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Sample records for dyspnea scale relationships

  1. [Confusion about MRC dyspnea scales in Japan--which MRC dyspnea scale should we employ?].

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    Miyamoto, Kenji

    2008-08-01

    Though the Hugh-Jones dyspnea scale has been widely used in Japan, the British Medical Research Council (MRC) dyspnea scale and/or modified MRC dyspnea scales have been used in many other countries. One of these modified MRC dyspnea scales was translated into Japanese and appeared in both the "Japanese Manual of Respiratory Rehabilitation (2003)" and the "Japanese Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease (2004)" which were published by the Japanese Respiratory Society. Subsequently, the MRC dyspnea scale appeared in a textbook and in review articles published in Japan. However, this dyspnea scale, which was translated into Japanese, is not used by the British Thoracic Society, American Thoracic Society, European Respiratory Society, Canadian Respiratory Society, or Global Initiative for Chronic Obstructive Lung Disease (GOLD). The Japanese version of the MRC dyspnea scale has two serious problems: 1) normal healthy subjects have to be classified into dyspnea grade 0 or grade 1, and 2) incorrect Japanese translation of the scale. The Japanese Respiratory Society has to decide which MRC dyspnea scale should be employed, with a well-thought-out translation.

  2. The Barthel index-dyspnea: a new two-dimensional dyspnea scale

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    Chuang ML

    2016-08-01

    Full Text Available Ming-Lung Chuang1–3 1Division of Pulmonary Medicine, Department of Internal Medicine, 2Department of Critical Care Medicine, Chung Shan Medical University Hospital, 3School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China Clinical evaluation tools have been widely used in assessing the baseline status, treatment response, and prognosis for patients with chronic respiratory diseases and mostly for patients with chronic obstructive pulmonary disease (COPD.1 By factor analysis, multiple domains of disease entities involve dyspnea, psychological status, health-related quality of life, and sensation or perception of dyspnea,2 wherein dyspnea is commonly evaluated by dyspnea scales such as Medical Research Council (MRC, Baseline Dyspnea Index, Oxygen-Cost Diagram, St George Respiratory Questionnaire activity domain, and Chronic Respiratory Disease Questionnaire dyspnea domain (CRQ-dyspnea.2 These scales describe the subjects’ capability to perform at various levels of motor activity or functional status influenced or even limited by dyspnea. Indeed, exercise capacity is quantified; however, dyspnea is not. In our experience, the exertional dyspnea scales had better correlations with exercise performances (|r|=0.29–0.65 than dyspnea sensation intensity (|r|=0.06–0.55 and better correlation with walking (|r|=0.5–0.65 than peak exercise (|r|=0.29–0.39.  View the original paper by Vitacca et al.  

  3. MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

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    Roussos Charis

    2010-05-01

    Full Text Available Abstract Background Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF. The Medical Research Chronic (MRC chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET and the 6-minute walk test (6MWT are shown to provide information on the severity and survival of disease. Methods We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Results Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p 2 at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p VO2 peak/kg (r = -.731, p 2 at peak exercise (r = -. 682, p 2 slope (r = .731, p 2 at AT (r = .630, p = 0.002 and the Borg scale at peak exercise (r = .50, p = 0.01 for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT. Conclusion In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.

  4. MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

    Science.gov (United States)

    2010-01-01

    Background Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease. Methods We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Results Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p dyspnea score provides reliable prognostic information on IPF. PMID:20509928

  5. MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study.

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    Manali, Effrosyni D; Lyberopoulos, Panagiotis; Triantafillidou, Christina; Kolilekas, Likourgos F; Sotiropoulou, Christina; Milic-Emili, Joseph; Roussos, Charis; Papiris, Spyros A

    2010-05-28

    Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease. We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p MRC score and VO2 peak/kg (r = -.731, p MRC is the distance walked at the 6MWT. In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.

  6. Modified Medical Research Council scale vs Baseline Dyspnea Index to evaluate dyspnea in chronic obstructive pulmonary disease

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    Perez, Thierry; Burgel, Pierre Régis; Paillasseur, Jean-Louis; Caillaud, Denis; Deslée, Gaetan; Chanez, Pascal; Roche, Nicolas

    2015-01-01

    Background Assessment of dyspnea in COPD patients relies in clinical practice on the modified Medical Research Council (mMRC) scale, whereas the Baseline Dyspnea Index (BDI) is mainly used in clinical trials. Little is known on the correspondence between the two methods. Methods Cross-sectional analysis was carried out on data from the French COPD cohort Initiatives BPCO. Dyspnea was assessed by the mMRC scale and the BDI. Spirometry, plethysmography, Hospital Anxiety-Depression Scale, St George’s Respiratory Questionnaire, exacerbation rates, and physician-diagnosed comorbidities were obtained. Correlations between mMRC and BDI scores were assessed using Spearman’s correlation coefficient. An ordinal response model was used to examine the contribution of clinical data and lung function parameters to mMRC and BDI scores. Results Data are given as median (interquartile ranges, [IQR]). Two-hundred thirty-nine COPD subjects were analyzed (men 78%, age 65.0 years [57.0; 73.0], forced expiratory volume in 1 second [FEV1] 48% predicted [34; 67]). The mMRC grade and BDI score were, respectively, 1 [1–3] and 6 [4–8]. Both BDI and mMRC scores were significantly correlated at the group level (rho =−0.67; Pdyspnea grade was also associated with the thromboembolic history and low body mass index. Conclusion Dyspnea is a complex symptom with multiple determinants in COPD patients. Although related to similar factors (including hyperinflation, depression, and heart failure), BDI and mMRC scores likely explore differently the dyspnea intensity in COPD patients and are clearly not interchangeable. PMID:26316740

  7. The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study

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    Launois Claire

    2012-10-01

    Full Text Available Abstract Background Dyspnea is very frequent in obese subjects. However, its assessment is complex in clinical practice. The modified Medical Research Council scale (mMRC scale is largely used in the assessment of dyspnea in chronic respiratory diseases, but has not been validated in obesity. The objectives of this study were to evaluate the use of the mMRC scale in the assessment of dyspnea in obese subjects and to analyze its relationships with the 6-minute walk test (6MWT, lung function and biological parameters. Methods Forty-five obese subjects (17 M/28 F, BMI: 43 ± 9 kg/m2 were included in this pilot study. Dyspnea in daily living was evaluated by the mMRC scale and exertional dyspnea was evaluated by the Borg scale after 6MWT. Pulmonary function tests included spirometry, plethysmography, diffusing capacity of carbon monoxide and arterial blood gases. Fasting blood glucose, total cholesterol, triglyceride, N-terminal pro brain natriuretic peptide, C-reactive protein and hemoglobin levels were analyzed. Results Eighty-four percent of patients had a mMRC ≥ 1 and 40% a mMRC ≥ 2. Compared to subjects with no dyspnea (mMRC = 0, a mMRC ≥ 1 was associated with a higher BMI (44 ± 9 vs 36 ± 5 kg/m2, p = 0.01, and a lower expiratory reserve volume (ERV (50 ± 31 vs 91 ± 32%, p = 0.004, forced expiratory volume in one second (FEV1 (86 ± 17 vs 101 ± 16%, p = 0.04 and distance covered in 6MWT (401 ± 107 vs 524 ± 72 m, p = 0.007. A mMRC ≥ 2 was associated with a higher Borg score after the 6MWT (4.7 ± 2.5 vs 6.5 ± 1.5, p  Conclusion This study confirms that dyspnea is very frequent in obese subjects. The differences between the “dyspneic” and the “non dyspneic” groups assessed by the mMRC scale for BMI, ERV, FEV1 and distance covered in 6MWT suggests that the mMRC scale might be an useful and easy-to-use tool to assess dyspnea in daily living in

  8. Evaluation of three scales of dyspnea in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Chhabra, S K; Gupta, A K; Khuma, M Z

    2009-01-01

    The Modified Medical Research Council (MMRC) scale, baseline dyspnea index (BDI) and the oxygen cost diagram (OCD) are widely used tools for evaluation of limitation of activities due to dyspnea in patients with chronic obstructive pulmonary disease (COPD). There is, however, limited information on how these relate with each other and with multiple parameters of physiological impairment. To study the interrelationships between MMRC, BDI and OCD scales of dyspnea and their correlation with multiple measures of physiological impairment. A retrospective analysis of pooled data of 88 male patients with COPD (GOLD stages 2, 3 and 4) was carried out. Dyspnea was evaluated using the MMRC, BDI and OCD scales. Physiological impairment was assessed by spirometry (FVC % predicted and FEV 1 % predicted), arterial blood gas (ABG) analysis and measurement of the 6-min walk distance (6MWD). The interrelationships between MMRC, BDI and OCD scales were moderately strong. The BDI and OCD scores had strong correlations with ABG abnormalities, weak correlations with spirometric parameters but none with 6MWD. MMRC grades were significantly associated with BDI and OCD scores but did not show clear associations with spirometric parameters, ABG abnormalities and 6MWD. The MMRC grades of dyspnea and the BDI and OCD scales are moderately interrelated. While the BDI and OCD scales have significant associations with parameters of physiological impairment, the MMRC scale does not. (author)

  9. Performance of a word labeled visual analog scale in determining the degree of dyspnea during exercise-induced bronchoconstriction in children and adolescents with asthma.

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    Lima, Patrícia Bueno; Santoro, Ilka Lopes; Caetano, Lilian Ballini; Cabral, Anna Lúcia de Barros; Fernandes, Ana Luisa Godoy

    2010-01-01

    There is an indirect relationship between airway obstruction in asthma and the intensity of breathlessness (dyspnea). A word labeled visual analog dyspnea scale with a 0-3 score has been widely used for the assessment of the degree of bronchoconstriction, although the perception of such obstruction varies considerably. The objective of this study was to determine whether children and adolescents are able to perceive acute exercise-induced bronchoconstriction (EIB), as well as to measure the discriminatory power of a word labeled visual analog dyspnea scale in relation to the intensity of the EIB. A cross-sectional study involving 134 children and adolescents with asthma and submitted to a six-minute steady-state exercise test on a cycle ergometer. The intensity of dyspnea was determined using a word labeled visual analog dyspnea scale prior to each determination of FEV1. The scale is scored from 0 to 3, with a logical sequence of pictures, ranging from "no symptoms" to "severe dyspnea". Variables were determined at baseline, as well as at 5, 10, and 20 min after the exercise test. The accuracy of the dyspnea scale in identifying the degree of EIB was determined by means of ROC curves for the post-exercise fall in FEV1, using cut-off points of 10%, 20%, 30%, and 40%. Of the patients selected, 111 finished the study, and 52 (46.8%) presented with EIB. The area under the ROC curve increased in direct proportion to increases in the degree of bronchoconstriction. Among children and adolescents with asthma, the accuracy of this dyspnea scale improves as the post-exercise percentage fall in FEV1 increases. However, the predictive value of the scale is suboptimal when the percentage fall in FEV1 is lower.

  10. Relationship between Dyspnea Descriptors and Underlying Causes of the Symptom; a Cross-sectional Study

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    Seyyed Mohammad Ali Sajadi

    2017-03-01

    Full Text Available Introduction: History taking and physical examination help clinicians identify the patient’s problem and effectively treat it. This study aimed to evaluate the descriptors of dyspnea in patients presenting to emergency department (ED with asthma, congestive heart failure (CHF, and chronic obstructive pulmonary disease (COPD. Method: This cross-sectional study was conducted on all patients presenting to ED with chief complaint of dyspnea, during 2 years. The patients were asked to describe their dyspnea by choosing three items from the valid and reliable questionnaire or articulating their sensation. The relationship between dyspnea descriptors and underlying cause of symptom was evaluated using SPSS version 16. Results: 312 patients with the mean age of 60.96±17.01 years were evaluated (53.2% male. Most of the patients were > 65 years old (48.7% and had basic level of education (76.9%.  "My breath doesn’t go out all the way" with 83.1%, “My chest feels tight " with 45.8%, and "I feel that my airway is obstructed" with 40.7%, were the most frequent dyspnea descriptors in asthma patients. "My breathing requires work" with 46.3%, "I feel that I am suffocating" with 31.5%, and "My breath doesn’t go out all the way" with 29.6%, were the most frequent dyspnea descriptors in COPD patients. "My breathing is heavy" with 74.4%, "A hunger for more air” with 24.4%, and "I cannot get enough air" with 23.2%, were the most frequent dyspnea descriptors in CHF patients. Except for “My breath does not go in all the way”, there was significant correlation between studied dyspnea descriptors and underlying disease (p = 0.001 for all analyses. Conclusion: It seems that dyspnea descriptors along with other findings from history and physical examination could be helpful in differentiating the causes of the symptom in patients presenting to ED suffering from dyspnea.  

  11. [Development of an activity of daily living scale for patients with COPD: the Activity of Daily Living Dyspnea scale].

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    Yoza, Yoshiyasu; Ariyoshi, Koya; Honda, Sumihisa; Taniguchi, Hiroyuki; Senjyu, Hideaki

    2009-10-01

    Patients with COPD often experience restriction in their activities of daily living (ADL) due to dyspnea. This type of restriction is unique to patients with COPD and cannot be adequately evaluated by the generic ADL scales. This study developed an ADL scale (the Activity of Daily Living Dyspnea scale [ADL-D scale]) for patients with COPD and investigated its validity and internal consistency. Patients with stable COPD were recruited and completed a pilot 26-item questionnaire. Patients also performed the Incremental Shuttle Walk Test (ISWT), and completed the St George's Respiratory Questionnaire (SGRQ), and Medical Research Council (MRC) dyspnea grade. There were 83 male participants who completed the pilot questionnaire. Following the pilot, 8 items that were not undertaken by the majority of subjects, and 3 items judged to be of low clinical importance by physical therapists were removed from the pilot questionnaire. The final ADL-D scale contained 15 items. Scores obtained with the ADL-D scale were significantly correlated with the MRC dyspnea grades, distance walked on the ISWT and SGRQ scores. The ADL-D scores were significantly different across the five grades of the MRC dyspnea grade. The ADL-D scale showed high consistency (Chronbach's alpha coefficient of 0.96). The ADL-D scale is a useful scale for assessing impairments in ADL in Japanese male patients with COPD.

  12. Reported dyspnea and fatigue using different scales during the physical effort in COPD

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    Alaís Camargo Corcioli

    Full Text Available Abstract Introduction: Therapy choice and its progression for patients with Chronic Obstructive Pulmonary Disease (COPD should be based on their symptoms and clinical condition according to reports of dyspnea and fatigue. Therefore patient-reported scales have presented a key role during the communication with the patient. Objective: To verify if patients with COPD prefer the Modified Borg Scale (MBS, Visual Analogue Scale (VAS, Glasses Scale (GS, Faces Scale (FS or Ratings of Perceived Exertion (RPE during the six-minute walk test(6MWT, and to compare and correlate the scales with each other, with peripheral oxygen saturation (SpO2 and heart rate (HR. Methods: 28 patients with COPD (50% had mild to moderate COPD and 50% had severe to very severe were evaluated by a respiratory and cognitive assessment. Additionally, they performed the 6MWT, in which the scales were applied simultaneously (random order and patients reported their preference in the end of the test. Results: 57% of patients were illiterate or presented incomplete primary education and most of them (67% chose the FS or GS. Significant positive correlations were observed between instruments for both dyspnea and fatigue in the end of the 6MWT, which the strongest was between MBS and FS (r = 0.95. Nevertheless, there was no correlation between the scales and SpO2 and HR. Conclusion: As the majority of patients preferred pictured to numerical scales we suggest their use as a resource for therapeutic evaluation; MBS might be replace by FS, even though they have different scores and not scaled proportionally. However, this change must be carefully considered because there is the risk of dubious interpretation.

  13. Relationship between anxiety and dyspnea on exertion in patients with chronic obstructive pulmonary disease

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    de Voogd, J.N.; Sanderman, R.; Postema, K.; van Sonderen, E.; Wempe, J.B.

    2011-01-01

    Dyspnea limits exercise in patients with chronic obstructive pulmonary disease (COPD) and is known to induce anxiety. Little is known whether anxiety contributes to exercise-induced dyspnea, which in turn might influence the outcome of diagnostic tests. The aim of the present study was to examine

  14. Modified Medical Research Council Dyspnea Scale in GOLD Classification Better Reflects Physical Activities of Daily Living.

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    Munari, Anelise B; Gulart, Aline A; Dos Santos, Karoliny; Venâncio, Raysa S; Karloh, Manuela; Mayer, Anamaria F

    2018-01-01

    In multidimensional Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, the choice of the symptom assessment instrument (modified Medical Research Council dyspnea scale [mMRC] or COPD assessment test [CAT]) can lead to a different distribution of patients in each quadrant. Considering that physical activities of daily living (PADL) is an important functional outcome in COPD, the objective of this study was to determine which symptom assessment instrument is more strongly associated with and differentiates better the PADL of patients with COPD. The study included 115 subjects with COPD (GOLD 2-4), who were submitted to spirometry, the mMRC, the CAT, and monitoring of PADL (triaxial accelerometer). Subjects were divided into 2 groups using the cutoffs proposed by the multidimensional GOLD classification: mMRC 2 and CAT > 10, respectively. Physical activities ≥ 3 METs differed only between mMRC classification criterion for symptom assessment in the GOLD ABCD system when focusing on PADL. Copyright © 2018 by Daedalus Enterprises.

  15. Gender effect on the use of modified borg and visual analog scales in the evaluation of dyspnea in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Ilgin, D.; Ozalevli, S.; Karaali, H.K.; Cimrin, A.H.; Ucan, E.S.

    2010-01-01

    To investigate the gender effect on the use of Modified Borg Scale (MBS) and Visual Analog Scale (VAS) for the effort dyspnea evaluation in Chronic Obstructive Pulmonary Disease (COPD) patients. Fifty-two patients with severe COPD were included in this study. Pulmonary function (spirometry), quality of life (Chronic Respiratory Disease Questionnaire-CRDQ), exercise capacity (6-minute walking test), and dyspnea severity (Modified Borg and Visual Analog Scales) were evaluated. The dyspnea severity scores were higher and walking distance was shorter in women (p<0.05). The scores of the both scales were correlated with each other in both genders (p<0.05). In men, the dyspnea scores obtained by MBS and VAS scales were significantly correlated with 6-minute walking distance (p=0.001) and total score of CRDQ (p=0.001). On the other hand, the dyspnea severity score of the women obtained by MBS was correlated with only the total score of CRDQ (p<0.05). The results of our study show that gender has an effect on dyspnea perception obtained by MBS and VAS. We suggest that MBS and VAS should be used for men whereas MBS may be more convenient for women in the evaluation of dyspnea in severe COPD. (author)

  16. The five-point Likert scale for dyspnea can properly assess the degree of pulmonary congestion and predict adverse events in heart failure outpatients

    OpenAIRE

    Weber, Cristina K.; Miglioranza, Marcelo H.; Moraes, Maria A.P. de; Sant'anna, Roberto T.; Rover, Marciane M.; Kalil, Renato A.K.; Leiria, Tiago Luiz L.

    2014-01-01

    OBJECTIVES: Proper assessment of dyspnea is important in patients with heart failure. Our aim was to evaluate the use of the 5-point Likert scale for dyspnea to assess the degree of pulmonary congestion and to determine the prognostic value of this scale for predicting adverse events in heart failure outpatients. METHODS: We undertook a prospective study of outpatients with moderate to severe heart failure. The 5-point Likert scale was applied during regular outpatient visits, along with cl...

  17. Psychogenic dyspnea

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    Tushar R Sahasrabudhe

    2013-01-01

    Full Text Available Dyspnea is a very common presenting complaint of a patient. Though commonly due to an organic disease, dyspnea can be a manifestation of underlying anxiety disorder. Three typical patterns of psychogenic dyspnea, viz. panic attack, psychogenic hyperventilation, and compulsive sighing, have been reviewed in this article. The article also comments on the diagnostic features and treatment of these patterns. The overlap with organic causes of dyspnea such as bronchial asthma and Chronic Obstructive Pulmonary Disease (COPD has also been discussed. For literature review, a Medline and Pubmed search was conducted using appropriate keywords. Articles were also identified from the authors′ own knowledge of the literature as well as reference lists in articles retrieved.

  18. Acute dyspnea

    International Nuclear Information System (INIS)

    Shekhter, A.I.

    1991-01-01

    Radiodiagnosis is applied to determine the causes of acute dyspnea. Acute dyspnea is shown to aggravate the course of pulmonary diseases (bronchial asthma, obstructive bronchitis, pulmonary edema, throboembolism of pulmonary arteries etc) and cardiovascular diseases (desiseas of myocardium). The main tasks of radiodiagnosis are to determine volume and state of the lungs, localization and type of pulmonary injuries, to verify heart disease and to reveal concomitant complications

  19. [Child dyspnea].

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    Levieux, Karine; Bihouée, Tiphaine

    2015-05-01

    The management of children dyspnea depends on the severity and symptomatology. The severity assessment requires knowledge of the standards of respiratory rate by age and signs of failure ventilatory mechanics. Recognize the time of dyspnea is important because it guides the diagnosis. Inspiratory dyspnea is most often due to viral laryngitis but an age of less than 6 months or no vaccination against Haemophilus should suggest other urgent diagnostics. Dyspnea with inspiratory and expiratory wheeze is a sign of tracheal damage and needs specialized hospital care. Expiratory dyspnea is the sign of a lower airway affection. A first episode of wheezing during epidemics sign acute bronchiolitis whose support is purely symptomatic with DRP and nutritional splitting. Corticosteroids, bronchodilators and chest physiotherapy are not indicated. Asthma attack is defined as a third episode of wheezing, that requires the administration of salbutamol with an inhalation room, and even oral corticosteroids. Febrile dyspnea must seek auscultatory or radiological abnormalities confirming pneumonia to be treated by a probabilistic and emergency antibiotherapy.

  20. Relationships between respiratory and airway resistances and activity-related dyspnea in patients with chronic obstructive pulmonary disease

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    Plantier L

    2012-03-01

    Full Text Available Bruno Mahut1,2, Aurore Caumont-Prim3,4, Laurent Plantier1,5, Karine Gillet-Juvin1,6, Etienne Callens1, Olivier Sanchez5,6, Brigitte Chevalier-Bidaud3, Plamen Bokov1, Christophe Delclaux1,5,71Assistance Publique – Hôpitaux de Paris (AP-HP, Hôpital Européen Georges Pompidou, Service de Physiologie – Clinique de la Dyspnée, F-75015 Paris, France; 2Cabinet La Berma, 4 avenue de la Providence; F-92160 Antony, France; 3AP-HP, Hôpital Européen Georges Pompidou, Unité d'Épidémiologie et de Recherche Clinique, F-75015 Paris, France; 4INSERM, Centre d'Investigation Épidémiologique 4, F-75015 Paris, France; 5Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, F-75015 Paris, France; 6AP-HP, Hôpital Européen Georges Pompidou, Service de Pneumologie; F-75015 Paris, France; 7CIC 9201 Plurithématique, Hôpital Européen Georges Pompidou, F-75015 Paris, FranceBackground: The aims of the study were: (1 to compare numerical parameters of specific airway resistance (total, sRawtot, effective, sRaweff and at 0.5 L • s-1, sRaw0.5 and indices obtained from the forced oscillation technique (FOT: resistance extrapolated at 0 Hz [Rrs0 Hz], mean resistance [Rrsmean], and resistance/frequency slope [Rrsslope] and (2 to assess their relationships with dyspnea in chronic obstructive pulmonary disease (COPD.Methods: A specific statistical approach, principal component analysis that also allows graphic representation of all correlations between functional parameters was used. A total of 108 patients (mean ± SD age: 65 ± 9 years, 31 women; GOLD stages: I, 14; II, 47; III, 39 and IV, 8 underwent spirometry, body plethysmography, FOT, and Medical Research Council (MRC scale assessments.Results: Principal component analysis determined that the functional parameters were described by three independent dimensions (airway caliber, lung volumes and their combination, specific resistance and that resistance parameters of the two techniques

  1. Defining the minimal important difference for the visual analogue scale assessing dyspnea in patients with malignant pleural effusions.

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    Eleanor K Mishra

    Full Text Available The minimal important difference (MID is essential for interpreting the results of randomised controlled trials (RCTs. Despite a number of RCTs in patients with malignant pleural effusions (MPEs which use the visual analogue scale for dyspnea (VASD as an outcome measure, the MID has not been established.Patients with suspected MPE undergoing a pleural procedure recorded their baseline VASD and their post-procedure VASD (24 hours after the pleural drainage, and in parallel assessed their breathlessness on a 7 point Likert scale.The mean decrease in VASD in patients with a MPE reporting a 'small but just worthwhile decrease' in their dyspnea (i.e. equivalent to the MID was 19mm (95% CI 14-24mm. The mean drainage volume required to produce a change in VASD of 19mm was 760ml.The mean MID for the VASD in patients with a MPE undergoing a pleural procedure is 19mm (95% CI 14-24mm. Thus choosing an improvement of 19mm in the VASD would be justifiable in the design and analysis of future MPE studies.

  2. Evaluation of health-related quality-of-life and dyspnea scales in patients with idiopathic pulmonary fibrosis. Correlation with pulmonary function tests.

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    Tzanakis, Nikolaos; Samiou, Maria; Lambiri, Irini; Antoniou, Katerina; Siafakas, Nikolaos; Bouros, Demosthenes

    2005-04-01

    BACKGROUND: Idiopathic pulmonary fibrosis (IPF) has a profound impact on the functional status of patients. We sought to determine whether the health-related quality of life is affected in patients with IPF. METHODS: A total of 25 patients with IPF (aged 41-72 years) and 30 healthy subjects were evaluated in a cross-sectional study. All subjects were asked to complete three dyspnea scales-the Borg (BORG), the oxygen-cost diagram (OCD) and the modified MRC questionnaire-as well as a number of health-related quality-of-life (HRQoL) questionnaires, i.e., the Saint-George Respiratory Questionnaire (SGRQ), the Quality of Well-Being (QWB) and the Hospital Anxiety and Depression Questionnaire (HAD). Pulmonary function tests, arterial blood gas measurements at rest and during exercise, chest radiographs and the duration of disease were used for correlation. RESULTS: The mean total values of all of the scales used were near the lower best values of each scale in IPF patients and were significantly different from values in the control group. Lung volumes (FVC and TLC) correlated significantly with the SGRQ. All dyspnea scales (BORG, OCD and MRC) showed a significant correlation with diffusing capacity and blood oxygenation at rest and during exercise. The duration of the disease correlated with all dyspnea scales used and with the SGRQ and HAD Questionnaires. CONCLUSIONS: Our results suggest that dyspnea scales and the SGRQ are sensitive tools for assessing health-related quality of life in patients with IPF.

  3. [The evaluation of dyspnea and quality of life in COPD].

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    Demir, Gizem; Akkoca, Oznur; Doğan, Ruşina; Saryal, Sevgi; Karabiyikoğlu, Gülseren

    2003-01-01

    Dyspnea defined as an uncomfortable sensation of breathing is the main cause of disability in chronic obstructive pulmonary disease (COPD) patients. There is evidence that the underlying mechanisms of dyspnea are multifactorial. The aim of this study was to investigate these mechanisms causing dyspnea in COPD patients and the relationship between functional parameters, dyspnea scales and quality of life questionnaire. For this purpose 56 patients (11 female, 45 male) were recruited. Pulmonary function tests including airflow rates, lung volumes, maximal respiratory muscle forces, diffusing capacity, breathing pattern, arterial blood gas analyses as well as dyspnea scales MRC, baseline dyspnea index (BDI) and The Saint George Respiratory Questionnaire (SGRQ) were performed. The overall group showed moderate obstructive disease (FEV1%= 59.02 +/- 3.30) and mild hypoxemia with some air trapping (RV/TLC%= 52.00 +/- 2.00). MRC scale did not show any significant correlation with pulmonary function parameters. There was significant positive correlation between BDI and airflow rates, PImax, DLCO and air trapping. Breathing pattern parameters (Ti/Ttot, VT/Ti) also correlated with BDI. There was positive correlation between PaO2 and BDI (prespiratory muscle strength, changes breathing pattern, hypoxemia, and air trapping which in turn affects quality of life in patients with COPD.

  4. Study of the relationship of dyspnea with depression and functional status in patients with interstitial lung disease

    Directory of Open Access Journals (Sweden)

    Hoda A. Abu Youssef

    2015-01-01

    Conclusion: Dyspnea is common in ILD and is strongly correlated with functional status and psychiatric disorders. Dyspnea score, functional status and psychiatric disorders are more affected in ILD with PHTN than in ILD without PHTN. Accordingly, routine screening for mental disorders is recommended for patients with ILD, and should be accompanied by accurate assessment of patient’s symptoms, particularly in patients with high levels of functional impairment.

  5. Dyspnea during Advanced Cancer

    Science.gov (United States)

    ... when the information is about children. Dyspnea During Advanced Cancer Key Points Many conditions can cause dyspnea. ... Echocardiography : A procedure in which high-energy sound waves ( ultrasound ) are bounced off internal tissues or organs ...

  6. Cigarette Smoking and Dyspnea Perception

    Directory of Open Access Journals (Sweden)

    Scano Giorgio

    2004-03-01

    Full Text Available Abstract Cigarette smoking has been implicated as an important risk factor for the development of respiratory symptoms in adults. The relationship of dyspnea with cigarette smoking has been examined in smokers and ex-smokers and the beneficial effects of smoking cessation have been demonstrated. Recent studies reported that in subjects who smoke cigarettes the risk of developing respiratory symptoms is higher in a dose-dependent way. Environmental tobacco smoke heavily influences the incidence of respiratory symptoms in both adults and in children. Up to the present time, the mechanisms whereby cigarette smoking causes dyspnea perception remain to be defined. Abnormalities in sensory nerves might diminish the perception of bronchoconstriction in smokers. In this regard, it has been postulated that prolonged exposure to cigarette smoke may lead to chronic depletion of sensory nerve neurotransmitters. Eosinophil airway inflammation has been proposed as a determinant of breathlessness via mechanisms affecting either the mechanical pathways that control breathlessness or the afferent nerves involved in perception of dyspnea. An increased number of eosinophils in some smokers implies the possibility that smoking may trigger immunological or other reactions associated with eosinophilia. In conclusion, cigarette smoking is by far one of the greatest risk factors for most respiratory symptoms, including dyspnea. Smoking is associated with the development of symptoms in a dose-dependent way and eosinophilia and airway hyperresponsiveness (AHR increase the risk of developing dyspnea.

  7. Analysis of longitudinal changes in dyspnea of patients with chronic obstructive pulmonary disease: an observational study

    Science.gov (United States)

    2012-01-01

    Background Guidelines recommend that symptoms as well as lung function should be monitored for the management of patients with chronic obstructive pulmonary disease (COPD). However, limited data are available regarding the longitudinal change in dyspnea, and it remains unknown which of relevant measurements might be used for following dyspnea. Methods We previously consecutively recruited 137 male outpatients with moderate to very severe COPD, and followed them every 6 months for 5 years. We then reviewed and reanalyzed the data focusing on the relationships between the change in dyspnea and the changes in other clinical measurements of lung function, exercise tolerance tests and psychological status. Dyspnea with activities of daily living was assessed with the Oxygen Cost Diagram (OCD) and modified Medical Research Council dyspnea scale (mMRC), and two dimensions of disease-specific health status questionnaires of the Chronic Respiratory Disease Questionnaire (CRQ) and the St. George’s Respiratory Questionnaire (SGRQ) were also used. Dyspnea at the end of exercise tolerance tests was measured using the Borg scale. Results The mMRC, CRQ dyspnea and SGRQ activity significantly worsened over time (p dyspnea and SGRQ activity were significantly correlated to changes in forced expiratory volume in one second (FEV1) (correlation of determination (r2) = 0.05-0.19), diffusing capacity for carbon monoxide (r2 = 0.04-0.08) and psychological status evaluated by Hospital Anxiety and Depression Scale (r2 = 0.14-0.17), although these correlations were weak. Peak Borg score decreased rather significantly, but was unrelated to changes in clinical measurements. Conclusion Dyspnea worsened over time in patients with COPD. However, as different dyspnea measurements showed different evaluative characteristics, it is important to follow dyspnea using appropriate measurements. Progressive dyspnea was related not only to progressive airflow limitation, but also to

  8. Diaphragmatic mobility: relationship with lung function, respiratory muscle strength, dyspnea, and physical activity in daily life in patients with COPD.

    Science.gov (United States)

    Rocha, Flávia Roberta; Brüggemann, Ana Karla Vieira; Francisco, Davi de Souza; Medeiros, Caroline Semprebom de; Rosal, Danielle; Paulin, Elaine

    2017-01-01

    To evaluate diaphragmatic mobility in relation to lung function, respiratory muscle strength, dyspnea, and physical activity in daily life (PADL) in patients with COPD. We included 25 patients with COPD, classified according to the Global Initiative for Chronic Obstructive Lung Disease criteria, and 25 healthy individuals. For all of the participants, the following were evaluated: anthropometric variables, spirometric parameters, respiratory muscle strength, diaphragmatic mobility (by X-ray), PADL, and the perception of dyspnea. In the COPD group, diaphragmatic mobility was found to correlate with lung function variables, inspiratory muscle strength, and the perception of dyspnea, whereas it did not correlate with expiratory muscle strength or PADL. In patients with COPD, diaphragmatic mobility seems to be associated with airway obstruction and lung hyperinflation, as well as with ventilatory capacity and the perception of dyspnea, although not with PADL. Avaliar a relação da mobilidade diafragmática com a função pulmonar, força muscular respiratória, dispneia e atividade física de vida diária (AFVD) em pacientes com DPOC. Foram avaliados 25 pacientes com diagnóstico de DPOC, classificados de acordo com critérios da Global Initiative for Chronic Obstructive Lung Disease, e 25 indivíduos saudáveis. Todos foram submetidos às seguintes avaliações: mensuração antropométrica, espirometria, força muscular respiratória, mobilidade diafragmática (por radiografia), AFVD e percepção de dispneia. No grupo DPOC, houve correlações da mobilidade diafragmática com variáveis de função pulmonar, força muscular inspiratória e percepção de dispneia. Não houve correlações da mobilidade diafragmática com força muscular expiratória e AFVD. A mobilidade diafragmática parece estar associada tanto com a obstrução das vias aéreas quanto com a hiperinsuflação pulmonar em pacientes com DPOC, assim como com a capacidade ventilatória e percep

  9. The Trajectory of Dyspnea in Hospitalized Patients

    Science.gov (United States)

    DiNino, Ernest; Stefan, Mihaela S.; Priya, Aruna; Martin, Benjamin; Pekow, Penelope S.; Lindenauer, Peter K.

    2015-01-01

    Context The trajectory of dyspnea for patients hospitalized with acute cardiopulmonary disease, who are not terminally ill, is poorly characterized. Objectives To investigate the natural history of dyspnea during hospitalization, and examine the role that admission diagnosis, and patient factors play in altering symptom resolution. Methods Prospective cohort study of patients hospitalized for an acute cardiopulmonary condition at a large tertiary care center. Dyspnea levels and change in dyspnea score were the main outcomes of interest and were assessed at admission, 24 and 48 hours and at discharge using the verbal 0 - 10 numeric scale. Results Among 295 patients enrolled, the median age was 68 years, and the most common admitting diagnoses were heart failure (32%), chronic obstructive pulmonary disease (COPD) (39%), and pneumonia (13%). The median dyspnea score at admission was 9 (interquartile range [IQR] 7, 10); decreased to 4 (IQR 2, 7) within the first 24 hours; and subsequently plateaued at 48 hours. At discharge, the median score had decreased to 2.75 (IQR 1, 4). Compared to patients with heart failure, patients with COPD had higher median dyspnea score at baseline and admission, and experienced a slower resolution of dyspnea symptoms. After adjusting for patient characteristics, the change in dyspnea score from admission to discharge was not significantly different between patients hospitalized with congestive heart failure, COPD or pneumonia. Conclusion Most patients admitted with acute cardiopulmonary conditions have severe dyspnea on presentation, and their symptoms improve rapidly after admission. The trajectory of dyspnea is associated with the underlying disease process. These findings may help set expectations for the resolution of dyspnea symptoms in hospitalized patients with acute cardiopulmonary diseases. PMID:26620232

  10. Relationship between N-terminal pro-B-type natriuretic peptide plasma levels and renal function evaluated with different formulae in older adult subjects admitted because of dyspnea.

    Science.gov (United States)

    Fabbian, Fabio; De Giorgi, Alfredo; Portaluppi, Francesco; Zuliani, Giovanni

    2012-01-01

    N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels are associated with congestive heart failure severity, and are an important diagnostic tool for assessing patients with acute dyspnea. Reduced renal function increases NT-proBNP concentrations, and therefore it might be a confounding factor in chronic kidney disease (CKD) patients. The aim of the present study was to relate NT-proBNP plasma levels to different stages of renal function assessed with different methods in older adult subjects admitted because of dyspnea. NT-proBNP plasma levels (Roche Diagnostic, Mannheim, Germany) were measured in 134 older adult patients (age: 80 ± 6 years) admitted to hospital because of dyspnea. Anthropometrics, anamnesis, and biochemical data were collected. Glomerular filtration rate (GFR) was evaluated with different equations, the 4 variables MDRD equations (GFR(MDRD186), GFR(MDRD175)), Mayo Clinic Quadratic formula (GFR(MAYO)), and the new CKD-EPI formula (GFR(CKD-EPI)). Patients were classified into the five K/DOQI stages of CKD and median NT-proBNP values were calculated evaluating their relationship with GFR. Median NT-proBNP values were better stratified into the five K/DOQI stages by GFR(MAYO) (stage 1 (n = 10) 1,640 pg/ml vs. stage 2 (n = 61) 2,371 pg/ml vs. stage 3 (n = 42) 3,815 pg/ml vs. stage 4 (n = 18) 6,320 pg/ml vs. stage 5 (n = 3) 7,256 pg/ml, p = 0.017). However, similar results were obtained with the other formulae. NT-proBNP was negatively correlated with GFR as evaluated with all the different formulae (r -0.25 to -0.29; all p formula appears to better stratify NT-proBNP in older adult subjects. Renal function should be considered when interpreting NT-proBNP levels in older adult patients admitted for dyspnoea. Copyright © 2011 S. Karger AG, Basel.

  11. Brain mechanisms of short-term habituation and sensitization toward dyspnea

    Science.gov (United States)

    Stoeckel, M. Cornelia; Esser, Roland W.; Gamer, Matthias; Büchel, Christian; von Leupoldt, Andreas

    2015-01-01

    Dyspnea is a prevalent and threatening cardinal symptom in many diseases including asthma. Whether patients suffering from dyspnea show habituation or sensitization toward repeated experiences of dyspnea is relevant for both quality of life and treatment success. Understanding the mechanisms, including the underlying brain activation patterns, that determine the dynamics of dyspnea perception seems crucial for the improvement of treatment and rehabilitation. Toward this aim, we investigated the interplay between short-term changes of dyspnea perception and changes of related brain activation. Healthy individuals underwent repeated blocks of resistive load induced dyspnea with parallel acquisition of functional magnetic resonance imaging data. Late vs. early ratings on dyspnea intensity and unpleasantness were correlated with late vs. early brain activation for both, dyspnea anticipation and dyspnea perception. Individual trait and state anxiety were determined using questionnaire data. Our results indicate an involvement of the orbitofrontal cortex (OFC), midbrain/periaqueductal gray (PAG) and anterior insular cortex in habituation/sensitization toward dyspnea. Changes in the anterior insular cortex were particularly linked to changes in dyspnea unpleasantness. Changes of both dyspnea intensity and unpleasantness were positively correlated with state and trait anxiety. Our findings are in line with the suggested relationship between the anterior insular cortex and dyspnea unpleasantness. They further support the notion that habituation/sensitization toward dyspnea is influenced by anxiety. Our study extends the known role of the midbrain/PAG in anti-nociception to an additional involvement in habituation/sensitization toward dyspnea and suggests an interplay with the OFC. PMID:26082746

  12. Validação do Modified Pulmonary Functional Status and Dyspnea Questionnaire e da escala do Medical Research Council para o uso em pacientes com doença pulmonar obstrutiva crônica no Brasil Validation of the Modified Pulmonary Functional Status and Dyspnea Questionnaire and the Medical Research Council scale for use in Brazilian patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Demetria Kovelis

    2008-12-01

    Full Text Available OBJETIVO: Verificar a validade e a reprodutibilidade do uso de dois instrumentos subjetivos para avaliar a limitação nas atividades da vida diária (AVD em pacientes com doença pulmonar obstrutiva crônica (DPOC no Brasil: o Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M e a escala do Medical Research Council (MRC. MÉTODOS: Trinta pacientes com DPOC (17 homens; idade, 67 ± 10 anos; volume expiratório forçado no primeiro segundo, 42% ± 13% do predito responderam por duas vezes às versões em português dos dois instrumentos com intervalo de uma semana. O PFSDQ-M contém três componentes: influência da dispnéia nas AVD, influência da fadiga nas AVD, e mudança nas AVD em comparação ao período anterior à doença. A escala do MRC é simples, com apenas cinco itens, dentre os quais o paciente escolhe qual o seu nível de limitação nas AVD devido à dispnéia. O tradicional questionário Saint George's Respiratory Questionnaire (SGRQ, já validado para o uso no Brasil, foi utilizado como critério de validação. RESULTADOS: A confiabilidade em reteste do PFSDQ-M utilizando o coeficiente de correlação intraclasse foi de 0,93, 0,92 e 0,90 para os componentes dispnéia, fadiga e mudança, respectivamente, enquanto que esta foi de 0,83 para a escala do MRC. A análise dos gráficos de Bland e Altman mostrou boa concordância entre a aplicação e a reaplicação do PFSDQ-M. Os componentes do PFSDQ-M e a escala do MRC se correlacionaram significativamente com os domínios e o escore total do SGRQ (0,49 OBJECTIVE: To determine the validity and reproducibility of two subjective instruments to assess limitations in activities of daily living (ADLs in patients with chronic obstructive pulmonary disease (COPD in Brazil: the Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M and the Medical Research Council (MRC scale. METHODS: Thirty patients with COPD (age, 67 ± 10 years

  13. Particle Bed Reactor scaling relationships

    International Nuclear Information System (INIS)

    Slovik, G.; Araj, K.; Horn, F.L.; Ludewig, H.; Benenati, R.

