The modification and standardisation of the Harter self-esteem questionnaire with Scottish school children

This paper describes a study to modify an American questionnaire measuring self-esteem in children for use in the United Kingdom and also to obtain normative values for this questionnaire with Scottish school children aged 8–15 years. Five thousand children resident in the Lothian Region of Scotland, a 5% sample of the age group, were identified using a cluster sampling technique in order to provide a random sample of the general population for this age group. The main findings were as follows: children usually rated themselves higher than the midpoint on most subscales, indicating that they have a positive regard for themselves; boys tended to rate themselves higher than girls on most subscales except behaviour; scores tended to decline as children get older, especially for girls; global or overall self-esteem was highly correlated with the other subscales, especially physical appearance or attractiveness; self-esteem scores were not influenced by social class, school or religion. The modified Harter questionnaire can be used to measure self-esteem in several situations. These include comparisons between different groups of children, changes in self-esteem following treatment interventions or the effects of illness on children's psychological adjustment. Finally, the study has provided normative values for a Scottish population of school children aged 8–15 years.

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Zusammenfassung Die vorliegende Arbeit beschreibt eine Studie, die es sich zum Ziel setzt, einen amerikanischen Fragebogen zum Gebrauch für 8–15jährige Schüler in Großbritannien zu modifizieren. Der Fragebogen mißt das Selbstwertgefühl der Kinder und ein Hauptziel der Studie war die Erlangung von normativen Basiswerten.Die wichtigsten Ergebnisse waren wie folgt: Kinder schätzen sich auf den meisten Unterskalen höher ein als der Mittelwert, was auf ein allgemein positives Selbstwertgefühl schließen läßt; Jungen tendieren sich auf allen Unterskalen mit Ausnahme der behaviour-Skala höher einzuschätzen als Mädchen; die Werte nehmen im Allgemeinen ab, wenn die Kinder älter werden, was vor allem für Mädchen deutlicher ist; globalses Selbstwertgefühl ist stark korreliert mit den Ergebnissen der Unterskalen, vor allem solchen die körperliches Erscheinungsbild oder Atraktivität beschreiben; die Ergebnisse sind nicht mit Faktoren wie sozialer Schicht, Schule oder Religion korreliert.Der modifizierte Harter-Fragebogen für die Bestimmung des Selbstwertgefühls kann in mehren Situationen Verwendung finden: Kinder verschiedener Altersgruppen können verglichen werden; Veränderungen nach Behandlungseingriffen oder der Einfluß von erkrankungen auf diesen Aspekt der Psyche können gemessen werden. Und schießlich hat der Fragebogen normative Grundwerte für eine Population von schottischen 8–15jährigen Schülern geliefert.

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Résumé Cet exposé décrit une étude faite pour apporter des modifications à un questionnaire américain sur l'évaluation du Respect de Soi ches les enfants, afin qù'il puisse être utilisé au Royaume Uni et aussi afin de normaliser ce questionnaire pour les écoliers écossais âgés de 8 à 15 ans.Cinc mille enfants de la région écossaise de Lothian, une section représentative de 5% du groupe d'âge, one été identifiés, en se servant d'un groupe de techniques d'échantillonnage afin d'obtenir un échantillon prélevé au hasard, de la population générale dans ce group d'âge.Les conclusions principles sont les suivantes: Les enfants se classent eux-mêmes généralement plus haut que la moyenne dans la plupart des cas de figures analysés, indiquant ainsi qu'ils ont une opinion positive d'eux mêmes. Les garçons ont tendance à avoir une plus haute opinion d'eux mêmes que les filles dans tous les cas de figures excepté la conduite. Les résultats obtenus ont tendance à diminuer en fonction de l'âge plus élevé des enfants, particulièrement pour les filles. Globalement ou en général le respect de soi était mis plus en corrélation avec les autres cas de figures, tout spécialement l'apparence physique ou l'attrait feminin. Les évaluations du respect de soi n'ont pas été influencées par la classe sociale, l'institution scolaire ou la religion.Le questionnaire Harter modifié peut être utilisé pour évaluer le respect de soi dans plusieurs situations. Celles-ci comprennent des comparaisons entre différents groupes d'enfants, des changements dans le respect de soi intervenant après un traitement ou les effets de maladie sur l'adaptation psychologique des enfants.Pour terminer, cette étude a permis d'obtenir des valeurs normalisées pour une population d'écoliers écossais âgés de 8 à 15 ans.

     

Medical technology: Assessment,adoption, and utilization

Promotion of appropriate diffusion of technology in medicine is handicapped by: (1) thorny conceptual, ethical, and methodological problems in technology assessment; (2) a lack of consistent findings on the factors affecting technology adoption and utilization; and (3) a disturbing lack of apparent connection between assessment, adoption, and utilization. This paper reviews published work in these areas of inquiry, highlights areas of needed research, and suggests areas in which the health system of the Veterans Administration could make particularly valuable contributions.     

