual decision-making dominance, r  = .17, p  = .023. Gender norms moderated the association between sexual trauma and sexual relationship power. Specifically, women who subscribed more to marianismo and reported sexual trauma had less decision-making dominance in sexual relationships, whereas those with lower ratings of marianismo reported higher levels of decision-making dominance despite sexual trauma, R²  = .03, p  = .022. Sexual trauma history coupled with higher ratings of egalitarian gender norms was associated with higher levels of sexual relationship control, DR²  = .02, p  = .023. These results highlight the importance of culturally informed research to increase the sexual and overall health of vulnerable populations (e.g., Latina immigrant farmworkers).