    1987-01-01

    Scaling relationships for Particle Bed Reactors (PBRs) are discussed. The particular applications are short duration systems, i.e., for propulsion or burst power. Particle Bed Reactors can use a wide selection of different moderators and reflectors and be designed for such a wide range of power and bed power densities. Additional design considerations include the effect of varying the number of fuel elements, outlet Mach number in hot gas channel, etc. All of these variables and options result in a wide range of reactor weights and performance. Extremely light weight reactors (approximately 1 kg/MW) are possible with the appropriate choice of moderator/reflector and power density. Such systems are very attractive for propulsion systems where parasitic weight has to be minimized

  14. Impact of adherence to GOLD guidelines on 6-minute walk distance, MRC dyspnea scale score, lung function decline, quality of life, and quality-adjusted life years in a Shanghai suburb.

    Science.gov (United States)

    Jiang, Y Q; Zhu, Y X; Chen, X L; Xu, X; Li, F; Fu, H J; Shen, C Y; Lu, Y Y; Zhuang, Q J; Xu, G; Cai, Y Y; Zhang, Y; Liu, S S; Zhu, M Y; Li, S H

    2015-08-03

    We performed a 1-year cluster-randomized field trial to assess the effect of standardized management of chronic obstructive pulmonary disease (COPD) on lung function and quality of life (QOL) measures in patients in China. We used the Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines and assessed indexes including pulmonary function, QOL, quality-adjusted life years (QALY), Medical Research Council (MRC) dyspnea scale, 6-min walk distance (6-MWD), number of emergency visits, and frequency of hospitalization. Of a total of 711 patients with chronic cough and asthma, 132 were diagnosed as having COPD and 102 participated in this study [intervention group (N = 47); control group (N = 55)]. We found that adherence to GOLD guidelines had a perceivable impact on 6-MWD, MRC dyspnea scale score, and QOL. The average QALY increased by 1.42/person/year in the intervention group, but declined by 0.95/person/year in the control group. We conclude that standardized management improves disease severity, QOL, and QALY in COPD patients when treatment protocols adhere to GOLD guidelines.

  15. Effect of Dyspnea Induced by Breath-holding on Maximal Muscular Strength of Patients with COPD.

    Science.gov (United States)

    Shingai, Kazuya; Kanezaki, Masashi

    2014-02-01

    [Purpose] The purpose of the present study was to clarify the effect of dyspnea induced by breath-holding on maximum muscular strength of patients with COPD. [Subjects] This study recruited 14 COPD subjects via public posting. [Methods] Dyspnea was assessed by the modified Borg scale. The subject asked to stop breathing at end-expiration and to hold their breath with a nose clip for as long as possible. Both total breath-holding time and threshold time of dyspnea were measured with a chronograph. Dyspnea reserve time (DRT) was defined by subtracting the threshold time of perception dyspnea from total breath-holding time in order to calculate the 50% DRT. The muscular strengths of maximal handgrip contraction were measured at baseline, 50% threshold time of dyspnea (subliminal point of dyspnea), and the 50% DRT (supraliminal point of dyspnea). [Results] The maximal handgrip at the supraliminal point of dyspnea was significantly lower than the baseline and subliminal point of dyspnea values. There was no statistically significant difference in maximal muscular strength between baseline and the subliminal point of dyspnea value. [Conclusion] The present results demonstrate that dyspnea induced by breath-holding aggravates weakness in the maximum muscular strength of patients with COPD.

  16. Brain mechanisms of short-term habituation and sensitization towards dyspnea

    Directory of Open Access Journals (Sweden)

    M Cornelia Stoeckel

    2015-06-01

    Full Text Available Dyspnea is a prevalent and threatening cardinal symptom in many diseases including asthma. Whether patients suffering from dyspnea show habituation or sensitization towards repeated experiences of dyspnea is relevant for both quality of life and treatment success. Understanding the mechanisms, including the underlying brain activation patterns, that determine the dynamics of dyspnea perception seems crucial for the improvement of treatment and rehabilitation. Towards this aim, we investigated the interplay between short-term changes of dyspnea perception and changes of related brain activation. Healthy individuals underwent repeated blocks of resistive load induced dyspnea with parallel acquisition of functional magnetic resonance imaging data. Late vs. early ratings on dyspnea intensity and unpleasantness were correlated with late vs. early brain activation for both, dyspnea anticipation and dyspnea perception. Individual trait and state anxiety were determined using questionnaire data. Our results indicate an involvement of the orbitofrontal cortex, midbrain/periaqueductal gray and anterior insular cortex in habituation/sensitization towards dyspnea. Changes in the anterior insular cortex were particularly linked to changes in dyspnea unpleasantness. Changes of both dyspnea intensity and unpleasantness were positively correlated with state and trait anxiety. Our findings are in line with the suggested relationship between the anterior insular cortex and dyspnea unpleasantness. They further support the notion that habituation/sensitization towards dyspnea is influenced by anxiety. Our study extends the known role of the midbrain/periaqueductal gray in anti-nociception to an additional involvement in habituation/sensitization towards dyspnea and suggests an interplay with the orbitofrontal cortex.

  17. [Acute respiratory dyspnea in children].

    Science.gov (United States)

    Casimir, G; Hanssens, L; Mulier, S

    2009-09-01

    Acute respiratory dyspnea is very frequent in children and must be quickly treated to obtain the best prognosis. The diagnosis depends from the natural history of the disease and from the quality of clinical assessment. The use of an algorithm according to the presence of stridor or bronchospasm is very contributive to the diagnosis. The paper reviews the pathophysiology of dyspnea in children and the more common diseases that are causing respiratory distress. Finally, treatment of respiratory failure and management of specific diseases are defined.

  18. Prevalence and Predictive Value of Dyspnea Ratings in Hospitalized Patients: Pilot Studies

    Science.gov (United States)

    Stevens, Jennifer P.

    2016-01-01

    Background Dyspnea (breathing discomfort) can be as powerfully aversive as pain, yet is not routinely assessed and documented in the clinical environment. Routine identification and documentation of dyspnea is the first step to improved symptom management and it may also identify patients at risk of negative clinical outcomes. Objective To estimate the prevalence of dyspnea and of dyspnea-associated risk among hospitalized patients. Design Two pilot prospective cohort studies. Setting Single academic medical center. Patients Consecutive patients admitted to four inpatient units: cardiology, hematology/oncology, medicine, and bariatric surgery. Measurements In Study 1, nurses documented current and recent patient-reported dyspnea at the time of the Initial Patient Assessment in 581 inpatients. In Study 2, nurses documented current dyspnea at least once every nursing shift in 367 patients. We describe the prevalence of burdensome dyspnea, and compare it to pain. We also compared dyspnea ratings with a composite of adverse outcomes: 1) receipt of care from the hospital’s rapid response system, 2) transfer to the intensive care unit, or 3) death in hospital. We defined burdensome dyspnea as a rating of 4 or more on a 10-point scale. Results Prevalence of burdensome current dyspnea upon admission (Study 1) was 13% (77 of 581, 95% CI 11%-16%). Prevalence of burdensome dyspnea at some time during the hospitalization (Study 2) was 16% (57 of 367, 95% CI 12%-20%). Dyspnea was associated with higher odds of a negative outcome. Conclusions In two pilot studies, we identified a significant symptom burden of dyspnea in hospitalized patients. Patients reporting dyspnea may benefit from a more careful focus on symptom management and may represent a population at greater risk for negative outcomes. PMID:27070144

  19. Hospitalist Attitudes towards the Assessment and Management of Dyspnea in Patients with Acute Cardiopulmonary Diseases

    Science.gov (United States)

    Stefan, Mihaela S.; Au, David; Mularski, Richard; Krishnan, Jerry; Naureckas, Eduard T.; Carson, Shannon; Godwin, Patrick; Priya, Aruna; Pekow, Penelope; Lindenauer, Peter K.

    2015-01-01

    Background Dyspnea is a common symptom in patients hospitalized with acute cardiopulmonary diseases. Routine assessment of dyspnea severity is recommended by clinical guidelines based on the evidence that patients are not treated consistently for dyspnea relief. Objective To evaluate attitudes and beliefs of hospitalists regarding the assessment and management of dyspnea. Design Cross-sectional survey Settings Nine hospitals in the United States. Measurements Survey questions assessed the following domains regarding dyspnea: importance in clinical care; potential benefits and challenges of implementing a standardized assessment; current approaches to assessment and how awareness of severity affects management. A five-point Likert scale was used to assess the respondent’s level of agreement; strongly agree and agree were combined into a single category. Results Of the 255 hospitalists invited to participate, 69.8% completed the survey; 77.0% agreed that dyspnea relief is an important goal when treating patients with cardiopulmonary conditions. Approximately 90% of respondents stated that awareness of dyspnea severity influences their decision to intensify treatment, to pursue additional diagnostic testing and the timing of discharge. 61.0% agreed that standardized assessment of dyspnea should be part of the vital signs and 64.6% that awareness of dyspnea severity influences their decision to prescribe opioids. Hospitalists who appreciated the importance of dyspnea in clinical practice were more likely to support the implementation of a standardized scale. Conclusions Most hospitalists believe that routine assessment of dyspnea severity would enhance their clinical decision-making and patient care. Measurement and documentation of dyspnea severity may represent an opportunity to improve dyspnea management. PMID:26199095

  20. An adipose woman with progressive dyspnea

    International Nuclear Information System (INIS)

    D'haene, E.G.M.; Fintelman, H.; Ditmars, M.J. van; Gruyl, J. de; Jacobs, A.S.M.

    1985-01-01

    A cardio-nuclear examination was done on an adipose woman with progressive dyspnea. The dyspnea was caused by an intrapulmonary process. After examination of the operation-preperate the process appeared to be a thymuscyst. (Auth.)

  1. Dyspnea-Related Cues Engage the Prefrontal Cortex

    Science.gov (United States)

    Herigstad, Mari; Hayen, Anja; Evans, Eleanor; Hardinge, Frances M.; Davies, Robert J.; Wiech, Katja

    2015-01-01

    BACKGROUND: Dyspnea is the major source of disability in COPD. In COPD, environmental cues (eg, the prospect of having to climb stairs) become associated with dyspnea and may trigger dyspnea even before physical activity commences. We hypothesized that brain activation relating to such cues would be different between patients with COPD and healthy control subjects, reflecting greater engagement of emotional mechanisms in patients. METHODS: Using functional MRI (FMRI), we investigated brain responses to dyspnea-related word cues in 41 patients with COPD and 40 healthy age-matched control subjects. We combined these findings with scores on self-report questionnaires, thus linking the FMRI task with clinically relevant measures. This approach was adapted from studies in pain that enabled identification of brain networks responsible for pain processing despite absence of a physical challenge. RESULTS: Patients with COPD demonstrated activation in the medial prefrontal cortex and anterior cingulate cortex, which correlated with the visual analog scale (VAS) response to word cues. This activity independently correlated with patient responses on questionnaires of depression, fatigue, and dyspnea vigilance. Activation in the anterior insula, lateral prefrontal cortex, and precuneus correlated with the VAS dyspnea scale but not with the questionnaires. CONCLUSIONS: The findings suggest that engagement of the emotional circuitry of the brain is important for interpretation of dyspnea-related cues in COPD and is influenced by depression, fatigue, and vigilance. A heightened response to salient cues is associated with increased symptom perception in chronic pain and asthma, and the findings suggest that such mechanisms may be relevant in COPD. PMID:26134891

  2. Routine Dyspnea Assessment on Unit Admission

    OpenAIRE

    Baker, Kathy; Barsamian, Jennifer; Leone, Danielle; Donovan, Barbara C.; Williams, Donna; Carnevale, Kerry; Lansing, Robert; Banzett, Robert

    2013-01-01

    Dyspnea assessment is valuable in diagnosis, prognosis, symptom management, and targeted intervention, and in the allotment and management of patient care resources. The assessment of dyspnea, like that of pain, depends on patient self-report. Expert consensus panels have called for dyspnea to be measured quantitatively and documented on a routine basis, as is the practice with pain. But little information is available on how to measure and record dyspnea ratings systematically. Consequently,...

  3. Brain Responses during the Anticipation of Dyspnea

    Science.gov (United States)

    Stoeckel, M. Cornelia; Esser, Roland W.; Büchel, Christian

    2016-01-01

    Dyspnea is common in many cardiorespiratory diseases. Already the anticipation of this aversive symptom elicits fear in many patients resulting in unfavorable health behaviors such as activity avoidance and sedentary lifestyle. This study investigated brain mechanisms underlying these anticipatory processes. We induced dyspnea using resistive-load breathing in healthy subjects during functional magnetic resonance imaging. Blocks of severe and mild dyspnea alternated, each preceded by anticipation periods. Severe dyspnea activated a network of sensorimotor, cerebellar, and limbic areas. The left insular, parietal opercular, and cerebellar cortices showed increased activation already during dyspnea anticipation. Left insular and parietal opercular cortex showed increased connectivity with right insular and anterior cingulate cortex when severe dyspnea was anticipated, while the cerebellum showed increased connectivity with the amygdala. Notably, insular activation during dyspnea perception was positively correlated with midbrain activation during anticipation. Moreover, anticipatory fear was positively correlated with anticipatory activation in right insular and anterior cingulate cortex. The results demonstrate that dyspnea anticipation activates brain areas involved in dyspnea perception. The involvement of emotion-related areas such as insula, anterior cingulate cortex, and amygdala during dyspnea anticipation most likely reflects anticipatory fear and might underlie the development of unfavorable health behaviors in patients suffering from dyspnea. PMID:27648309

  4. Development of the Dyadic Relationship Scale

    Science.gov (United States)

    Haskan Avci, Özlem

    2014-01-01

    Problem Statement: The rise of premarital studies raises questions about the effectiveness of educational programs developed to prepare young couples for marriage and family life. Purpose of Study: The purpose of this study is to describe and introduce the Dyadic Relationship Scale (DRS) for use with university students. The author developed the…

  5. Prognostic Importance of Dyspnea for Cardiovascular Outcomes and Mortality in Persons without Prevalent Cardiopulmonary Disease: The Atherosclerosis Risk in Communities Study

    Science.gov (United States)

    Santos, Mario; Kitzman, Dalane W.; Matsushita, Kunihiro; Loehr, Laura; Sueta, Carla A.; Shah, Amil M.

    2016-01-01

    Background The relationship between dyspnea and incident heart failure (HF) and myocardial infarction (MI) among patients without previously diagnosed cardiopulmonary disease is unclear. We studied the prognostic relevance of self-reported dyspnea for cardiovascular outcomes and all-cause mortality in persons without previously diagnosed cardiopulmonary disease. Methods and Results We studied 10 881 community-dwelling participants (mean age 57±6, 56% women, 25% black) who were free of prevalent cardiopulmonary disease from Atherosclerosis Risk in Communities Study. Dyspnea status at study entry using the modified Medical Research Council (mMRC) scale. The primary outcomes were time to HF, MI or all-cause death. Dyspnea prevalence was 22%, and was mild (mMRC grade 1 or 2) in 21% and moderate-to-severe (mMRC 3 or 4) in 1%. The main correlates of dyspnea were older age, female sex, higher BMI and active smoking. Over a follow-up of 19±5 years, greater self-reported dyspnea severity was associated with worse prognosis. Mild dyspnea was associated with significantly heightened risk of HF (adjusted Hazard Ratio, HR,1.30; 95% CI: 1.16–1.46), MI (adjusted HR 1.34; 95%CI: 1.20–1.50), and death (adjusted HR 1.16; 95%CI: 1.06–1.26), with moderate/severe dyspnea associated with an even greater risk (adjusted HR 2.14, 95%CI: 1.59–2.89; 1.93, 95%CI: 1.41–2.56; 1.96, 95%CI: 1.55–2.48, respectively). Conclusion In community-dwelling persons free of previously diagnosed cardiopulmonary disease, self-reported dyspnea is common and, even when of mild intensity, it is independently associated with a greater risk of incident HF, MI, and death. Our data emphasize the prognostic importance of even mild self-reported dyspnea for cardiovascular outcomes. PMID:27780208

  6. Brain Activation during Perception and Anticipation of Dyspnea in Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Esser, Roland W.; Stoeckel, Maria C.; Kirsten, Anne; Watz, Henrik; Taube, Karin; Lehmann, Kirsten; Magnussen, Helgo; Büchel, Christian; von Leupoldt, Andreas

    2017-01-01

    Background: Dyspnea is the impairing cardinal symptom in COPD, but the underlying brain mechanisms and their relationships to clinical patient characteristics are widely unknown. This study compared neural responses to the perception and anticipation of dyspnea between patients with stable moderate-to-severe COPD and healthy controls. Moreover, associations between COPD-specific brain activation and clinical patient characteristics were examined. Methods: During functional magnetic resonance imaging, dyspnea was induced in patients with stable moderate-to-severe COPD (n = 17) and healthy control subjects (n = 21) by resistive-loaded breathing. Blocks of severe and mild dyspnea were alternating, with each block being preceded by visually cued anticipation phases. Results: During the perception of increased dyspnea, both patients and controls showed comparable brain activation in common dyspnea-relevant sensorimotor and cortico-limbic brain regions. During the anticipation of increased dyspnea, patients showed higher activation in hippocampus and amygdala than controls which was significantly correlated with reduced exercise capacity, reduced health-related quality of life, and higher levels of dyspnea and anxiety. Conclusions: This study suggests that patients with stable moderate-to-severe COPD show higher activation in emotion-related brain areas than healthy controls during the anticipation, but not during the actual perception of experimentally induced dyspnea. These brain activations were related to important clinical characteristics and might contribute to an unfavorable course of the disease via maladaptive psychological and behavioral mechanisms. PMID:28878693

  7. Patient-Reported Dyspnea in COPD Reliability and Association With Stage of Disease

    Science.gov (United States)

    Ward, Joseph; Waterman, Laurie A.; McCusker, Corliss; ZuWallack, Richard; Baird, John C.

    2009-01-01

    Background: Although questionnaires are used frequently with patients to self-report the severity of dyspnea as related to activities of daily living, the reliability of these instruments has not been established. The two purposes of this study were to examine the test-retest reliability of three widely used dyspnea instruments and to compare dyspnea scores at different stages of disease. Methods: At paired baseline visits, 101 stable patients with COPD were tested; at paired follow-up visits at 3 months, 89 of these patients were tested. At each visit, patients rated dyspnea with three instruments presented in random order and then performed post-bronchodilator therapy lung function tests. Results: Patient-reported dyspnea scores and lung function were similar at baseline (interval, 6 ± 5 days) and follow-up visits (interval, 4 ± 2 days). Intraclass correlation coefficients at baseline and at follow-up were 0.82 and 0.82, respectively, for the modified Medical Research Council scale; 0.90 and 0.84, respectively, for the self-administered computerized versions of the baseline dyspnea index and transition dyspnea indexes; and 0.95 and 0.89 for the University of San Diego Shortness of Breath Questionnaire results. Dyspnea ratings were significantly related to the stage of disease severity based on percent predicted FEV1 (p the 3-month follow-up. Our results demonstrate for the first time that patient-reported dyspnea ratings are related to the stage of disease severity. PMID:19696126

  8. Scale Construction: Motivation and Relationship Scale in Education

    Directory of Open Access Journals (Sweden)

    Yunus Emre Demir

    2016-01-01

    Full Text Available The aim of this study is to analyze the validity and reliability of the Turkish version of Motivation and Relationship Scale (MRS, (Raufelder , Drury , Jagenow , Hoferichter & Bukowski , 2013.Participants were 526 students of secondary school. The results of confirmatory factor analysis described that the 21 items loaded three factor and the three-dimensional model was well fit (x2= 640.04, sd= 185, RMSEA= .068, NNFI= .90, CFI = .91, IFI=.91,SRMR=079, GFI= .90,AGFI=.87. Overall findings demonstrated that this scale is a valid and indicates that the adapted MRS is a valid instrument for measuring secondary school children’s motivation in Turkey.

  9. [Dyspnea in the terminal stage].

    Science.gov (United States)

    Binsack, T

    2001-10-01

    From all symptoms in palliative medicine those concerning respiration are most excruciating and most difficult to treat. No other symptom is more dependent on psychosocial circumstances and on the atmosphere around the patient. Therefore the relief of respiratory problems is as important as the therapy of pain. A consequent therapy comprises besides drug therapy (adrenocortical steroids, brochodilators, opioids, sedatives and sometimes antibiotics) also physiotherapy and in special cases oncological treatment and radiotherapy. A team present twenty-four hours a day, the training of relatives and friends, the frank dealing with the patient's anxiety of suffocation are the basis of all therapeutic measures. Dyspnea often is the reason for a longer stay in a palliative care unit.

  10. Determinants of dyspnea in chronic heart failure

    NARCIS (Netherlands)

    Kupper, N.; Bonhof, C.S.; Westerhuis, Bert; Widdershoven, J.W.M.G.; Denollet, J.

    2016-01-01

    Background Dyspnea is a hallmark symptom of heart failure (HF), associated with impaired functional capacity and quality of life. The experience of dyspnea is multifactorial and may originate from different sources. This study set out to examine the relative importance of potential contributors to

  11. Dyspnea in Chronic Fatigue Syndrome (CFS): Comparison of Two Prospective Cross-Sectional Studies

    Science.gov (United States)

    Ravindran, Murugan K.; Adewuyi, Oluwatoyin; Zheng, Yin; Rayhan, Rakib U.; Le, Uyenphuong; Timbol, Christian R.; Merck, Samantha; Esteitie, Rania; Cooney, Michelle; Read, Charles; Baraniuk, James N.

    2013-01-01

    Chronic Fatigue Syndrome (CFS) subjects have many systemic complaints including shortness of breath. Dyspnea was compared in two CFS and control cohorts to characterize pathophysiology. Cohort 1 of 257 CFS and 456 control subjects were compared using the Medical Research Council chronic Dyspnea Scale (MRC Score; range 0-5). Cohort 2 of 106 CFS and 90 controls answered a Dyspnea Severity Score (range 0-20) adapted from the MRC Score. Subsets of both cohorts completed CFS Severity Scores, fatigue, and other questionnaires. A subset had pulmonary function and total lung capacity measurements. Results show MRC Scores were equivalent between sexes in Cohort 1 CFS (1.92 [1.72-2.16]; mean [95% C.I.]) and controls (0.31 [0.23-0.39]; pdyspnea. In Cohort 2, Dyspnea Score threshold of 4 indicated shortness of breath in 67% of CFS and 23% of controls. Cohort 2 Dyspnea Scores were higher for CFS (7.80 [6.60-9.00]) than controls (2.40 [1.60-3.20]; pDyspnea with rapid heart rate, chest pain and dizziness. In conclusion, sensory hypersensitivity without airflow limitation contributed to dyspnea in CFS. Correlates of dyspnea in controls were distinct from CFS suggesting different mechanisms. PMID:23445698

  12. Assessment of dyspnea in terminally III cancer patients. Role of the thoracic surgeon as a palliative care physician

    International Nuclear Information System (INIS)

    Yoshino, Kazuo; Nishiumi, Noboru; Masuda, Ryota; Iwazaki, Masayuki; Saito, Yuki; Tokuda, Yutaka

    2011-01-01

    Many cancer patients suffer from rapidly-progressing dyspnea that is difficult to relieve. The subjects were 26 patients who had dyspnea that was difficult to relieve. The Numeric Rating Scale was used to evaluate their dyspnea. For all patients, the cause of the dyspnea was investigated by CT and x-rays. The principal causes of the dyspnea were pleural effusion that increased daily, complications from pneumonia, massive ascites, multiple metastatic lung tumors and atelectasis, recurrent laryngeal nerve paralysis and narrowing secondary airway compression. Dyspnea was caused by a variety of conditions that overlapped over time, intensifying patients' discomfort. Among 14 patients for whom we recommended treatment with sedation, only 8 of them consented. Among the patients who were treated with sedation, the median interval between the exacerbation of dyspnea and death was 16 days; among non-sedated patients it was 18 days. Palliative care physicians who specialize in the respiratory system can, to some extent, predict the occurrence of rapidly progressive dyspnea in cancer patients. It is important to explain the methods of relieving dyspnea to the patient, the patient's family, and the oncologist early, so that decisions on how to manage dyspnea can be made in advance. (author)

  13. Mechanisms of dyspnea in healthy subjects

    Directory of Open Access Journals (Sweden)

    Gigliotti Francesco

    2010-06-01

    Full Text Available Abstract Dyspnea is a general term used to characterize a range of different descriptors; it varies in intensity, and is influenced by a wide variety of factors such as cultural expectations and the patient's experiences. Healthy subjects can experience dyspnea in different situations, e.g. at high altitude, after breath-holding, during stressful situations that cause anxiety or panic, and more commonly during strenuous exercise. Discussing the mechanisms of dyspnea we need to briefly take into account the physiological mechanisms underlying the sensation of dyspnea: the functional status of the respiratory muscles, the role of chemoreceptors and mechanoreceptors, and how the sense of respiratory motor output reaches a level of conscious awareness. We also need to take into account theories on the pathophysiological mechanisms of the sensation of dyspnea and the possibility that each pathophysiological mechanism produces a distinct quality of breathing discomfort. The terms used by subjects to identify different characteristics of breathing discomfort - dyspnea descriptors - may contribute to understanding the mechanisms of dyspnea and providing the rationale for a specific diagnosis.

  14. Effect of Dyspnea Induced by Breath-holding on Maximal Muscular Strength of Patients with COPD

    OpenAIRE

    Shingai, Kazuya; Kanezaki, Masashi

    2014-01-01

    [Purpose] The purpose of the present study was to clarify the effect of dyspnea induced by breath-holding on maximum muscular strength of patients with COPD. [Subjects] This study recruited 14 COPD subjects via public posting. [Methods] Dyspnea was assessed by the modified Borg scale. The subject asked to stop breathing at end-expiration and to hold their breath with a nose clip for as long as possible. Both total breath-holding time and threshold time of dyspnea were measured with a chronogr...

  15. Development of the Gay and Lesbian Relationship Satisfaction Scale.

    Science.gov (United States)

    Belous, Christopher K; Wampler, Richard S

    2016-07-01

    This article describes the development and evaluation of the Gay and Lesbian Relationship Satisfaction Scale (GLRSS) as a measure of individuals' gay and lesbian same-gender relationship satisfaction and social support. Clinicians and researchers administer relationship satisfaction scales to persons in gay and lesbian relationships with a heteronormative assumption that scales developed and validated with opposite-gender couples measure identical relationship issues. Gay and Lesbian couples have unique concerns that influence relationship satisfaction, most notably social support. Using online recruitment and data collection, the GLRSS was evaluated with data from 275 gay and lesbian individuals in a same-gender relationship. © 2016 American Association for Marriage and Family Therapy.

  16. Dyspnea as an Independent Predictor of Mortality

    Science.gov (United States)

    Pesola, Gene R.; Ahsan, Habibul

    2014-01-01

    Background Dyspnea is a common and easily elicited presenting complaint in patients seen by physicians who evaluate and take care of chronic respiratory disorders. Although dyspnea is subjective and tends to increase with age or reduced lung function, it appears to be reproducible as a symptom and often signifies serious underlying disease. Methods Systematic review of longitudinal studies with dyspnea as the exposure and mortality as the outcome; age, smoking, and lung function had to be controlled for to be included in the review. In addition, a minimum sample size at baseline of 500 subjects was required for each study. Results From over 3,000 potential references ten longitudinal studies met all criteria and were included. All ten studies suggested that dyspnea was an independent predictor of mortality with point estimates by odds ratio, rate ratio, or hazard ratios ranging from 1.3 up to 2.9-fold greater than baseline. All ten studies had actual or implied 95% confidence interval bands greater than the null value of one. Conclusion Dyspnea, a symptom, predicts mortality and is a proxy for underlying diseases, most often of heart and lung. Therefore, chronic dyspnea needs to be evaluated as to etiology to allow for treatment to minimize morbidity and mortality when possible. PMID:25070878

  17. Effects of inspiratory muscle training on respiratory muscle electromyography and dyspnea during exercise in healthy men.

    Science.gov (United States)

    Ramsook, Andrew H; Molgat-Seon, Yannick; Schaeffer, Michele R; Wilkie, Sabrina S; Camp, Pat G; Reid, W Darlene; Romer, Lee M; Guenette, Jordan A

    2017-05-01

    Inspiratory muscle training (IMT) has consistently been shown to reduce exertional dyspnea in health and disease; however, the physiological mechanisms remain poorly understood. A growing body of literature suggests that dyspnea intensity can be explained largely by an awareness of increased neural respiratory drive, as measured indirectly using diaphragmatic electromyography (EMGdi). Accordingly, we sought to determine whether improvements in dyspnea following IMT can be explained by decreases in inspiratory muscle electromyography (EMG) activity. Twenty-five young, healthy, recreationally active men completed a detailed familiarization visit followed by two maximal incremental cycle exercise tests separated by 5 wk of randomly assigned pressure threshold IMT or sham control (SC) training. The IMT group ( n = 12) performed 30 inspiratory efforts twice daily against a 30-repetition maximum intensity. The SC group ( n = 13) performed a daily bout of 60 inspiratory efforts against 10% maximal inspiratory pressure (MIP), with no weekly adjustments. Dyspnea intensity was measured throughout exercise using the modified 0-10 Borg scale. Sternocleidomastoid and scalene EMG was measured using surface electrodes, whereas EMGdi was measured using a multipair esophageal electrode catheter. IMT significantly improved MIP (pre: -138 ± 45 vs. post: -160 ± 43 cmH 2 O, P muscle EMG during exercise in either group. Improvements in dyspnea intensity ratings following IMT in healthy humans cannot be explained by changes in the electrical activity of the inspiratory muscles. NEW & NOTEWORTHY Exertional dyspnea intensity is thought to reflect an increased awareness of neural respiratory drive, which is measured indirectly using diaphragmatic electromyography (EMGdi). We examined the effects of inspiratory muscle training (IMT) on dyspnea, EMGdi, and EMG of accessory inspiratory muscles. IMT significantly reduced submaximal dyspnea intensity ratings but did not change EMG of any

  18. Predictors of dyspnea prevalence: Results from the BOLD study

    Science.gov (United States)

    Grønseth, Rune; Vollmer, William M.; Hardie, Jon A.; Ólafsdóttir, Inga Sif; Lamprecht, Bernd; Buist, A. Sonia; Gnatiuc, Louisa; Gulsvik, Amund; Johannessen, Ane; Enright, Paul

    2014-01-01

    Dyspnea is a cardinal symptom for cardiorespiratory diseases. No study has assessed worldwide variation in dyspnea prevalence or predictors of dyspnea. We used cross-sectional data from population-based samples in 15 countries of the BOLD study to estimate prevalence of dyspnea in the full sample as well as in an a priori defined low-risk group (few risk factors or dyspnea-associated diseases). Dyspnea was defined by the modified Medical Research Council questions. We used ordered logistic regression analysis to study the association of dyspnea with site, sex, age, education, smoking habits, low/high BMI, self-reported disease, and spirometry results. Of the 9,484 participants, 27% reported any dyspnea. In the low-risk subsample (N=4,329), 16% reported some dyspnea. In multivariate analyses, all covariates were correlated to dyspnea, but only 13% of dyspnea variation was explained. Women reported more dyspnea than men (odds ratio ≈ 2.1). When forced vital capacity (FVC) fell below 60% of predicted, dyspnea was much more likely. There was considerable geographical variation in dyspnea, even when we adjusted for known risk factors and spirometry results. We were only able to explain 13% of dyspnea variation. PMID:24176991

  19. Role of biomarkers in patients with dyspnea.

    Science.gov (United States)

    Gori, C S; Magrini, L; Travaglino, F; Di Somma, S

    2011-02-01

    The use of biomarkers has been demonstrated useful in many acute diseases both for diagnosis, prognosis and risk stratification. The purpose of this review is to analyze several biomarkers of potential use in patients referring to Emergency Department with acute dyspnea. The role of natriuretic peptides has a proven utility in the diagnosis, risk stratification, patient management and prediction of outcome in acute and chronic heart failure (HF). New immunoassays are available for the detection of mid-region prohormones in patients with acute dyspnea such as Mid-region pro-adrenomedullin (MR-proADM) and Mid-region pro-atrial natriuretic peptide (MR-proANP). Also procalcitonin, copeptin and D-dimer, which are markers of inflammation, bacterial infections and sepsis, seem to be useful in the differential diagnosis of dyspnea. Conventional and high-sensitivity troponins are fundamental, not only in the diagnosis of acute coronary syndromes, but also as indicators of mortality in patients with acute decompensated heart failure. Further studies with randomized controlled clinical trials will be needed to prove the theoretical clinical advantages offered by a shortness of breath biomarkers in terms of diagnostic, prognostic, cost effective work-up and management of patients with acute dyspnea. A multimarker pannel approach performed by rapid and accurate assays could be useful for emergency physicians to promptly identify different causes of dyspnea thus managing to improve diagnosis, treatment and risk stratification.

  20. Invariant relationships deriving from classical scaling transformations

    International Nuclear Information System (INIS)

    Bludman, Sidney; Kennedy, Dallas C.

    2011-01-01

    Because scaling symmetries of the Euler-Lagrange equations are generally not variational symmetries of the action, they do not lead to conservation laws. Instead, an extension of Noether's theorem reduces the equations of motion to evolutionary laws that prove useful, even if the transformations are not symmetries of the equations of motion. In the case of scaling, symmetry leads to a scaling evolutionary law, a first-order equation in terms of scale invariants, linearly relating kinematic and dynamic degrees of freedom. This scaling evolutionary law appears in dynamical and in static systems. Applied to dynamical central-force systems, the scaling evolutionary equation leads to generalized virial laws, which linearly connect the kinetic and potential energies. Applied to barotropic hydrostatic spheres, the scaling evolutionary equation linearly connects the gravitational and internal energy densities. This implies well-known properties of polytropes, describing degenerate stars and chemically homogeneous nondegenerate stellar cores.

  1. Extra-pulmonary features in COPD patients entering rehabilitation after stratification for MRC dyspnea grade.

    Science.gov (United States)

    Spruit, Martijn A; Pennings, Herman-Jan; Janssen, Paul P; Does, Joan D; Scroyen, Sigrid; Akkermans, Marco A; Mostert, Rob; Wouters, Emiel F M

    2007-12-01

    Experts have stated that referral for rehabilitation of patients with chronic obstructive pulmonary disease (COPD) becomes appropriate when these patients become aware of their disability (e.g. usually grade 3 to 5 on the Medical Research Council (MRC) dyspnea scale). However, patients with MRC dyspnea grade 1/2 may also suffer from extra-pulmonary features, such as abnormal body composition, exercise intolerance and reduced disease-specific health status. In the present study, we have studied whether and to what extent chronic obstructive pulmonary disease (COPD) patients with MRC dyspnea grade 1/2 have extra-pulmonary features compared to patients with grade 3, 4 or 5? Pulmonary function, body composition, 6-min walking distance, peak exercise capacity, anxiety, depression and disease-specific health status have been assessed in 333 outpatients who had been referred for pulmonary rehabilitation. On average, patients with MRC dyspnea grade 1/2 had a better exercise tolerance and disease-specific health status compared to patients with grade 4 or 5. Nevertheless, grade 1/2 patients had a higher prevalence of muscle mass depletion. In addition, these patients did still have aberrant values in one or more of the aforementioned outcomes. On average, patients with MRC dyspnea grade 1/2 may clearly suffer from extra-pulmonary features, indicating the necessity to refer these patients for rehabilitation. Therefore, MRC dyspnea scale alone does not appear to be a suitable measure to identify most patients with COPD who have to be referred for rehabilitation.

  2. Predicting Dyspnea Inducers by Molecular Topology

    Directory of Open Access Journals (Sweden)

    María Gálvez-Llompart

    2013-01-01

    Full Text Available QSAR based on molecular topology (MT is an excellent methodology used in predicting physicochemical and biological properties of compounds. This approach is applied here for the development of a mathematical model capable to recognize drugs showing dyspnea as a side effect. Using linear discriminant analysis, it was found a four-variable regression equations enabling a predictive rate of about 81% and 73% in the training and test sets of compounds, respectively. These results demonstrate that QSAR-MT is an efficient tool to predict the appearance of dyspnea associated with drug consumption.

  3. Perception of dyspnea in childhood asthma crisis by the patients and those in charge of them.

    Science.gov (United States)

    Parente, Ana Alice Amaral Ibiapina; March, Maria Fátima Pombo; Evangelista, Lucia Araujo; Cunha, Antonio Ledo

    2011-01-01

    To evaluate the correlation between perception of dyspnea during a mild to moderate asthma attack using the Modified Borg Scale (MBS) and peak expiratory flow rate (PEFR). This was a cross-sectional study conducted with children and adolescents who sought a pediatric emergency service due to an asthma attack. Data were collected from July 2005 to June 2006. Demographic data were recorded. Patients and those in charge of them were requested to grade, individually, the patient's dyspnea using the MBS; afterwards, the peak expiratory flow rate was measured. 181 asthmatic patients were evaluated, with a mean age of 7.2 (± 2.4) years (range, 4-12). The mother sought medical aid in 83.4% of the cases (151/181). Patient symptoms included coughing in 68.5% (124/181), dyspnea in 47.0% (85/181), and wheezing in 12.7% (23/181). Thirty-six percent (65/181) had a mild attack, and 64.1% (116/181) a moderate one. A significant negative correlation was found between the patients' and accompanying adults' perceptions of patient's dyspnea and the PEFR (% predicted; rs = -0.240 and rs = -0.385, respectively). Both the patients and those looking after them had a poor perception of the severity of the patient's dyspnea. This emphasizes the need to monitor objective measures such as the PEFR and to develop better ways of evaluating dyspnea.

  4. Postprandial dyspnea and malnutrition in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Gray-Donald, K; Carrey, Z; Martin, J G

    1998-06-01

    To compare ventilatory response, oxygen uptake and sense of dyspnea of underweight versus normal-weight patients with chronic obstructive pulmonary disease (COPD) after a standard meal, in order to investigate whether an increase in dyspnea due to diet-induced thermogenesis might lead to altered eating habits. Weight loss in patients with COPD leads to adverse health effects, but the reasons for this loss are not well understood. Prospective study. A total of 18 patients (14 men, 4 women) aged 46 to 83 with severe, stable COPD. Minute ventilation (VE), tidal volume (VT), frequency of breathing, oxygen uptake (VO2), carbon dioxide excretion (VCO2) and sense of dyspnea (using the Borg scale) were measured 15 minutes before a 2.5-MJ (600-kcal) balanced liquid meal and at four 15-minute intervals after the meal. Increases in VE, VT, VO2 and VCO2 were observed for all subjects. Corrected for body surface area, the maximum postprandial changes in these indicators did not differ between the underweight and the normal-weight subjects with COPD. Work of breathing (measured in 11 subjects) did not differ between the 2 groups, nor did the number of subjects reporting increased dyspnea. Since the increases in VE, VO2, VCO2 and perceived dyspnea did not differ between the normal-weight and underweight patients, this indicates that dyspnea at mealtimes is not likely to lead to decreased food intake.

  5. Trajectory of Dyspnea and Respiratory Distress among Patients in the Last Month of Life.

    Science.gov (United States)

    Campbell, Margaret L; Kiernan, Jason M; Strandmark, John; Yarandi, Hossein N

    2018-02-01

    The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death. A prospective, repeated-measures study of dyspnea/respiratory distress among a sample of hospice patients was done. Measures were collected at each patient encounter from hospice enrollment until patient death. Dyspnea was measured in response to "Are you short of breath?" and using the numeric rating scale anchored at 0 and 10. Nurses measured respiratory distress with the Respiratory Distress Observation Scale (RDOS). Patient consciousness (Reaction Level Scale), nearness to death (Palliative Performance Scale), diagnoses, and demographics were recorded. Data for the 30-day interval before death were analyzed. The sample was 91 patients who were female (58%) and Caucasian (83%) with dementia (32%), heart failure (26%), and cancer (13%). RDOS increased significantly from mild distress 30 days before death to moderate/severe distress on the day of death (F = 10.8, p Respiratory distress escalated in the last days. Inability to self-report raises care concerns about under-recognition and under-treatment of respiratory distress.

  6. Dyspnea in Pregnancy: An Unusual Cause

    African Journals Online (AJOL)

    Eventration of diaphragm is usually asymptomatic, but can present with symptoms ranging from mild dyspnea to a life‑threatening emergency. It can pose a management dilemma when diagnosed incidentally especially during the pregnancy. We report a case of eventration of diaphragm diagnosed during pregnancy and ...

  7. Speaking-Related Dyspnea in Healthy Adults

    Science.gov (United States)

    Hoit, Jeannette D.; Lansing, Robert W.; Perona, Kristen E.

    2007-01-01

    Purpose: To reveal the qualities and intensity of speaking-related dyspnea in healthy adults under conditions of high ventilatory drive, in which the behavioral and metabolic control of breathing must compete. Method: Eleven adults read aloud while breathing different levels of inspired carbon dioxide (CO[subscript 2]). After the highest level,…

  8. University Students Leaving Relationships (USLR): Scale Development and Gender Differences in Decisions to Leave Romantic Relationships

    Science.gov (United States)

    Hendy, Helen M.; Can, S. Hakan; Joseph, Lauren J.; Scherer, Cory R.