Recombinant human relaxin as a cervical ripening agent

Objective The aim of this study was to investigate the efficacy and safety of recombinant human relaxin (rhRIx) as a cervical ripening agent in women with an unfavourable cervix before induction of labour at term.
Design A multi-centre, double-blind, placebo-controlled trial performed in Edinburgh, Glasgow and Oxford. Women were treated with 0, 1, 2 or 4 mg of rhRIx in a gel vehicle administered intravaginally. Analysis of variance tests were performed on all continuous variables, and Cochran Mantel-Haenszel tests employed for all discrete variables.
Participants Ninety-six women at 37 to 42 weeks of gestation with a singleton pregnancy and a modified Bishop score of 4 were recruited.
Results There was no significant difference in the change in modified Bishop score between the four treatment groups. The lengths of the first and second stages of labour were similar in all 4 groups. PGE₂ and oxytocin requirements were similar in all groups, as was the mode of delivery. There was no evidence that relaxin was absorbed systemically when given in this way.
Conclusion Recombinant human relaxin 1 to 4 mg, administered as an intravaginal gel, has no effect as a cervical ripening agent before induction of labour at term.     

Glomerulocystic disease with hepatoblastoma in a neonate: a case report

Glomerulocystic disease (GCD) is a very rare condition. Only two previous reports have linked this condition with hepatoblastoma. We report a neonate with US evidence of grossly enlarged echogenic kidneys and features typical of hepatic fibrosis, complicated by the presence of a hepatoblastoma. The report discusses the differential diagnosis and highlights GCD as one cause of large, bright kidneys on US. It also adds further evidence to the suggested association between GCD and hepatoblastoma. Received: 15 May 1997 Accepted: 24 February 1998     

Exploring the decision-making preferences of people with colorectal cancer

OBJECTIVES: To explore patient views on participation in treatment, physical care and psychological care decisions and factors that facilitate and hinder patients from making decisions. DESIGN: Qualitative study using semi-structured interviews with patients. SETTING AND PARTICIPANTS: Three NHS Trusts in the north-west of England. Theoretical sampling including 41 patients who had been treated for colorectal cancer. RESULTS: For patients, participation in the decision-making process was about being informed and feeling involved in the consultation process, whether patients actually made decisions or not. The perceived availability of treatment choices (surgery, radiotherapy, chemotherapy) was related to type of treatment. Factors that impacted on whether patients wanted to make decisions included a lack of information, a lack of medical knowledge and trust in medical expertise. Patients perceived that they could have a more participatory role in decisions related to physical and psychological care. CONCLUSION: This study has implications for health professionals aiming to implement policy guidelines that promote patient participation and shared partnerships. Patients in this study wanted to be well informed and involved in the consultation process but did not necessarily want to use the information they received to make decisions. The presentation of choices and preferences for participation may be context specific and it cannot be assumed that patients who do not want to make decisions about one aspect of their care and treatment do not want to make decisions about other aspects of their care and treatment.     

Phase I and pharmacologic study of infusional topotecan and Carboplatin in relapsed and refractory acute leukemia.

PURPOSE: To assess the maximum tolerated dose, toxicities, pharmacokinetics, and antileukemic activity of topotecan and carboplatin in adults with recurrent or refractory acute leukemias. EXPERIMENTAL DESIGN: Patients received topotecan and carboplatin by 5-day continuous infusion at nine dose levels. Patients achieving a complete remission received up to two additional courses for consolidation. Plasma topotecan and ultrafilterable platinum were assayed on days 1 to 5. In addition, pretreatment levels of various polypeptides in leukemic cells were examined by immunoblotting to assess possible correlations with response. RESULTS: Fifty-one patients received a total of 69 courses of therapy. Dose-limiting toxicity consisted of grade 4/5 typhlitis and grade 3/4 mucositis after one course of therapy or grade 4 neutropenia and thrombocytopenia lasting >50 days when a second course was administered on day 21. Among 45 evaluable patients, there were 7 complete remissions, 2 partial remissions, 1 incomplete complete remission, and 1 reversion to chronic-phase chronic myelogenous leukemia. Topotecan steady-state plasma concentrations increased with dose. No accumulation of topotecan or ultrafilterable platinum occurred between days 1 and 5 of therapy. Leukemic cell levels of topoisomerase I, checkpoint kinase 1, checkpoint kinase 2, and Mcl-1 correlated with proliferating cell nuclear antigen but not with response. In contrast, low Bcl-2 expression correlated with response (P = 0.014, Mann-Whitney U test). CONCLUSIONS: The maximum tolerated dose was 1.6 mg/m(2)/d topotecan plus 150 mg/m(2)/d carboplatin. The complete remission rate in a heavily pretreated population was 16% (33% at the highest three dose levels). Responses seem to correlate with low pretreatment blast cell Bcl-2 expression.