    2013-01-01

    The University Students Leaving Relationships scale was developed to identify student concerns when contemplating dissolution of romantic relationships. Participants included 1,106 students who rated the importance of issues when deciding to leave relationships. Factor analysis produced three dimensions: Missing the Relationship, Social…

  9. Impact of Blunted Perception of Dyspnea on Medical Care Use and Expenditure, and Mortality in Elderly People

    Directory of Open Access Journals (Sweden)

    Satoru eEbihara

    2012-07-01

    Full Text Available Dyspnea is an alarming symptom responsible for millions of patient visits each year. Poor perception of dyspnea might be reasonably attributed to an inappropriately low level of fear and inadequate earlier medical treatment for both patients and physicians, resulting in subsequent intensive care. This study was conducted to evaluate medical care use and cost, and mortality according to the perception of dyspnea in community-dwelling elderly people. We analyzed baseline data from a community-based Comprehensive Geriatric Assessment (CGA in 2002. The perception of dyspnea in 479 Japanese community-dwelling elderly people with normal lung function was measured in August 2002. The sensation of dyspnea during breathing with a linear inspiratory resistance of 10, 20 and 30 cmH2O/L/s was rated using the Borg scale. According to the perception of dyspnea, we divided the elderly into tertiles and compared all hospitalizations, out-patient visits, costs and death through computerized linkage with National Health Insurance (NHI beneficiaries claims history files between August 2002 and March 2008. In-patient hospitalization days and medical care costs significantly increased with the blunted perception of dyspnea, resulting in an increase in total medical-costs with blunted perception of dyspnea. With low perception group as reference, the hazard ratios of all cause mortality were 0.65 (95%CI 0.23-1.89 for intermediate perception group and 0.31(0.10-0.97 for high perception group, indicating the mortality rate also significantly increased with the blunted perception of dyspnea after multivariates adjustment (p=0.04. The blunted perception of dyspnea is related to hospitalization, large medical costs and all-cause mortality in community-dwelling elderly people. These findings provide a rational for preventing serious illness with careful monitoring of objective conditions in the elderly.

  10. Specific respiratory warm-up improves rowing performance and exertional dyspnea.

    Science.gov (United States)

    Volianitis, S; McConnell, A K; Koutedakis, Y; Jones, D A

    2001-07-01

    The purpose of this study was a) to compare the effect of three different warm-up protocols upon rowing performance and perception of dyspnea, and b) to identify the functional significance of a respiratory warm-up. A group of well-trained club rowers (N = 14) performed a 6-min all-out rowing simulation (Concept II). We examined differences in mean power output and dyspnea measures (modified CR-Borg scale) under three different conditions: after a submaximal rowing warm-up (SWU), a specific rowing warm-up (RWU), and a specific rowing warm-up with the addition of a respiratory warm-up (RWUplus) protocol. Mean power output during the 6-min all-out rowing effort increased by 1.2% after the RWUplus compared with that obtained after the RWU (P < 0.05) which, in turn, was by 3.2% higher than the performance after the SWU (P < 0.01). Similarly, after the RWUplus, dyspnea was 0.6 +/- 0.1 (P < 0.05) units of the Borg scale lower compared with the dyspnea after the RWU and 0.8 +/- 0.2 (P < 0.05) units lower than the dyspnea after the SWU. These data suggest that a combination of a respiratory warm-up protocol together with a specific rowing warm-up is more effective than a specific rowing warm-up or a submaximal warm-up alone as a preparation for rowing performance.

  11. Dyspnea severity, changes in dyspnea status and mortality in the general population : the Vlagtwedde/Vlaardingen study

    NARCIS (Netherlands)

    Figarska, Sylwia M; Boezen, Hendrika; Vonk, Judith M

    2012-01-01

    Dyspnea is a predictor of mortality. The effects of dyspnea severity and changes in dyspnea status on all-cause and cause-specific mortality remain unclear. The Vlagtwedde/Vlaardingen study started in 1965 and subjects were re-examined every 3 years until 1989/1990. Vital status of all 8,465

  12. Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition

    Science.gov (United States)

    Miner, Brienne; Tinetti, Mary E.; Van Ness, Peter H.; Han, Ling; Leo-Summers, Linda; Newman, Anne B.; Lee, Patty J.; Fragoso, Carlos A. Vaz

    2016-01-01

    Objectives The evaluation of dyspnea in older persons is traditionally focused on cardiorespiratory diseases, rather than systematically evaluating the multiple impairments that often occur with advancing age and which may also contribute to dyspnea. Accordingly, we have evaluated the associations between a broad array of cardiorespiratory and non-cardiorespiratory impairments and dyspnea in older persons. Design Cross-sectional. Setting Cardiovascular Health Study. Participants 4,413 community-dwelling persons; mean age was 72.6, 57.1% were female, 4.5% were African-American, 27.2% had less than a high school education, and 54.7% were ever-smokers. Measurements Dyspnea severity (American Thoracic Society grade ≥2 defined moderate-to-severe) and several impairments, including those established by: spirometry (forced expiratory volume in 1-second [FEV1]), maximal inspiratory pressure (respiratory muscle strength), echocardiography, ankle-brachial index, blood pressure, whole-body muscle mass (bioelectrical impedance), single chair stand (lower extremity function), grip strength, serum hemoglobin and creatinine, Center for Epidemiologic Studies Depression Scale (CES-D), Mini Mental State Examination, medication use, and body mass index (BMI). Results In a multivariable logistic regression model, impairments having strong associations with moderate-to-severe dyspnea included: FEV1 dyspnea included respiratory muscle weakness, diastolic cardiac dysfunction, grip weakness, anxiety symptoms, and use of cardiovascular and psychoactive medications (adjORs ranged from 1.31-1.71). Conclusion In community-dwelling older persons, several cardiorespiratory and non-cardiorespiratory impairments were significantly associated with moderate-to-severe dyspnea, akin to a multifactorial geriatric health condition. PMID:27549914

  13. The 10-item Remembered Relationship with Parents (RRP10) scale

    DEFF Research Database (Denmark)

    Denollet, Johan; Smolderen, Kim G E; van den Broek, Krista C

    2007-01-01

    Dysfunctional parenting styles are associated with poor mental and physical health. The 10-item Remembered Relationship with Parents (RRP(10)) scale retrospectively assesses Alienation (dysfunctional communication and intimacy) and Control (overprotection by parents), with an emphasis...... on deficiencies in empathic parenting. We examined the 2-factor structure of the RRP(10) and its relationship with adult depression....

  14. Botulinum toxin injection in laryngeal dyspnea.

    Science.gov (United States)

    Woisard, Virginie; Liu, Xuelai; Bes, Marie Christine Arné; Simonetta-Moreau, Marion

    2017-02-01

    Data, regarding the use of botulinum toxin (BT-A) in laryngeal dyspnea, are scarce, coming from some cases reports in the literature, including Vocal fold paralysis, laryngeal dystonia, vocal cord dysfunction also called paradoxical motion of the vocal fold (PMVF), and post-neuroleptic laryngeal dyskinesia. There is no consensus regarding the muscles and the doses to inject. The aim of this study is to present a retrospective review of patients treated in our ENT Department by BT-A injection in this indication. This study is a retrospective study describing patients who underwent an injection of botulinum toxin for laryngeal dyspnea in the ENT Department from 2005 to 2015 years. The inclusion criteria were a dyspnea associated with a laryngeal dysfunction, confirmed by flexible fiberoptic nasopharyngolaryngoscopy. Information concerning the causes of the dyspnea, the botulinum toxin BT-A injections procedure, post-injection follow-up, and respiratory outcome were collected for all patients included. In the group of 13 patients included, the main cause identified as principal factor linked with the short breath was: a bilateral VF paralysis (Patel et al., Otolaryngol Head Neck Surg 130:686-689, 7), laryngeal dystonia (Balkissoon and Kenn, Semin Respir Crit Care Med 33:595-605, 2), Anxiety syndrome associated with unilateral vocal fold paralysis or asthma (Marcinow et al., Laryngoscope 124:1425-1430, 3), and an isolated asthma (Zwirner et al., Eur Arch Otorhinolaryngol 254:242-245, 1). Nine out of the thirteen patients were improved by the injections. A BT-A-induced stable benefit for four patients led them to stop the injections in the follow-up. Good outcome was observed in five other patients (main cause: bilateral VP paralysis), allowing a progressive lengthening of the delay between BT-A injections. Four patients did not report a positive risk/benefit ratio after BT-A injections; two of them (with bilateral VF paralysis), because of respiratory side effects and

  15. Value of plasma brain natriuretic peptide for differentiating cardiogenic dyspnea from pulmogenic dyspnea

    International Nuclear Information System (INIS)

    Qu Yuejin; Yu Hao; Chen Guibing; Huang Jingxiong; He Xiaojiang; Fang Ya

    2008-01-01

    Objective: To evaluate the value of plasma brain natriuretic peptide (BNP)level for differentiating cardiogenic dyspnea from pulmogenic dyspnea. Methods: The detection of plasma BNP was carried out in 248 patients with dyspnea. The apparatus was the CENTUR type chemiluminescence detection produced by the Bayer companies of USA. All patients were divided into three groups depending on disease severity. The level of plasma BNP in each group was compared. Results: The level of plasma BNP in pulmonary disease complicated with left ventricular dysfunction was higher than that of pulmonary disease non-complicated with left ventricular dysfunction. There was significant difference between two groups(χ 2 = 25.597, P 0.05). The level of plasma BNP in pulmonary disease complicated with left ventricular dysfunction was higher than that of pulmonary disease complicated with right ventricular dysfunction. There was significant difference between two groups (t=2.531, P 2 =29.463, P<0.001). Conclusion: Plasma BNP analysis is an importent method for differentiating cardiogenic dyspnea from pulmogenic dyspnea. Meanwhile, it is also helpful to evaluating the severity of pulmonary disease complicated with left ventricular dysfunction. (authors)

  16. Translation and Validation of the Multidimensional Dyspnea-12 Questionnaire.

    Science.gov (United States)

    Amado Diago, Carlos Antonio; Puente Maestu, Luis; Abascal Bolado, Beatriz; Agüero Calvo, Juan; Hernando Hernando, Mercedes; Puente Bats, Irene; Agüero Balbín, Ramón

    2018-02-01

    Dyspnea is a multidimensional symptom, but this multidimensionality is not considered in most dyspnea questionnaires. The Dyspnea-12 takes a multidimensional approach to the assessment of dyspnea, specifically the sensory and the affective response. The objective of this study was to translate into Spanish and validate the Dyspnea-12 questionnaire. The original English version of the Dyspnea-12 questionnaire was translated into Spanish and backtranslated to analyze its equivalence. Comprehension of the text was verified by analyzing the responses of 10 patients. Reliability and validation of the questionnaire were studied in an independent group of COPD patients attending the pulmonology clinics of Hospital Universitario Marqués de Valdecilla, diagnosed and categorized according to GOLD guidelines. The mean age of the group (n=51) was 65 years and mean FEV1 was 50%. All patients understood all questions of the translated version of Dyspnea-12. Internal consistency of the questionnaire was α=0.937 and intraclass correlation coefficient was=.969; P<.001. Statistically significant correlations were found with HADS (anxiety r=.608 and depression r=.615), mMRC dyspnea (r=.592), 6MWT (r=-0.445), FEV1 (r=-0.312), all dimensions of CRQ-SAS (dyspnea r=-0.626; fatigue r=-0.718; emotional function r=-0.663; mastery r=-0.740), CAT (r=0.669), and baseline dyspnea index (r=-0.615). Dyspnea-12 scores were 10.32 points higher in symptomatic GOLD groups (B and D) (P<.001). The Spanish version of Dyspnea-12 is a valid and reliable instrument to study the multidimensional nature of dyspnea. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Progressive dyspnea due to pulmonary carcinoid tumorlets

    Directory of Open Access Journals (Sweden)

    Anastasios Kallianos

    2017-01-01

    Full Text Available This is a case description of a female patient, 77 years-old, who presented with progressive dyspnea and cough. She had a mild hypoxemia in the arterial blood gases (PaO2 72 mmHg and normal spirometry. The chest computer tomography revealed diffuse “ground glass” opacities, segmental alveolitis, bronchiectasis, fibrotic lesions and numerous micronodules. A thoracoscopy was performed and the obtained biopsy showed carcinoid tumorlets, with positive CK8/18, CD56, TTF-1 and synaptophysin immunohistochemical markers. Pulmonary carcinoid tumorlets are rare, benign lesions and individuals with tumorlets are typically asymptomatic. Our report presents a symptomatic clinical case of carcinoid tumorlet.

  18. Scaling relationship between tree respiration rates and biomass.

    Science.gov (United States)

    Cheng, Dong-Liang; Li, Tao; Zhong, Quan-Lin; Wang, Gen-Xuan

    2010-10-23

    The WBE theory proposed by West, Brown and Enquist predicts that larger plant respiration rate, R, scales to the three-quarters power of body size, M. However, studies on the R versus M relationship for larger plants (i.e. trees larger than saplings) have not been reported. Published respiration rates of field-grown trees (saplings and larger trees) were examined to test this relationship. Our results showed that for larger trees, aboveground respiration rates RA scaled as the 0.82-power of aboveground biomass MA, and that total respiration rates RT scaled as the 0.85-power of total biomass MT, both of which significantly deviated from the three-quarters scaling law predicted by the WBE theory, and which agreed with 0.81-0.84-power scaling of biomass to respiration across the full range of measured tree sizes for an independent dataset reported by Reich et al. (Reich et al. 2006 Nature 439, 457-461). By contrast, R scaled nearly isometrically with M in saplings. We contend that the scaling exponent of plant metabolism is close to unity for saplings and decreases (but is significantly larger than three-quarters) as trees grow, implying that there is no universal metabolic scaling in plants.

  19. Relationship status: Scales for assessing the vitality of late adolescents' relationships with their parents.

    Science.gov (United States)

    Klos, D S; Paddock, J R

    1978-12-01

    Three criteria for assessing relationship status were proposed: self-disclosure despite the risk of parental disapproval; openness to critical feedback from parents; constructive confrontation when angry with parents. These concepts were operationalized as narratives of nine interpersonal dilemmas, to which late adolescents responded by indicating "What would you do if you were in this situation?" Reliable example-anchored scales were constructed from the responses of one sample of college students and then cross-validated with two other samples. Social class had a significant but small effect on the relationship status scores; but age and sex of adolescent and sex of parent did not. The patterns of correlations of the Relationship Status Scales among themselves and with the Parent-Child Relations Questionnaire, the College Self-Expression Scale, the Fear of Negative Evaluation Scale, and Hogan's Empathy Scale were interpreted as evidence of construct validity.

  20. Dexamethasone for Dyspnea in Cancer Patients: A Pilot Double-Blind, Randomized, Controlled Trial

    Science.gov (United States)

    Hui, David; Kilgore, Kelly; Frisbee-Hume, Susan; Park, Minjeong; Tsao, Anne; Guay, Marvin Delgado; Lu, Charles; William, William; Pisters, Katherine; Eapen, George; Fossella, Frank; Amin, Sapna; Bruera, Eduardo

    2016-01-01

    Context Dexamethasone is often used to treat dyspnea in cancer patients but evidence is lacking. Objectives We determined the feasibility of conducting a randomized trial of dexamethasone in cancer patients, and estimated the efficacy of dexamethasone in the treatment of dyspnea. Methods In this double-blind, randomized, controlled trial, patients with dyspnea ≥4 were randomized to receive either dexamethasone 8 mg twice daily × four days then 4 mg twice daily × three days or placebo for seven days, followed by an open-label phase for seven days. We documented the changes in dyspnea (0-10 numeric rating scale [NRS]), spirometry measures, quality of life and toxicities. Results A total of 41 patients were randomized and 35 (85%) completed the blinded phase. Dexamethasone was associated with a significant reduction in dyspnea NRS of -1.9 (95% confidence interval [CI] -3.3 to -0.5, P=0.01) by day 4 and -1.8 (95% CI -3.2 to -0.3, P=0.02) by day 7. In contrast, placebo was associated with a reduction of -0.7 (95% CI -2.1 to 0.6, P=0.38) by day 4 and -1.3 (95% CI -2.4 to -0.2, P=0.03) by day 7. The between-arm difference was not statistically significant. Drowsiness improved with dexamethasone. Dexamethasone was well tolerated with no significant toxicities. Conclusion A double-blind, randomized, controlled trial of dexamethasone was feasible with a low attrition rate. Our preliminary data suggest that dexamethasone may be associated with rapid improvement in dyspnea and was well tolerated. Further studies are needed to confirm our findings. PMID:27330023

  1. Relationship Between the Death Anxiety Scale and Repression

    Science.gov (United States)

    Handal, Paul J.

    1975-01-01

    The present study was designed to test further the hypothesis that the Death Anxiety Scale is a valid measure of repression by establishing the relationship between the DAS and Gleser and Ihilevich's Reversal Score, a measure of repression, on the Defense Mechanism Inventory (DMI). (Author)

  2. The Barthel index-dyspnea: a new two-dimensional dyspnea scale

    OpenAIRE

    Chuang, Ming-Lung

    2016-01-01

    Ming-Lung Chuang1–3 1Division of Pulmonary Medicine, Department of Internal Medicine, 2Department of Critical Care Medicine, Chung Shan Medical University Hospital, 3School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China Clinical evaluation tools have been widely used in assessing the baseline status, treatment response, and prognosis for patients with chronic respiratory diseases and mostly for patients with chronic obstructive pul...

  3. Intrathoracic Caecal Perforation Presenting as Dyspnea

    Directory of Open Access Journals (Sweden)

    Vincent Granier

    2010-01-01

    Full Text Available Introduction. Bochdalek hernia is a congenital defect of the diaphragm that is usually diagnosed in the neonatal period and incidentally in asymptomatic adults. Small bowel incarceration in a right-sided Bochdalek hernia is exceptional for an adult. Case Presentation. A 54-year-old woman was admitted for acute dyspnea, tachycardia, hypotension, and fever. Five days before, she had been experiencing an episode of diffuse abdominal pain. The admission chest X-ray was interpreted as right pleural effusion and pneumothorax with left mediastinal shift. Chest tube drainage was purulent. The thoracoabdominal CT examination suspected an intestinal incarceration through a right diaphragmatic defect. At laparotomy, a right-sided Bochdalek hernia was confirmed with a complete necrosis of the incarcerated caecum. Ileocaecal resection was performed, but the patient died from delayed septic complications. Conclusion. Intrathoracic perforation of the caecum is a rare occurrence; delayed diagnosis due to misleading initial symptoms may lead to severe complications and poor prognosis.

  4. Preliminary investigation of cardiopulmonary function in stroke patients with stable heart failure and exertional dyspnea

    Science.gov (United States)

    Liaw, Mei-Yun; Wang, Lin-Yi; Pong, Ya-Ping; Tsai, Yu-Chin; Huang, Yu-Chi; Yang, Tsung-Hsun; Lin, Meng-Chih

    2016-01-01

    Abstract The aim of this study was to investigate the relationships between pulmonary function, respiratory muscle strength, perceived dyspnea, degree of fatigue, and activity of daily living with motor function and neurological status in stroke patients with stable congestive heart failure (CHF). This was a cohort study in a tertiary care medical center. Stroke patients with CHF and exertional dyspnea (New York Heart Association class I–III) were recruited. The baseline characteristics included duration of disease, Brunnstrom stage, spirometry, resting heart rate, resting oxyhemoglobin saturation (SpO2), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Borg scale, fatigue scale, and Barthel index. A total of 47 stroke patients (24 males, 23 females, mean age 65.9 ± 11.5 years) were included. The average Brunnstrom stages of affected limbs were 3.6 ± 1.3 over the proximal parts and 3.5 ± 1.4 over the distal parts of upper limbs, and 3.9 ± 0.9 over lower limbs. The average forced vital capacity (FVC) was 2.0 ± 0.8 L, with a predicted FVC% of 67.9 ± 18.8%, forced expiratory volume in the first second (FEV1) of 1.6 ± 0.7 L, predicted FEV1% of 70.6 ± 20.1%, FEV1/FVC of 84.2 ± 10.5%, and maximum mid-expiratory flow of 65.4 ± 29.5%. The average MIP and MEP were −52.9 ± 33.3 cmH2O and 60.8 ± 29.0 cmH2O, respectively. The Borg scale was 1.5 ± 0.8. MIP was negatively associated with the average Brunnstrom stage of the proximal (r = −0.318, P lower extremities (r = −0.288, P lower extremities (r = −0.311, P limbs. FVC was more strongly associated with MIP and MEP than predicted FVC%. FEV1/FVC may be used as a reference for the pulmonary dysfunction. PMID:27749577

  5. Physiological mechanisms of dyspnea during exercise with external thoracic restriction: Role of increased neural respiratory drive

    Science.gov (United States)

    Mendonca, Cassandra T.; Schaeffer, Michele R.; Riley, Patrick

    2013-01-01

    We tested the hypothesis that neuromechanical uncoupling of the respiratory system forms the mechanistic basis of dyspnea during exercise in the setting of “abnormal” restrictive constraints on ventilation (VE). To this end, we examined the effect of chest wall strapping (CWS) sufficient to mimic a “mild” restrictive lung deficit on the interrelationships between VE, breathing pattern, dynamic operating lung volumes, esophageal electrode-balloon catheter-derived measures of the diaphragm electromyogram (EMGdi) and the transdiaphragmatic pressure time product (PTPdi), and sensory intensity and unpleasantness ratings of dyspnea during exercise. Twenty healthy men aged 25.7 ± 1.1 years (means ± SE) completed symptom-limited incremental cycle exercise tests under two randomized conditions: unrestricted control and CWS to reduce vital capacity (VC) by 21.6 ± 0.5%. Compared with control, exercise with CWS was associated with 1) an exaggerated EMGdi and PTPdi response; 2) no change in the relationship between EMGdi and each of tidal volume (expressed as a percentage of VC), inspiratory reserve volume, and PTPdi, thus indicating relative preservation of neuromechanical coupling; 3) increased sensory intensity and unpleasantness ratings of dyspnea; and 4) no change in the relationship between increasing EMGdi and each of the intensity and unpleasantness of dyspnea. In conclusion, the increased intensity and unpleasantness of dyspnea during exercise with CWS could not be readily explained by increased neuromechanical uncoupling but likely reflected the awareness of increased neural respiratory drive (EMGdi) needed to achieve any given VE during exercise in the setting of “abnormal” restrictive constraints on tidal volume expansion. PMID:24356524

  6. Intravenous Fentanyl for Dyspnea at the End of Life: Lessons for Future Research in Dyspnea.

    Science.gov (United States)

    Pang, G S; Qu, L M; Tan, Y Y; Yee, A C P

    2016-04-01

    To determine the efficacy of intravenous (IV) Fentanyl in dyspnoeic patients with advanced cancer. Dyspnoeic patients with advanced cancer satisfying the selection criteria received (IV) Fentanyl and were evaluated for response 24 hours post-administration in a prospective observational study. Altogether 36 patients were enrolled into the study. However, data from only 16 patients could be analysed as 20 patients had died or were too sick to self-report scores. Seven out of 16 patients responded to IV Fentanyl although the result was not statistically significant (non-responders versus responders: 56.3% vs 43.8%, p = 0.33). The strongest correlations for variables predictive of responder status were the absence of anxiety and lung metastases. This exploratory study shows that IV Fentanyl can alleviate dyspnea in some patients but is an example of the difficulties conducting dyspnea research. Future studies would benefit from novel developments in the areas of measuring dyspnea in dying patients and statistical analysis of small sample sizes. © The Author(s) 2014.

  7. Exercise tolerance and dyspnea in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Čekerevac Ivan

    2010-01-01

    Full Text Available Background/Aim. Peripheral muscle weakness and nutritional disorders, firstly loss of body weight, are common findings in patients with chronic obstructive pulmonary disease (COPD. The aim of this study was to analyse the impact of pulmonary function parameters, nutritional status and state of peripheral skeletal muscles on exercise tolerance and development of dyspnea in COPD patients. Methods. Thirty COPD patients in stable state of disease were analyzed. Standard pulmonary function tests, including spirometry, body pletysmography, and measurements of diffusion capacity were performed. The 6-minute walking distance test (6MWD was done in order to assess exercise tolerance. Level of dyspnea was measured with Borg scale. In all patients midthigh muscle cross-sectional area (MTCSA was measured by computerized tomography scan. Nutritional status of patients was estimated according to body mass index (BMI. Results. Statistically significant correlations were found between parameters of pulmonary function and exercise tolerance. Level of airflow limitation and lung hyperinflation had significant impact on development of dyspnea at rest and especially after exercise. Significant positive correlation was found between MTCSA and exercise tolerance. Patients with more severe airflow limitation, lung hyperinflation and reduced diffusion capacity had significantly lower MTCSA. Conclusion. Exercise tolerance in COPD patients depends on severity of bronchoobstruction, lung hyperinflation and MTCSA. Severity of bronchoobstruction and lung hyperinflation have significant impact on dyspnea level.

  8. Development of the cat-owner relationship scale (CORS).

    Science.gov (United States)

    Howell, Tiffani J; Bowen, Jonathan; Fatjó, Jaume; Calvo, Paula; Holloway, Anna; Bennett, Pauleen C

    2017-08-01

    Characteristics of the human-animal bond can be influenced by both owner-related and pet-related factors, which likely differ between species. Three studies adapted the Monash Dog-Owner Relationship Scale (MDORS) to permit assessment of human-cat interactions as perceived by the cat's owner. In Study 1293 female cat owners completed a modified version of the MDORS, where 'dog' was replaced with 'cat' for all items. Responses were compared with a matched sample of female dog owners. A partial least squares discriminant analysis revealed systematic differences between cat and dog owners in the Dog (Cat)-Owner Interaction subscale (MDORS subscale 1), but not for Perceived Emotional Closeness or Perceived Costs (Subscales 2 and 3). Study 2 involved analysis of free-text descriptions of cat-owner interactions provided by 61 female cat owners. Text mining identified key words which were used to create additional questions for a new Cat-Owner Interaction subscale. In Study 3, the resulting cat-owner relationship scale (CORS) was tested in a group of 570 cat owners. The main psychometric properties of the scale, including internal consistency and factor structure, were evaluated. We propose that this scale can be used to accurately assess owner perceptions of their relationship with their cat. A modified scale, combining items from the CORS and MDORS (a C/DORS), is also provided for when researchers would find it desirable to compare human-cat and human-dog interactions. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Scaling Relationships Based on Scaled Tank Mixing and Transfer Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Piepel, Gregory F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Holmes, Aimee E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Heredia-Langner, Alejandro [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lee, Kearn P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kelly, Steven E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-01-01

    This report documents the statistical analyses performed (by Pacific Northwest National Laboratory for Washington River Protection Solutions) on data from 26 tests conducted using two scaled tanks (43 and 120 inches) in the Small Scale Mixing Demonstration platform. The 26 tests varied several test parameters, including mixer-jet nozzle velocity, base simulant, supernatant viscosity, and capture velocity. For each test, samples were taken pre-transfer and during five batch transfers. The samples were analyzed for the concentrations (lbs/gal slurry) of four primary components in the base simulants (gibbsite, stainless steel, sand, and ZrO2). The statistical analyses including modeling the component concentrations as functions of test parameters using stepwise regression with two different model forms. The resulting models were used in an equivalent performance approach to calculate values of scaling exponents (for a simple geometric scaling relationship) as functions of the parameters in the component concentration models. The resulting models and scaling exponents are displayed in tables and graphically. The sensitivities of component concentrations and scaling exponents to the test parameters are presented graphically. These results will serve as inputs to subsequent work by other researchers to develop scaling relationships that are applicable to full-scale tanks.

  10. Scaling Relationships Based on Scaled Tank Mixing and Transfer Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Piepel, Gregory F.; Holmes, Aimee E.; Heredia-Langner, Alejandro

    2013-09-18

    This report documents the statistical analyses performed (by Pacific Northwest National Laboratory for Washington River Protection Solutions) on data from 26 tests conducted using two scaled tanks (43 and 120 inches) in the Small Scale Mixing Demonstration platform. The 26 tests varied several test parameters, including mixer-jet nozzle velocity, base simulant, supernatant viscosity, and capture velocity. For each test, samples were taken pre-transfer and during five batch transfers. The samples were analyzed for the concentrations (lbs/gal slurry) of four primary components in the base simulants (gibbsite, stainless steel, sand, and ZrO2). The statistical analyses including modeling the component concentrations as functions of test parameters using stepwise regression with two different model forms. The resulting models were used in an equivalent performance approach to calculate values of scaling exponents (for a simple geometric scaling relationship) as functions of the parameters in the component concentration models. The resulting models and scaling exponents are displayed in tables and graphically. The sensitivities of component concentrations and scaling exponents to the test parameters are presented graphically. These results will serve as inputs to subsequent work by other researchers to develop scaling relationships that are applicable to full-scale tanks.

  11. Multidimensional Dyspnea Profile: an instrument for clinical and laboratory research.

    Science.gov (United States)

    Banzett, Robert B; O'Donnell, Carl R; Guilfoyle, Tegan E; Parshall, Mark B; Schwartzstein, Richard M; Meek, Paula M; Gracely, Richard H; Lansing, Robert W

    2015-06-01

    There is growing awareness that dyspnoea, like pain, is a multidimensional experience, but measurement instruments have not kept pace. The Multidimensional Dyspnea Profile (MDP) assesses overall breathing discomfort, sensory qualities, and emotional responses in laboratory and clinical settings. Here we provide the MDP, review published evidence regarding its measurement properties and discuss its use and interpretation. The MDP assesses dyspnoea during a specific time or a particular activity (focus period) and is designed to examine individual items that are theoretically aligned with separate mechanisms. In contrast, other multidimensional dyspnoea scales assess recalled recent dyspnoea over a period of days using aggregate scores. Previous psychophysical and psychometric studies using the MDP show that: 1) subjects exposed to different laboratory stimuli could discriminate between air hunger and work/effort sensation, and found air hunger more unpleasant; 2) the MDP immediate unpleasantness scale (A1) was convergent with common dyspnoea scales; 3) in emergency department patients, two domains were distinguished (immediate perception, emotional response); 4) test-retest reliability over hours was high; 5) the instrument responded to opioid treatment of experimental dyspnoea and to clinical improvement; 6) convergent validity with common instruments was good; and 7) items responded differently from one another as predicted for multiple dimensions. Copyright ©ERS 2015.

  12. [Effect of dynamic hyperinflation on exertional dyspnea, exercise performance and quality of life in COPD].

    Science.gov (United States)

    Ozgur, Eylem Sercan; Atis, Sibel; Kanik, Arzu

    2008-01-01

    There is increasing evidence that dynamic hyperinflation (DH) have negative effects on exercise performance and quality of life in chronic obstructive pulmonary disease (COPD) patients. The aim of this study was to investigate effect of dynamic hyperinflation on exertional dyspnea, exercise performance and quality of life in patients with COPD. 72 clinically stable patients with moderate to severe COPD and 30 healthy age-matched control subjects were included in this study. Pulmonary function tests including lung volumes and maximal respiratory muscle forces, arterial blood gas analyses, evaluation of exertional dyspnea with the Borg scale, and The Saint George Respiratory Questionnaire (SGRQ, Turkish version) were performed at rest and after a 6-min walk test. We measured the change in inspiratory capacity (AlphaIC) after exercise to reflect DH. 80% of patients with COPD significantly decreased IC after exercise (DH). AlphaIC were -0.27 +/- 0.26 L in COPD and 0.8 +/- 0.17 L in controls (p= 0.001). A stepwise multiple regression analysis showed that to be a patient with COPD, Basal Dyspnea Index (BDI) and AlphaIC were the best predictors of 6 MWD (r(2)= 0.53, p< 0.001). FEV1 added an additinal 9% to the variance in 6 MWD. Exertional dyspnea (AlphaBorg) correlated with AlphaIC (r= -0.44, p= 0.0001) and BDI (r= 0.34, p= 0.02). AlphaIC significantly correlated with symptom (r= -0.36, p= 0.008), activity (r= -0.31, p= 0.03) and total scores (r= -0.30, p= 0.04) of SGRQ. Dynamic hyperinflation can often occur during exersice in patients with COPD. Extent of dynamic hyperinflation could able to explain exercise capacity limitation, exercise dyspnea, and poor quality of life in patients with COPD.

  13. Gender and perception of dyspnea: The role of the variation in the forced expiratory volume in one second

    Directory of Open Access Journals (Sweden)

    Carlos A. Nigro

    2010-08-01

    Full Text Available During bronchoconstriction women perceive more breathlessness than men. The aims of study were 1 to evaluate if quality of dyspnea in bronchoconstriction was different in women and men 2 to assess if gender difference in the perception of dyspnea could be related to the level of bronchoconstriction. 457 subjects (257 women inhaled methacholine to a 20% decrease in FEV1, or 32 mg/ml. Dyspnea was evaluated using the modified Borg scale and a list of expressions of dyspnea. Borg scores were recorded immediately before the challenge test baseline and at the maximum FEV1 decrease. The prevalence of descriptors of dyspnea reported by women and men was similar. Dyspnea was related to the level of FEV1 (ΔFEV1: OR 1.05, 95%CI 1.01-1.09, p 0.0095, females (OR 2.90, 95%CI 1.33-6.33, p 0.0072, younger subjects (OR 0.93, 95%CI 0.89- 0.97, p 0.0013 and body mass index (BMI (OR 1.11, 95%CI 1.01-1.23, p 0.023. As the FEV1 fell less than 20% from baseline, only the ΔFEV1 was significantly associated with dyspnea (ΔFEV1:OR 1.15, 95%CI 1.07- 1.24, p 0.0002. Instead, if the FEV1 fell higher ≥ 20%, the presence of dyspnea was related to the degree of bronchoconstriction (ΔFEV1: OR 1.04, 95%CI 1.01-1.09, p 0.0187, females (OR 3.02, 95%CI 1.36-6.72, p 0.0067, younger subjects (OR 0.92, 95%CI 0.88-0.96, p 0.0007 and BMI (OR 1.12, 95%CI 1.01-1.23, p 0.023. The quality of dyspnea during the bronchoconstriction was similar in women and men; women showed a higher perception of dyspnea than men only when the FEV1 fell more than 20% from baseline.

  14. Size structuring and allometric scaling relationships in coral reef fishes.

    Science.gov (United States)

    Dunic, Jillian C; Baum, Julia K

    2017-05-01

    Temperate marine fish communities are often size-structured, with predators consuming increasingly larger prey and feeding at higher trophic levels as they grow. Gape limitation and ontogenetic diet shifts are key mechanisms by which size structuring arises in these communities. Little is known, however, about size structuring in coral reef fishes. Here, we aimed to advance understanding of size structuring in coral reef food webs by examining the evidence for these mechanisms in two groups of reef predators. Given the diversity of feeding modes amongst coral reef fishes, we also compared gape size-body size allometric relationships across functional groups to determine whether they are reliable indicators of size structuring. We used gut content analysis and quantile regressions of predator size-prey size relationships to test for evidence of gape limitation and ontogenetic niche shifts in reef piscivores (n = 13 species) and benthic invertivores (n = 3 species). We then estimated gape size-body size allometric scaling coefficients for 21 different species from four functional groups, including herbivores/detritivores, which are not expected to be gape-limited. We found evidence of both mechanisms for size structuring in coral reef piscivores, with maximum prey size scaling positively with predator body size, and ontogenetic diet shifts including prey type and expansion of prey size. There was, however, little evidence of size structuring in benthic invertivores. Across species and functional groups, absolute and relative gape sizes were largest in piscivores as expected, but gape size-body size scaling relationships were not indicative of size structuring. Instead, relative gape sizes and mouth morphologies may be better indicators. Our results provide evidence that coral reef piscivores are size-structured and that gape limitation and ontogenetic niche shifts are the mechanisms from which this structure arises. Although gape allometry was not indicative of

  15. The Unidimensional Relationship Closeness Scale (URCS): Reliability and Validity Evidence for a New Measure of Relationship Closeness

    Science.gov (United States)

    Dibble, Jayson L.; Levine, Timothy R.; Park, Hee Sun

    2012-01-01

    A fundamental dimension along which all social and personal relationships vary is closeness. The Unidimensional Relationship Closeness Scale (URCS) is a 12-item self-report scale measuring the closeness of social and personal relationships. The reliability and validity of the URCS were assessed with college dating couples (N = 192), female friends…

  16. Assessing exertional dyspnea in patients with idiopathic pulmonary fibrosis

    OpenAIRE

    Swigris, JJ; Streiner, DL; Brown, KK; Belkin, A; Green, KE; Wamboldt, FS; Schwarz, M; Zisman, DA; Hunninghake, G; Chapman, J; Olman, M; Lubell, S; Morrison, LD; Steele, MP; Haram, T

    2014-01-01

    Background: Dyspnea is a hallmark symptom of idiopathic pulmonary fibrosis (IPF), and dyspnea induced physical activity limitation is a prominent driver of quality of life impairment among IPF patients. Methods: We examined response data for the 21 physical activity items (the first 21 of 24) from the University of California San Diego Shortness of Breath Questionnaire (UCSD) collected at baseline in a recently conducted IPF trial. We used Rasch analysis and hypothesis testing with convention...

  17. Effect of Nebulized Morphine on Dyspnea of Mustard Gas-Exposed Patients: A Double-Blind Randomized Clinical Trial Study

    Directory of Open Access Journals (Sweden)

    Majid Shohrati

    2012-01-01

    Full Text Available Background. Dyspnea is one of the main complaints in a group of COPD patients due to exposure to sulfur mustard (SM and is refractory to conventional therapies. We designed this study to evaluate effectiveness of nebulized morphine in such patients. Materials and Methods. In a double-blind clinical trial study, 40 patients with documented history of exposure to SM were allocated to two groups: group 1 who received 1 mg morphine sulfate diluted by 4 cc normal saline 0.5% using nebulizer once daily for 5 days and group 2 serving as control who received normal saline as placebo. They were visited by pulmonologist 7 times per day to check symptoms and signs and adverse events. Different parameters including patient-scored peak expiratory flow using pick flow meter, visual analogue scale (VAS for dyspnea, global quality of life and cough, and number of respiratory rate, night time awaking for dyspnea and cough have been assessed. Results. The scores of VAS for dyspnea, cough and quality of life and also respiratory rate, heart rate, and night time awaking due to dyspnea and night time awaking due to cough improved significantly after morphine nebulization without any major adverse events. Also pick expiratory flow has been improved significantly after nebulization in each day. Conclusion. Our results showed the clinical benefit of nebulized morphine on respiratory complaints of patients due to exposure to SM without significant side effects.

  18. The Effect of Using an Electric Fan on Dyspnea in Chinese Patients With Terminal Cancer.

    Science.gov (United States)

    Wong, Sio Leng; Leong, Sok Man; Chan, Cheng Man; Kan, Sut Peng; Cheng, Hon Wai Benjamin

    2017-02-01

    Fan therapy is often suggested for relieving the symptom of dyspnea in patients with advanced cancer, but relevant literature among Asians is limited. Phase 2 clinical trial to assess the clinical feasibility and outcome of using an electric fan to alleviate the symptom of dyspnea in Chinese patients with advanced cancer. Thirty patients with advanced cancer having unresolved breathlessness were recruited from Hospice and Palliative Care Centre of Kiang Wu Hospital in Macau. Participants were randomly and equally allocated to the experimental group and the control group, respectively. Verbal numerical rating scale (NRS) of breathlessness, respiratory rate (RR), and saturation of peripheral oxygen (SpO 2 ) was collected before and after the intervention. T test was used to analyze the data collected. There was a significant difference in the NRS scores of the experimental group ( P fan therapy, whereas no significant difference was found in the objective statistic results of RR and SpO 2 . No significant difference ( P > .05) was found in the control group for all the 3 variables before and after routine treatment. The results of the study suggested that fan therapy could be effective in alleviating dyspnea in Chinese patients with advanced cancer. It should be considered as one of the nonpharmacological treatment option. Future large-scale phase 3 clinical trials are warranted.

  19. The crucible differentiation scale: assessing differentiation in human relationships.

    Science.gov (United States)

    Schnarch, David; Regas, Susan

    2012-10-01

    Whereas most existing differentiation measures are grounded in Bowen's writings about differentiation, the self-report instrument created in this study addresses differentiation according to the Four Points of Balance articulated by the Crucible Approach. The Crucible Differentiation Scale (CDS) is a 63-item, Likert-type, multidimensional measure of differentiation focused on adults and their important relationships. The psychometric properties of the CDS were tested through five studies with a total of 4,169 participants. The identified CDS subscales are Solid Self, Connectedness, Anxiety Regulation through Self-Soothing, Anxiety Regulation through Accommodation, Reactivity through Avoidance, Reactivity through Arguments, and Tolerating Discomfort for Growth. The CDS has potential use in evaluating differentiation theory, organizing treatment, and measuring therapy process and outcome. © 2012 American Association for Marriage and Family Therapy.

  20. Does nebulized fentanyl relieve dyspnea during exercise in healthy man?

    Science.gov (United States)

    Kotrach, Houssam G; Bourbeau, Jean; Jensen, Dennis

    2015-06-01

    Few therapies exist for the relief of dyspnea in restrictive lung disorders. Accumulating evidence suggests that nebulized opioids selective for the mu-receptor subtype may relieve dyspnea by modulating intrapulmonary opioid receptor activity. Our respective primary and secondary objectives were to test the hypothesis that nebulized fentanyl (a mu-opioid receptor agonist) relieves dyspnea during exercise in the presence of abnormal restrictive ventilatory constraints and to identify the physiological mechanisms of this improvement. In a randomized, double-blind, placebo-controlled crossover study, we examined the effect of 250 μg nebulized fentanyl, chest wall strapping (CWS), and their interaction on detailed physiological and perceptual responses to constant work rate cycle exercise (85% of maximum incremental work rate) in 14 healthy, fit young men. By design, CWS decreased vital capacity by ∼20% and mimicked the negative consequences of a mild restrictive lung disorder on exercise endurance time and on dyspnea, breathing pattern, dynamic operating lung volumes, and diaphragmatic electromyographic and respiratory muscle function during exercise. Compared with placebo under both unrestricted control and CWS conditions, nebulized fentanyl had no effect on exercise endurance time, integrated physiological response to exercise, sensory intensity, unpleasantness ratings of exertional dyspnea. Our results do not support a role for intrapulmonary opioids in the neuromodulation of exertional dyspnea in health nor do they provide a physiological rationale for the use of nebulized fentanyl in the management of dyspnea due to mild restrictive lung disorders, specifically those arising from abnormalities of the chest wall and not affiliated with airway inflammation. Copyright © 2015 the American Physiological Society.

  1. Three-minute constant rate step test for detecting exertional dyspnea relief after bronchodilation in COPD

    Directory of Open Access Journals (Sweden)

    Borel B

    2016-11-01

    Full Text Available Benoit Borel,1,2 Courtney A Wilkinson-Maitland,3 Alan Hamilton,4 Jean Bourbeau,5 Hélène Perrault,6 Dennis Jensen,3,5,7 François Maltais2 1Laboratoire HAVAE, Université de Limoges, Limoges, France; 2Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, 3Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montréal, QC, 4Boehringer Ingelheim (Canada Limited, Burlington, ON, 5Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University Health Center, Montreal, QC, 6Faculty of Health Sciences, University of Ottawa, Ottawa, ON, 7Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada Background: The aim of this study was to evaluate the responsiveness of the 3-minute constant rate step test (3-MST to detect the relief of exertional dyspnea (respiratory discomfort after acute bronchodilation in COPD patients. Patients and methods: A total of 40 patients with moderate-to-severe COPD (mean forced expiratory volume in 1 second: 45.7 (±14.7, % predicted performed four 3-MSTs at randomly assigned stepping rates of 14, 16, 20 and 24 steps/min after inhalation of nebulized ipratropium bromide (500 µg/salbutamol (2.5 mg and saline placebo, which were randomized to order. Patients rated their intensity of perceived dyspnea at the end of each 3-MST using Borg 0–10 category ratio scale. Results: A total of 37 (92.5%, 36 (90%, 34 (85% and 27 (67.5% patients completed all 3 minutes of exercise at 14, 16, 20 and 24 steps/min under both treatment conditions, respectively. Compared with placebo, ipratropium bromide/salbutamol significantly decreased dyspnea at the end of the third minute of exercise at 14 steps/min (by 0.6±1.0 Borg 0–10 scale units, P<0.01 and 16 steps/min (by 0.7±1.3 Borg 0–10 scale

  2. Acupuncture Treatment for Dyspnea due to Combined Pulmonary Fibrosis and Emphysema: A Case Report.

    Science.gov (United States)

    Matsumoto-Miyazaki, Jun; Miyazaki, Nagisa; Nishiwaki, Ayuko; Endo, Junki; Ushikoshi, Hiroaki; Ohno, Yasushi; Minatoguchi, Shinya

    2015-12-01

    Combined idiopathic pulmonary fibrosis with pulmonary emphysema (CPFE) is a syndrome with a characteristic presentation of upper lobe emphysema and lower lobe fibrosis. Dyspnea on exertion (DOE) is a major symptom of CPFE. We report a patient with DOE due to CPFE who was successfully treated with acupuncture. Case report. A 72-year-old Japanese man with a 4-year history of DOE was diagnosed with CPFE 2 years previously in another hospital. He received standard Western medicine treatment, which included bronchodilators. However, his DOE did not improve. Consequently, he visited our hospital for acupuncture treatment and received acupuncture treatment once a week for 1 year. After 10 weeks of acupuncture treatment, the results of the 6-minute walk test (6-minute walking distance, 379 m; lowest oxygen saturation, 86%; modified Borg dyspnea scale score: 2 units) were better than those at baseline (352 m, 84%, 4 units, respectively). These values were sustained at both 30 weeks (470 m, 88%, 1 unit) and 60 weeks (473 m, 85%, 2 units). Serum interstitial biomarkers, Krebs von den Lungen and surfactant protein-D, decreased after commencement of acupuncture therapy. A patient with CPFE showed improvements in dyspnea scores, exercise tolerance, and serum biomarkers during a 1-year course of acupuncture treatment. Use of acupuncture might be an effective adjunct therapy in relieving DOE due to CPFE. A large, well-designed cohort study that includes patients with CPFE treated with acupuncture should be conducted.

  3. Markers of decongestion, dyspnea relief, and clinical outcomes among patients hospitalized with acute heart failure.

    Science.gov (United States)

    Kociol, Robb D; McNulty, Steven E; Hernandez, Adrian F; Lee, Kerry L; Redfield, Margaret M; Tracy, Russell P; Braunwald, Eugene; O'Connor, Christopher M; Felker, G Michael

    2013-03-01

    Congestion is a primary driver of symptoms in patients with acute heart failure, and relief of congestion is a critical goal of therapy. Monitoring of response to therapy through the assessment of daily weights and net fluid loss is the current standard of care, yet the relationship between commonly used markers of decongestion and both patient reported symptom relief and clinical outcomes are unknown. We performed a retrospective analysis of the randomized clinical trial, diuretic optimization strategy evaluation in acute heart failure (DOSE-AHF), enrolling patients hospitalized with a diagnosis of acute decompensated heart failure. We assessed the relationship among 3 markers of decongestion at 72 hours-weight loss, net fluid loss, and percent reduction in serum N terminal B-type natriuretic peptide (NT-proBNP) level-and relief of symptoms as defined by the dyspnea visual analog scale area under the curve. We also determined the relationship between each marker of decongestion and 60-day clinical outcomes defined as time to death, first rehospitalization or emergency department visit. Mean age was 66 years, mean ejection fraction was 35%, and 27% had ejection fraction ≥50%. Of the 3 measures of decongestion assessed, only percent reduction in NT-proBNP was significantly associated with symptom relief (r=0.13; P=0.04). There was no correlation between either weight loss or net fluid loss and symptom relief, (r=0.04; P=0.54 and r=0.07; P=0.27, respectively). Favorable changes in each of the 3 markers of decongestion were associated with improvement in time to death, rehospitalization, or emergency department visit at 60 days (weight: hazard ratio, 0.91; 95% confidence interval, 0.85-0.97 per 4 lbs; weight lost; fluid hazard ratio, 0.94; 95% confidence interval, 0.90-0.99 per 1000 mL fluid loss; NT-proBNP hazard ratio, 0.95; 95% confidence interval, 0.91-0.99 per 10% reduction). These associations were unchanged after multivariable adjustment with the exception

  4. Interactions Between Dyspnea and the Brain Processing of Nociceptive Stimuli: Experimental Air Hunger Attenuates Laser-Evoked Brain Potentials in Humans.

    Science.gov (United States)

    Dangers, Laurence; Laviolette, Louis; Similowski, Thomas; Morélot-Panzini, Capucine

    2015-01-01

    Dyspnea and pain share several characteristics and certain neural networks and interact with each other. Dyspnea-pain counter-irritation consists of attenuation of preexisting pain by intercurrent dyspnea and has been shown to have neurophysiological correlates in the form of inhibition of the nociceptive spinal reflex RIII and laser-evoked potentials (LEPs). Experimentally induced exertional dyspnea inhibits RIII and LEPs, while "air hunger" dyspnea does not inhibit RIII despite its documented analgesic effects. We hypothesized that air hunger may act centrally and inhibit LEPs. LEPs were obtained in 12 healthy volunteers (age: 21-29) during spontaneous breathing (FB), ventilator-controlled breathing (VC) tailored to FB, after inducing air hunger by increasing the inspired fraction of carbon dioxide -FiCO2- (VCCO2), and during ventilator-controlled breathing recovery (VCR). VCCO2 induced intense dyspnea (visual analog scale = 63% ± 6% of full scale, p air hunger type. VC alone reduced the amplitude of the N2-P2 component of LEPs (Δ = 24.0% ± 21.1%, p air hunger (Δ = 22.6% ± 17.9%, p air hunger interferes with the cortical mechanisms responsible for the cortical response to painful laser skin stimulation, which provides a neurophysiological substrate to the central nature of its otherwise documented analgesic effects.

  5. Evaluation of the Appropriate Washout Period Following Fan Therapy for Dyspnea in Patients With Advanced Cancer: A Pilot Study.

    Science.gov (United States)

    Kako, Jun; Morita, Tatsuya; Yamaguchi, Takuhiro; Sekimoto, Asuko; Kobayashi, Masamitsu; Kinoshita, Hiroya; Ogawa, Asao; Zenda, Sadamoto; Uchitomi, Yosuke; Inoguchi, Hironobu; Matsushima, Eisuke

    2018-02-01

    To clarify the duration required for dyspnea to return to baseline severity after fan therapy, to evaluate whether fan-to-legs therapy or no fan therapy would be a suitable control therapy, and to investigate changes in patients' face surface temperature after fan therapy. In this pilot study, all participants received 3 interventions in the following order: no fan, fan to legs, and fan to face. Participants used a fan for 5 minutes, and they scored their dyspnea at 10-minute intervals for 60 minutes or until the score had returned to its baseline value, whichever occurred first. Nine patients with advanced cancer admitted to a palliative care unit were included; they had dyspnea at rest and rated its severity as at least 3 points on a 0- to 10-point numerical rating scale. Descriptive statistics and the Wilcoxon signed rank test were used to analyze the data. All patients completed the study. Of the 9 participants, 6 experienced a clinical benefit from using a fan to their faces. Of these patients, only 2 participants' (2 of 6) dyspnea scores returned to baseline by the end of the 60-minute assessment period after exposure to fan-to-face therapy. In fan-to-legs and no fan settings, there was no change in the dyspnea scores. There were significant differences between the baseline face surface temperature and that after fan-to-face and fan-to-legs settings. When using a crossover design to investigate the effect of fan therapy on dyspnea, 1 hour is an insufficient washout period.

  6. Understanding relationships among abundance, extirpation, and climate at ecoregional scales.

    Science.gov (United States)

    Beever, Erik A; Dobrowski, S Z; Long, J; Mynsberge, A R; Piekielek, N B

    2013-07-01

    Recent research on mountain-dwelling species has illustrated changes in species distributional patterns in response to climate change. Abundance of a species will likely provide an earlier warning indicator of change than will occupancy, yet relationships between abundance and climatic factors have received less attention. We tested whether predictors of counts of American pikas (Ochotona princeps) during surveys from the Great Basin region in 1994-1999 and 2003-2008 differed between the two periods. Additionally, we tested whether various modeled aspects of ecohydrology better predicted relative density than did average annual precipitation, and whether risk of site-wide extirpation predicted subsequent population counts of pikas. We observed several patterns of change in pika abundance at range edges that likely constitute early warnings of distributional shifts. Predictors of pika abundance differed strongly between the survey periods, as did pika extirpation patterns previously reported from this region. Additionally, maximum snowpack and growing-season precipitation resulted in better-supported models than those using average annual precipitation, and constituted two of the top three predictors of pika density in the 2000s surveys (affecting pikas perhaps via vegetation). Unexpectedly, we found that extirpation risk positively predicted subsequent population size. Our results emphasize the need to clarify mechanisms underlying biotic responses to recent climate change at organism-relevant scales, to inform management and conservation strategies for species of concern.

  7. Self-Reported Dyspnea is Associated With Impaired Global Longitudinal Strain in Ambulatory Type 1 Diabetes Patients With Normal Ejection Fraction and Without Known Heart Disease - The Thousand & 1 Study

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Risum, Niels; Rossing, Peter

    2016-01-01

    and degree of dyspnea in patients with normal left ventricular ejection fraction (LVEF) and without known heart disease. METHODS: Ambulatory patients from Steno Diabetes Center. Conventional echocardiography and GLS was performed. Patients reported degree of dyspnea according to the NYHA classification....... Patients with LVEF≤45% were excluded. Data were analyzed in uni-and multivariable models. RESULTS: A total of 1075 T1DM patients were included. Mean age 49.5years, 52% men, mean diabetes duration 25.8years; 835 (77.7%) reported no dyspnea, 156 (14.5%) NYHA I, 68 (6.3%) NYHA II, and 16 (1.5%) NYHA III......-IV. LVEF did not differ between groups of dyspnea in neither univariable nor multivariable models (p>0.1). E/e' was associated with degree of dyspnea in both univariable (pdyspnea in a dose-response relationship in both...

  8. Scale-Free Relationships between Social and Landscape Factors in Urban Systems

    Directory of Open Access Journals (Sweden)

    Chunzhu Wei

    2017-01-01

    Full Text Available Urban planners and ecologists have long debated the relationship between the structure of urban landscapes and social activities. There have, however, been very few discussions as to whether any such relationships might depend on the scales of observation. This work applies a hierarchical zoning technique to data from the city of Quito, Ecuador, to examine how relationships between typical spatial landscape metrics and social indicators depend on zoning scales. Our results showed that the estimates of both landscape heterogeneity features and social indicators significantly depend on the zoning scale. The mean values of the typical landscape metrics and the social indicators all exhibited predictable responses to a changing zoning scale, suggesting a consistent and significant scaling relationship within the multiple zoning scales. Yet relationships between these pairs of variables remain notably invariant to scale. This quantitative demonstration of the scale-free nature of the relationship between landscape characteristics and social indicators furthers our understanding of the relationships between landscape structures and social aspects of urban spaces, including deprivation and public service accessibility. The relationships between social indicators and one typical landscape aggregation metric (represented as the percentage of like adjacencies were nevertheless significantly dependent on scale, suggesting the importance of zoning scale decisions for analyzing the relationships between the social indicators and the landscape characteristics related with landscape adjacency. Aside from this typical landscape aggregation metric, the general invariance to the zoning scale of relationships between landscape structures and socioeconomic indicators in Quito suggests the importance of applying these scale-free relationships in understanding complex socio-ecological systems in other cities, which are shaped by the conflated influences of both

  9. Dyspnea from exercise in cold air is not always asthma.

    Science.gov (United States)

    Ternesten-Hasséus, Ewa; Johansson, Ewa-Lena; Bende, Mats; Millqvist, Eva

    2008-10-01

    In the absence of other explanations, exercise-induced dyspnea is often labeled as a manifestation of asthma. The aim of this study was to use exercise provocation in cold air among patients with exercise-induced dyspnea, but without any bronchoconstriction, in order to study induced symptoms and different physiological parameters and to measure the possible influence of exercise in cold air on capsaicin cough sensitivity. Eleven patients with exercise-induced dyspnea but no asthma, along with 11 healthy controls, performed a capsaicin inhalation provocation on two occasions. One of these provocations was preceded by an exercise provocation in a cold chamber. Number of coughs, airway symptoms, spirometry, respiratory rate, pulse rate, end-tidal CO(2), and PSaO(2) were registered. During exercise, the patients coughed more than the controls and also had more airway symptoms. After exercise provocation, spirometry values remained unchanged, but capsaicin cough sensitivity was increased and end-tidal CO(2) decreased among the patients, both in comparison to the controls and in comparison to the patients themselves prior to exercise. Exercise-induced dyspnea may be associated with hypocapnia from hyperventilation and increased capsaicin cough sensitivity. The diagnosis of exercise-induced asthma should be questioned when the patient has no signs of bronchoconstriction.

  10. Multi scale habitat relationships of Martes americana in northern Idaho, U.S.A.

    Science.gov (United States)

    Tzeidle N. Wasserman; Samuel A. Cushman; David O. Wallin; Jim Hayden

    2012-01-01

    We used bivariate scaling and logistic regression to investigate multiple-scale habitat selection by American marten (Martes americana). Bivariate scaling reveals dramatic differences in the apparent nature and strength of relationships between marten occupancy and a number of habitat variables across a range of spatial scales. These differences include reversals in...

  11. New allometric scaling relationships and applications for dose and toxicity extrapolation.

    Science.gov (United States)

    Cao, Qiming; Yu, Jimmy; Connell, Des

    2014-01-01

    Allometric scaling between metabolic rate, size, body temperature, and other biological traits has found broad applications in ecology, physiology, and particularly in toxicology and pharmacology. Basal metabolic rate (BMR) was observed to scale with body size and temperature. However, the mass scaling exponent was increasingly debated whether it should be 2/3, 3/4, or neither, and scaling with body temperature also attracted recent attention. Based on thermodynamic principles, this work reports 2 new scaling relationships between BMR, size, temperature, and biological time. Good correlations were found with the new scaling relationships, and no universal scaling exponent can be obtained. The new scaling relationships were successfully validated with external toxicological and pharmacological studies. Results also demonstrated that individual extrapolation models can be built to obtain scaling exponent specific to the interested group, which can be practically applied for dose and toxicity extrapolations. © The Author(s) 2014.

  12. High Flow Oxygen and Bilevel Positive Airway Pressure for Persistent Dyspnea in Patients With Advanced Cancer: A Phase II Randomized Trial

    Science.gov (United States)

    Hui, David; Morgado, Margarita; Chisholm, Gary; Withers, Laura; Nguyen, Quan; Finch, Clarence; Frisbee-Hume, Susan; Bruera, Eduardo

    2013-01-01

    Context Dyspnea is one of the most distressing symptoms for cancer patients. The role of high flow oxygen (HFO) and bilevel positive airway pressure (BiPAP) in the palliation of dyspnea has not been well characterized. Objectives To determine the feasibility of conducting a randomized trial of HFO and BiPAP in cancer patients, and to examine the changes in dyspnea, physiologic parameters and adverse effects with these modalities. Methods In this randomized study (ClinicalTrials.gov Identifier: NCT01518140), we assigned hospitalized patients with advanced cancer and persistent dyspnea to either HFO or BiPAP for two hours. We assessed dyspnea with a numeric rating scale (NRS) and modified Borg scale (MBS) before and after the intervention. We also documented vital signs, transcutaneous carbon dioxide and adverse effects. Results Thirty patients were enrolled (1:1 ratio) and 23 (77%) completed the assigned intervention. HFO was associated with improvements in both NRS (mean 1.9, 95% confidence interval [CI] 0.4, 3.4; P=0.02) and MBS (mean 2.1, 95% CI 0.6, 3.5; P=0.007). BiPAP also was associated with improvements in NRS (mean 3.2; 95% CI 1.3, 5.1; P=0.004) and MBS (mean 1.5, 95% CI −0.3, 3.2; P=0.13). There were no significant differences between HFO and BiPAP in dyspnea NRS (P=0.14) and MBS (P=0.47). Oxygen saturation improved with HFO (93% vs. 99%, P=0.003), and respiratory rate had a non-statistically significant decrease with both interventions (HFO -3; P=0.11; BiPAP -2, P=0.11 ). No significant adverse effects were observed. Conclusion HFO and BiPAP alleviated dyspnea, improved physiologic parameters and were safe. Our results justify larger randomized controlled trials to confirm these findings. PMID:23739633

  13. Development and validation of the Dyspnea Index (DI): a severity index for upper airway-related dyspnea.

    Science.gov (United States)

    Gartner-Schmidt, Jackie L; Shembel, Adrianna C; Zullo, Thomas G; Rosen, Clark A

    2014-11-01

    To (1) develop and validate the Dyspnea Index (DI); (2) quantify severity of symptoms in upper airway dyspnea; and (3) validate the DI as an outcome measure. Survey development and validation. Three hundred sixty-nine participants were recruited for different phases of the study. Two hundred participants with chief complaints of dyspnea were given a 41-item questionnaire addressing common symptoms of dyspnea related to the upper airway. The questions were then reduced based on principal component analysis (PCA) and internal consistency resulting in a 10-item questionnaire. Cognitive interviews were conducted with 15 participants. Test-retest reliability and discriminant validity were measured from 51 participants. The DI was further validated by administering the index to 57 healthy controls (HC). Validation of the DI as a treatment outcome tool occurred with 46 participants' pre- and post-treatment scores. PCA revealed that only a single factor was being measured in both the original 41- and 10-item questionnaires. Additional cognitive interviewing suggested that no modification was needed to the DI. Test-retest reliability was r = 0.83. Discriminant validity was r = 0.62. The Mann-Whitney test demonstrated significant differences between healthy/symptomatic participants. Scores from the HC cohort resulted in a mean of 3.12 (SEM = 0.484; SD = 3.65) for the normative values. The DI is an effective and efficient instrument to quantify patients' symptoms of upper airway dyspnea. It is a statistically robust index, with significant reliability and validity, and can be dependably used as a treatment outcome measure. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  14. The effect of home-based inspiratory muscle training on exercise capacity, exertional dyspnea and pulmonary function in COPD patients.

    Science.gov (United States)

    Bavarsad, Maryam Bakhshandeh; Shariati, Abdolali; Eidani, Esmaeil; Latifi, Mahmud

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is currently the fourth cause of mortality worldwide. Patients with COPD experience periods of dyspnea, fatigue, and disability, which impact on their life. The objective of this study was to investigate the effect of short-term inspiratory muscle training on exercise capacity, exertional dyspnea, and pulmonary lung function. A randomized, controlled trial was performed. Thirty patients (27 males, 3 females) with mild to very severe COPD were randomly assigned to a training group (group T) or to a control group (group C). Patients in group T received training for 8 weeks (15 min/day for 6 days/week) with flow-volumetric inspiratory exerciser named (Respivol). Each patient was assessed before and after 8 weeks of training for the following clinical parameters: exercise capacity by 6-min walking test (6MWT), exertional dyspnea by Borg scale, and pulmonary lung function by spirometry. Patients used training together with medical treatment. The data were analyzed using paired t-test and independent t-test. Results showed statistically significant increase in 6MWT at the end of the training from 445.6 ± 22.99 to 491.06 ± 17.67 meters? (P training group but not in the control group. The values for exercise capacity and dyspnea improved after 8 weeks in group T in comparison with group C (P = 0.001 and P = 0.0001, respectively). No changes were observed in any measure of pulmonary function in both groups. Short-term inspiratory muscle training has beneficial effects on exercise capacity and exertional dyspnea in COPD patients.

  15. Gender and respiratory factors associated with dyspnea in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Aguirre-Jaime Armando

    2007-03-01

    Full Text Available Abstract Rationale We had shown that COPD women expressed more dyspnea than men for the same degree of airway obstruction. Objectives Evaluate gender differences in respiratory factors associated with dyspnea in COPD patients. Methods In a FEV1 % matched population of 100 men and women with COPD we measured: age, MMRC, FEV1, FVC, TLC, IC/TLC, PaO2, PaCO2, DLCO, Pimax, P0.1, Ti/Ttot, BMI, ffmi, 6MWD and VAS scale before and after the test, the Charlson score and the SGRQ. We estimated the association between these parameters and MMRC scores. Multivariate analysis determined the independent strength of those associations. Results MMRC correlated with: BMI (men:-0.29, p = 0.04; women:-0.28, p = 0.05, ffmi (men:-0.39, p = 0.01, FEV1 % (men:-0.64, p 2 (men:-0.59, p 2 (men:0.27, p = 0.05, DLCO (men:-0.54, p 0.1/Pimax (men:0.46, p = 0.002; women:0.47, p = 0.005, dyspnea measured with the Visual Analog Scale before (men:0.37, p = 0.04; women:0.52, p = 0.004 and after 6MWD (men:0.52, p = 0.002; women:0.48, p = 0.004 and SGRQ total (men:0.50, p 0.1/Pimax in women (r2 = 0.30 and BMI, DLCO, PaO2 and P0.1/Pimax in men (r2 = 0.81 were the strongest predictors of MMRC scores. Conclusion In mild to severe COPD patients attending a pulmonary clinic, P0.1/Pimax was the unique predictor of MMRC scores only in women. Respiratory factors explain most of the variations of MMRC scores in men but not in women. Factors other than the respiratory ones should be included in the evaluation of dyspnea in women with COPD.

  16. Cardiopulmonary exercise testing in the assessment of exertional dyspnea

    Directory of Open Access Journals (Sweden)

    Debapriya Datta

    2015-01-01

    Full Text Available Dyspnea on exertion is a commonly encountered problem in clinical practice. It is usually investigated by resting tests such as pulmonary function tests and echocardiogram, which may at times can be non-diagnostic. Cardiopulmonary exercise testing (CPET measures physiologic parameters during exercise which can enable accurate identification of the cause of dyspnea. Though CPET has been around for decades and provides valuable and pertinent physiologic information on the integrated cardiopulmonary responses to exercise, it remains underutilized. The objective of this review is to provide a comprehensible overview of the underlying principles of exercise physiology, indications and contraindications of CPET, methodology and interpretative strategies involved and thereby increase the understanding of the insights that can be gained from the use of CPET.

  17. Imaging-based assessment of dyspnea in cigarette smokers

    Science.gov (United States)

    Galvin, Jeffrey R.; Chang, Paul J.; Schwartz, David A.; Hunninghake, Gary W.; Helmers, Richard; Mori, Masaki

    1994-05-01

    Patients with pulmonary fibrosis frequently smoke cigarettes. The cause of dyspnea in these patients is often complex because of the coexistence of multiple disease processes. We investigated 10 cigarette smokers with pulmonary fibrosis who were referred for evaluation of new onset or worsening dyspnea. Chest radiographs and pulmonary function tests were obtained in addition to high-resolution computed tomography (HRCT). In those patients with HRCT evidence of both diseases, spirometry and lung volumes were most often normal. Although plain films provided a reasonable assessment of fibrosis, they underestimated the severity of emphysema. Quantitation of both emphysema and fibrosis by HRCT was reproducible and correlated with key pulmonary function tests. Our findings indicate that the HRCT scan is a useful diagnostic test in patients with pulmonary fibrosis who are also cigarette smokers.

  18. Sex differences in the intensity and qualitative dimensions of exertional dyspnea in physically active young adults

    Science.gov (United States)

    Cory, Julia M.; Schaeffer, Michele R.; Wilkie, Sabrina S.; Ramsook, Andrew H.; Puyat, Joseph H.; Arbour, Brandon; Basran, Robbi; Lam, Michael; Les, Christian; MacDonald, Benjamin; Jensen, Dennis

    2015-01-01

    Understanding sex differences in the qualitative dimensions of exertional dyspnea may provide insight into why women are more affected by this symptom than men. This study explored the evolution of the qualitative dimensions of dyspnea in 70 healthy, young, physically active adults (35 M and 35 F). Participants rated the intensity of their breathing discomfort (Borg 0-10 scale) and selected phrases that best described their breathing from a standardized list (work/effort, unsatisfied inspiration, and unsatisfied expiration) throughout each stage of a symptom-limited incremental-cycle exercise test. Following exercise, participants selected phrases that described their breathing at maximal exercise from a list of 15 standardized phrases. Intensity of breathing discomfort was significantly higher in women for a given ventilation, but differences disappeared when ventilation was expressed as a percentage of maximum voluntary ventilation. The dominant qualitative descriptor in both sexes throughout exercise was increased work/effort of breathing. At peak exercise, women were significantly more likely to select the following phrases: “my breathing feels shallow,” “I cannot get enough air in,” “I cannot take a deep breath in,” and “my breath does not go in all the way.” Women adopted a more rapid and shallow breathing pattern and had significantly higher end-inspiratory lung volumes relative to total lung capacity throughout exercise relative to men. These findings suggest that men and women do not differ in their perceived quality of dyspnea during submaximal exercise, but subjective differences appear at maximal exercise and may be related, at least in part, to underlying sex differences in breathing patterns and operating lung volumes during exercise. PMID:26338458

  19. Severe dyspnea due to a giant antrochoanal polyp

    OpenAIRE

    Coloma-Milano M; Gil-Carcedo-Sañudo E; Gil-Carcedo-García LM.; Martín-Batista S; Madrigal-Revuelta M; Vallejo-Valdezate LA

    2012-01-01

    SummaryIntroduction: The antrochoanal polyp is a prevalent pathology in teenagers and young adults. It usually presents with nasal obstruction.Patient and method: Case report: An 80-year-old male with alcoholic encephalopathy, chronic bronchial disease of unknown etiology and polypoid chronic rhinosinusitis came to the emergency service with severe dyspnea without laryngeal features.Anterior rhinoscopy showed a polypoid mass in left nostril that prevented the visualization with nasal endoscop...

  20. Parapharyngeal space lipomatosis with secondary dyspnea, disphagia and disphonia

    OpenAIRE

    Garcia-Ortega, Dorian Yarih; Gomez-Pedraza, Antonio; Luna-Ortiz, Kuauhyama

    2015-01-01

    Introduction: Parapharyngeal space tumors are a small percentage of all head and neck neoplasms. Due to their anatomic location, they represent a therapeutic challenge. To our knowledge, 11 cases of parapharyngeal lipomatous tumors have been reported in the literature. Case: A 48 year old male with chief complaints of dyspnea, dysphagia and dysphonia was found to have a parapharyngeal space tumor. He was scheduled to undergo lumpectomy and neck exploration. Discussion: Benign tumors rep...

  1. Visualizing the Earth and Moon Relationship via Scaled Drawings

    Science.gov (United States)

    Fidler, Chuck; Dotger, Sharon

    2009-01-01

    Students' difficulties with accurately conceptualizing the relationships among the Earth, Moon, and Sun are well documented. Any teacher who has seen the film "A Private Universe" (Schneps and Sadler 1988) will remember the challenge the interviewees experienced when trying to explain their understanding of this phenomenon. This paper describes a…

  2. Relationship Quality Time: The Validation of a Relationship Quality Scale in Higher Education

    Science.gov (United States)

    Snijders, Ingrid; Rikers, Remy M. J. P.; Wijnia, Lisette; Loyens, Sofie M. M.

    2018-01-01

    This study investigated the overall "quality" of the interpersonal relationship students have with faculty and staff, that is, relationship quality (RQ). In relationship management research, RQ is paramount for the creation of bonds with customers, which in turn is necessary for the sustainability of organizations, that is, continuity…

  3. Relationships between the Thurstone and Rasch Approaches to Item Scaling.

    Science.gov (United States)

    Andrich, David

    1978-01-01

    When the logistic function is substituted for the normal, Thurstone's Case V specialization of the law of comparative judgment for paired comparison responses gives an identical equation for the estimation of item scale values, as does the Rasch formulation for direct responses. Comparisons are made. (Author/CTM)

  4. An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

    Science.gov (United States)

    Parshall, Mark B.; Schwartzstein, Richard M.; Adams, Lewis; Banzett, Robert B.; Manning, Harold L.; Bourbeau, Jean; Calverley, Peter M.; Gift, Audrey G.; Harver, Andrew; Lareau, Suzanne C.; Mahler, Donald A.; Meek, Paula M.; O'Donnell, Denis E.

    2012-01-01

    Background: Dyspnea is a common, distressing symptom of cardiopulmonary and neuromuscular diseases. Since the ATS published a consensus statement on dyspnea in 1999, there has been enormous growth in knowledge about the neurophysiology of dyspnea and increasing interest in dyspnea as a patient-reported outcome. Purpose: The purpose of this document is to update the 1999 ATS Consensus Statement on dyspnea. Methods: An interdisciplinary committee of experts representing ATS assemblies on Nursing, Clinical Problems, Sleep and Respiratory Neurobiology, Pulmonary Rehabilitation, and Behavioral Science determined the overall scope of this update through group consensus. Focused literature reviews in key topic areas were conducted by committee members with relevant expertise. The final content of this statement was agreed upon by all members. Results: Progress has been made in clarifying mechanisms underlying several qualitatively and mechanistically distinct breathing sensations. Brain imaging studies have consistently shown dyspnea stimuli to be correlated with activation of cortico-limbic areas involved with interoception and nociception. Endogenous and exogenous opioids may modulate perception of dyspnea. Instruments for measuring dyspnea are often poorly characterized; a framework is proposed for more consistent identification of measurement domains. Conclusions: Progress in treatment of dyspnea has not matched progress in elucidating underlying mechanisms. There is a critical need for interdisciplinary translational research to connect dyspnea mechanisms with clinical treatment and to validate dyspnea measures as patient-reported outcomes for clinical trials. PMID:22336677

  5. Dyspnea evolution after high-dose radiotherapy in patients with non-small cell lung cancer

    International Nuclear Information System (INIS)

    De Ruysscher, Dirk; Dehing, Cary; Yu, Shipeng; Wanders, Rinus; Ollers, Michel; Dingemans, Anne-Marie C.; Bootsma, Gerben; Hochstenbag, Monique; Geraedts, Wiel; Pitz, Cordula; Simons, Jean; Boersma, Liesbeth; Borger, Jacques; Dekker, Andre; Lambin, Philippe

    2009-01-01

    Purpose: To determine what the influence is of dyspnea (CTCAE3.0) before high-dose radiotherapy (RT) on the incidence and severity of subsequent lung toxicity in patients with non-small cell lung cancer (NSCLC). Methods: In 197 patients with stage I-III NSCLC maximal dyspnea scores (CTCAE3.0) were obtained prospectively at three time periods: before RT, the first 6 months post-RT and 6-9 months post-RT. Only patients who were clinically progression-free 12 months or more after RT were included, thus minimizing dyspnea due to tumor progression. Time-trends of dyspnea as a function of baseline dyspnea were investigated and correlated with gender, age, chemotherapy, mean lung dose (MLD), lung function parameters (FeV1 and DLCO), stage, PTV dose, overall treatment time and smoking habits. Results: The proportion developing less, the same or more dyspnea 6-9 months post-treatment according to their baseline dyspnea scores was: Grade 0: none, 82.9%, 17.1%; Grade 1: 21.2%, 51.9%, 26.9%; Grade 2: 27.3%, 54.5%, 18.2%, respectively. Only age was associated with increased dyspnea after RT. Conclusions: Patients with dyspnea before therapy have a realistic chance to improve after high-dose radiotherapy. Reporting only dyspnea at one time-point post-RT is insufficient to determine radiation-induced dyspnea.

  6. SCALE AND RELATIONSHIP ANALYSIS FOR TURKISH FURNITURE SECTOR

    Directory of Open Access Journals (Sweden)

    Ahmet Bahattin DALGAKIRAN

    2017-04-01

    Full Text Available The aim of this study is to develop a scale for the existing problems in the furniture industry and to analyze the relevance of the developed scale factors within the framework of supply chain management. In the study, literature research was done and the competition elements used in the furniture sector were determined. These identified elements were updated by using Delphi technique and a questionnare form was prepared. Factor analysis was performed with the data obtained in response to the responses given to the sector authorities. 16 elements were analyzed under three main factors; supply chain management, environment factor and innovative factor. Then, regression analysis was carried out to elaborate the relations among these three factors. 64% of supply chain management is explained by environmental elements and 23% by innovative elements. All of the hypotheses developed in the study were accepted.

  7. Technical Basis of Scaling Relationships for the Pretreatment Engineering Platform

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, William L.; Arm, Stuart T.; Huckaby, James L.; Kurath, Dean E.; Rassat, Scot D.

    2008-07-15

    Pacific Northwest National Laboratory has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Waste Treatment Plant (RPP-WTP) project to perform research and development activities. The Pretreatment Engineering Platform (PEP) is being designed and constructed as part of a plan to respond to an issue raised by the WTP External Flowsheet Review Team (EFRT) entitled “Undemonstrated Leaching Processes” and numbered M12. The PEP replicates the WTP leaching process using prototypic equipment and control strategies. The approach for scaling PEP performance data to predict WTP performance is critical to the successful resolution of the EFRT issue. This report describes the recommended PEP scaling approach, PEP data interpretation and provides recommendations on test conduct and data requirements.

  8. Large-scale prediction of drug-target relationships

    DEFF Research Database (Denmark)

    Kuhn, Michael; Campillos, Mónica; González, Paula

    2008-01-01

    , but also provides a more global view on drug-target relations. Here we review recent attempts to apply large-scale computational analyses to predict novel interactions of drugs and targets from molecular and cellular features. In this context, we quantify the family-dependent probability of two proteins...... to bind the same ligand as function of their sequence similarity. We finally discuss how phenotypic data could help to expand our understanding of the complex mechanisms of drug action....

  9. Massive right atrial myxoma with dyspnea at rest in an elderly patient: A case report

    Directory of Open Access Journals (Sweden)

    Romanović Radoslav

    2015-01-01

    Full Text Available Introduction. Primary heart tumors are extremely rare and myxoma is the most common type of these tumors. Although intraatrial presentation is a predilection place, right atrial localization is atypical. The symptom triad is characteristic in the clinical presentation of the tumor: embolic complication, intracardiac blood flow obstruction and systemic manifestations like elevated erythrocyte sedimentation rate, fever, anemia, body weight loss. Case report. We presented an elderly female patient with massive myxoma in the right atrium, 77 × 44 mm in diameter, which filled the entire right atrium and spread into the right ventricle, causing the tricuspid valve obstruction and dyspnea. It was visualized by transthoracic echocardiography and small and insignificant pericardial effusion was also seen. After surgical removal of the tumor, the patient remained without any symptoms and pericardial effusion. Conclusion. Tumors of the right heart have to be considered in the differential diagnosis of unexplained dyspnea in elderly patients. Transthoracic echocardiography is certainly necessary and mostly available diagnostic tool that can be of great help in diagnosing heart tumor as well as planning cardiac surgery, as it provides in most cases excellent visualization of the tumor and its relationship with other parts of the heart.

  10. Yoga-based pulmonary rehabilitation for the management of dyspnea in coal miners with chronic obstructive pulmonary disease: A randomized controlled trial.

    Science.gov (United States)

    Ranjita, Rajashree; Hankey, Alex; Nagendra, H R; Mohanty, Soubhagylaxmi

    Coal mine dust exposure causes chronic airflow limitation in coal miners resulting in dyspnea, fatigue, and eventually chronic obstructive pulmonary disease (COPD). Yoga can alleviate dyspnea in COPD by improving ventilatory mechanics, reducing central neural drive, and partially restoring neuromechanical coupling of the respiratory system. To evaluate the effectiveness of Integrated Approach of Yoga Therapy (IAYT) in the management of dyspnea and fatigue in coal miners with COPD. Randomized, waitlist controlled, single-blind clinical trial. Eighty-one coal miners (36-60 years) with stable Stages II and III COPD were recruited. The yoga group received an IAYT module for COPD that included asanas, loosening exercises, breathing practices, pranayama, cyclic meditation, yogic counseling and lectures 90 min/day, 6 days/week for 12 weeks. Measurements of dyspnea and fatigue on the Borg scale, exercise capacity by the 6 min walk test, peripheral capillary oxygen saturation (SpO 2 %), and pulse rate (PR) using pulse oximetry were made before and after the intervention. Statistically significant within group reductions in dyspnea (P yoga group; all except the last were significant compared to controls (P Yoga can now be included as an adjunct to conventional therapy for pulmonary rehabilitation programs for COPD patients. Copyright © 2016 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

  11. Allometric scaling relationship between above- and below-ground biomass within and across five woody seedlings.

    Science.gov (United States)

    Cheng, Dongliang; Ma, Yuzhu; Zhong, Quanling; Xu, Weifeng

    2014-10-01

    Allometric biomass allocation theory predicts that leaf biomass (M L ) scaled isometrically with stem (M S ) and root (M R ) biomass, and thus above-ground biomass (leaf and stem) (M A ) and root (M R ) scaled nearly isometrically with below-ground biomass (root) for tree seedlings across a wide diversity of taxa. Furthermore, prior studies also imply that scaling constant should vary with species. However, litter is known about whether such invariant isometric scaling exponents hold for intraspecific biomass allocation, and how variation in scaling constants influences the interspecific scaling relationship between above- and below-ground biomass. Biomass data of seedlings from five evergreen species were examined to test scaling relationships among biomass components across and within species. Model Type II regression was used to compare the numerical values of scaling exponents and constants among leaf, stem, root, and above- to below-ground biomass. The results indicated that M L and M S scaled in an isometric or a nearly isometric manner with M R , as well as M A to M R for five woody species. Significant variation was observed in the Y-intercepts of the biomass scaling curves, resulting in the divergence for intraspecific scaling and interspecific scaling relationships for M L versus M S and M L versus M R , but not for M S versus M R and M A versus M R . We conclude, therefore, that a nearly isometric scaling relationship of M A versus M R holds true within each of the studied woody species and across them irrespective the negative scaling relationship between leaf and stem.

  12. Relationship Among McCarthy Scales of Children's Abilities, WPPSI, and Columbia Mental Maturity Scale

    Science.gov (United States)

    Phillips, Betty L.; And Others

    1978-01-01

    Concurrent validity of the McCarthy Scales of Children's Abilities for 60 kindergartners was investigated, using the WPPSI and Columbia Mental Maturity Scale. Although correlations were of acceptable magnitude, the General Cognitive Index of the MSCA was significantly lower than major scores obtained on the other two tests. (Author)

  13. Interactions between dyspnea and the brain processing of nociceptive stimuli:experimental air hunger attenuates laser-evoked brain potentials in humans.

    Directory of Open Access Journals (Sweden)

    Laurence eDANGERS

    2015-12-01

    Full Text Available Dyspnea and pain share several characteristics and certain neural networks and interact with each other. Dyspnea-pain counter-irritation consists of attenuation of preexisting pain by intercurrent dyspnea and has been shown to have neurophysiological correlates in the form of inhibition of the nociceptive spinal reflex RIII and laser-evoked potentials (LEPs. Experimentally induced exertional dyspnea inhibits RIII and LEPs, while air hunger dyspnea does not inhibit RIII despite its documented analgesic effects. We hypothesized that air hunger may act centrally and inhibit LEPs. LEPs were obtained in 12 healthy volunteers (age: 21-29 during spontaneous breathing (FB, ventilator-controlled breathing (VC tailored to FB, after inducing air hunger by increasing the inspired fraction of carbon dioxide -FiCO2- (VCCO2, and during ventilator-controlled breathing recovery (VCR. VCCO2 induced intense dyspnea (visual analogue scale = 63% ± 6% of full scale, p<0.001 vs. VC, predominantly of the air hunger type. VC alone reduced the amplitude of the N2-P2 component of LEPs (∆ = 24.0% ± 21.1%, p<0.05, effect-size = 0.74 predominantly through a reduction in P2, and the amplitude of this inhibition was further reduced by inducting air hunger (∆ = 22.6% ± 17.9%, p<0.05, effect-size = 0.53, predominantly through a reduction in N2. Somatosensory-evoked potentials (SEPs were not affected by VC or VCCO2, suggesting that the observed effects are specific to pain transmission. We conclude that air hunger interferes with the cortical mechanisms responsible for the cortical response to painful laser skin stimulation, which provides a neurophysiological substrate to the central nature of its otherwise documented analgesic effects.

  14. [A case of laryngeal papilloma with sudden dyspnea].

    Science.gov (United States)

    Pabiszczak, Maciej; Wierzbicka, Małgorzata; Borucki, Lukasz; Iwanik, Katarzyna

    2005-01-01

    Laryngeal papilloma is one of the most common non-malignant tumors of the larynx. In adult they are included to pre-cancerous diseases. In morphological examination, it is a solid tumor. Often it is possible to cure them during one surgical procedure. The disease is mostly localized on the anterior commissurae region, vocal fold, ventricules, and on the laryngeal surface of the epiglottis. If the malignant transformation is suspected, a large excision with margin has to be performed, completed by a histological evaluation. A case of a huge laryngeal papilloma with dyspnea is presented.

  15. Encountering unexpected difficult airway: relationship with the intubation difficulty scale.

    Science.gov (United States)

    Koh, Wonuk; Kim, Hajung; Kim, Kyongsun; Ro, Young-Jin; Yang, Hong-Seuk

    2016-06-01

    An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation.

  16. Relationships between avian richness and landscape structure at multiple scales using multiple landscapes

    Science.gov (United States)

    Michael S. Mitchell; Scott H. Rutzmoser; T. Bently Wigley; Craig Loehle; John A. Gerwin; Patrick D. Keyser; Richard A. Lancia; Roger W. Perry; Christopher L. Reynolds; Ronald E. Thill; Robert Weih; Don White; Petra Bohall Wood

    2006-01-01

    Little is known about factors that structure biodiversity on landscape scales, yet current land management protocols, such as forest certification programs, place an increasing emphasis on managing for sustainable biodiversity at landscape scales. We used a replicated landscape study to evaluate relationships between forest structure and avian diversity at both stand...

  17. Dyspnea is a dangerous symptom in the pre-hospital setting

    DEFF Research Database (Denmark)

    Bøtker, Morten Thingemann; Kirkegaard, Hans; Christensen, Erika Frischknecht

    , resuscitation from cardiac arrest, acute dyspnea of unknown origin and other suspicion of STEMI. We hypothesize that unresolved dyspnea is an independent predictor of mortality in this prehospital setting and that the mortality is higher in patients with acute dyspnea of unknown origin than in patients......,204 (70%) of the patients, acute dyspnea of unknown origin in 1,461 (8 %), resuscitated from cardiac arrest in 163 (1%) and other suspicion of STEMI in 3,533 (20%). When adjusting for age, sex, systolic blood pressure and Charlson Comorbidity Index (p... with unresolved dyspnea than in patients with chest pain with a RR 2.55 (CI 2.09-3.10). This difference remained significant at 4 years with a RR of 1.34 (CI 1.24-1.45). Conclusion Acute dyspnea of unknown origin in the pre-hospital setting is an independent predictor of mortality and the mortality is higher than...

  18. Acute laryngeal dyspnea as first presentation of granulomatosis with polyangiitis.

    Science.gov (United States)

    Pajor, Anna Maria; Kwiatkowska, Sylwia; Kroczyńska-Bednarek, Jadwiga; Piotrowski, Wojciech J

    2015-01-01

    Granulomatosis with polyangiitis (GPA) is a multi-organ disease which mostly affects lungs, kidney, and head and neck region. We report a rare case of acute laryngeal dyspnea and rapidly progressive pulmonary changes as first manifestations of disease. A 53 year-old woman presented with symptoms of two-week dyspnea, which aggravated rapidly in the preceding hours. Laryngological examination revealed subglottic infiltrations and vocal fold oedema which required urgent tracheotomy. During few days she developed gingival ulcerations and pulmonary infiltration with negative serum c-ANCA titers. The histopathological examination of subglottic and gingival biopsies and the clinical picture established the diagnosis of GPA. She was treated with prednisone and cyclophosphamide with recovery; however, during over 3 years of follow-up, pulmonary symptoms relapsed and subglottic stenosis persisted. The difficulties in diagnosis and treatment in this unusual presentation of GPA are outlined with conclusion that in patients with subglottic infiltration, which develops rapidly, even when this is a sole presentation of the disease, and when c-ANCA are negative, GPA should always be considered.

  19. A Large Intra-Abdominal Hiatal Hernia as a Rare Cause of Dyspnea

    Directory of Open Access Journals (Sweden)

    Cem Sahin

    2015-01-01

    Full Text Available Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiac symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period, by compressing the left atrium and right pulmonary vein. We considered presenting this case as large hiatal hernia is a rare, intra-abdominal cause of dyspnea.

  20. Evaluation of a combination of low-dose ketamine and low-dose midazolam in terminal dyspnea-attenuation of "double-effect"

    Directory of Open Access Journals (Sweden)

    Abhijit Kanti Dam

    2008-01-01

    Full Text Available Aim: Of all symptoms in palliative medicine those concerning respiration are most excruciating and difficult to treat. Reticence about the use of morphine for palliation of dyspnea is common, especially in nonmalignant diseases, as there is a fear of causing respiratory depression, particularly where Chronic Obstructive Pulmonary Disease (COPD exists. This factor is also compounded by the lack of availability of morphine in parts of developing countries. Ketamine has excellent anesthetic and analgesic effects in addition to being easily available. It produces bronchodilatation and does not produce respiratory or cardiovascular depression. The author seeks to evaluate the role of low-dose (0.2 mg/kg ketamine and midazolam (0.02 mg/kg in the attenuation of terminal dyspnea. Methods: Sixteen patients with terminal dyspnea, admitted to the Critical Care Unit (CCU with cancer and other noncancer diagnoses were recruited. The subjective component of dyspnea was assessed using the Graphic Rating Scale (GRS, which has values from 0 - 10, 10 being maximum dyspnea. Each patient received a low-dose of ketamine and midazolam for relief of dyspnea. All the patients received low-flow (2 L/min. oxygen therapy via nasal cannula. Immediately after admission, all the patients were reassured and nursed in a decubitus position of their choice. The GRS was recorded at the point of admission, 10 minutes after starting oxygen therapy, and ten minutes after administration of low-dose ketamine and midazolam. Hemodynamic parameters were also recorded at these three points. Result: All the patients who enrolled in our study had significant dyspnea at admission, as was evident from the GRS scores of 8.250 (SD 0.91, respiratory rate of 28.56 (SD 5.0, mean arterial blood pressure (MABP of 102.7 (SD 14.63, pulse rate of 115.62 (SD 23.3, and SpO2 of 92.43 (SD 2.38. All the patients benefited from the combination of ketamine and midazolam, as evidenced by the statistically

  1. PROMIS Pediatric Peer Relationships Scale: development of a peer relationships item bank as part of social health measurement.

    Science.gov (United States)

    Dewalt, Darren A; Thissen, David; Stucky, Brian D; Langer, Michelle M; Morgan Dewitt, Esi; Irwin, Debra E; Lai, Jin-Shei; Yeatts, Karin B; Gross, Heather E; Taylor, Olivia; Varni, James W

    2013-10-01

    This study's objective was to develop a measure of social health using item response theory as part of the Patient Reported Outcomes Measurement Information System (PROMIS). After candidate items were generated from review of prior literature, focus groups, expert input, and cognitive interviews, items were administered to youth aged 8-17 as part of the PROMIS pediatric large scale testing. Exploratory and confirmatory factor analyses were used to assess dimensionality and to identify instances of local dependence. Items that met the unidimensionality criteria were subsequently calibrated using Samejima's Graded Response Model. Differential item functioning was examined by gender and age. The sample included 3,048 youth who completed the questionnaire (51.8% female, 60% white, and 22.7% with chronic illness). The initial conceptualization of social function and sociability did not yield unidimensional item banks. Rather, factor analysis revealed dimensions contrasting peer relationships and adult relationships. The analysis also identified dimensions formed by responses to positively versus negatively worded items. The resulting 15-item bank measures quality of peer relationships and has strong psychometric characteristics as a full bank or an 8-item short form. The PROMIS pediatric peer relationships scale demonstrates good psychometric characteristics and addresses an important aspect of child health. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  2. [Hemosiderin-laden macrophages count in sputum in diagnosis of dyspnea of heart origin].

    Science.gov (United States)

    Bellido-Casado, Jesús; Belda, José; Bayés-Genís, Antonio; Margarit, Gisela; López, Laura; Casan, Pere; Hernán Cotes, Carlos; Antón, Antonio; Santaló, Miguel; Ordóñez-Llanos, Jordi

    2005-04-23

    The respiratory or heart origin of dyspnea is not always easy to find out using the available diagnostic tools. Many patients present both heart and lung diseases that cause dyspnea. The role of hemosiderin-laden macrophages count (HC) in sputum in this context has not been well settled so far. The objective was to describe the prediction usefulness of HC in patients suffering from dyspnea of heart origin, and to find out if HC changed after administering treatment. HC was analyzed in 61 patients whose main symptom was dyspnea in the emergency department, and it was evaluated by means of clinical history, clinical course and performance of lung function tests and echocardiography. 35 patients were classified as having dyspnea of heart origin, 17 as having dyspnea of lung origin and 9 had dyspnea of both origins. The HC was higher in patients with dyspnea of heart origin 37% (95% CI, 26-47) or cardiopulmonary origin 30% (95% CI, 8-52) than in patients with dyspnea of lung origin 15% (95% CI, 4-27), and it remained higher despite administering treatment. The sensitivity (52%), specificity (88%), positive predictive value (92%) and negative predictive value (58%) was established for a 30% HC cutoff. The prediction model of heart origin dyspnea presented an area under the ROC curve of 0.978 (95% CI, 0.95-1). HC reflects the severity of pulmonary venocapillar disturbance, identifies the majority of patients suffering from current or past heart failure or severe cardiac dysfunction, and is useful for the prediction of dyspnea of heart origin. HC utility should focus on selected patients.

  3. Acromegaly presented as a cause of laryngeal dyspnea.

    Science.gov (United States)

    Saussez, S; Mahillon, V; Chantrain, G; Thill, M P; Lequeux, T

    2007-12-01

    Acromegalic patients can develop obstructive sleep apnea syndrome or upper airflow obstruction. The development of dyspnea is unusual and the fixation of both vocal cords is exceptional. We report the case of a patient with bilateral vocal cord paralysis. Fiberoptic laryngoscopy and computed tomography (CT) of the neck showed a supra-glottic stenosis due to a swelling of the soft tissue. A tracheostomy was first performed. Thereafter, micro-laryngoscopy using laser vaporisation of the supra-glottic soft tissue was attempted but failed to remove the tracheostomy canula. Finally, blood tests and cerebral MRI revealed an acromegaly. The patient underwent a trans-sphenoidal resection of the pituitary adenoma. Fifteen months later, fiberoptic laryngoscopy showed bilateral restoration of vocal cord mobility and the tracheostomy canula was successfully removed after 18 months. Vocal cord fixation is probably due to hypopharyngeal and laryngeal soft tissue swelling and can be reversible after successful treatment of the adenoma.

  4. Dyspnea and dysphagia associated to hypopharyngeal fibrolipoma: A case report

    Directory of Open Access Journals (Sweden)

    Marco A. Mendez Saenz, MD

    2017-04-01

    Full Text Available Fibrolipomas are benign lesions conformed by fat and connective tissue, classified as histologic variants of lipomas. They are rarely located in the head and neck and represent less than 0.6% of the benign tumors of the larynx and hypopharynx. Their clinical presentation depends on its location and size. We present the case of a 51-year-old male patient who reported progressive dyspnea, dysphagia and obstructive sleep symptoms with a duration of 3 months, without apparent cause. A pharyngolaryngeal fiberoptic endoscopy showed a smooth, rounded mass in the posterior wall of the hypopharynx, partially obstructing the laryngeal vestibule, creating a valve effect. Complete trans-cervical resection of the lesion was performed after the airway was secured by means of a tracheotomy. The final histopathology report was fibrolipoma. He is currently asymptomatic and without evidence of relapse one year after the procedure.

  5. Severe dyspnea in a patient with neurofibromatosis type 1

    Directory of Open Access Journals (Sweden)

    P.B. Poble

    2017-01-01

    Full Text Available Neurofibromatosis type 1 (NF1 is a genetic disease in which pulmonary complications are rare, but severe, especially pulmonary hypertension (PH. The mechanisms underlying the onset of PH in patients with NF1 are unclear and might be multifactorial. In particular, the frequent presence of pulmonary parenchymal lesions makes etiological diagnosis of PH difficult. We describe here the case of a patient with NF1 admitted to our clinic with dyspnea and right heart failure revealing severe pre-capillary PH. Parenchymal lesions were mild and PH was attributed to pulmonary vascular involvement. Clinical and hemodynamic conditions of the patient improved under pulmonary arterial hypertension-specific combination therapy. This case suggests that treatment of PH due to pulmonary vascular involvement in NF1 may be aligned with recommendations for PAH treatment.

  6. Parapharyngeal space lipomatosis with secondary dyspnea, disphagia and disphonia.

    Science.gov (United States)

    Garcia-Ortega, Dorian Yarih; Gomez-Pedraza, Antonio; Luna-Ortiz, Kuauhyama

    2015-01-01

    Parapharyngeal space tumors are a small percentage of all head and neck neoplasms. Due to their anatomic location, they represent a therapeutic challenge. To our knowledge, 11 cases of parapharyngeal lipomatous tumors have been reported in the literature. A 48 year old male with chief complaints of dyspnea, dysphagia and dysphonia was found to have a parapharyngeal space tumor. He was scheduled to undergo lumpectomy and neck exploration. Benign tumors represented 70% of all cases. Open neck surgery is considered the gold-standard of treatment. It is important to bear in mind the lipomas of the parapharyngeal space to establish an accurate diagnosis and implement timely, appropriate treatment in order to avoid future complications and reduce morbidity and mortality. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. The scaling relationship between baryonic mass and stellar disc size in morphologically late-type galaxies

    Science.gov (United States)

    Wu, Po-Feng

    2018-02-01

    Here I report the scaling relationship between the baryonic mass and scale-length of stellar discs for ∼1000 morphologically late-type galaxies. The baryonic mass-size relationship is a single power law R_\\ast ∝ M_b^{0.38} across ∼3 orders of magnitude in baryonic mass. The scatter in size at fixed baryonic mass is nearly constant and there are no outliers. The baryonic mass-size relationship provides a more fundamental description of the structure of the disc than the stellar mass-size relationship. The slope and the scatter of the stellar mass-size relationship can be understood in the context of the baryonic mass-size relationship. For gas-rich galaxies, the stars are no longer a good tracer for the baryons. High-baryonic-mass, gas-rich galaxies appear to be much larger at fixed stellar mass because most of the baryonic content is gas. The stellar mass-size relationship thus deviates from the power-law baryonic relationship, and the scatter increases at the low-stellar-mass end. These extremely gas-rich low-mass galaxies can be classified as ultra-diffuse galaxies based on the structure.

  8. Work addiction in Poland: adaptation of the Bergen Work Addiction Scale and relationship with psychopathology

    OpenAIRE

    Paweł Andrzej Atroszko; Ståle Pallesen; Mark D. Griffiths; Cecilie Schou Andreassen

    2017-01-01

    Background:\\ud Work addiction has been recognized as a potential behavioral addiction, and studies have consistently shown its negative relationship with psychosocial functioning. However, in many countries, such as Poland, very few work addiction studies are based on measures developed using an addiction framework. Against this backdrop, the Bergen Work Addiction Scale (BWAS) was adapted for use in Polish samples and its relationship with psychopathology was investigated.\\ud Participants and...

  9. Desensitization to dyspnea in COPD with specificity for exercise training mode

    Directory of Open Access Journals (Sweden)

    Christopher B Cooper

    2008-09-01

    Full Text Available Christopher B CooperDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USAAbstract: Patients with chronic obstructive pulmonary disease (COPD exhibit improved exercise capacity after physical training due to reconditioning and improved ventilatory efficiency. Other possible effects are improved ventilatory muscle function and desensitization to dyspnea. We compared general physical training (GPT, consisting of walking and stair climbing exercises, with inspiratory muscle training (IMT, consisting of targeted breathing through inspiratory resistances, in two groups with severe COPD. Seven subjects; age 60 (8 years, forced expiratory volume in one second (FEV1 0.84 (0.35 L, arterial oxygen tension (PaO2 11.1 (0.8 kPa, arterial carbon dioxide tension (PaCO2 4.9 (0.3 kPa, had GPT and nine subjects; age 60 (9 years, FEV1 0.83 (0.31 L, PaO2 10.4 (0.8 kPa, PaCO2 4.4 (0.5 kPa had IMT. Each group trained daily for 30 minutes for eight weeks and 70% of the sessions were supervised. Six minute walking distance increased in both groups: 32 m (6.9% P < 0.05 with GPT and 23 m (4.8%; P < 0.05 with IMT but significant improvements in symptom-limited incremental cycle exercise performance were not detected. Breathlessness by visual analog scale was reduced following 6-minute walks after GPT (P < 0.05 but not after IMT. Following maximal incremental tests, breathlessness scores were unchanged for both groups. COPD patients performing regular physical exercise report reductions in breathlessness which are specific to the exercise training mode.Keywords: COPD, exercise, ventilatory muscles, dyspnea

  10. Inspiratory muscle training reduces diaphragm activation and dyspnea during exercise in COPD.

    Science.gov (United States)

    Langer, Daniel; Ciavaglia, Casey E; Faisal, Azmy; Webb, Katherine A; Neder, J Alberto; Gosselink, Rik; Dacha, Sauwaluk; Topalovic, Marko; Ivanova, Anna; O'Donnell, Denis E

    2018-03-15

    Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max). The effects of 8 weeks of controlled IMT on respiratory muscle function, dyspnea, respiratory mechanics, and diaphragm electromyography (EMGdi) during constant-work rate cycle exercise were evaluated in patients with activity-related dyspnea (Baseline Dyspnea Index training control group (n=10 each). Twenty subjects (FEV 1 = 47{plus minus}19 %predicted; Pi,max= -59{plus minus}14 cmH 2 O; cycle ergometer peak work rate= 47{plus minus}21 %predicted) completed the study; groups had comparable baseline lung function, respiratory muscle strength, activity-related dyspnea and exercise capacity. IMT, compared with control, was associated with greater increases in inspiratory muscle strength and endurance, with attendant improvements in exertional dyspnea and exercise endurance time (all pinspiratory pressures, breathing pattern and operating lung volumes during exercise. In conclusion, IMT improved inspiratory muscle strength and endurance in mechanically compromised patients with COPD and low Pi,max. The attendant reduction in EMGdi/EMGdi,max helped explain the decrease in perceived respiratory discomfort despite sustained high ventilation and intrinsic mechanical loading over a longer exercise duration.

  11. Prevalence and potential determinants of exertional dyspnea after acute pulmonary embolism.

    NARCIS (Netherlands)

    Klok, F.A.; Kralingen, K.W. van; Dijk, A.P.J. van; Heyning, F.H.; Vliegen, H.W.; Huisman, M.V.

    2010-01-01

    BACKGROUND: The exact prevalence and etiology of exertional dyspnea in the clinical course of acute pulmonary embolism (PE) have not yet been established. METHODS: A large cohort of consecutive patients diagnosed with acute PE was subjected to a dyspnea questionnaire and invited for cardiopulmonary

  12. Unrecognized suffering in the ICU: Addressing dyspnea in mechanically ventilated patients

    Science.gov (United States)

    Schmidt, Matthieu; Banzett, Robert B.; Raux, Mathieu; Morélot-Panzini, Capucine; Dangers, Laurence; Similowski, Thomas; Demoule, Alexandre

    2014-01-01

    Background Intensive care unit (ICU) patients are exposed to many sources of discomfort. Although growing attention has been given to the detection and treatment of pain, very little has been given to the detection and treatment of dyspnea (defined as ‘breathing discomfort’). Discussion In this article, we review the published information on prevalence, mechanisms and potential negative impacts of dyspnea in mechanically ventilated patients. In addition, we review the most appropriate tools to detect and quantify dyspnea in ICU patients. Conclusions Growing evidence suggests that dyspnea is a frequent issue in mechanically ventilated ICU patients, is highly associated with anxiety and pain, and is improved in many patients by altering ventilator settings. Future studies are needed to better delineate the impact of dyspnea in the ICU, and to define diagnostic, monitoring and therapeutic protocols. PMID:24132382

  13. Exercise therapy in the management of dyspnea in patients with cancer

    Science.gov (United States)

    Koelwyn, Graeme J.; Jones, Lee W.; Hornsby, Whitney; Eves, Neil D.

    2013-01-01

    Purpose of review Dyspnea is a frequent, debilitating, and understudied symptom in cancer associated with poor prognosis and reduced health-related quality of life. The purpose of this study is to review the incidence, pathophysiology, and mechanisms of dyspnea in patients diagnosed with cancer. We also discuss the existing evidence supporting the efficacy of exercise therapy to complement traditional approaches to reduce the impact of this devastating symptom in persons with cancer. Recent findings In other clinical populations presenting with dyspnea, such as chronic obstructive pulmonary disease, exercise therapy is demonstrated to be an efficacious strategy. In contrast, relatively few studies to date have investigated the efficacy of exercise training as a therapeutic strategy to mitigate dyspnea in patients with cancer. Summary Although much more work is required, exercise therapy is a promising adjunct strategy to systematically reduce dyspnea in the oncology setting that may also provide additive efficacy when prescribed in combination with other adjunct therapies including pharmacologic interventions. PMID:22516976

  14. An Investigation of the Relationship Between the Alliance Negotiation Scale and Psychotherapy Process and Outcome.

    Science.gov (United States)

    Doran, Jennifer M; Safran, Jeremy D; Muran, J Christopher

    2017-04-01

    This study examines the validity of the Alliance Negotiation Scale (ANS) in a psychotherapy research program. Analyses were designed to evaluate the relationship between the ANS and psychotherapy process and outcome variables. Data were collected in a metropolitan psychotherapy research program. Participants completed 30 sessions of therapy, postsession assessments, and a battery of measures at intake and termination. Relationships were found between the ANS and session outcome, working alliance, and the presence of ruptures and their resolution. Relationships emerged between the ANS and treatment outcome on measures of psychiatric distress and interpersonal problems. The ANS demonstrated relationships with several psychotherapy process and outcome variables. The ANS was the most differentiated from the working alliance on measures of interpersonal functioning and in discriminating personality disorder pathology. These results extend previous findings on the ANS' psychometric integrity, and offer new data on the relationship between negotiation and treatment outcome. © 2016 Wiley Periodicals, Inc.

  15. Regional processes in mangrove ecosystems: Spatial scaling relationships, biomass, and turnover rates following catastrophic disturbance

    Science.gov (United States)

    Ward, G.A.; Smith, T. J.; Whelan, K.R.T.; Doyle, T.W.

    2006-01-01

    Physiological processes and local-scale structural dynamics of mangroves are relatively well studied. Regional-scale processes, however, are not as well understood. Here we provide long-term data on trends in structure and forest turnover at a large scale, following hurricane damage in mangrove ecosystems of South Florida, U.S.A. Twelve mangrove vegetation plots were monitored at periodic intervals, between October 1992 and March 2005. Mangrove forests of this region are defined by a -1.5 scaling relationship between mean stem diameter and stem density, mirroring self-thinning theory for mono-specific stands. This relationship is reflected in tree size frequency scaling exponents which, through time, have exhibited trends toward a community average that is indicative of full spatial resource utilization. These trends, together with an asymptotic standing biomass accumulation, indicate that coastal mangrove ecosystems do adhere to size-structured organizing principles as described for upland tree communities. Regenerative dynamics are different between areas inside and outside of the primary wind-path of Hurricane Andrew which occurred in 1992. Forest dynamic turnover rates, however, are steady through time. This suggests that ecological, more-so than structural factors, control forest productivity. In agreement, the relative mean rate of biomass growth exhibits an inverse relationship with the seasonal range of porewater salinities. The ecosystem average in forest scaling relationships may provide a useful investigative tool of mangrove community biomass relationships, as well as offer a robust indicator of general ecosystem health for use in mangrove forest ecosystem management and restoration. ?? Springer 2006.

  16. Patient-Reported Dyspnea Correlates Poorly with Aerobic Exercise Capacity Measured During Cardiopulmonary Exercise Testing.

    Science.gov (United States)

    Gaspard, Dany; Kass, Jonathan; Akers, Stephen; Hunter, Krystal; Pratter, Melvin

    2017-10-01

    Patient-reported dyspnea plays a central role in assessing cardiopulmonary disease. There is little evidence, however, that dyspnea correlates with objective exercise capacity measurements. If the correlation is poor, dyspnea as a proxy for objective assessment may be misleading. To compare patient's perception of dyspnea with maximum oxygen uptake (MaxVO2) during cardiopulmonary exercise testing (CPET). Fifty patients undergoing CPET for dyspnea evaluation were studied prospectively. Dyspnea assessment was measured by a metabolic equivalent of task (METs) table, Mahler Dyspnea Index, Borg Index, number of blocks walked, and flights of stairs climbed before stopping due to dyspnea. These descriptors were compared to MaxVO2. MaxVO2 showed low correlation with METs table (r = 0.388, p = 0.005) and no correlation with Mahler Index (r = 0.24, p = 0.093), Borg Index (r = -0.017, p = 0.905), number of blocks walked (r = 0.266, p = 0.077) or flights of stairs climbed (r = 0.188, p = 0.217). When adjusted for weight (maxVO2/kg), there was significant correlation between MaxVO2 and METs table (r = 0.711, p  30 had moderate correlation between MaxVO2 and METs table (r = 0.568, p = 0.002). Patient-reported dyspnea correlates poorly with MaxVO2 and fails to predict exercise capacity. Reliance on reported dyspnea may result in suboptimal categorization of cardiopulmonary disease severity.

  17. Sampling scales define occupancy and underlying occupancy-abundance relationships in animals.

    Science.gov (United States)

    Steenweg, Robin; Hebblewhite, Mark; Whittington, Jesse; Lukacs, Paul; McKelvey, Kevin

    2018-01-01

    Occupancy-abundance (OA) relationships are a foundational ecological phenomenon and field of study, and occupancy models are increasingly used to track population trends and understand ecological interactions. However, these two fields of ecological inquiry remain largely isolated, despite growing appreciation of the importance of integration. For example, using occupancy models to infer trends in abundance is predicated on positive OA relationships. Many occupancy studies collect data that violate geographical closure assumptions due to the choice of sampling scales and application to mobile organisms, which may change how occupancy and abundance are related. Little research, however, has explored how different occupancy sampling designs affect OA relationships. We develop a conceptual framework for understanding how sampling scales affect the definition of occupancy for mobile organisms, which drives OA relationships. We explore how spatial and temporal sampling scales, and the choice of sampling unit (areal vs. point sampling), affect OA relationships. We develop predictions using simulations, and test them using empirical occupancy data from remote cameras on 11 medium-large mammals. Surprisingly, our simulations demonstrate that when using point sampling, OA relationships are unaffected by spatial sampling grain (i.e., cell size). In contrast, when using areal sampling (e.g., species atlas data), OA relationships are affected by spatial grain. Furthermore, OA relationships are also affected by temporal sampling scales, where the curvature of the OA relationship increases with temporal sampling duration. Our empirical results support these predictions, showing that at any given abundance, the spatial grain of point sampling does not affect occupancy estimates, but longer surveys do increase occupancy estimates. For rare species (low occupancy), estimates of occupancy will quickly increase with longer surveys, even while abundance remains constant. Our results

  18. Assessing Disharmony and Disaffection in Intimate Relationships: Revision of the Marital Satisfaction Inventory Factor Scales

    Science.gov (United States)

    Herrington, Rachael L.; Mitchell, Alexandra E.; Castellani, Angela M.; Joseph, Jana I.; Snyder, Douglas K.; Gleaves, David H.

    2008-01-01

    Previous research has identified 2 broad components of distress in intimate relationships: overt conflict, or "disharmony", and emotional distance, or "disaffection". Using confirmatory factor analysis, the authors derived 2 broadband scales of disharmony and disaffection from the Marital Satisfaction Inventory-Revised (D. K. Snyder, 1997),…

  19. Assessment of Romantic Perfectionism: Psychometric Properties of the Romantic Relationship Perfectionism Scale

    Science.gov (United States)

    Matte, Melody; Lafontaine, Marie-France

    2012-01-01

    The objective of the present study was to provide validity evidence for the scores from the Romantic Relationship Perfectionism Scale. Results indicate a two-factor structure, adequate reliability, and overall good convergent, concurrent, discriminant, and incremental validity evidence. The strengths and limitations of this measure are discussed.…

  20. Development and properties of a brief scale to assess intimate partner relationship in the postnatal period.

    Science.gov (United States)

    Wynter, Karen; Tran, Thach Duc; Rowe, Heather; Fisher, Jane

    2017-06-01

    Poor quality intimate partner relationship is associated with postnatal depression and anxiety among women. Existing scales assessing the quality of this relationship are long and measure stable aspects of the relationship rather than specific behaviours which may respond to targeted interventions. The aim was to develop and investigate the properties of a brief, life stage-specific scale to assess potentially modifiable partner behaviours in the postpartum period. Participants were primiparous women from diverse geographical and socio-economic backgrounds in Victoria, Australia. Seven study-specific items were developed to assess potentially modifiable aspects of the intimate partner relationship at 6 months postpartum. Women's mental health was assessed using the Composite International Diagnostic Interview and the Patient Health Questionnaire depression and generalised anxiety modules. Factor analysis was conducted on the 7 items, and associations calculated between factor scores. Factor scores were compared for women with and without mental health problems. Mean inter-item correlations were computed to assess internal consistency. Factor analysis on data from 355 women revealed two factors with good internal consistency: Caring Partner Behaviours and Emotionally Abusive Partner Behaviours. Having mental health problems was associated with lower Caring Partner Behaviours and higher Emotionally Abusive Partner Behaviours scores. Interaction between partners was not observed; thus external criterion validity was not assessed. This brief scale is a promising means of assessing potentially modifiable aspects of the intimate partner relationship in the postnatal period. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Relationship between Hounsfield Unit in CT Scan and Gray Scale in CBCT

    Directory of Open Access Journals (Sweden)

    Tahmineh Razi

    2014-06-01

    Full Text Available Background and aims. Cone-beam computed tomography (CBCT is an imaging system which has many advantages over computed tomography (CT. In CT scan, Hounsfield Unit (HU is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value. The aim of the present study was to investigate the relationship between gray scale in CBCT and Hounsfield Unit (HU in CT scan. Materials and methods. In this descriptive study, the head of a sheep was scanned with 3 CBCT and one medical CT scanner. Gray scales and HUs were detected on images. Reconstructed data were analyzed to investigate relationship between CBCT gray scales and HUs. Results. A strong correlation between gray scales of CBCT and HUs of CT scan was determined. Conclusion. Considering the fact that gray scale in CBCT is the criteria in measurement of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

  2. Impact of Prophylactic Fentanyl Pectin Nasal Spray on Exercise-Induced Episodic Dyspnea in Cancer Patients: A Double-Blind, Randomized Controlled Trial

    Science.gov (United States)

    Hui, David; Kilgore, Kelly; Park, Minjeong; Williams, Janet; Liu, Diane; Bruera, Eduardo

    2016-01-01

    Context Episodic breathlessness is common and debilitating in cancer patients. Objectives In this pilot study, we examined the effect of prophylactic fentanyl pectin nasal spray (FPNS) on exercise-induced dyspnea, physiologic function and adverse events. Methods In this parallel, double-blind randomized placebo-controlled trial, opioid-tolerant patients performed three six-minute walk tests (6MWT) to induce dyspnea. They were randomized to receive either FPNS (15−25% of total daily opioid dose each time) or placebo 20 minutes before the second and third 6MWTs. We compared dyspnea numeric rating scale (NRS, 0−10, primary outcome), walk distance, vital signs, neurocognitive function and adverse events between the first and second 6MWTs (T2-T1) and between the first and third 6MWTs (T3-T1). Results Twenty-four patients enrolled, with 96% completion. FPNS was associated with significant within-arm reduction in dyspnea NRS at rest (T2-T1: −0.9 [95% confidence interval [CI] −1.7,−0.1]; T3-T1: −1.3 [95% CI −2.0,−0.5]) and after six minutes (T2-T1: −2.0 [95% CI −3.5,−0.6]; T3-T1: −2.3 [95% CI −4.0,−0.7]), and longer walk distance (T2-T1 +23.8m [95% CI +1.3,+46.2m]; T3-T1: +23.3m [95% CI −1.7,+48.2]). In the placebo arm, we observed no significant change in walk distance nor dyspnea NRS at rest, but significant reduction in dyspnea NRS at 6 minutes (T2-T1: −1.7 [95% CI −3.3,−0.1]; T3-T1: −2.5 [95% CI −4.2,−0.9]). Vital signs, neurocognitive function and adverse effects did not differ significantly. Conclusion FPNS was safe, reduced dyspnea at rest and increased walk distance in before-after comparison. The placebo effect was substantial, which needs to be factored in future study designs.(clinicaltrials.gov registration: NCT01832402) PMID:27401508

  3. Daily functioning of dyspnea, self-esteem and physical self in patients with moderate COPD before, during and after a first inpatient rehabilitation program.

    Science.gov (United States)

    Ninot, Gregory; Moullec, Gregory; Desplan, Jacques; Prefaut, Christian; Varray, Alain

    2007-11-30

    Inpatient rehabilitation improves dyspnea and increases self-esteem between admission and discharge in patients with moderate chronic obstructive pulmonary disease (COPD). Some researchers nevertheless argue that the changes may be due to nursing effects and thus that scores will decrease quickly at home after discharge. This study assessed the change in dyspnea, self-esteem and physical self mean scores and stability in patients with moderate COPD during three consecutive four-week periods: at home, during an inpatient rehabilitation program, and again at home post-discharge. Twenty-three consecutive patients [63.9 years (SD 6.6)] with moderate COPD [FEV1 = 55.8% (SD 13.2)] were included. The participants responded to the Physical Self Inventory and rated dyspnea using a visual analogue scale twice a day. Exercise tolerance was assessed with the six-minute walk test (6MWT) at admission and discharge. 6MWT performance improved between admission and discharge [452.3 m. (SD 74.0) vs. 503.3 m. (SD 80.4), p self-esteem and physical self scores between the two home periods (p self-worth at home post-discharge compared to pre-admission (p self-esteem, the perceptions of physical condition and attractive body were all significant. After rehabilitation, the coefficients between dyspnea, and perceived physical condition, physical strength and sport competence were significant (p self scores in patients with moderate COPD and decreases their instability; the program also improves dyspnea. However, the impact of rehabilitation was greater on specific perceptions of physical abilities than on the global self-esteem. Randomized controlled trials are needed to confirm these changes, which were probably due to rehabilitation program.

  4. Dyspnea in a nonagenarian: The usual suspects, an unexpected culprit.

    Science.gov (United States)

    Madeira, Sérgio; Raposo, Luís; David, Raquel; Marques, Alexandre; Andrade Gomes, José; Cardim, Nuno; Anjos, Rui

    2015-09-01

    Platypnea-orthodeoxia syndrome (POS) is an uncommon syndrome characterized by dyspnea and hypoxemia triggered by orthostatism and relieved by recumbency. It is often associated with an interatrial shunt through a patent foramen ovale (PFO). We report the case of a 92-year-old woman initially admitted in the setting of a traumatic femoral neck fracture (successfully treated with hip replacement surgery) in whom a reversible decline in transcutaneous oxygen saturation from 98% (in the supine position) to 84% (in the upright position) was noted early post-operatively. Thoracic multislice computed tomography excluded pulmonary embolism and severe parenchymal lung disease. The diagnosis of POS was confirmed by tilt-table contrast transesophageal echocardiography, which demonstrated a dynamic and position-dependent right-to-left shunt (torrential when semi-upright and minimal in the supine position) through a PFO. The patient underwent percutaneous closure of the PFO with an Amplatzer device, which led to prompt symptom relief and full functional recovery. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  5. Pathophysiology of dyspnea evaluated by breath-holding test: studies of furosemide treatment.

    Science.gov (United States)

    Nishino, Takashi

    2009-05-30

    Breath-holding is one of the most powerful methods to induce the dyspneic sensation, and the breath-holding test gives us much information on the onset and endurance of dyspnea. In conscious subjects, immediately after the start of breath-holding at functional residual capacity (FRC), there is a certain period of no particular respiratory sensation lasting for 20-30s, which is designated "no respiratory sensation period". This period is terminated by the onset of dyspnea and followed by a progressive increase in the intensity of dyspnea until the breaking point of breath-holding. The measurement of the period of no respiratory sensation provides us with information about the threshold of dyspneic sensation whereas the measurement of the total breath-holding time is a behavioral measure of the tolerable limit of dyspneic sensation. The behavioral measure of tolerable limit of dyspnea can permit the study of dyspnea even in anesthetized animals while observing escape behavior in response to airway occlusion. Inhaled furosemide causes prolongation of both the period of no respiratory sensation and total breath-holding time in conscious subjects, indicating that inhaled furosemide alleviates experimentally induced dyspnea. Alleviation of dyspnea with inhaled furosemide in conscious subjects is also consistent with the result of animal studies in which inhaled furosemide suppresses the escape behavior in the lightly anesthetized condition. The purpose of this article is to emphasize the usefulness of breath-holding test as a tool for evaluation of dyspnea. Furthermore, the possible mechanisms of alleviation of dyspnea with inhaled furosemide are highlighted.

  6. An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis.

    Science.gov (United States)

    Mularski, Richard A; Reinke, Lynn F; Carrieri-Kohlman, Virginia; Fischer, Mark D; Campbell, Margaret L; Rocker, Graeme; Schneidman, Ann; Jacobs, Susan S; Arnold, Robert; Benditt, Joshua O; Booth, Sara; Byock, Ira; Chan, Garrett K; Curtis, J Randall; Donesky, Doranne; Hansen-Flaschen, John; Heffner, John; Klein, Russell; Limberg, Trina M; Manning, Harold L; Morrison, R Sean; Ries, Andrew L; Schmidt, Gregory A; Selecky, Paul A; Truog, Robert D; Wang, Angela C C; White, Douglas B

    2013-10-01

    In 2009, the American Thoracic Society (ATS) funded an assembly project, Palliative Management of Dyspnea Crisis, to focus on identification, management, and optimal resource utilization for effective palliation of acute episodes of dyspnea. We conducted a comprehensive search of the medical literature and evaluated available evidence from systematic evidence-based reviews (SEBRs) using a modified AMSTAR approach and then summarized the palliative management knowledge base for participants to use in discourse at a 2009 ATS workshop. We used an informal consensus process to develop a working definition of this novel entity and established an Ad Hoc Committee on Palliative Management of Dyspnea Crisis to further develop an official ATS document on the topic. The Ad Hoc Committee members defined dyspnea crisis as "sustained and severe resting breathing discomfort that occurs in patients with advanced, often life-limiting illness and overwhelms the patient and caregivers' ability to achieve symptom relief." Dyspnea crisis can occur suddenly and is characteristically without a reversible etiology. The workshop participants focused on dyspnea crisis management for patients in whom the goals of care are focused on palliation and for whom endotracheal intubation and mechanical ventilation are not consistent with articulated preferences. However, approaches to dyspnea crisis may also be appropriate for patients electing life-sustaining treatment. The Ad Hoc Committee developed a Workshop Report concerning assessment of dyspnea crisis; ethical and professional considerations; efficient utilization, communication, and care coordination; clinical management of dyspnea crisis; development of patient education and provider aid products; and enhancing implementation with audit and quality improvement.

  7. Inter-relationship between scaling exponents for describing self-similar river networks

    Science.gov (United States)

    Yang, Soohyun; Paik, Kyungrock

    2015-04-01

    Natural river networks show well-known self-similar characteristics. Such characteristics are represented by various power-law relationships, e.g., between upstream length and drainage area (exponent h) (Hack, 1957), and in the exceedance probability distribution of upstream area (exponent ɛ) (Rodriguez-Iturbe et al., 1992). It is empirically revealed that these power-law exponents are within narrow ranges. Power-law is also found in the relationship between drainage density (the total stream length divided by the total basin area) and specified source area (the minimum drainage area to form a stream head) (exponent η) (Moussa and Bocquillon, 1996). Considering that above three scaling relationships all refer to fundamental measures of 'length' and 'area' of a given drainage basin, it is natural to hypothesize plausible inter-relationship between these three scaling exponents. Indeed, Rigon et al. (1996) demonstrated the relationship between ɛ and h. In this study, we expand this to a more general ɛ-η-h relationship. We approach ɛ-η relationship in an analytical manner while η-h relationship is demonstrated for six study basins in Korea. Detailed analysis and implications will be presented. References Hack, J. T. (1957). Studies of longitudinal river profiles in Virginia and Maryland. US, Geological Survey Professional Paper, 294. Moussa, R., & Bocquillon, C. (1996). Fractal analyses of tree-like channel networks from digital elevation model data. Journal of Hydrology, 187(1), 157-172. Rigon, R., Rodriguez-Iturbe, I., Maritan, A., Giacometti. A., Tarboton, D. G., & Rinaldo, A. (1996). On Hack's Law. Water Resources Research, 32(11), 3367-3374. Rodríguez-Iturbe, I., Ijjasz-Vasquez, E. J., Bras, R. L., & Tarboton, D. G. (1992). Power law distributions of discharge mass and energy in river basins. Water Resources Research, 28(4), 1089-1093.

  8. [Exercise laryngoscopy: a new method for the differential diagnosis of dyspnea on exertion].

    Science.gov (United States)

    Tervonen, Hanna; Iljukov, Sergei; Niskanen, Minna-Liisa; Vilkman, Erkki; Sovijärvi, Anssi; Aaltonen, Leena-Maija

    2011-01-01

    Exertional dyspnea originating from the laryngeal level can be established with certainty only if the paradoxical vocal cord adduction is observed during dyspnea. We have developed a novel diagnostic method, exercise laryngoscopy, which involves observation of the larynx with a flexible endoscope applied via the nose during a bicycle ergometry test. It has been our aim to improve the differential diagnosis of dyspnea on exertion and thus also reduce unnecessary antiasthmatic medication. Exercise laryngoscopy allows examination in the out-patient clinics because the method is well tolerated.

  9. Dyspnea and Pain Frequently Co-occur among Medicare Managed Care Recipients

    Science.gov (United States)

    Clark, Nathan; Fan, Vincent S.; Slatore, Christopher G.; Locke, Emily; Whitson, Heather E.; Nici, Linda

    2014-01-01

    Rationale: Experimental and neuroimaging studies have suggested strong associations between dyspnea and pain. The co-occurrence of these symptoms has not been examined in community samples. Objectives: We sought to ascertain the co-occurrence of pain and dyspnea by self-report in a large cohort of Medicare recipients. Methods: We analyzed data from 266,000 Medicare Managed Care recipients surveyed in 2010 and 2012. Dyspnea was defined by aggregating three questions about shortness of breath (at rest, while walking one block, and while climbing stairs). Pain was measured by four questions about pain interference, chest pain, back pain, and arthritis pain. All measures were dichotomized as high or low/none. We calculated the co-occurrence of pain and dyspnea at baseline, and generated logistic regression models to find the adjusted relative risk (RR) of their co-occurrence, adjusting for patient-level factors and three potential medical causes of dyspnea (chronic obstructive pulmonary disease/emphysema/asthma, congestive heart failure, and obesity). We modeled the simultaneous development and the simultaneous resolution of dyspnea and pain between baseline and 2 years. Measurements and Main Results: Participants with dyspnea had considerably higher prevalence of pain than those without (64 vs. 18%). In fully adjusted models, participants with any of the types of pain were substantially more likely to report dyspnea than those without these types of pain (high pain interference: relative risk [RR], 1.99; 95% confidence interval [CI], 1.92–2.07; chest pain: RR, 2.11; 95% CI, 2.04–2.18; back pain: RR, 1.76; 95% CI, 1.71–1.82; and arthritis pain: RR, 1.49; 95% CI, 1.44–1.54). The relative risks of dyspnea developing or resolving at 2 years were greatly increased (RRs of 1.5 – 4) if pain also developed or resolved. Conclusions: Pain and dyspnea commonly occurred, developed, and resolved together. Most older adults with dyspnea also reported pain. Medical

  10. Spatial relationships between polychaete assemblages and environmental variables over broad geographical scales.

    Directory of Open Access Journals (Sweden)

    Lisandro Benedetti-Cecchi

    2010-09-01

    Full Text Available This study examined spatial relationships between rocky shore polychaete assemblages and environmental variables over broad geographical scales, using a database compiled within the Census of Marine Life NaGISA (Natural Geography In Shore Areas research program. The database consisted of abundance measures of polychaetes classified at the genus and family levels for 74 and 93 sites, respectively, from nine geographic regions. We tested the general hypothesis that the set of environmental variables emerging as potentially important drivers of variation in polychaete assemblages depend on the spatial scale considered. Through Moran's eigenvector maps we indentified three submodels reflecting spatial relationships among sampling sites at intercontinental (>10,000 km, continental (1000-5000 km and regional (20-500 km scales. Using redundancy analysis we found that most environmental variables contributed to explain a large and significant proportion of variation of the intercontinental submodel both for genera and families (54% and 53%, respectively. A subset of these variables, organic pollution, inorganic pollution, primary productivity and nutrient contamination was also significantly related to spatial variation at the continental scale, explaining 25% and 32% of the variance at the genus and family levels, respectively. These variables should therefore be preferably considered when forecasting large-scale spatial patterns of polychaete assemblages in relation to ongoing or predicted changes in environmental conditions. None of the variables considered in this study were significantly related to the regional submodel.

  11. Validation of the Scale of Preferences and Expectations in Close Interpersonal Relationships (EPERIC).

    Science.gov (United States)

    Fontanil, Yolanda; Ezama, Esteban; Alonso, Yolanda

    2013-01-01

    The most commonly used instruments for assessing adult attachment have shown differing combinations of items and divergences in the resulting sub-scales. This study presents the Scale of Preferences and Expectations in Close Interpersonal Relationships ( Escala de Preferencias y Expectativas en las Relaciones Interpersonales Cercanas, EPERIC), made up of 22 items, and based upon the Relationship Scales Questionnaire (RSQ) of Griffin and Bartholomew. Exploratory and confirmatory factorial analyses (EFA and CFA) were undertaken using data from a sample of 594 people. Factor analysis distinguishes three sub-scales: Fear of rejection or abandonment , Desire for closeness and Preference for independence , which explains 42.78% of the total variance. The alpha coefficients reveal a high internal consistency of the instrument and its sub-scales. Regarding validity, CFA showed an adequate fit for the trifactorial solution, and the expected correlations with other instruments for assessing attachment style in adults were found. EPERIC is also suitable for predicting affective states and psychological well-being. The EPERIC is a potentially useful and valid instrument for research and clinical purposes. The discussion focuses on the fact that our results support a model of three factors rather than two, as is usual in studies on adult attachment.

  12. [FINDRISC Test: Relationship between cardiovascular risk parameters and scales in Spanish Mediterranean population].

    Science.gov (United States)

    López-González, Ángel Arturo; García-Agudo, Sheila; Tomás-Salvá, Matías; Vicente-Herrero, María Teófila; Queimadelos-Carmona, Milagros; Campos-González, Irene

    2017-01-01

    The Finnish Diabetes Risk Score (FINDRISC) questionnaire has been used to assess the risk of type 2 diabetes and metabolic syndrome. The objetive was to assess the relationship between different scales related to cardiovascular risk and FINDRISC questionnaire. Values of different anthropometric and clinical parameters (body mass index, waist circumference, waist to height ratio, blood pressure), analytical parameters (lipid profile, blood glucose) and scales related to cardiovascular risk (atherogenic index, metabolic syndrome, REGICOR, SCORE, heart age and vascular age) were determined on the basis of the value of the FINDRISC questionnaire. All analyzed parameters related to cardiovascular risk were getting worse at the same time that the value of the FINDRISC questionnaire increased. There is a close relationship between FINDRISC questionnaire values and those obtained in the different parameters by which cardiovascular risk was measured directly or indirectly.

  13. Linear scaling relationships and volcano plots in homogeneous catalysis - revisiting the Suzuki reaction.

    Science.gov (United States)

    Busch, Michael; Wodrich, Matthew D; Corminboeuf, Clémence

    2015-12-01

    Linear free energy scaling relationships and volcano plots are common tools used to identify potential heterogeneous catalysts for myriad applications. Despite the striking simplicity and predictive power of volcano plots, they remain unknown in homogeneous catalysis. Here, we construct volcano plots to analyze a prototypical reaction from homogeneous catalysis, the Suzuki cross-coupling of olefins. Volcano plots succeed both in discriminating amongst different catalysts and reproducing experimentally known trends, which serves as validation of the model for this proof-of-principle example. These findings indicate that the combination of linear scaling relationships and volcano plots could serve as a valuable methodology for identifying homogeneous catalysts possessing a desired activity through a priori computational screening.

  14. Relationship between the Berg Balance Scale and Static Balance Test in Hemiplegic Patients with Stroke

    OpenAIRE

    Suzuki, Makoto; Fujisawa, Hiroyuki; Machida, Yooichiro; Minakata, Shin

    2013-01-01

    [Purpose] The purpose of this study was to analyze the relationship between results of the Berg Balance Scale (BBS) and Static Balance Test (SBT) in hemiplegic patients with stroke. [Subjects] The subjects were 39 hemiplegic patients (25 men, 14 women; mean age, 69.4 ? 11.0?years) with stroke that had occurred within the preceding 6 months and who had good understanding of verbal instructions. [Methods] The SBT consists of five posture-holding tasks (sitting, stride standing, close standing, ...

  15. Relationships between avian richness and landscape structure at multiple scales using multiple landscapes

    Science.gov (United States)

    Mitchell, M.S.; Rutzmoser, S.H.; Wigley, T.B.; Loehle, C.; Gerwin, J.A.; Keyser, P.D.; Lancia, R.A.; Perry, R.W.; Reynolds, C.J.; Thill, R.E.; Weih, R.; White, D.; Wood, P.B.

    2006-01-01

    Little is known about factors that structure biodiversity on landscape scales, yet current land management protocols, such as forest certification programs, place an increasing emphasis on managing for sustainable biodiversity at landscape scales. We used a replicated landscape study to evaluate relationships between forest structure and avian diversity at both stand and landscape-levels. We used data on bird communities collected under comparable sampling protocols on four managed forests located across the Southeastern US to develop logistic regression models describing relationships between habitat factors and the distribution of overall richness and richness of selected guilds. Landscape models generated for eight of nine guilds showed a strong relationship between richness and both availability and configuration of landscape features. Diversity of topographic features and heterogeneity of forest structure were primary determinants of avian species richness. Forest heterogeneity, in both age and forest type, were strongly and positively associated with overall avian richness and richness for most guilds. Road density was associated positively but weakly with avian richness. Landscape variables dominated all models generated, but no consistent patterns in metrics or scale were evident. Model fit was strong for neotropical migrants and relatively weak for short-distance migrants and resident species. Our models provide a tool that will allow managers to evaluate and demonstrate quantitatively how management practices affect avian diversity on landscapes.

  16. Scale indicators of social exchange relationships: a comparison of relative content validity.

    Science.gov (United States)

    Colquitt, Jason A; Baer, Michael D; Long, David M; Halvorsen-Ganepola, Marie D K

    2014-07-01

    Although social exchange theory has become one of the most oft-evoked theories in industrial and organizational psychology, there remains no consensus about how to measure its key mechanism: social exchange relationships (Blau, 1964). Drawing on Cropanzano and Byrne's (2000) review of contemporary social exchange theorizing, we examined the content validity of perceived support, exchange quality, affective commitment, trust, and psychological contract fulfillment as indicators of social exchange relationships. We used Hinkin and Tracey's (1999) quantitative approach to content validation, which asks participants to rate the correspondence between scale items and definitions of intended (and unintended) constructs. Our results revealed that some of the most frequently utilized indicators of social exchange relationships--perceived support and exchange quality--were significantly less content valid than rarely used options like affect-based trust. Our results also revealed that 2 direct measures--Bernerth, Armenakis, Feild, Giles, and Walker's (2007) scale and a scale created for this study--were content valid. We discuss the implications of these results for future applications of social exchange theory.

  17. Self-hypnosis for management of chronic dyspnea in pediatric patients.

    Science.gov (United States)

    Anbar, R D

    2001-02-01

    Hypnotherapy can be useful in the management of anxiety, discomfort, and psychosomatic symptoms, all of which may contribute to a complaint of dyspnea. Therefore, instruction in self-hypnosis was offered to 17 children and adolescents with chronic dyspnea, which had not resolved despite medical therapy, and who were documented to have normal lung function at rest. This report documents the result of this intervention. A retrospective chart review identified all patients followed by a single pediatric pulmonologist (R.D.A.), with a chief complaint of chronic dyspnea from April 1998 through December 1999. These patients had been evaluated and treated for medical diseases according to their history, physical examination, and laboratory investigations. The pulmonologist offered to teach self-hypnosis to all of these patients, who comprise the cohort in this report. Chronic dyspnea was defined as recurrent difficulty breathing or shortness of breath at rest or with exertion, which had existed for at least 1 month in patients who had not suffered within a month from an acute pulmonary illness. The pulmonologist was trained in hypnosis through his attendance at three 20-hour workshops. Hypnosis was taught to individual patients in 1 or two 15- to 45-minute sessions. Patients were taught hypnotic self-induction techniques and imagery to achieve relaxation. Additionally, imagery relating to dyspnea was developed by coaching patients to change their imagined lung appearance from a dyspneic to a healthy state. Patients were encouraged to practice self-hypnosis regularly and to use lung imagery to eliminate dyspnea if it occurred. Seventeen patients (13 males and 4 females) with chronic dyspnea were documented to have normal pulmonary function at rest. Their mean age was 13.4 years (range: 8-18 years). Twelve of the 17 previously were diagnosed with other conditions, such as allergies, asthma, and gastroesophageal reflux. Fifteen of the 17 manifested at least 1 other symptom

  18. Dyspnea as a side effect of subthalamic nucleus deep brain stimulation for Parkinson's disease.

    Science.gov (United States)

    Chalif, Joshua I; Sitsapesan, Holly A; Pattinson, Kyle T S; Herigstad, Mari; Aziz, Tipu Z; Green, Alexander L

    2014-02-01

    Bilateral subthalamic nucleus deep brain stimulation for Parkinson's disease improves limb function. Unpublished observations from our clinic noted that some subthalamic nucleus deep brain stimulation patients complain of post-operative dyspnea. Therefore, we designed a prospective, longitudinal study to characterize this in greater depth. We used specific questionnaires to assess dyspnea in patients with electrodes in the subthalamic nucleus (n=13) or ventral intermediate thalamus (n=7). St. George's Hospital Respiratory Questionnaire symptom subscale scores were greater in subthalamic nucleus patients (median=18.60, interquartile range=40.80) than ventral intermediate thalamus patients (median = 0.00, interquartile range=15.38) at greater than 6 months post-operatively (pdyspnea severity. We have shown, for the first time, that dyspnea can be a side effect of subthalamic nucleus deep brain stimulation, and that this dyspnea may be highly disabling. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Pulmonary Endarterectomy Improves Dyspnea by the Relief of Dead Space Ventilation

    NARCIS (Netherlands)

    van der Plas, Mart N.; Reesink, Herre J.; Roos, Carel M.; van Steenwijk, Reindert P.; Kloek, Jaap J.; Bresser, Paul

    2010-01-01

    Background. In chronic thromboembolic pulmonary hypertension (CTEPH), dyspnea is considered to be related to increased dead space ventilation caused by vascular obstruction. Pulmonary endarterectomy releases the thromboembolic obstruction, thereby improving regional pulmonary blood flow. We

  20. Evidence for cognitive–behavioral strategies improving dyspnea and related distress in COPD

    Directory of Open Access Journals (Sweden)

    Norweg A

    2013-09-01

    Full Text Available Anna Norweg,1 Eileen G Collins2,3 1Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago (UIC, Chicago, IL, USA; 2Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago (UIC, Chicago, IL, USA; 3Rehabilitation Research and Development (RR&D, Edward Hines Jr. VA Hospital, Hines, IL, USA Background: Dyspnea is a complex, prevalent, and distressing symptom of chronic obstructive pulmonary disease (COPD associated with decreased quality of life, significant disability, and increased mortality. It is a major reason for referral to pulmonary rehabilitation. Methods: We reviewed 23 COPD studies to examine the evidence for the effectiveness of cognitive–behavioral strategies for relieving dyspnea in COPD. Results: Preliminary evidence from randomized controlled trials exists to support cognitive–behavioral strategies, used with or without exercise, for relieving sensory and affective components of dyspnea in COPD. Small to moderate treatment effects for relieving dyspnea were noted for psychotherapy (effect size [ES] = 0.08–0.25 for intensity; 0.26–0.65 for mastery and distractive auditory stimuli (ES = 0.08–0.33 for intensity; 0.09 to -0.61 for functional burden. Small to large dyspnea improvements resulted from yoga (ES = 0.2–1.21 for intensity; 0.67 for distress; 0.07 for mastery; and −8.37 for functional burden; dyspnea self-management education with exercise (ES = −0.14 to −1.15 for intensity; −0.62 to −0.69 for distress; 1.04 for mastery; 0.14–0.35 for self-efficacy; and slow-breathing exercises (ES = 4390.34 to −0.83 for intensity; -0.61 to -0.80 for distress; and 0.62 for self-efficacy. Cognitive–behavioral interventions may relieve dyspnea in COPD by (1 decreasing sympathetic nerve activity, dynamic hyperinflation, and comorbid anxiety, and (2 promoting arterial oxygen saturation, myelinated vagus nerve activity, a greater

  1. The affective dimension of laboratory dyspnea: air hunger is more unpleasant than work/effort.

    Science.gov (United States)

    Banzett, Robert B; Pedersen, Sarah H; Schwartzstein, Richard M; Lansing, Robert W

    2008-06-15

    It is hypothesized that the affective dimension of dyspnea (unpleasantness, emotional response) is not strictly dependent on the intensity of dyspnea. We tested the hypothesis that the ratio of immediate unpleasantness (A(1)) to sensory intensity (SI) varies depending on the type of dyspnea. Twelve healthy subjects experienced three stimuli: stimulus 1: maximal eucapnic voluntary hyperpnea against inspiratory resistance, requiring 15 times the work of resting breathing; stimulus 2: Pet(CO(2)) 6.1 mm Hg above resting with ventilation restricted to less than spontaneous breathing; stimulus 3: Pet(CO(2)) 7.7 mm Hg above resting with ventilation further restricted. After each trial, subjects rated SI, A(1), and qualities of dyspnea on the Multidimensional Dyspnea Profile (MDP), a comprehensive instrument tested here for the first time. Stimulus 1 was always limited by subjects failing to meet a higher ventilation target; none signaled severe discomfort. This evoked work and effort sensations, with relatively low unpleasantness (mean A(1)/SI = 0.64). Stimulus 2, titrated to produce dyspnea ratings similar to those subjects gave during stimulus 1, evoked air hunger and produced significantly greater unpleasantness (mean A(1)/SI = 0.95). Stimulus 3, increased until air hunger was intolerable, evoked the highest intensity and unpleasantness ratings and high unpleasantness ratio (mean A(1)/SI = 1.09). When asked which they would prefer to repeat, all subjects chose stimulus 1. (1) Maximal respiratory work is less unpleasant than moderately intense air hunger in this brief test; (2) unpleasantness of dyspnea can vary independently from perceived intensity, consistent with the prevailing model of pain; (3) separate dimensions of dyspnea can be measured with the MDP.

  2. Use of post-exercise laryngoscopy to evaluate exercise induced dyspnea.

    LENUS (Irish Health Repository)

    McNally, P

    2010-10-01

    We present the case of a child with asthma who continued to have marked exercise induced dyspnea despite appropriate treatment, and in the face of adequate control of all other asthma symptoms. Spirometry showed a marked truncation of inspiratory flow, and laryngoscopy performed immediately after exercise showed laryngomalacia with dynamic, partial inspiratory obstruction. Exercise induced laryngomalacia (EIL) is a rare cause of exercise induced dyspnea which is diagnosed by post exercise flexible laryngoscopy and may require supraglottoplasty.

  3. Prevalence of diastolic dysfunction as a possible cause of dyspnea in the elderly

    DEFF Research Database (Denmark)

    Pedersen, Frants; Raymond, Ilan; Mehlsen, Jesper

    2005-01-01

    Symptoms in patients with heart failure and preserved left ventricular ejection fraction may be caused by isolated diastolic dysfunction. The purpose of this study was to assess the prevalence of diastolic dysfunction as a potential cause of dyspnea in a sample of elderly subjects, as well...... as of isolated diastolic dysfunction as a potential cause of dyspnea in a subgroup with a preserved left ventricular ejection fraction and normal lung function....

  4. Hipsometric relationship modeling using data sampled in tree scaling and inventory plots

    Directory of Open Access Journals (Sweden)

    Valdir Carlos Lima de Andrade

    2011-02-01

    Full Text Available This work evaluated eight hypsometric models to represent tree height-diameter relationship, using data obtained from the scaling of 118 trees and 25 inventory plots. Residue graphic analysis and percent deviation mean criteria, qui-square test precision, residual standard error between real and estimated heights and the graybill f test were adopted. The identity of the hypsometric models was also verified by applying the F(Ho test on the plot data grouped to the scaling data. It was concluded that better accuracy can be obtained by using the model prodan, with h and d1,3 data measured in 10 trees by plots grouped into these scaling data measurements of even-aged forest stands.

  5. Dissecting the multi-scale spatial relationship of earthworm assemblages with soil environmental variability.

    Science.gov (United States)

    Jiménez, Juan J; Decaëns, Thibaud; Lavelle, Patrick; Rossi, Jean-Pierre

    2014-12-05

    Studying the drivers and determinants of species, population and community spatial patterns is central to ecology. The observed structure of community assemblages is the result of deterministic abiotic (environmental constraints) and biotic factors (positive and negative species interactions), as well as stochastic colonization events (historical contingency). We analyzed the role of multi-scale spatial component of soil environmental variability in structuring earthworm assemblages in a gallery forest from the Colombian "Llanos". We aimed to disentangle the spatial scales at which species assemblages are structured and determine whether these scales matched those expressed by soil environmental variables. We also tested the hypothesis of the "single tree effect" by exploring the spatial relationships between root-related variables and soil nutrient and physical variables in structuring earthworm assemblages. Multivariate ordination techniques and spatially explicit tools were used, namely cross-correlograms, Principal Coordinates of Neighbor Matrices (PCNM) and variation partitioning analyses. The relationship between the spatial organization of earthworm assemblages and soil environmental parameters revealed explicitly multi-scale responses. The soil environmental variables that explained nested population structures across the multi-spatial scale gradient differed for earthworms and assemblages at the very-fine- (30 m), fine (10-20 m) and very fine scales (<10 m). Variation partitioning analysis revealed that the soil environmental variability explained from less than 1% to as much as 48% of the observed earthworm spatial variation. A large proportion of the spatial variation did not depend on the soil environmental variability for certain species. This finding could indicate the influence of contagious biotic interactions, stochastic factors, or unmeasured relevant soil environmental variables.

  6. Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma.

    Science.gov (United States)

    Weinberger, Miles; Abu-Hasan, Mutasim

    2007-10-01

    Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome. The respiratory sounds that occur with the upper airway obstruction caused by the various manifestations of the vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia are often mischaracterized as wheezing and attributed to asthma. The perception of dyspnea is a prominent symptom of hyperventilation attacks. This can occur in those with or without asthma, and patients with asthma may not readily distinguish the perceived dyspnea of a hyperventilation attack from the acute airway obstruction of asthma. Dyspnea on exertion, in the absence of other symptoms of asthma or an unequivocal response to albuterol, is most likely a result of other causes. Most common is the dyspnea associated with normal exercise limitation, but causes of dyspnea on exertion can include other physiologic abnormalities including exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, and exercise-induced supraventricular tachycardia. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations.

  7. SHORT TERM EFFECT OF ACUPUNCTURE-TENS ON LUNG FUNCTIONS AND DYSPNEA FOR SUBJECTS WITH MODERATE COPD

    Directory of Open Access Journals (Sweden)

    Vinod Babu. K

    2015-10-01

    Full Text Available Background: Acupuncture TENS is used to improve pain instead of invasive acupuncture. Acupuncture shown to improve dyspnoea and lung functions in COPD (Chronic Obstructive Pulmonary Disease patients. The purpose of the study is to determine Short term effectiveness of Acupuncture-TENS in reducing dyspnea and improving lung functions for subjects with moderate COPD. Method: An experimental study design, selected 30 geriatric subjects with COPD randomized 15 subjects into each Study and Control group. Study group received Acu-TENS for 45 minutes for total 5 sessions, while control group received placebo TENS. Outcome measurements such as breathlessness using Modified Borg Scale (MBS, Lung functions using Pulmonary Function Test (PFT was measured before and after intervention. Results: Analysis from pre-intervention to post-intervention within study group found that there is statistically significant change in means of MBS, FEV1, FEV1/FVC ratio and within control group there is a statistically significant change in means of MBS, but there is no statistically significant change in means of FEV1, FVC and FEV1/FVC ratio. When post-intervention means were compared between the groups there is no statistically significant difference in means of MBS and FEV1, FVC and FEV1/FVC ratio. Conclusion: It is concluded that one week of Acu-TENS on EXL1 point found no significant effect on improving dyspnea and lung functions in subjects with moderate COPD in geriatric populations.

  8. Relationship between Fractal Dimension and Spectral Scaling Decay Rate in Computer-Generated Fractals

    Directory of Open Access Journals (Sweden)

    Alexander J. Bies

    2016-07-01

    Full Text Available Two measures are commonly used to describe scale-invariant complexity in images: fractal dimension (D and power spectrum decay rate (β. Although a relationship between these measures has been derived mathematically, empirical validation across measurements is lacking. Here, we determine the relationship between D and β for 1- and 2-dimensional fractals. We find that for 1-dimensional fractals, measurements of D and β obey the derived relationship. Similarly, in 2-dimensional fractals, measurements along any straight-line path across the fractal’s surface obey the mathematically derived relationship. However, the standard approach of vision researchers is to measure β of the surface after 2-dimensional Fourier decomposition rather than along a straight-line path. This surface technique provides measurements of β that do not obey the mathematically derived relationship with D. Instead, this method produces values of β that imply that the fractal’s surface is much smoother than the measurements along the straight lines indicate. To facilitate communication across disciplines, we provide empirically derived equations for relating each measure of β to D. Finally, we discuss implications for future research on topics including stress reduction and the perception of motion in the context of a generalized equation relating β to D.

  9. Online Friendship, Romance, and Sex: Properties and Associations of the Online Relationship Initiation Scale.

    Science.gov (United States)

    Harris, Keith M; Aboujaoude, Elias

    2016-08-01

    Online relationships are increasingly central to many people's lives. As a result, there is a growing need to scientifically examine their psychosocial implications. This study developed and tested the Online Relationship Initiation Scale (ORIS) through classical and item response theory analyses to address this need. An anonymous online survey included 713 adults, aged 18-71 years. The ORIS was tested on psychometric properties and examined for associations with gender and several standardized psychosocial measures. Results demonstrated unidimensionality of nine items, strong factor loadings, and high internal consistency (α = 0.90, ωt = 0.94). All items captured significant information on the latent trait and none showed differential item functioning by sex, age group, or ethnicity. General linear modeling confirmed hypotheses that men were more likely than women to initiate online relationships. Online relationship initiation was not strongly associated with perceived social support, but was positively related to financial distress, and willingness to engage in infidelity or unprotected sex. The ORIS was negatively associated with age and satisfaction with life and showed modest interactions with ethnicity and hours online. This study provided empirical evidence for an interpersonal relationship initiation construct. The ORIS was shown to be a psychometrically sound instrument for evaluating online interpersonal behaviors and their associations with psychosocial and demographic factors. Such psychometrically sound instruments can be useful in exploring online interpersonal behaviors and their significance.

  10. An Elderly Female with Dyspnea and Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Jon Van Heukelom

    2017-01-01

    Full Text Available History of Present Illness: A 55-year-old female presented via transfer from a referring hospital with 48 hours of abdominal pain, vomiting and dyspnea. She was found to be in severe distress. Her temperature was 37.5° C (99.5° F, heart rate 130 beats per minute, respiratory rate 47 breaths per minute, blood pressure 80/48, and oxygen saturation of 95% on a non-rebreather mask. She had distended neck veins, diminished breath sounds on the left hemi-thorax, and a distended abdomen. A chest x-ray that had been obtained at the referring hospital was immediately reviewed. The decision was made to intubate the patient. Following intubation, a nasogastric tube was placed with marked improvement in her hemodynamics. An abdomen-pelvis CT was obtained which showed a para-esophageal hernia with the majority of the stomach located in the left hemi-thorax and evidence of a bowel obstruction. Significant findings: Radiography shows a dilated, gas-filled structure that fills nearly the entire left hemi-thorax. Lung markings are visible in the uppermost portion of the left hemi-thorax. There is mediastinal shift to the right. In the visualized portion of the abdomen, dilated loops of bowel are also visualized. This constellation of findings is consistent with a tension gastrothorax. Discussion: Tension gastrothorax is a rare complication of blunt trauma, diaphragmatic hernias, and certain surgical procedures.1,2 Clinically, a tension gastrothorax may mimic that of a tension pneumothorax, making it difficult to diagnose.3,4 Stabilizing treatment includes decompressing the stomach by means of a nasogastric (NG tube.2 Placement may be difficult due the intra-thoracic position of the stomach leading to kinking of the tube. The attempt to place an NG tube can lead to hyperventilation and air swallowing, which can aggravate gastric distention.4 Failure to decompress the stomach, however, may lead to patient decompensation and cardiac arrest.5 Definitive treatment

  11. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial.

    Science.gov (United States)

    Davies, Helen E; Mishra, Eleanor K; Kahan, Brennan C; Wrightson, John M; Stanton, Andrew E; Guhan, Anur; Davies, Christopher W H; Grayez, Jamal; Harrison, Richard; Prasad, Anjani; Crosthwaite, Nicola; Lee, Y C Gary; Davies, Robert J O; Miller, Robert F; Rahman, Najib M

    2012-06-13

    Malignant pleural effusion causes disabling dyspnea in patients with a short life expectancy. Palliation is achieved by fluid drainage, but the most effective first-line method has not been determined. To determine whether indwelling pleural catheters (IPCs) are more effective than chest tube and talc slurry pleurodesis (talc) at relieving dyspnea. Unblinded randomized controlled trial (Second Therapeutic Intervention in Malignant Effusion Trial [TIME2]) comparing IPC and talc (1:1) for which 106 patients with malignant pleural effusion who had not previously undergone pleurodesis were recruited from 143 patients who were treated at 7 UK hospitals. Patients were screened from April 2007-February 2011 and were followed up for a year. Indwelling pleural catheters were inserted on an outpatient basis, followed by initial large volume drainage, education, and subsequent home drainage. The talc group were admitted for chest tube insertion and talc for slurry pleurodesis. Patients completed daily 100-mm line visual analog scale (VAS) of dyspnea over 42 days after undergoing the intervention (0 mm represents no dyspnea and 100 mm represents maximum dyspnea; 10 mm represents minimum clinically significant difference). Mean difference was analyzed using a mixed-effects linear regression model adjusted for minimization variables. Dyspnea improved in both groups, with no significant difference in the first 42 days with a mean VAS dyspnea score of 24.7 in the IPC group (95% CI, 19.3-30.1 mm) and 24.4 mm (95% CI, 19.4-29.4 mm) in the talc group, with a difference of 0.16 mm (95% CI, −6.82 to 7.15; P = .96). There was a statistically significant improvement in dyspnea in the IPC group at 6 months, with a mean difference in VAS score between the IPC group and the talc group of −14.0 mm (95% CI, −25.2 to −2.8 mm; P = .01). Length of initial hospitalization was significantly shorter in the IPC group with a median of 0 days (interquartile range [IQR], 0-1 day) and 4 days

  12. Relationships between aboveground biomass and plant cover at two spatial scales and their determinants in northern Tibetan grasslands.

    Science.gov (United States)

    Jiang, Yanbin; Zhang, Yangjian; Wu, Yupeng; Hu, Ronggui; Zhu, Juntao; Tao, Jian; Zhang, Tao

    2017-10-01

    The relationships between cover and AGB for the dominant and widely distributed alpine grasslands on the northern Tibetan Plateau is still not fully examined. The objectives of this study are to answer the following question: (1) How does aboveground biomass (AGB) of alpine grassland relate to plant cover at different spatial scales? (2) What are the major biotic and abiotic factors influencing on AGB-cover relationship? A community survey (species, cover, height, and abundance) was conducted within 1 m × 1 m plots in 70 sites along a precipitation gradient of 50-600 m. Ordinary linear regression was employed to examine AGB-cover relationships of both community and species levels at regional scale of entire grassland and landscape scale of alpine meadow, alpine steppe, and desert steppe. Hierarchical partitioning was employed to estimate independent contributions of biotic and abiotic factors to AGB and cover at both scales. Partial correlation analyses were used to discriminate the effects of biotic and abiotic factors on AGB-cover relationships at two spatial scales. AGB and community cover both exponentially increased along the precipitation gradient. At community level, AGB was positively and linearly correlated with cover for all grasslands except for alpine meadow. AGB was also linearly correlated with cover of species level at both regional and landscape scales. Contributions of biotic and abiotic factors to the relationship between AGB and cover significantly depended on spatial scales. Cover of cushions, forbs, legumes and sedges, species richness, MAP, and soil bulk density were important factors that influenced the AGB-cover relationship at either regional or landscape scale. This study indicated generally positive and linear relationships between AGB and cover are at both regional and landscape scales. Spatial scale may affect ranges of cover and modify the contribution of cover to AGB. AGB-cover relationships were influenced mainly by species

  13. Ranolazine versus placebo in patients with ischemic cardiomyopathy and persistent chest pain or dyspnea despite optimal medical and revascularization therapy: randomized, double-blind crossover pilot study

    Directory of Open Access Journals (Sweden)

    Shammas NW

    2015-03-01

    Full Text Available Nicolas W Shammas,1 Gail A Shammas,1 Kathleen Keyes,2 Shawna Duske,1 Ryan Kelly,1 Michael Jerin3 1Midwest Cardiovascular Research Foundation, 2Cardiovascular Medicine, Private Corporation, 3St Ambrose University, Davenport, IA, USA Background: Patients with ischemic cardiomyopathy (ICM may continue to experience persistent chest pain and/or dyspnea despite pharmacologic therapy and revascularization. We hypothesized that ranolazine would reduce anginal symptoms or dyspnea in optimally treated ICM patients.Methods: In this randomized, double-blind, crossover-design pilot study, 28 patients with ICM (ejection fraction less or equal 40% were included after providing informed consent. A total of 24 patients completed both placebo and ranolazine treatments and were analyzed. All patients were on treatment with a beta blocker, an angiotensin-converting enzyme inhibitor (or angiotensin receptor blocker, and at least one additional antianginal drug. After randomization, patients received up to 1,000 mg ranolazine orally twice a day, as tolerated, versus placebo. The primary end point was change in angina as assessed by the Seattle Angina Questionnaire (SAQ, or in dyspnea as assessed by the Rose Dyspnea Scale (RDS. Change in the RDS and SAQ score from baseline was compared, for ranolazine and placebo, using the Wilcoxon signed rank test or paired t-test.Results: Patients had the following demographic and clinical variables: mean age of 71.5 years; male (82.1%; prior coronary bypass surgery (67.9%; prior coronary percutaneous intervention (85.7%; prior myocardial infarction (82.1%; diabetes (67.9%; and mean ejection fraction of 33.1%. No statistical difference was seen between baseline RDS score and that after placebo or ranolazine (n=20 (P≥0.05. There was however, an improvement in anginal frequency (8/10 patients (P=0.058, quality of life (8/10 patients (P=0.048, and mean score of all components of the SAQ questionnaire (n=10 (P=0.047 with ranolazine

  14. Scale effects on spatially varying relationships between urban landscape patterns and water quality.

    Science.gov (United States)

    Sun, Yanwei; Guo, Qinghai; Liu, Jian; Wang, Run

    2014-08-01

    Scientific interpretation of the relationships between urban landscape patterns and water quality is important for sustainable urban planning and watershed environmental protection. This study applied the ordinary least squares regression model and the geographically weighted regression model to examine the spatially varying relationships between 12 explanatory variables (including three topographical factors, four land use parameters, and five landscape metrics) and 15 water quality indicators in watersheds of Yundang Lake, Maluan Bay, and Xinglin Bay with varying levels of urbanization in Xiamen City, China. A local and global investigation was carried out at the watershed-level, with 50 and 200 m riparian buffer scales. This study found that topographical features and landscape metrics are the dominant factors of water quality, while land uses are too weak to be considered as a strong influential factor on water quality. Such statistical results may be related with the characteristics of land use compositions in our study area. Water quality variations in the 50 m buffer were dominated by topographical variables. The impact of landscape metrics on water quality gradually strengthen with expanding buffer zones. The strongest relationships are obtained in entire watersheds, rather than in 50 and 200 m buffer zones. Spatially varying relationships and effective buffer zones were verified in this study. Spatially varying relationships between explanatory variables and water quality parameters are more diversified and complex in less urbanized areas than in highly urbanized areas. This study hypothesizes that all these varying relationships may be attributed to the heterogeneity of landscape patterns in different urban regions. Adjustment of landscape patterns in an entire watershed should be the key measure to successfully improving urban lake water quality.

  15. Dike intrusions during rifting episodes obey scaling relationships similar to earthquakes

    Science.gov (United States)

    L., Passarelli; E., Rivalta; A., Shuler

    2014-01-01

    As continental rifts evolve towards mid-ocean ridges, strain is accommodated by repeated episodes of faulting and magmatism. Discrete rifting episodes have been observed along two subaerial divergent plate boundaries, the Krafla segment of the Northern Volcanic Rift Zone in Iceland and the Manda-Hararo segment of the Red Sea Rift in Ethiopia. In both cases, the initial and largest dike intrusion was followed by a series of smaller intrusions. By performing a statistical analysis of these rifting episodes, we demonstrate that dike intrusions obey scaling relationships similar to earthquakes. We find that the dimensions of dike intrusions obey a power law analogous to the Gutenberg-Richter relation, and the long-term release of geodetic moment is governed by a relationship consistent with the Omori law. Due to the effects of magma supply, the timing of secondary dike intrusions differs from that of the aftershocks. This work provides evidence of self-similarity in the rifting process. PMID:24469260

  16. Effect of slip-area scaling on the earthquake frequency-magnitude relationship

    Science.gov (United States)

    Senatorski, Piotr

    2017-06-01

    The earthquake frequency-magnitude relationship is considered in the maximum entropy principle (MEP) perspective. The MEP suggests sampling with constraints as a simple stochastic model of seismicity. The model is based on the von Neumann's acceptance-rejection method, with b-value as the parameter that breaks symmetry between small and large earthquakes. The Gutenberg-Richter law's b-value forms a link between earthquake statistics and physics. Dependence between b-value and the rupture area vs. slip scaling exponent is derived. The relationship enables us to explain observed ranges of b-values for different types of earthquakes. Specifically, different b-value ranges for tectonic and induced, hydraulic fracturing seismicity is explained in terms of their different triggering mechanisms: by the applied stress increase and fault strength reduction, respectively.

  17. The Femininity Ideology Scale (FIS): dimensions and its relationship to anxiety and feminine gender role stress.

    Science.gov (United States)

    Richmond, Katherine; Levant, Ronald; Smalley, Bryant; Cook, Stephen

    2015-01-01

    The purpose of this study was to conduct a confirmatory factor analytic investigation of the Femininity Ideology Scale (FIS) and to assess whether feminine gender role stress mediated the relationship between femininity ideology and anxiety. During the 2010-2011 academic year, a convenience sample of 606 college women were recruited from three universities and one college. Confirmatory factor analysis supported a four- versus the hypothesized five-factor model, resulting in the elimination of the Dependency/Deference factor. Mediation analysis using structural equation modeling indicated no direct relationship between Femininity Ideology and Anxiety, although an indirect one was observed, mediated through Feminine Gender Role Stress. The results are discussed in terms of possible changes in contemporary notions of femininity, and the utility of using the FIS in applied therapeutic settings.

  18. Relationships between human population density and burned area at continental and global scales.

    Science.gov (United States)

    Bistinas, Ioannis; Oom, Duarte; Sá, Ana C L; Harrison, Sandy P; Prentice, I Colin; Pereira, José M C

    2013-01-01

    We explore the large spatial variation in the relationship between population density and burned area, using continental-scale Geographically Weighted Regression (GWR) based on 13 years of satellite-derived burned area maps from the global fire emissions database (GFED) and the human population density from the gridded population of the world (GPW 2005). Significant relationships are observed over 51.5% of the global land area, and the area affected varies from continent to continent: population density has a significant impact on fire over most of Asia and Africa but is important in explaining fire over population density is associated with both increased and decreased in fire. The nature of the relationship depends on land-use: increasing population density is associated with increased burned are in rangelands but with decreased burned area in croplands. Overall, the relationship between population density and burned area is non-monotonic: burned area initially increases with population density and then decreases when population density exceeds a threshold. These thresholds vary regionally. Our study contributes to improved understanding of how human activities relate to burned area, and should contribute to a better estimate of atmospheric emissions from biomass burning.

  19. Paradoxical vocal fold motion in children presenting with exercise induced dyspnea.

    Science.gov (United States)

    Hseu, Anne; Sandler, Mykayla; Ericson, Dawn; Ayele, Nohamin; Kawai, Kosuke; Nuss, Roger

    2016-11-01

    Although dyspnea with exercise in the pediatric population can be multifactorial, the diagnosis of paradoxical vocal fold motion disorder (PVFMD) in this group is not well characterized. The objective of this study is to review the multiple causes of dyspnea with exercise in children, including the prevalence of PVFMD within this study population. A retrospective review was conducted of patients seen at a tertiary pediatric hospital for exercise-induced dyspnea suspected to be related to PVFMD between January 2007 and July 2015. Inclusion criteria included assessment in a specialty exercise clinic and evaluation by a pediatric otolaryngologist and pulmonologist. Pre- and post-exercise pulmonary function tests and laryngoscopic examinations were performed. Data including co-morbidities, presenting symptoms, prior diagnoses and treatments, final diagnoses, prescribed treatments and outcomes were collected and analyzed. 294 patients were evaluated at our institution during the study period. 4 patients were excluded for insufficient data, which left 290 for analysis. 75 were male, 215 female. All patients underwent treadmill testing with monitoring to simulate strenuous exercise. Average patient age was 14.6 years; average BMI was 21.53. The most common sports to elicit symptoms were running and soccer. Patients most frequently complained of stridor or wheezing in addition to dyspnea. Throat tightness was also a common complaint. After evaluation, 86 patients were given the primary diagnosis of exercise-induced PVFMD. 54 patients were diagnosed with physiologic dyspnea and 30 with exercise-induced asthma. Pediatric patients presenting with exercise-induced dyspnea can have multiple etiologies for their symptoms including PVFMD. Other causes of dyspnea with exercise should not be underestimated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Data quality and factor analysis of the Danish version of the Relationship Scale Questionnaire

    DEFF Research Database (Denmark)

    Andersen, Christina Maar; Pedersen, Anette Fischer; Carlsen, Anders Helles

    2017-01-01

    BACKGROUND: The Relationship Scale Questionnaire (RSQ) is a widely-used measure of adult attachment, but whether the results obtained by the RSQ fit the attachment construct has only been examined to a limited extent.OBJECTIVE: The objectives of this study were to investigate the psychometric......-factor structure which was validated through a confirmatory factor analyses in a second subsample comprised of 278 cancer patients and 289 general practitioners.RESULTS: The data quality of the RSQ was generally good, except low internal consistency and low to moderate test-retest reliability. The four subscales...

  1. Determining the minimal length scale of the generalized uncertainty principle from the entropy-area relationship

    International Nuclear Information System (INIS)

    Kim, Wontae; Oh, John J.

    2008-01-01

    We derive the formula of the black hole entropy with a minimal length of the Planck size by counting quantum modes of scalar fields in the vicinity of the black hole horizon, taking into account the generalized uncertainty principle (GUP). This formula is applied to some intriguing examples of black holes - the Schwarzschild black hole, the Reissner-Nordstrom black hole, and the magnetically charged dilatonic black hole. As a result, it is shown that the GUP parameter can be determined by imposing the black hole entropy-area relationship, which has a Planck length scale and a universal form within the near-horizon expansion

  2. Relationships and scaling laws among correlation, fractality, Lyapunov divergence and q-Gaussian distributions

    Science.gov (United States)

    Afsar, Ozgur; Tirnakli, Ugur

    2014-04-01

    We numerically introduce the relationships among correlation, fractality, Lyapunov divergence and q-Gaussian distributions. The scaling arguments between the range of the q-Gaussian and correlation, fractality, Lyapunov divergence are obtained for periodic windows (i.e., periods 2, 3 and 5) of the logistic map as chaos threshold is approached. Firstly, we show that the range of the q-Gaussian (g) tends to infinity as the measure of the deviation from the correlation dimension (D=0.5) at the chaos threshold, (this deviation will be denoted by l), approaches to zero. Moreover, we verify that a scaling law of type 1/g∝lτ is evident with the critical exponent τ=0.23±0.01. Similarly, as chaos threshold is approached, the quantity l scales as l∝(, where the exponent is γ=0.84±0.01. Secondly, we also show that the range of the q-Gaussian exhibits a scaling law with the correlation length (1/g∝ξ), Lyapunov divergence (1/g∝λμ) and the distance to the critical box counting fractal dimension (1/g∝() with the same exponent μ≅0.43. Finally, we numerically verify that these three quantities (ξ, λ, D-Dc) scale with the distance to the critical control parameter of the map (i.e., a-ac) in accordance with the universal Huberman-Rudnick scaling law with the same exponent ν=0.448±0.003. All these findings can be considered as a new evidence supporting that the central limit behaviour at the chaos threshold is given by a q-Gaussian.

  3. Computational Study of the Scaling relationship between Fluid Flow and Fracture Stiffness

    Science.gov (United States)

    Petrovitch, C.; Pyrak-Nolte, L. J.; Nolte, D.

    2008-12-01

    To sequester CO2 in the subsurface requires an understanding of the relationships among physical processes that occur on multiple length and time scales. If seismic techniques are to be developed to monitor the injection and containment phases of CO2 sequestration, it is important to understand not only how the microscopic behavior affects macroscopic measurements, but to determine how measurements made on the laboratory scale may be relevant to the field scale. We performed a computational study to investigate the scaling behavior of the interrelationship between the fracture specific stiffness and fluid flow through fractures to promote development of active seismic monitoring techniques to quantify the time-dependent changes in a subsurface CO2 reservoir. The relationship between the hydraulic and seismic properties of fractures is based on the empirical relationship between fluid flow through a fracture and fracture specific stiffness. Experimental work has shown that fracture stiffness and fluid flow through a fracture both depend on the topology of the fracture. In our study, we focus on the role of fracture in expressing the fracture stiffness - flow fluid relationship in scaling form. The geometry of fractures were simulated using stratified continuum percolation that constructs a hierarchical aperture distribution with a tunable spatial correlation length. Correlation lengths were varied from a quarter of the fracture length to the full length of the fracture. The dimensions of the fractures ranged from 1024 to 32 pixels (1 m to 0.03 m) to observe scaling behavior. The spatial and size distribution of the aperture and contact area for each simulated fracture were quantified along with percolation probabilities, percolation cluster statistics and other geometric parameters. The fracture specific stiffness was determined using an algorithm that models the asperities of the fracture surface on a regular lattice grid. The half-spaces and asperities deformed

  4. Discriminating between cardiac and pulmonary dysfunction in the general population with dyspnea by plasma pro-B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Mogelvang, R; Goetze, JP; Schnohr, P

    2007-01-01

    OBJECTIVES: This study was designed to determine whether measurement of plasma pro-B-type natriuretic peptide (proBNP) could be used in discriminating between cardiac and pulmonary dyspnea in the general population. BACKGROUND: Natriuretic peptides are useful markers in ruling out acute cardiac...... dyspnea in the emergency department, but their diagnostic significance in evaluating chronic dyspnea in the general population is unknown. METHODS: Within the Copenhagen City Heart Study, a large, community-based population study, dyspnea was evaluated by spirometry, oxygen saturation, echocardiography......, and plasma proBNP. RESULTS: Of 2,929 participants, 959 reported dyspnea. The plasma proBNP concentration was higher in the group with dyspnea (mean 17.8 pmol/l; 95% confidence interval [CI] 16.3 to 19.4 pmol/l) than in the group without (10.6 pmol/l; 95% CI 10.0 to 11.4 pmol/l; p

  5. Cervical Hyperostosis Leading to Dyspnea, Aspiration and Dysphagia: Strategies to Improve Patient Management

    Directory of Open Access Journals (Sweden)

    Georgios Psychogios

    2018-04-01

    Full Text Available Diffuse idiopathic skeletal hyperostosis (DISH is a rare but well known cause of dysphagia. In very few cases aspiration and dyspnea are described as a clinical manifestation. An 82-year-old man presented himself in our clinic with severe dyspnea, aspiration, and pneumonia. After performing a microlaryngoscopy an emergency tracheotomy became necessary.In laryngoscopy a severe bulging of the posterior oropharyngeal and hypopharyngeal wall was detected. The glottis area was not observable and immobilisation of the right vocal cord could be detected. The CT showed anterior osteophytes and ossification of the anterior longitudinal ligament from C2–C7. We performed a panendoscopy in order to explore the upper aerodigestive area. Postoperatively an emergency tracheotomy was needed due to the development of laryngeal edema. The osteophytes were removed in cooperation with the department of orthopaedics. Three months postoperative the patient had no dyspnea or dysphagia, so the tracheotomy could be closed.Cervical hyperostosis is commonly described in elderly patients and usually presenting without symptoms, therefore a surgical treatment is usually not necessary. Nevertheless it can lead to severe morbidity and dyspnea with airway obstruction. Therefore it is essential that cervical hyperostosis is recognized early enough and appropriate treatment is initiated. Flexible endoscopy should be preferred over direct panendoscopy because it could lead to life-threatening edema and a prophylactic tracheostomy should be strongly considered in patients that present with severe dyspnea,

  6. Development of a Barthel Index based on dyspnea for patients with respiratory diseases

    Science.gov (United States)

    Vitacca, Michele; Paneroni, Mara; Baiardi, Paola; De Carolis, Vito; Zampogna, Elisabetta; Belli, Stefano; Carone, Mauro; Spanevello, Antonio; Balbi, Bruno; Bertolotti, Giorgio

    2016-01-01

    Background As Barthel Index (BI) quantifies motor impairment but not breathlessness, the use of only this index could underestimate disability in chronic respiratory disease (CRD). To our knowledge, no study evaluates both motor and respiratory disability in CRD during activities of daily living (ADLs) simultaneously and with a unique tool. The objective of this study was to propose for patients with CRD an additional tool for dyspnea assessment during ADLs based on BI items named Barthel Index dyspnea. Methods Comprehensibility, reliability, internal consistency, validity, responsiveness, and ability to differentiate between disease groups were assessed on 219 subjects through an observational study performed in an in-hospital rehabilitation setting. Results Good comprehensibility, high reliability (interrater intraclass correlation coefficient was 0.93 [95% confidence interval 0.892–0.964] and test–retest intraclass correlation coefficient was 0.99 [95% confidence interval 0.983–0.994]), good internal consistency (Cronbach’s alpha 0.89), strong concurrent validity with 6 minute walking distance (Pearson r=−0.538, Pdyspnea severity. Divergent validity showed weak correlation (Pearson r=−0.38) comparing Barthel Index dyspnea and BI. Conclusion The BI based on dyspnea perception proved to be reliable, sensitive, and adequate as a tool for measuring the level of dyspnea perceived in performing basic daily living activities. A unique instrument simultaneously administered may provide a global assessment of disability during ADLs incorporating both motor and respiratory aspects. PMID:27354778

  7. Do isolated leg exercises improve dyspnea during exercise in chronic obstructive pulmonary disease?

    Science.gov (United States)

    Molgat-Seon, Yannick; Road, Jeremy D; Sheel, A William

    2013-09-01

    Dyspnea, the subjective feeling of shortness of breath, is a hallmark feature of chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) programs aim to improve dyspnea, thereby increasing exercise tolerance and health-related quality of life in patients with COPD. Exercise training is proven to be an essential component of PR; however, there is no consensus regarding which training modality confers the greatest therapeutic benefit. Secondary to pulmonary impairment, many COPD patients develop limb muscle dysfunction (LMD), particularly in the leg muscles. Mounting evidence suggests that peripheral limitation to exercise as a result of LMD is frequent in patients with COPD. LMD of the legs, or lower limb muscle dysfunction, has been shown to markedly influence ventilatory and dyspnea responses to exercise. Accordingly, isolated training of leg muscles may contribute to reducing dyspnea and increase exercise tolerance in patients with COPD. Indeed, relative to the largely irreversible impairment of the pulmonary system, the leg muscles are an important site by which to improve patients' level of function and quality of life. Isolated leg exercises have been shown to improve LMD and may constitute an effective training modality to improve dyspnea and exercise tolerance in COPD within the context of PR.

  8. Relationship between fine-mode AOD and precipitation on seasonal and interannual time scales

    Directory of Open Access Journals (Sweden)

    Hwayoung Jeoung

    2014-01-01

    Full Text Available On seasonal and interannual time scales, weather is highly influential in aerosol variability. In this study, we investigate the relationship between fine-mode AOD (fAOD and precipitation on these scales, in order to unravel the effect of wet weather on aerosol amount. We find with integrated satellite and ground observations that biomass burning related fAOD has a relatively greater seasonal variation than fossil fuel combustion related fAOD. It is also found that wet weather reduces biomass burning fAOD and increases fossil fuel combustion fAOD. Aerosol simulation models forced by reanalyses consistently simulate the biomass burning fAOD reduced during wet weather but only in the tropics and furthermore do not consistently increase fossil fuel combustion fAOD during wet conditions. The identified relationship between fAOD and precipitation in observations allows for seasonal predictability of fAOD, since average precipitation can be predicted a few to several months in advance due to the well-established predictability of El Niño-Southern Oscillation (ENSO. We reveal ENSO-covariant fAOD using a rotated component principal analysis of combined interannual variation of sea surface temperature, precipitation and fAOD. During the warm phase of ENSO, we find that fAOD increases over Indonesia and the eastern coastal area of China, and decreases over South Asia, the Amazon and the continental parts of China.

  9. Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer

    Science.gov (United States)

    Guirimand, Frédéric; Sahut d'izarn, Marine; Laporte, Lucy; Francillard, Marie; Richard, Jean-François; Aegerter, Philippe

    2015-01-01

    Dyspnea is a symptom that severely affects the quality of life of terminally ill patients. Its frequency differs considerably between studies. We aimed to characterize the frequency of dyspnea in a palliative care hospital (PCH) and to identify factors predisposing to dyspnea, particularly during the very last days of life, as a function of the underlying disease. Episodes of dyspnea were identified by the computerized extraction of prospectively collected data from the reports of care assistants or from medical observations recorded in the medical files for all stays at our PCH during the last 6 years. There were 6455 hospital stays, 88% ending in the death of the patient; 13,282 episodes of dyspnea were recorded during 2608 hospital stays (40%). Dyspnea was more frequently observed in cases of cancer than in other conditions (RR = 1.30; 95% CI: 1.14–1.48). Pulmonary metastasis increased the risk of dyspnea from 37% to 51% (RR = 1.37; 95% CI: 1.29–1.46). Dyspnea frequency varied with the primary cancer site, from 24% (brain cancer) to 60% (esophageal cancer). The data for cancer patients staying for more than 6 days who subsequently died indicated that 8% of patients experienced dyspnea exclusively during the last 4 days of the life, independently of the site of the primary cancer. Dyspnea during the last few days of life requires systematic assessment. Exclusively terminal dyspnea should be distinguished from more precocious dyspnea, as the pathophysiological mechanisms and treatments of these two forms are probably different. PMID:25644607

  10. Conflict Resolution Styles Scale in Romantic Relationship: The Validity and Reliability Study

    Directory of Open Access Journals (Sweden)

    Ayca Ozen

    2016-06-01

    Full Text Available The aim of the current study is to test the reliability and validity of the 'Conflict Resolution Styles Scale' (CRSS, which was developed by the researchers. For this aim, two studies have been conducted. In the first study, semi-structured interviews were conducted with participants who are either married or involved in romantic relationship. A large item pool was generated with the items developed from the interviews and the items developed by the authors after reviewing the related literature. Exploratory factor analysis with 200 dating participants (M= 23.13, SD = 2.96 revealed that four factor solution is suitable for the CRSS. These factors were named as negative conflict resolution style, positive conflict resolution style, subordination, and retreat. In order to confirm the factor structure of the scale, 140 married couples (280 individuals; M = 38.09, SD = 10.35 were participated to the second study. Both exploratory and confirmatory factor analyses were used to test the factor structure of the scale. The results of these analyses and the correlations with the related variables showed that CRSS was reliable and valid measurement tool in the assessment of the conflict resolution styles.

  11. Scaling relationship for surface water transport in stream networks and sub-surface flow interaction

    Science.gov (United States)

    Worman, A.

    2005-12-01

    Ground surface topography is known to control the circulation pattern of groundwater and also reflects the surface hydrological pathways through the landscape. This means that similar geometrical distributions typical to the landscape can be related physically-mathematically to the overall circulation of water and solute elements on land. Such understanding is needed in the management of water resources, especially on the watershed scale or larger. This paper outlines a theory by which we represent landscape topography in terms of its Fourier spectrum of a typical wave-function, formally relate this spectrum to the sub-surface flow of water and solute elements. Further, the stream network characteristics is analysed both in terms of the fractal distribution of individual stream lengths and the distribution of total transport distances in the watershed. Empirical relationships between the three types of distributions are established for two example watersheds in the middle and southern Sweden. Because the flow of water and solute elements in the stream network can also be described by convoluting unit solutions over the stream network, this paper describes an approach that relate lanscape topography to hydrological and geochemical circulation. The study shows that surface topography, stream network characteristics and thickness of quaternary deposits controls the circulation pattern of the deep groundwater. The water exchange is controlled by topography on both the continental scale as well as regional scale. The residence of deep groundwater in the stream network - before entering the coastal zone - is, therefore also controlled by the landscape topography.

  12. A case of vogt-koyanagi-harada syndrome with persistent dyspnea secondary to laryngeal edema.

    Science.gov (United States)

    Mantopoulos, Dimosthenis; deSilva, Brad W; Cebulla, Colleen M

    2014-01-01

    We report a case of laryngeal edema associated with the Vogt-Koyanagi-Harada (VKH) syndrome. A 32-year-old African-American female presented with a 12-day prodrome, including headache, tinnitus and shortness of breath, which preceded sudden photophobia and bilateral visual loss. Examination and clinical testing were most consistent with VKH, and the patient improved with intravenous methylprednisolone therapy. The patient had persistent dyspnea, which was out of proportion to chest CT findings and which was exacerbated during a recurrence of VKH. Flexible fiberoptic laryngoscopy with stroboscopy revealed diffuse laryngeal edema. Symptoms were alleviated with breathing exercises. Several autoimmune diseases may cause diffuse laryngeal edema. In this case, VKH was associated with the patient's glottic edema and dyspnea. We recommend that laryngeal edema be considered in the differential diagnosis for patients with dyspnea and VKH.

  13. A Case of Vogt-Koyanagi-Harada Syndrome with Persistent Dyspnea Secondary to Laryngeal Edema

    Directory of Open Access Journals (Sweden)

    Dimosthenis Mantopoulos

    2014-11-01

    Full Text Available Purpose: We report a case of laryngeal edema associated with the Vogt-Koyanagi-Harada (VKH syndrome. Patient and Methods: A 32-year-old African-American female presented with a 12-day prodrome, including headache, tinnitus and shortness of breath, which preceded sudden photophobia and bilateral visual loss. Examination and clinical testing were most consistent with VKH, and the patient improved with intravenous methylprednisolone therapy. Results: The patient had persistent dyspnea, which was out of proportion to chest CT findings and which was exacerbated during a recurrence of VKH. Flexible fiberoptic laryngoscopy with stroboscopy revealed diffuse laryngeal edema. Symptoms were alleviated with breathing exercises. Conclusions: Several autoimmune diseases may cause diffuse laryngeal edema. In this case, VKH was associated with the patient's glottic edema and dyspnea. We recommend that laryngeal edema be considered in the differential diagnosis for patients with dyspnea and VKH.

  14. Dyspnea in the ambulance - etiology, mortality, and point-of-care diagnostics

    DEFF Research Database (Denmark)

    Bøtker, Morten Thingemann

    2016-01-01

    that are highly prioritized in emergency medical services – including chest pain and trauma. Whether this increased mortality can be ascribed to an older age and comorbidity among patients suffering dyspnea, or if modifiable risk factors are also present, is unsettled. Improving outcome for patients suffering...... of a point-of-care examination for heart failure improves management of patients suffering dyspnea because of heart disease beyond usual care. Methods The thesis includes two register-based studies (Part 1) and one interventional study (Part2). In Part 1, the risk of death in patients suffering dyspnea...... on the interpretation of their electrocardiogram. In addition, we compared short-term mortality between patients diagnosed with different heart, lung, and other diseases among patients included in the second study. In Part 2 we conducted a randomized controlled study examining whether addition of point-of-care N...

  15. McArdle's Disease Presenting as Unexplained Dyspnea in a Young Woman

    Directory of Open Access Journals (Sweden)

    Nha Voduc

    2004-01-01

    Full Text Available McArdle's disease is a rare, inherited deficiency of myophosphorylase, an enzyme required for the utilization of glycogen. Patients with myophosphorylase deficiency classically present with exercise intolerance, leg pain and muscle fatigue. The case of a young woman with exertional dyspnea and leg cramps is described. Exercise testing confirmed the presence of exercise intolerance and demonstrated an accelerated heart rate response, despite the absence of an anaerobic threshold and a respiratory exchange ratio of less than 1.0. Subsequent ischemic forearm testing and muscle biopsy confirmed the diagnosis of myophosphorylase deficiency. Evaluation of lung mechanics with esophageal pressure measurements demonstrated the presence of respiratory muscle weakness and early fatiguability, suggesting that the patient's dyspnea might have been attributable to an increased respiratory effort. Dyspnea is not a classic symptom associated with myophosphorylase deficiency, although subclinical respiratory muscle impairment may be present. No previous studies have evaluated respiratory muscle function during exercise in patients with myophosphorylase deficiency.

  16. Cultural adaptation and reliability analysis of the Modified Dyspnea Index for the Brazilian culture.

    Science.gov (United States)

    Miura, Cinthya Tamie Passos; Gallani, Maria Cecília Bueno Jayme; de Barros Leite Domingues, Gabriela; Rodrigues, Roberta Cunha Matheus; Stoller, James K

    2010-01-01

    This study aims to present the cross-cultural adaptation process of the Modified Dyspnea Index to the Brazilian culture and to investigate its content validity and reliability. This process included the steps of translation, back translation and review by two experts to assess semantic, conceptual, idiomatic, cultural and metabolic equivalence. The Index of Content Validity was used to evaluate the extent of inter-observer agreement. A Guide to implement the Modified Dyspnea Index was developed and validated. Two different professionals assessed the reliability of the Brazilian version of the Modified Dyspnea Index, according to the inter-observer equivalence criterion, with 31 patients, indicating a Kappa coefficient=0.960 (pBrazilian version of MDI presented evidence of interobserver equivalence when applied by different health professionals in the population of cardiac patients.

  17. Determining Central Black Hole Masses in Distant Active Galaxies and Quasars. II. Improved Optical and UV Scaling Relationships

    DEFF Research Database (Denmark)

    Vestergaard, Marianne; Peterson, B. M.

    2006-01-01

    We present four improved empirical relationships useful for estimating the central black hole mass in nearby AGNs and distant luminous quasars alike using either optical or UV single-epoch spectroscopy. These mass-scaling relationships between line widths and luminosity are based on recently...

  18. Spatial disaggregation of complex soil map units at regional scale based on soil-landscape relationships

    Science.gov (United States)

    Vincent, Sébastien; Lemercier, Blandine; Berthier, Lionel; Walter, Christian

    2015-04-01

    Accurate soil information over large extent is essential to manage agronomical and environmental issues. Where it exists, information on soil is often sparse or available at coarser resolution than required. Typically, the spatial distribution of soil at regional scale is represented as a set of polygons defining soil map units (SMU), each one describing several soil types not spatially delineated, and a semantic database describing these objects. Delineation of soil types within SMU, ie spatial disaggregation of SMU allows improved soil information's accuracy using legacy data. The aim of this study was to predict soil types by spatial disaggregation of SMU through a decision tree approach, considering expert knowledge on soil-landscape relationships embedded in soil databases. The DSMART (Disaggregation and Harmonization of Soil Map Units Through resampled Classification Trees) algorithm developed by Odgers et al. (2014) was used. It requires soil information, environmental covariates, and calibration samples, to build then extrapolate decision trees. To assign a soil type to a particular spatial position, a weighed random allocation approach is applied: each soil type in the SMU is weighted according to its assumed proportion of occurrence in the SMU. Thus soil-landscape relationships are not considered in the current version of DSMART. Expert rules on soil distribution considering the relief, parent material and wetlands location were proposed to drive the procedure of allocation of soil type to sampled positions, in order to integrate the soil-landscape relationships. Semantic information about spatial organization of soil types within SMU and exhaustive landscape descriptors were used. In the eastern part of Brittany (NW France), 171 soil types were described; their relative area in the SMU were estimated, geomorphological and geological contexts were recorded. The model predicted 144 soil types. An external validation was performed by comparing predicted

  19. Thyroid ablation by radioactive iodine in the management of intractable dyspnea and chest pain

    International Nuclear Information System (INIS)

    Greve, M.J.

    1980-01-01

    A study is reported of the treatment of 21 patients with radioactive iodine over the past 15 years, all of whom had intractable symptoms of dyspnea or exertional chest pain due to heart or pulmonary disease. The evaluation of benefits was subjective, but all patients were followed by one observer. About 60% of the patients received benefit that was worthwhile. Indications for administration of radioactive iodine are: Life expectancy over 3 months, severe angina or dyspnea, lack of response to usual therapeutic measures, spontaneous improvement unlikely, relatively stable symptoms and signs and a cooperative patient and family. (Auth.)

  20. Excess Ventilation in Chronic Obstructive Pulmonary Disease-Heart Failure Overlap. Implications for Dyspnea and Exercise Intolerance.

    Science.gov (United States)

    Rocha, Alcides; Arbex, Flavio F; Sperandio, Priscilla A; Souza, Aline; Biazzim, Ligia; Mancuso, Frederico; Berton, Danilo C; Hochhegger, Bruno; Alencar, Maria Clara N; Nery, Luiz E; O'Donnell, Denis E; Neder, J Alberto

    2017-11-15

    An increased ventilatory response to exertional metabolic demand (high [Formula: see text]e/[Formula: see text]co 2 relationship) is a common finding in patients with coexistent chronic obstructive pulmonary disease and heart failure. We aimed to determine the mechanisms underlying high [Formula: see text]e/[Formula: see text]co 2 and its impact on operating lung volumes, dyspnea, and exercise tolerance in these patients. Twenty-two ex-smokers with combined chronic obstructive pulmonary disease and heart failure with reduced left ventricular ejection fraction undertook, after careful treatment optimization, a progressive cycle exercise test with capillary (c) blood gas collection. Regardless of the chosen metric (increased [Formula: see text]e-[Formula: see text]co 2 slope, [Formula: see text]e/[Formula: see text]co 2 nadir, or end-exercise [Formula: see text]e/[Formula: see text]co 2 ), ventilatory inefficiency was closely related to Pc CO 2 (r values from -0.80 to -0.84; P < 0.001) but not dead space/tidal volume ratio. Ten patients consistently maintained exercise Pc CO 2 less than or equal to 35 mm Hg (hypocapnia). These patients had particularly poor ventilatory efficiency compared with patients without hypocapnia (P < 0.05). Despite the lack of between-group differences in spirometry, lung volumes, and left ventricular ejection fraction, patients with hypocapnia had lower resting Pa CO 2 and lung diffusing capacity (P < 0.01). Excessive ventilatory response in this group was associated with higher exertional Pc O 2 . The group with hypocapnia, however, had worse mechanical inspiratory constraints and higher dyspnea scores for a given work rate leading to poorer exercise tolerance compared with their counterparts (P < 0.05). Heightened neural drive promoting a ventilatory response beyond that required to overcome an increased "wasted" ventilation led to hypocapnia and poor exercise ventilatory efficiency in chronic obstructive pulmonary disease

  1. Is there any relationship between the Modified Ashworth Scale scores and alpha motoneuron excitability indicators?

    Science.gov (United States)

    Ghotbi, N; Olyaei, G R; Hadian, M R; Ansari, N N; Bagheri, H

    2006-09-01

    The purpose of this study was to investigate the relationship between the modified Ashworth scale (MAS) scores and alpha motoneuron excitability indicators. Thirty-one post-stroke patients were assessed for this object. The main outcome measures were the MAS and electro physiologic assessments. The latter was performed using both conventional (Hmax/Mmax) and new (Hslope/Mslope) measures of spinal excitability. Data on thirty-one adult subjects with hemiplegia (twenty-five men and six women) were analysed. The soleus Hmax/Mmax ratio appeared to correlate directly with the MAS scores (r = 0.36; P 0.05). In seventeen patients whose H-reflex could be evoked bilaterally, spinal excitability indicators showed significant difference between the affected and non-affected sides (P < 0.05). Based on the results of this study, there is no relationship between the MAS scores and the preferred measure of alpha motoneuron excitability. This research suggests that the MAS could not distinguish between the reflexive and non-reflexive components of the hypertonicity in ankle plantar flexors.

  2. The relationship between sensory processing and anxiety on cars scale in autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Novaković Neda

    2015-01-01

    Full Text Available Autism Spectrum Disorder is a neurodevelopmental disorder, characterized by deficits in social interactions, social communication, stereotyped behavior associated with sensory disorders occurring before the age of 3. There has been a growing trend of this neurodevelopmental disorder in recent years. Although the sensory processing problems have been noticed since the first descriptions of autism spectrum disorders, it is only the DSM-5, diagnostic and statistical manual of mental disorders, that includes sensory problems, as the crucial symptom in diagnostic profile of autism spectrum disorder. Objective: To establish the relationship between functional areas related to sensory processing and anxiety, as well as to determine the degree of autistic disorder in adolescents and adults with autism spectrum disorder. Method: 42 participants, adolescents and adults with severe autism disorder and intellectual disability, aged 15-35, of both sexes from Belgrade were evaluated by Childhood Autism Rating Scale (CARS used to determine the degree of autistic disorder. The following functional areas were compared: sensory interests and anxiety in adolescents and adults with autistic spectrum of both sexes. Results: The results indicated the existence of the relationship between anxiety and unusual sensory interests and the severity of autism spectrum disorder. The results showed that there was a correlation between visual perception and the level of intellectual functioning, especially of the severity of autistic disorder and visual perception. Conclusion: These results indicate the reasons of the problems and difficulties in the field of general adaptation of the individuals with autism spectrum disorder.

  3. Improving extinction projections across scales and habitats using the countryside species-area relationship.

    Science.gov (United States)

    Martins, Inês Santos; Pereira, Henrique Miguel

    2017-10-10

    The species-area relationship (SAR) has been often used to project species extinctions as a consequence of habitat loss. However, recent studies have suggested that the SAR may overestimate species extinctions, at least in the short-term. We argue that the main reason for this overestimation is that the classic SAR ignores the persistence of species in human-modified habitats. We use data collected worldwide to analyse what is the fraction of bird and plant species that remain in different human-modified habitats at the local scale after full habitat conversion. We observe that both taxa have consistent responses to the different land-use types, with strongest reductions in species richness in cropland across the globe, and in pasture in the tropics. We show that the results from these studies cannot be linearly scaled from plots to large regions, as this again overestimates the impacts of land-use change on biodiversity. The countryside SAR provides a unifying framework to incorporate both the effect of species persistence in the landscape matrix and the non-linear response of the proportion of species extinctions to sampling area, generating more realistic projections of biodiversity loss.

  4. GALAXY CLUSTER RADIO RELICS IN ADAPTIVE MESH REFINEMENT COSMOLOGICAL SIMULATIONS: RELIC PROPERTIES AND SCALING RELATIONSHIPS

    International Nuclear Information System (INIS)

    Skillman, Samuel W.; Hallman, Eric J.; Burns, Jack O.; Smith, Britton D.; O'Shea, Brian W.; Turk, Matthew J.

    2011-01-01

    Cosmological shocks are a critical part of large-scale structure formation, and are responsible for heating the intracluster medium in galaxy clusters. In addition, they are capable of accelerating non-thermal electrons and protons. In this work, we focus on the acceleration of electrons at shock fronts, which is thought to be responsible for radio relics-extended radio features in the vicinity of merging galaxy clusters. By combining high-resolution adaptive mesh refinement/N-body cosmological simulations with an accurate shock-finding algorithm and a model for electron acceleration, we calculate the expected synchrotron emission resulting from cosmological structure formation. We produce synthetic radio maps of a large sample of galaxy clusters and present luminosity functions and scaling relationships. With upcoming long-wavelength radio telescopes, we expect to see an abundance of radio emission associated with merger shocks in the intracluster medium. By producing observationally motivated statistics, we provide predictions that can be compared with observations to further improve our understanding of magnetic fields and electron shock acceleration.

  5. Allometric scaling relationship between frequency of intestinal contraction and body size in rodents and rabbits.

    Science.gov (United States)

    Arab, Hossein-Ali; Muhammadnejad, Samad; Naeimi, Saeideh; Arab, Attieh

    2013-06-01

    This study aimed to establish an allometric scaling relationship between the frequency of intestinal contractions and body mass of different mammalian species. The frequency of intestinal contractions of rabbit, guinea pig, rat and mouse were measured using an isolated organ system. The isolated rings were prepared from proximal segments of jejunums and the frequency of contractions was recorded by an isometric force procedure. The coefficients of the obtained allometric equation were ascertained by computation of least squares after logarithmic transformation of both body mass and frequency. Significant differences (p less than 0.001) were shown in the frequency of contractions between different species. The highest frequency that corresponded to the mice was 57.7 min-1 and the 95 percent confidence interval (CI) ranged from 45.4 to 70, while rabbits showed the lowest frequency (12.71 min-1, CI: 8.6-16.8). Logarithms of frequency were statistically proportional to logarithms of body mass (r00.99; p less than 0.001). The data fitted an equation F 1/4 18:51B 0:31 and the 95 percent confidence interval of the exponent ranged from -0.30 to -0.32. The results of this study suggest that it is probably possible to extrapolate the intestinal contraction frequency of other mammalian species by the means of allometry scaling.

  6. Measuring disability in stroke: relationship between the modified Rankin scale and the Barthel index.

    Science.gov (United States)

    Uyttenboogaart, M; Luijckx, G-J; Vroomen, P C A J; Stewart, R E; De Keyser, J

    2007-08-01

    The effectiveness of therapeutic interventions in acute stroke trials is traditionally measured with the modified Rankin scale (mRs) and the Barthel index (BI). The mRs is a global disability scale divided into six steps from total independence to total dependence. The BI assesses ten basal activities of daily living, of which eight assess level of dependence (bathing, grooming, using stairs, dressing, feeding, toilet use, transfers and walking). The aim of this study was to investigate the relationship between the mRs and the total scores and item-scores of the BI. During a period of 3 months mRs and BI scores were collected from two multicentre randomised, placebo-controlled trials with lubeluzole (515 and 519 patients). In each patient we compared the mRs grades with the total BI score and the scores on the ten subitems. For both trials there was extensive overlap of BI scores between mRs grades and a wide range in BI scores among patients with mRs grades 3 and 4. We also found discrepancies between the BI item-scores and mRs grades. About 40% of patients with mRs grades 1 (able to carry out all usual activities) and 2 (able to look after own affairs without assistance) were not independent on at least one activity of the BI. In both studies, about 30% of the patients needed help or supervision for walking, although they were classified as mRs 3 (requiring some help but able to walk without assistance). Investigators in stroke trials use the mRs as a subjective global disability scale, and they do not strictly take into account limitations in performing specific basal activities of daily living, as assessed by the BI, to assign mRs grades.

  7. Micro scale spatial relationships in urban studies : The relationship between private and public space and its impact on street life

    NARCIS (Netherlands)

    Van Nes, A.; Lopez, M.J.J.

    2007-01-01

    Research on urban environment by means of space syntax theory and methods tends to focus on macro scale spatial conditions. However, micro scale conditions should not be neglected. In research on street life and dispersal of crime in urban areas, it became inevitable to pay attention to the

  8. Qualitative aspects of exertional dyspnea in patients with restrictive lung disease

    Directory of Open Access Journals (Sweden)

    Laveneziana Pierantonio

    2010-06-01

    Full Text Available Abstract Restrictive lung disease is a broad term encompassing a number of conditions in which lung volumes are reduced. Dyspnea is a common clinical manifestation of restrictive lung disease and frequently becomes a prominent and disabling symptom that undermines patients' ability to function and engage in activities of daily living (especially in those with more advanced restriction. Effective management of this disabling symptom awaits a better understanding of its underlying physiology. In recent decades, our understanding of the mechanisms of dyspnea in restrictive lung disease has been improved by a small, but significant, body of research. One approach to the study of dyspnea is to identify the major qualitative dimensions of the symptom in an attempt to uncover different underlying neurophysiologic mechanisms. This article will review the existing literature on the intensity and qualitative dimensions of dyspnea during exercise in patients with restrictive lung disease. The main focus will be on interstitial lung disease (ILD, since it is the prototypical restrictive disease.

  9. Right sided arcus aorta as a cause of dyspnea and chronic cough

    Directory of Open Access Journals (Sweden)

    Ozkaya Sevket

    2012-10-01

    Full Text Available Abstract Background Right sided arcus aorta (RSAA is a rare condition that is usually asymptomatic. Patients may present with exertional dyspnea and chronic cough. A recent article suggested that RSAA should be included in the differential diagnosis of asthma, especially in patients with intractable exertional dyspnea. We aimed to present the clinical, radiologic and spirometric features of thirteen patients with RSAA observed in four years at the Rize Education and Research Hospital and Samsun Chest Diseases and Thoracic Surgery Hospital. Methods The characteristics of patients with RSAA, including age, gender, symptoms, radiologic and spirometric findings, were retrospectively evaluated. Results A total of thirteen patients were diagnosed with RSAA. Their ages ranged from 17 to 86 years and the male to female ratio was 11:2. Seven of the patients (54% were symptomatic. The most common symptoms were exertional dyspnea, dysphagia and chronic cough. Five patients had received treatment for asthma with bronchodilators. Spirometry showed intrathoracic tracheal obstruction in five patients. Conclusions The RSAA anomaly occurs more frequently than might be estimated from the number of patients who are detected. Patients with intractable exertional dyspnea and chronic cough should be evaluated for the RSAA anomaly by thoracic CT.

  10. Dyspnea Review for the Palliative Care Professional: Treatment Goals and Therapeutic Options

    Science.gov (United States)

    Kamal, Arif H.; Maguire, Jennifer M.; Wheeler, Jane L.; Currow, David C.

    2012-01-01

    Abstract Although dyspnea is frequently encountered in the palliative care setting, its optimal management remains uncertain. Clinical approaches begin with accurate assessment, as delineated in part one of this two-part series. Comprehensive dyspnea assessment, which encompasses the physical, emotional, social, and spiritual aspects of this complex symptom, guide the clinician in choosing therapeutic approaches herein presented as part two. Global management of dyspnea is appropriate both as complementary to disease-targeted treatments that target the underlying etiology, and as the sole focus when the symptom has become intractable, disease is maximally treated, and goals of care shift to comfort and quality of life. In this setting, current evidence supports the use of oral or parenteral opioids as the mainstay of dyspnea management, and of inhaled furosemide and anxiolytics as adjuncts. Nonpharmacologic interventions such as acupuncture and pulmonary rehabilitation have potential effectiveness, although further research is needed, and use of a simple fan warrants consideration given its potential benefit and minimal burden and cost. PMID:22268406

  11. [A 35-year-old woman with fever, dyspnea, and pain in the left thigh].

    Science.gov (United States)

    Picardi, A; Navajas, F; De Iorio, F; Amicarelli, M; Spoto, S; De Galasso, L; Vespaciani Gentilucci, U; Scarlata, S; Zardi, E; Di Cuonzo, G

    2001-01-01

    A thirty-five years old woman during her twelfth pregnancy presented fever and pain at the left thigh. After cesarean delivery dyspnea added to the first two symptoms and pulmonary embolism was suspected. A clinical history revaluation suggested a diagnosis of infectious endocarditis and femoural osteomielitis due to a septic embolus.

  12. Dyspnea Caused by Atlantoaxial Subluxation in a Patient with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Lin

    2012-01-01

    Full Text Available Atlantoaxial subluxation is a well-known but poorly recognized disease in rheumatoid patients. We report a patient with rheumatoid arthritis whose chief complaint was dyspnea on arrival to the emergency department (ED. After further investigation, spinal cord compression caused by atlantoaxial subluxation was diagnosed. This is an uncommon but important case that ED physicians should be aware of.

  13. Effects of dead space loading on neuro-muscular and neuro-ventilatory coupling of the respiratory system during exercise in healthy adults: implications for dyspnea and exercise tolerance.

    Science.gov (United States)

    Jensen, Dennis; O'Donnell, Denis E; Li, Ruifa; Luo, Yuan-Ming

    2011-12-15

    We examined the effects of dead space loading (DSL) on ventilation (V˙E), neural respiratory drive (EMGdi%max, diaphragm EMG expressed as a % of maximal EMGdi), contractile respiratory muscle effort (Pes,tidal%P(Imax), tidal esophageal pressure swing expressed as a % of maximal inspiratory Pes) and exertional dyspnea intensity ratings in 11 healthy adults with normal spirometry. Subjects completed, in random order, symptom-limited incremental cycle exercise tests under control (CTRL) and DSL (500 ml) conditions. Compared with CTRL, DSL decreased exercise tolerance by 20-25%; increased exertional dyspnea intensity ratings in direct proportion to concurrent increases in EMGdi%max, Pes,tidal%P(Imax) and V˙E; and had little/no effect on the inter-relationships between EMGdi%max, Pes,tidal%P(Imax) and V˙E during exercise. In conclusion, DSL was associated with an earlier onset of intolerable dyspnea; however, neuro-muscular and neuro-ventilatory coupling of the respiratory system remained relatively preserved during exercise in the presence of an increased external dead space. Under these circumstances, DSL-induced increases in exertional dyspnea intensity ratings reflected, at least in part, the awareness of increased neural respiratory drive, contractile respiratory muscle effort and ventilatory output. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. An Instrument to Investigate Expectations about and Experiences of the Parent-Child Relationship: The Parent-Child Relationship Schema Scale

    Directory of Open Access Journals (Sweden)

    Marcia Dixson

    2014-02-01

    Full Text Available This paper explains the reasons for and process of creating and testing for reliability and constructing the validity of the Parent-Child Relationship Schema Scale (PCRSS. The instrument is based on the Model of Relationships Survey (MRS. However, where the MRS is an open-ended survey which takes 20–30 minutes to complete and longer to analyze, the PCRSS is a Likert scale survey which can be completed in less than half the time and offers more sophisticated analysis possibilities as well as new research opportunities. The paper explains the three-stage process used to create the PCRSS and the five tests of reliability and concurrent validity that it “passed”. We also discuss the potential for new areas of research about the parent-child relationship with the PCRSS.

  15. Patient-Reported Outcome Measures in Upper Airway-Related Dyspnea: A Systematic Review.

    Science.gov (United States)

    Noud, Meaghan; Hovis, Kristen; Gelbard, Alexander; Sathe, Nila A; Penson, David F; Feurer, Irene D; McPheeters, Melissa L; Francis, David O

    2017-08-01

    Patient-reported outcome (PRO) measures address the need for patient-centered data and are now used in diverse clinical, research, and policy pursuits. They are important in conditions causing upper airway-related dyspnea in which the patient's reported experience and physiological data can be discrepant. To perform a systematic review of the literature on upper airway dyspnea-related PRO measures and to rigorously evaluate each measure's developmental properties, validation, and applicability. This study strictly adhered to Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. MEDLINE via the PubMed interface, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Health and Psychosocial Instruments (HaPI) database were searched using relevant vocabulary terms and key terms related to PRO measures and upper airway-related dyspnea. Three investigators performed abstract review, and 2 investigators independently performed full-text review by applying an established checklist to evaluate the conceptual model, content validity, reliability, construct validity, scoring and interpretability, and respondent burden and presentation of each identified instrument. The initial literature search was conducted in November 2014 and was updated in April 2016. Of 1269 studies reviewed, 3 upper airway-related dyspnea PRO measures met criteria for inclusion. One PRO measure was designed de novo to assess upper airway-related dyspnea symptoms and monitor treatment outcomes, while 2 were adapted from established instruments designed for lower airway disease. Measurement properties and psychometric characteristics differed, and none met all checklist criteria. Two met a criterion in each of 7 domains evaluated. Two demonstrated test-retest and internal consistency reliability, and 2 showed that their scores were responsive to change. Thematic deficiencies in current upper airway-related dyspnea PRO measures are lack of patient

  16. EMD-regression for modelling multi-scale relationships, and application to weather-related cardiovascular mortality

    Science.gov (United States)

    Masselot, Pierre; Chebana, Fateh; Bélanger, Diane; St-Hilaire, André; Abdous, Belkacem; Gosselin, Pierre; Ouarda, Taha B. M. J.

    2018-01-01

    In a number of environmental studies, relationships between natural processes are often assessed through regression analyses, using time series data. Such data are often multi-scale and non-stationary, leading to a poor accuracy of the resulting regression models and therefore to results with moderate reliability. To deal with this issue, the present paper introduces the EMD-regression methodology consisting in applying the empirical mode decomposition (EMD) algorithm on data series and then using the resulting components in regression models. The proposed methodology presents a number of advantages. First, it accounts of the issues of non-stationarity associated to the data series. Second, this approach acts as a scan for the relationship between a response variable and the predictors at different time scales, providing new insights about this relationship. To illustrate the proposed methodology it is applied to study the relationship between weather and cardiovascular mortality in Montreal, Canada. The results shed new knowledge concerning the studied relationship. For instance, they show that the humidity can cause excess mortality at the monthly time scale, which is a scale not visible in classical models. A comparison is also conducted with state of the art methods which are the generalized additive models and distributed lag models, both widely used in weather-related health studies. The comparison shows that EMD-regression achieves better prediction performances and provides more details than classical models concerning the relationship.

  17. Assessing Weather-Yield Relationships in Rice at Local Scale Using Data Mining Approaches.

    Science.gov (United States)

    Delerce, Sylvain; Dorado, Hugo; Grillon, Alexandre; Rebolledo, Maria Camila; Prager, Steven D; Patiño, Victor Hugo; Garcés Varón, Gabriel; Jiménez, Daniel

    2016-01-01

    Seasonal and inter-annual climate variability have become important issues for farmers, and climate change has been shown to increase them. Simultaneously farmers and agricultural organizations are increasingly collecting observational data about in situ crop performance. Agriculture thus needs new tools to cope with changing environmental conditions and to take advantage of these data. Data mining techniques make it possible to extract embedded knowledge associated with farmer experiences from these large observational datasets in order to identify best practices for adapting to climate variability. We introduce new approaches through a case study on irrigated and rainfed rice in Colombia. Preexisting observational datasets of commercial harvest records were combined with in situ daily weather series. Using Conditional Inference Forest and clustering techniques, we assessed the relationships between climatic factors and crop yield variability at the local scale for specific cultivars and growth stages. The analysis showed clear relationships in the various location-cultivar combinations, with climatic factors explaining 6 to 46% of spatiotemporal variability in yield, and with crop responses to weather being non-linear and cultivar-specific. Climatic factors affected cultivars differently during each stage of development. For instance, one cultivar was affected by high nighttime temperatures in the reproductive stage but responded positively to accumulated solar radiation during the ripening stage. Another was affected by high nighttime temperatures during both the vegetative and reproductive stages. Clustering of the weather patterns corresponding to individual cropping events revealed different groups of weather patterns for irrigated and rainfed systems with contrasting yield levels. Best-suited cultivars were identified for some weather patterns, making weather-site-specific recommendations possible. This study illustrates the potential of data mining for

  18. The parsec-scale relationship between ICO and AV in local molecular clouds

    Science.gov (United States)

    Lee, Cheoljong; Leroy, Adam K.; Bolatto, Alberto D.; Glover, Simon C. O.; Indebetouw, Remy; Sandstrom, Karin; Schruba, Andreas

    2018-03-01

    We measure the parsec-scale relationship between integrated CO intensity (ICO) and visual extinction (AV) in 24 local molecular clouds using maps of CO emission and dust optical depth from Planck. This relationship informs our understanding of CO emission across environments, but clean Milky Way measurements remain scarce. We find uniform ICO for a given AV, with the results bracketed by previous studies of the Pipe and Perseus clouds. Our measured ICO-AV relation broadly agrees with the standard Galactic CO-to-H2 conversion factor, the relation found for the Magellanic clouds at coarser resolution, and numerical simulations by Glover & Clark (2016). This supports the idea that CO emission primarily depends on shielding, which protects molecules from dissociating radiation. Evidence for CO saturation at high AV and a threshold for CO emission at low AV varies remains uncertain due to insufficient resolution and ambiguities in background subtraction. Resolution of order 0.1 pc may be required to measure these features. We use this ICO-AV relation to predict how the CO-to-H2 conversion factor (XCO) would change if the Solar Neighbourhood clouds had different dust-to-gas ratio (metallicity). The calculations highlight the need for improved observations of the CO emission threshold and H I shielding layer depth. They are also sensitive to the shape of the column density distribution. Because local clouds collectively show a self-similar distribution, we predict a shallow metallicity dependence for XCO down to a few tenths of solar metallicity. However, our calculations also imply dramatic variations in cloud-to-cloud XCO at subsolar metallicity.

  19. Assessing Weather-Yield Relationships in Rice at Local Scale Using Data Mining Approaches.

    Directory of Open Access Journals (Sweden)

    Sylvain Delerce

    Full Text Available Seasonal and inter-annual climate variability have become important issues for farmers, and climate change has been shown to increase them. Simultaneously farmers and agricultural organizations are increasingly collecting observational data about in situ crop performance. Agriculture thus needs new tools to cope with changing environmental conditions and to take advantage of these data. Data mining techniques make it possible to extract embedded knowledge associated with farmer experiences from these large observational datasets in order to identify best practices for adapting to climate variability. We introduce new approaches through a case study on irrigated and rainfed rice in Colombia. Preexisting observational datasets of commercial harvest records were combined with in situ daily weather series. Using Conditional Inference Forest and clustering techniques, we assessed the relationships between climatic factors and crop yield variability at the local scale for specific cultivars and growth stages. The analysis showed clear relationships in the various location-cultivar combinations, with climatic factors explaining 6 to 46% of spatiotemporal variability in yield, and with crop responses to weather being non-linear and cultivar-specific. Climatic factors affected cultivars differently during each stage of development. For instance, one cultivar was affected by high nighttime temperatures in the reproductive stage but responded positively to accumulated solar radiation during the ripening stage. Another was affected by high nighttime temperatures during both the vegetative and reproductive stages. Clustering of the weather patterns corresponding to individual cropping events revealed different groups of weather patterns for irrigated and rainfed systems with contrasting yield levels. Best-suited cultivars were identified for some weather patterns, making weather-site-specific recommendations possible. This study illustrates the potential of

  20. Investigation of the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales.

    Science.gov (United States)

    Matsumoto, Yuuki; Hoshiko, Michiko; Morimatsu, Yoshitaka; Mori, Mihoko; Kushino, Nanae; Ishitake, Tatsuya

    2015-01-01

    Fatigue caused by high workload is often responsible for the high attrition among doctors, and has contributed to a disruption in community medicine. In order to address this problem, institutional mechanisms at the hospital level are required. Previous studies have shown that systemic measures at the hospital level and a change in the mindset of patients can help manage the problem. "Convenient visits" refer to emergency visits for non-emergency problems. It is an avoidable cause of high workload on doctors. Convenient visits also refer to emergency consultation for non-emergency symptoms. As this is a new phenomenon, its relationship with doctors' fatigue needs further research. We investigated the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales. We selected 44 hospitals, with >200 beds each, in provincial cities of prefectures with a doctor-population ratio lower than the national average. These cities were considered likely to manifest the phenomenon of 24-hour society and include overworked doctors. Ordinance-designated cities were excluded from this study owing to wide population variability. Three doctors from each hospital were randomly selected from among physicians, surgeons, and pediatricians. We distributed questionnaires (a questionnaire concerning convenient visits, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale) to 132 doctors. Forty-two doctors responded to the survey. The median proportion of convenient visits among emergency visits was 50%. Sixty percent of the doctors surveyed were annoyed by convenient visits. Other doctors indicated good collaboration between the hospitals and communities or that they were not currently annoyed by convenient visits, although they had been annoyed previously. The emotional exhaustion in doctors, who worked in hospitals that did not restrict convenient visits, was significantly higher than in those who worked in hospitals

  1. Scaling relationship for NO2 pollution and urban population size: a satellite perspective.

    Science.gov (United States)

    Lamsal, L N; Martin, R V; Parrish, D D; Krotkov, N A

    2013-07-16

    Concern is growing about the effects of urbanization on air pollution and health. Nitrogen dioxide (NO2) released primarily from combustion processes, such as traffic, is a short-lived atmospheric pollutant that serves as an air-quality indicator and is itself a health concern. We derive a global distribution of ground-level NO2 concentrations from tropospheric NO2 columns retrieved from the Ozone Monitoring Instrument (OMI). Local scaling factors from a three-dimensional chemistry-transport model (GEOS-Chem) are used to relate the OMI NO2 columns to ground-level concentrations. The OMI-derived surface NO2 data are significantly correlated (r = 0.69) with in situ surface measurements. We examine how the OMI-derived ground-level NO2 concentrations, OMI NO2 columns, and bottom-up NOx emission inventories relate to urban population. Emission hot spots, such as power plants, are excluded to focus on urban relationships. The correlation of surface NO2 with population is significant for the three countries and one continent examined here: United States (r = 0.71), Europe (r = 0.67), China (r = 0.69), and India (r = 0.59). Urban NO2 pollution, like other urban properties, is a power law scaling function of the population size: NO2 concentration increases proportional to population raised to an exponent. The value of the exponent varies by region from 0.36 for India to 0.66 for China, reflecting regional differences in industrial development and per capita emissions. It has been generally established that energy efficiency increases and, therefore, per capita NOx emissions decrease with urban population; here, we show how outdoor ambient NO2 concentrations depend upon urban population in different global regions.

  2. A validation of the Experiences in Close Relationships-Relationship Structures scale (ECR-RS) in adolescents

    DEFF Research Database (Denmark)

    Elklit, Ask; Feddern, Dagmar

    2014-01-01

    , exhibiting satisfactory construct validity, including factor-specific links to the model of adult attachment (Bartholomew & Horowitz, 1991), and independent factor discrimination between subgroups. A robust validation supports the application of the ECR-RS to assessing relationship-specific adolescent...

  3. RELATIONSHIP BETWEEN MODIFIED ASHWORTH SCALE AND ALPHA MOTONEURON EXCITABILITY IN SPINAL CORD LESIONS

    Directory of Open Access Journals (Sweden)

    Narkeesh Arumugam

    2016-08-01

    Full Text Available Background: Spasticity is one of the major neurological complications occurring in people with Spinal Cord Lesions due to loss of supra-spinal and spinal control over alpha motor neuron activity. Its accurate assessment is necessary for tailoring patient specific rehabilitation program. Clinical assessment is commonly done through Modified Ashworth Scale where in the examiner subjectively judges resistance to passive range of motion whereas, electrophysiological quantification of spasticity can be done through Hoffman’s Reflex which is an estimate of alpha motor neuron activity. Methods: This co-relational study establishes an association between MAS and H reflex in a sample of both traumatic and non-traumatic Spinal Cord lesion patients. A sample of 22 patients was obtained who were rated for MAS grades 0,1,1+,2 and 3 in bilateral gastro soleus and consequent H reflex elicitation was done. Results: Karl Pearson Correlation coefficient was calculated between MAS and H amplitude (r = 0.342, p0.05 ; MAS and H/M ratio (r=0.190 ,p>0.05. Conclusion: It was concluded that there exists a weak but significant correlation between MAS and H amplitude but non-significant relationship between MAS and H latency; MAS and H/M ratio.

  4. Development of a Barthel Index based on dyspnea for patients with respiratory diseases

    Directory of Open Access Journals (Sweden)

    Vitacca M

    2016-06-01

    Full Text Available Michele Vitacca,1 Mara Paneroni,1 Paola Baiardi,2 Vito De Carolis,3 Elisabetta Zampogna,4 Stefano Belli,5 Mauro Carone,3 Antonio Spanevello,4,6 Bruno Balbi,5 Giorgio Bertolotti7 1Respiratory Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Institute of Lumezzane, Brescia, 2Scientific Direction, Salvatore Maugeri Foundation, IRCCS, Institute of Pavia, Pavia, 3Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Cassano delle Murge, Bari, 4Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, 5Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Veruno, Novara, 6Respiratory Diseases Unit, University of Insubria, Varese, 7Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, Italy Background: As Barthel Index (BI quantifies motor impairment but not breathlessness, the use of only this index could underestimate disability in chronic respiratory disease (CRD. To our knowledge, no study evaluates both motor and respiratory disability in CRD during activities of daily living (ADLs simultaneously and with a unique tool. The objective of this study was to propose for patients with CRD an additional tool for dyspnea assessment during ADLs based on BI items named Barthel Index dyspnea.Methods: Comprehensibility, reliability, internal consistency, validity, responsiveness, and ability to differentiate between disease groups were assessed on 219 subjects through an observational study performed in an in-hospital rehabilitation setting.Results: Good comprehensibility, high reliability (interrater intraclass correlation coefficient was 0.93 [95% confidence interval 0.892–0.964] and test–retest intraclass correlation coefficient was 0.99 [95% confidence interval 0.983–0.994], good internal consistency (Cronbach’s alpha 0.89, strong concurrent validity with 6 minute walking distance (Pearson r=–0.538, P<0.001 and Medical Research Council

  5. Noninvasive Tests for the Diagnostic Evaluation of Dyspnea Among Outpatients: the Multi-Ethnic Study of Atherosclerosis Lung Study

    Science.gov (United States)

    Oelsner, Elizabeth C; Lima, Joao AC; Kawut, Steven M; Burkart, Kristin M; Enright, Paul L; Ahmed, Firas S; Barr, R Graham

    2015-01-01

    Background Dyspnea on exertion is a common and debilitating complaint, yet evidence for the relative value of cardiac and pulmonary tests for the evaluation of chronic dyspnea among adults without known cardiac or pulmonary disease is limited. Methods The Multi-Ethnic Study of Atherosclerosis (MESA) enrolled participants ages 45-84 years who were free of clinical cardiovascular disease from six communities; participants with clinical pulmonary disease were excluded from this report. Dyspnea on exertion was assessed via structured interview. Tests included electrocardiograms, cardiac computed tomography (CT) for coronary artery calcium, cardiac magnetic resonance imaging, spirometry, percent emphysema (percent of lung regions dyspnea after adjustment for age, sex, body mass index, physical activity, anxiety, and leg pain. Results Among 1,969 participants without known cardiopulmonary disease, 9% had dyspnea. The forced expiratory volume in one second (FEV1) (p dyspnea. Associations with the FEV1 were stronger among smokers and participants with other recent respiratory symptoms or seasonal allergies; associations with NT-proBNP were present only among participants with coexisting symptoms of lower extremity edema. Only the FEV1 provided a significant improvement in the receiver operating curve. Conclusions Among adults without known cardiac or pulmonary disease reporting dyspnea on exertion, spirometry, NT-proBNP, and CT imaging for pulmonary parenchymal disease were the most informative tests. PMID:25447621

  6. Measuring thought content valence after a breakup: Development of the Positive and Negative Ex-Relationship Thoughts (PANERT) scale.

    Science.gov (United States)

    Brenner, Rachel E; Vogel, David L

    2015-07-01

    The end of a romantic relationship is a common and serious presenting concern among clients at university counseling centers. Researchers have highlighted the need to understand the nature of thoughts about an ex-relationship, because they may lead to unique clinical interventions. One aspect of thought that may be clinically relevant is content valence, or the positive or negative emotions associated with the content of the thought. Unfortunately, content valence has not been addressed in the romantic relationship dissolution literature. To address this omission, we developed the 12-item Positive and Negative Ex-Relationship Thoughts (PANERT) scale across 4 samples. In Sample 1 (n = 475), exploratory factor analyses demonstrated a multidimensional scale with 2 factors: positive content valence and negative content valence. Sample 2 (n = 509) and Sample 3 (n = 291) confirmed the factor structure in college and community samples. Internal consistencies ranged from .88-.94 for positive content valence and from .87-.94 for negative content valence. In Sample 4 (n = 133), construct validity was supported, with the PANERT factors uniquely predicting breakup distress, relationship preoccupation, depression, loss of self-concept, rediscovery of self-concept, negative emotional adjustment, and positive emotional adjustment. Further, the direction of these relationships suggest that positive thought content valence may be consistently maladaptive to recovery from an ex-relationship, and negative thought content valence may have maladaptive and adaptive features. Implications for future research and practice are discussed. (c) 2015 APA, all rights reserved).

  7. Psychometric Properties of the Orgasm Rating Scale in Context of Sexual Relationship in a Spanish Sample.

    Science.gov (United States)

    Arcos-Romero, Ana Isabel; Moyano, Nieves; Sierra, Juan Carlos

    2018-03-29

    dysfunction. The ORS is an appropriate measure for its use for both research and clinical purposes. As limitations, quota sampling implies that the extent to which the results can be generalized is modest. Measurement invariance did not reach the level of weak invariance, and it was not tested across sexual orientation because most individuals identified themselves as heterosexual. The ORS is a multidimensional measure of the subjective experience of orgasm which has adequate psychometric properties; it is a reliable and valid scale. Arcos-Romero AI, Moyano N, Sierra JC. Psychometric Properties of the Orgasm Rating Scale in Context of Sexual Relationship in a Spanish Sample. J Sex Med 2018;XX:XXX-XXX. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  8. Unraveling Kinase Activation Dynamics Using Kinase-Substrate Relationships from Temporal Large-Scale Phosphoproteomics Studies.

    Science.gov (United States)

    Domanova, Westa; Krycer, James; Chaudhuri, Rima; Yang, Pengyi; Vafaee, Fatemeh; Fazakerley, Daniel; Humphrey, Sean; James, David; Kuncic, Zdenka

    2016-01-01

    In response to stimuli, biological processes are tightly controlled by dynamic cellular signaling mechanisms. Reversible protein phosphorylation occurs on rapid time-scales (milliseconds to seconds), making it an ideal carrier of these signals. Advances in mass spectrometry-based proteomics have led to the identification of many tens of thousands of phosphorylation sites, yet for the majority of these the kinase is unknown and the underlying network topology of signaling networks therefore remains obscured. Identifying kinase substrate relationships (KSRs) is therefore an important goal in cell signaling research. Existing consensus sequence motif based prediction algorithms do not consider the biological context of KSRs, and are therefore insensitive to many other mechanisms guiding kinase-substrate recognition in cellular contexts. Here, we use temporal information to identify biologically relevant KSRs from Large-scale In Vivo Experiments (KSR-LIVE) in a data-dependent and automated fashion. First, we used available phosphorylation databases to construct a repository of existing experimentally-predicted KSRs. For each kinase in this database, we used time-resolved phosphoproteomics data to examine how its substrates changed in phosphorylation over time. Although substrates for a particular kinase clustered together, they often exhibited a different temporal pattern to the phosphorylation of the kinase. Therefore, although phosphorylation regulates kinase activity, our findings imply that substrate phosphorylation likely serve as a better proxy for kinase activity than kinase phosphorylation. KSR-LIVE can thereby infer which kinases are regulated within a biological context. Moreover, KSR-LIVE can also be used to automatically generate positive training sets for the subsequent prediction of novel KSRs using machine learning approaches. We demonstrate that this approach can distinguish between Akt and Rps6kb1, two kinases that share the same linear consensus motif

  9. Unraveling Kinase Activation Dynamics Using Kinase-Substrate Relationships from Temporal Large-Scale Phosphoproteomics Studies.

    Directory of Open Access Journals (Sweden)

    Westa Domanova

    Full Text Available In response to stimuli, biological processes are tightly controlled by dynamic cellular signaling mechanisms. Reversible protein phosphorylation occurs on rapid time-scales (milliseconds to seconds, making it an ideal carrier of these signals. Advances in mass spectrometry-based proteomics have led to the identification of many tens of thousands of phosphorylation sites, yet for the majority of these the kinase is unknown and the underlying network topology of signaling networks therefore remains obscured. Identifying kinase substrate relationships (KSRs is therefore an important goal in cell signaling research. Existing consensus sequence motif based prediction algorithms do not consider the biological context of KSRs, and are therefore insensitive to many other mechanisms guiding kinase-substrate recognition in cellular contexts. Here, we use temporal information to identify biologically relevant KSRs from Large-scale In Vivo Experiments (KSR-LIVE in a data-dependent and automated fashion. First, we used available phosphorylation databases to construct a repository of existing experimentally-predicted KSRs. For each kinase in this database, we used time-resolved phosphoproteomics data to examine how its substrates changed in phosphorylation over time. Although substrates for a particular kinase clustered together, they often exhibited a different temporal pattern to the phosphorylation of the kinase. Therefore, although phosphorylation regulates kinase activity, our findings imply that substrate phosphorylation likely serve as a better proxy for kinase activity than kinase phosphorylation. KSR-LIVE can thereby infer which kinases are regulated within a biological context. Moreover, KSR-LIVE can also be used to automatically generate positive training sets for the subsequent prediction of novel KSRs using machine learning approaches. We demonstrate that this approach can distinguish between Akt and Rps6kb1, two kinases that share the same

  10. Brief Report: Intimacy, Passion, and Commitment in Romantic Relationships--Validation of a "Triangular Love Scale" for Adolescents

    Science.gov (United States)

    Overbeek, Geertjan; Ha, Thao; Scholte, Ron; de Kemp, Raymond; Engels, Rutger C. M. E.

    2007-01-01

    This study examined the psychometric properties of an adolescent version of the "triangular love scale" (TLS), which assesses three components of romantic relationships: intimacy, passion, and commitment. Using data from 435 Dutch adolescents aged 12-18 years, we found evidence for convergent validity, showing that dimensions of…

  11. The Relationship between Student Achievement, School District Economies of Scale, School District Size, and Student Socioeconomic Status

    Science.gov (United States)

    Trani, Randy

    2009-01-01

    The relationships between student achievement, school district economies of scale, school district size and student socioeconomic status were measured for 131 school districts in the state of Oregon. Data for school districts ranging in size from districts with around 300 students to districts with more than 40,000 students were collected for…

  12. Validation of the Oral Hygiene Habits Scale: Relationships with sociodemographic variables in the general and clinical population of Monterrey, Mexico.

    Directory of Open Access Journals (Sweden)

    Norma Rodríguez

    2016-12-01

    Full Text Available Several socioeconomic factors are associated with poor oral hygiene habits. A version of the Oral Hygiene Habits Scale (OHHS was developed in Mexico to measure these factors; however, its relationship with sociodemographic variables has not been studied. The verification of these relationships could contribute to the validation of the scale. Objective: To evaluate the relationship between oral hygiene habits and sociodemographic variables of sex, age, schooling, self-defined socioeconomic stratum, occupation and marital status in the general and clinical population of Monterrey, Mexico. Materials and Methods: A general population sample (GPS of 256 participants and a clinical sample (CPS of 240 participants were studied. The OHHS consisted of an eight-item Likert scale of 4 points ranging from 0 to 4. A descriptive correlational study was performed with a cross-sectional design. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Spearman correlation coefficient, Cramer's V coefficient, and multivariate aligned rank test. Results: In GPS and CPS groups, OHHS was related to sex, schooling, socioeconomic stratum, occupation and marital status, but not to age. There were no significant interactions between the samples (GPS and CPS and sociodemographic variables. Conclusion: There is a statistically significant relationship between oral hygiene habits and some sociodemographic variables in the general and clinical population. This relationship supports the validity of the OHHS.

  13. Injury Rehabilitation Overadherence: Preliminary Scale Validation and Relationships With Athletic Identity and Self-Presentation Concerns

    Science.gov (United States)

    Podlog, Leslie; Gao, Zan; Kenow, Laura; Kleinert, Jens; Granquist, Megan; Newton, Maria; Hannon, James

    2013-01-01

    Context: Evidence suggests that nonadherence to rehabilitation protocols may be associated with worse clinical and functional rehabilitation outcomes. Recently, it has been recognized that nonadherence may not only reflect a lack of rehabilitation engagement but that some athletes may “overadhere” to their injury-rehabilitation regimen or risk a premature return to sport. Presently, no measure of overadherence exists, and correlates of overadherence and risking a premature return to sport remain uncertain. Objective: To provide initial validation of a novel injury-rehabilitation overadherence measure (study 1) and to examine correlates of overadherence and risking a premature return to sport (study 2). Design: Cross-sectional study. Setting: High school athletes (study 1) and collegiate athletes (study 2). Patients or Other Participants: In study 1, 118 currently injured US adolescent athletes competing in a range of high school sports participated. In study 2, 105 currently injured collegiate athletes (National Collegiate Athletic Association Divisions I–III) volunteered. Main Outcome Measure(s): The Rehabilitation Overadherence Questionnaire was a novel instrument developed to assess injured athletes' tendency toward overadherence behaviors and beliefs. We used an adapted version of the Injury Psychological Readiness to Return to Sport Scale to assess the tendency to risk a premature return to sport. Results: In study 1, the construct validity of the overadherence measure was supported using principal axis factoring. Moreover, bivariate correlation and regression analyses indicated that self-presentation concerns and athletic identity were positive predictors of adolescent rehabilitation overadherence and a premature return to sport. Study 2 provided support for the 2-factor structure of the overadherence measure found in study 1 via confirmatory factor analysis. Further support for the relationship among self-presentation concerns, athletic identity, and

  14. Data quality and factor analysis of the Danish version of the Relationship Scale Questionnaire.

    Science.gov (United States)

    Andersen, Christina Maar; Pedersen, Anette Fischer; Carlsen, Anders Helles; Olesen, Frede; Vedsted, Peter

    2017-01-01

    The Relationship Scale Questionnaire (RSQ) is a widely-used measure of adult attachment, but whether the results obtained by the RSQ fit the attachment construct has only been examined to a limited extent. The objectives of this study were to investigate the psychometric properties of the Danish translation of the RSQ and to test whether the results are consistent with the hypothesized model of attachment. The study included two samples: 602 general practitioners and 611 cancer patients. The two samples were analyzed separately. Data quality was assessed by mean, median and missing values for each item, floor and ceiling effects, average inter-item correlations and Cronbach's α for each subscale. Test-retest was assessed by intra-class correlations among 76 general practitioners. A confirmatory factor analysis was conducted to establish evidence of the four proposed subscales. Due to an inadequate fit of the model, data was randomly split into two equally sized subsamples and an exploratory factor analysis was conducted for all 30 items in the first subsample comprised of 286 cancer patients and 285 general practitioners. The EFA yielded a three-factor structure which was validated through a confirmatory factor analyses in a second subsample comprised of 278 cancer patients and 289 general practitioners. The data quality of the RSQ was generally good, except low internal consistency and low to moderate test-retest reliability. The four subscales of the RSQ were not confirmed by the confirmatory factor analysis. An exploratory factor analysis suggested a three-factor solution for both general practitioners and patients, which accounted for 61.1% of the variance among general practitioners and 62.5% among patients. The new three-factor solution was verified in a confirmatory factor analyses. The proposed four-factor model of the RSQ could not be confirmed in this study. Similar challenges have been found by other studies validating the RSQ. An alternative three

  15. Injury rehabilitation overadherence: preliminary scale validation and relationships with athletic identity and self-presentation concerns.

    Science.gov (United States)

    Podlog, Leslie; Gao, Zan; Kenow, Laura; Kleinert, Jens; Granquist, Megan; Newton, Maria; Hannon, James

    2013-01-01

    Evidence suggests that nonadherence to rehabilitation protocols may be associated with worse clinical and functional rehabilitation outcomes. Recently, it has been recognized that nonadherence may not only reflect a lack of rehabilitation engagement but that some athletes may "overadhere" to their injury-rehabilitation regimen or risk a premature return to sport. Presently, no measure of overadherence exists, and correlates of overadherence and risking a premature return to sport remain uncertain. To provide initial validation of a novel injury-rehabilitation overadherence measure (study 1) and to examine correlates of overadherence and risking a premature return to sport (study 2). Cross-sectional study. High school athletes (study 1) and collegiate athletes (study 2). In study 1, 118 currently injured US adolescent athletes competing in a range of high school sports participated. In study 2, 105 currently injured collegiate athletes (National Collegiate Athletic Association Divisions I-III) volunteered. The Rehabilitation Overadherence Questionnaire was a novel instrument developed to assess injured athletes' tendency toward overadherence behaviors and beliefs. We used an adapted version of the Injury Psychological Readiness to Return to Sport Scale to assess the tendency to risk a premature return to sport. In study 1, the construct validity of the overadherence measure was supported using principal axis factoring. Moreover, bivariate correlation and regression analyses indicated that self-presentation concerns and athletic identity were positive predictors of adolescent rehabilitation overadherence and a premature return to sport. Study 2 provided support for the 2-factor structure of the overadherence measure found in study 1 via confirmatory factor analysis. Further support for the relationship among self-presentation concerns, athletic identity, and rehabilitation overadherence was also noted. The Rehabilitation Overadherence Questionnaire is a valid and

  16. Scales

    Science.gov (United States)

    Scales are a visible peeling or flaking of outer skin layers. These layers are called the stratum ... Scales may be caused by dry skin, certain inflammatory skin conditions, or infections. Examples of disorders that ...

  17. Unexplained dyspnea in a patient of chronic arsenicosis: A diagnostic challenge and learning curve for physicians

    Directory of Open Access Journals (Sweden)

    Amitabha Sengupta

    2015-01-01

    Full Text Available Chronic arsenic exposure causes cutaneous effects like hyperkeratosis, peripheral vascular disease, hypertension, ischemic heart disease, non-cirrhotic portal hypertension, hepatomegaly, peripheral neuropathy, respiratory involvement, bad obstetrical outcome, hematological disturbances, and diabetes mellitus. Here we present a case of a 24-year-old lady, with chronic exposure to arsenic, presenting to us with progressive dyspnea. We found pulmonary arterial hypertension (PAH as a cause of her dyspnea. PAH can occur in arsenicosis, secondary to arsenic-induced chronic obstructive pulmonary disease (COPD, lung fibrosis, and portal hypertension, which we excluded by appropriate investigations in our case. We also excluded a familial or heritable form of PAH. Thus, with the exclusion of all these secondary causes of PAH, as well as a hereditary cause, we came to a conclusion that this PAH might be due to chronic arsenic exposure. To the best of our knowledge, no case of PAH in chronic arsenicosis has been reported to date.

  18. 29-year-old man presenting with progressive dyspnea, oculocutaneous albinism, and epistaxis.

    Science.gov (United States)

    Asefi, Golriz; Lahiji, Arta; Kamangar, Nader

    2015-06-01

    A 29-year-old man with a history of oculocutaneous albinism presented to the ED complaining of progressive dyspnea on exertion. One month prior to admission, the patient had begun to experience worsening dyspnea provoked by routine household activities. Additionally, he had developed a nonproductive cough, exacerbated by cold weather. He denied associated chest pain, hemoptysis, fever, chills, or night sweats. He denied any new exposures or sick contacts in the recent past. A review of systems was significant for a history of epistaxis and frequent bruising. Born in Honduras, he had immigrated to the United States approximately 10 years prior to his presentation to our facility. Furthermore, there was no family history of albinism, bleeding disorders, or pulmonary disease.

  19. The relationship of DSM diagnostic criteria and Gough's Prejudice Scale: exploring the clinical manifestations of the prejudiced personality.

    Science.gov (United States)

    Dunbar, E

    1997-01-01

    The relationship of psychopathology, symptoms of personality disorder, and outgroup prejudice was examined with 193 outpatient psychotherapy clients. Primary DSM-IV diagnosis, General Adaptive Functioning (GAF) scores, personality disorder criteria, and Minnesota Multiphasic Personality Inventory (MMPI) scale scores were examined in relationship to Pr (Prejudice) Scale scores and client outgroup attributions. Results of a 3 x 10 Multivariate analysis of variance (MANOVA) indicated that clinician ratings of outgroup bias were significantly related with the Axis II criteria for Paranoid, Borderline, and Antisocial disorders. MANOVA results for ratings of outgroup bias and MMPI scores did not yield a significant multivariate effect; however, significant univariate ANOVA results were found with the MMPI F, HS, PD, and MA scales. Computed univariate ANOVA results indicated that Pr Scale scores did not significantly vary between primary Axis I and Axis II DSM-IV diagnosis, but did yield a significant difference for (categorical) diagnosis by Axis II Cluster groups. Both Pr Scale scores and clinician ratings of client outgroup bias were significantly related to greater psychopathology, as reflected by lower GAF scores assigned at the initiation of treatment. Findings provide preliminary evidence of the relationship of traits of personality disorder, as characterized by impulsivity, relational disturbance, and affective lability, to outgroup prejudice with a clinical population.

  20. Addition of non-invasive ventilatory support to combined aerobic and resistance training improves dyspnea and quality of life in heart failure patients: a randomized controlled trial.

    Science.gov (United States)

    Bittencourt, Hugo Souza; Cruz, Cristiano Gonçalves; David, Bruno Costa; Rodrigues, Erenaldo; Abade, Camille Magalhães; Junior, Roque Aras; Carvalho, Vitor Oliveira; Dos Reis, Francisco Borges Faria; Gomes Neto, Mansueto

    2017-11-01

    To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. A randomized, single-blind, controlled study. Cardiac rehabilitation center. A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support ( n = 23) or combined aerobic and resistance training alone ( n = 23). Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire. Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change: 4.8 vs. 1.3, p = 0.004), and quality of life (mean change: 19.3 vs. 6.8, p = 0.017 ). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 vs. 44.1, p = 0.924), but without a statistically significant difference. Non-invasive ventilatory support combined with combined aerobic and resistance training provides additional benefits for dyspnea and quality of life in moderate heart failure patients. ClinicalTrials.gov identifier: NCT02384798. Registered 03 April 2015.

  1. The relationship between large-scale and convective states in the tropics - Towards an improved representation of convection in large-scale models

    Energy Technology Data Exchange (ETDEWEB)

    Jakob, Christian [Monash Univ., Melbourne, VIC (Australia)

    2015-02-26

    This report summarises an investigation into the relationship of tropical thunderstorms to the atmospheric conditions they are embedded in. The study is based on the use of radar observations at the Atmospheric Radiation Measurement site in Darwin run under the auspices of the DOE Atmospheric Systems Research program. Linking the larger scales of the atmosphere with the smaller scales of thunderstorms is crucial for the development of the representation of thunderstorms in weather and climate models, which is carried out by a process termed parametrisation. Through the analysis of radar and wind profiler observations the project made several fundamental discoveries about tropical storms and quantified the relationship of the occurrence and intensity of these storms to the large-scale atmosphere. We were able to show that the rainfall averaged over an area the size of a typical climate model grid-box is largely controlled by the number of storms in the area, and less so by the storm intensity. This allows us to completely rethink the way we represent such storms in climate models. We also found that storms occur in three distinct categories based on their depth and that the transition between these categories is strongly related to the larger scale dynamical features of the atmosphere more so than its thermodynamic state. Finally, we used our observational findings to test and refine a new approach to cumulus parametrisation which relies on the stochastic modelling of the area covered by different convective cloud types.

  2. Laryngeal schwannoma in an 8-year-old boy with inspiratory dyspnea.

    Science.gov (United States)

    Rognone, Elisa; Rossi, Andrea; Conte, Massimo; Nozza, Paolo; Tarantino, Vincenzo; Fibbi, Antonio; Saetti, Roberto; Cutrone, Cesare; Tortori-Donati, Paolo

    2007-10-01

    Schwannomas of the larynx are rare lesions in the pediatric age group. In this article, we report on the neuroimaging features of a schwannoma arising from the left aryepiglottic fold in an 8-year-old boy with a 6-month history of inspiratory dyspnea. Neuroimaging showed a well-defined, avoid mass originating from the left aryepiglottic fold. The lesion was removed endoscopically. Complete removal of laryngeal schwannomas is curative, and adjuvant treatment is not required.

  3. A Case of Vogt-Koyanagi-Harada Syndrome with Persistent Dyspnea Secondary to Laryngeal Edema

    OpenAIRE

    Dimosthenis Mantopoulos; Brad W. deSilva; Colleen M. Cebulla

    2014-01-01

    Purpose: We report a case of laryngeal edema associated with the Vogt-Koyanagi-Harada (VKH) syndrome. Patient and Methods: A 32-year-old African-American female presented with a 12-day prodrome, including headache, tinnitus and shortness of breath, which preceded sudden photophobia and bilateral visual loss. Examination and clinical testing were most consistent with VKH, and the patient improved with intravenous methylprednisolone therapy. Results: The patient had persistent dyspnea, which wa...

  4. Benefits of short inspiratory muscle training on exercise capacity, dyspnea, and inspiratory fraction in COPD patients.

    Science.gov (United States)

    Shahin, Barakat; Germain, Michele; Kazem, Alzahouri; Annat, Guy

    2008-01-01

    Abstract: Static lung hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT). The present study is designed to investigate the benefits of a short outpatient program of IMT on inspiratory muscle performance, exercise capacity, perception of dyspnea, and the inspiratory fraction (IF). Thirty patients (24 males, 6 females) with significant COPD (forced expiratory volume in one second [FEV1] = 46.21% +/- 6.7% predicted, FEV1 = 33.6% +/- 8.04% predicted) were recruited for this study and had 3 months of IMT (30 minutes/day for 6 days/week) in an outpatient clinic. Following IMT, there was a statistically significant increase in inspiratory muscle performance (an increase of the maximal inspiratory pressure from 59% +/- 19.1% to 79% +/- 21.85% predicted; p = 0.0342), a decrease in dyspnea (from 5.8 +/- 0.78 to 1.9 +/- 0.57; p = 0.0001), an increase in the distance walked during the 6 minute walk test, from 245 +/- 52.37 m to 302 +/- 41.30 m, and finally an increase in the IF (the new prognostic factor in COPD) from 27.6 +/- 9.7% to 31.4% +/- 9.8%. The present study concludes that in patients with significant COPD, IMT results in improvement in performance, exercise capacity, sensation of dyspnea, and moreover an improvement in the IF prognostic factor.

  5. An optimum city size? The scaling relationship for urban population and fine particulate (PM2.5) concentration

    International Nuclear Information System (INIS)

    Han, Lijian; Zhou, Weiqi; Pickett, Steward T.A.; Li, Weifeng; Li, Li

    2016-01-01

    We utilize the distribution of PM 2.5 concentration and population in large cities at the global scale to illustrate the relationship between urbanization and urban air quality. We found: 1) The relationship varies greatly among continents and countries. Large cities in North America, Europe, and Latin America have better air quality than those in other continents, while those in China and India have the worst air quality. 2) The relationships between urban population size and PM 2.5 concentration in large cities of different continents or countries were different. PM 2.5 concentration in large cities in North America, Europe, and Latin America showed little fluctuation or a small increasing trend, but those in Africa and India represent a “U” type relationship and in China represent an inverse “U” type relationship. 3) The potential contribution of population to PM 2.5 concentration was higher in the large cities in China and India, but lower in other large cities. - Highlights: • Urban population and PM 2.5 concentration varies greatly among regions. • Urban population size increase does not always enhances PM 2.5 concentration. • Population's potential contribution to PM 2.5 concentration higher in China. - We utilize the distribution of PM 2.5 concentration and population in large cities at the global scale to illustrate the relationship between urbanization and urban air quality.

  6. Development of a Barthel Index based on dyspnea for patients with respiratory diseases.

    Science.gov (United States)

    Vitacca, Michele; Paneroni, Mara; Baiardi, Paola; De Carolis, Vito; Zampogna, Elisabetta; Belli, Stefano; Carone, Mauro; Spanevello, Antonio; Balbi, Bruno; Bertolotti, Giorgio

    2016-01-01

    As Barthel Index (BI) quantifies motor impairment but not breathlessness, the use of only this index could underestimate disability in chronic respiratory disease (CRD). To our knowledge, no study evaluates both motor and respiratory disability in CRD during activities of daily living (ADLs) simultaneously and with a unique tool. The objective of this study was to propose for patients with CRD an additional tool for dyspnea assessment during ADLs based on BI items named Barthel Index dyspnea. Comprehensibility, reliability, internal consistency, validity, responsiveness, and ability to differentiate between disease groups were assessed on 219 subjects through an observational study performed in an in-hospital rehabilitation setting. Good comprehensibility, high reliability (interrater intraclass correlation coefficient was 0.93 [95% confidence interval 0.892-0.964] and test-retest intraclass correlation coefficient was 0.99 [95% confidence interval 0.983-0.994]), good internal consistency (Cronbach's alpha 0.89), strong concurrent validity with 6 minute walking distance (Pearson r=-0.538, Pmeasuring the level of dyspnea perceived in performing basic daily living activities. A unique instrument simultaneously administered may provide a global assessment of disability during ADLs incorporating both motor and respiratory aspects.

  7. An adult cystic fibrosis patient presenting with persistent dyspnea: case report

    Directory of Open Access Journals (Sweden)

    Farinet Catherine L

    2006-05-01

    Full Text Available Abstract Background Persistent dyspnea is a common finding in the cystic fibrosis patient that typically leads to further work up of an alternative pulmonary etiology. Adult cystic fibrosis patients; however, are growing in numbers and they are living into the ages in which coronary artery disease becomes prevalent. Coronary disease should be included in the consideration of diagnostic possibilities. Case presentation A 52-year-old white male with cystic fibrosis was evaluated for exertional dyspnea associated with vague chest discomfort. Diagnostic testing revealed normal white blood cell, hemoglobin and platelet count, basic metabolic panel, fasting lipid profile, HbA1c, with chest radiograph confirming chronic cystic findings unchanged from prior radiographs and an electrocardiogram that revealed sinus rhythm with left anterior fascicular block. Stress thallium testing demonstrated a reversible anteroseptal perfusion defect with a 55% left ventricular ejection fraction. Heart catheterization found a 99% occlusion of the left anterior descending artery extending into the two diagonal branches, with 100% obstruction of the left anterior descending artery at the trifurcation and 70% lesion affecting the first posterior lateral branch of the circumflex artery. Conclusion This case report represents the first description in the medical literature of a cystic fibrosis patient diagnosed with symptomatic coronary artery disease. Applying a standard clinical practice guide proved useful toward evaluating a differential diagnosis for a cystic fibrosis patient presenting with dyspnea and chest discomfort.

  8. Hepatopulmonary syndrome is a frequent cause of dyspnea in the short telomere disorders.

    Science.gov (United States)

    Gorgy, Amany I; Jonassaint, Naudia L; Stanley, Susan E; Koteish, Ayman; DeZern, Amy E; Walter, Jolan E; Sopha, Sabrina C; Hamilton, James P; Hoover-Fong, Julie; Chen, Allen R; Anders, Robert A; Kamel, Ihab R; Armanios, Mary

    2015-10-01

    Telomere syndromes have their most common manifestation in idiopathic pulmonary fibrosis and emphysema. The short telomere defect in these patients may manifest systemically as bone marrow failure and liver disease. We sought to understand the causes of dyspnea in telomerase and telomere gene mutation carriers who have no parenchymal lung disease. Clinical and pathologic data were reviewed as part of a Johns Hopkins-based natural history study of short telomere syndromes including dyskeratosis congenita. Hepatopulmonary syndrome (HPS) was diagnosed in nine of 42 cases (21%). Their age at presentation was significantly younger than that of cases initially presenting with pulmonary fibrosis and emphysema (median, 25 years vs 55 years; P time to death or liver transplantation was 6 years (range, 4-10 years; n = 6). In cases that underwent liver transplantation, dyspnea and hypoxia improved, but pulmonary fibrosis subsequently developed. This report identifies HPS as a frequent cause of dyspnea in telomerase and telomere gene mutation carriers. While it usually precedes the development of parenchymal lung disease, HPS may also co-occur with pulmonary fibrosis and emphysema. Recognizing this genetic diagnosis is critical for management, especially in the lung and liver transplantation setting.

  9. Patients' experience of oxygen therapy and dyspnea: a qualitative study in home palliative care.

    Science.gov (United States)

    Jaturapatporn, Darin; Moran, Erica; Obwanga, Chris; Husain, Amna

    2010-06-01

    Dyspnea is a common and distressing symptom in advanced cancer patients. Our preliminary work shows that in the home palliative care population sampled for this study, the prevalence of dyspnea is 29.5% and of those, 26.2% used oxygen therapy. Previous studies suggested that oxygen therapy can be a burden to patients. This study seeks to report the prevalence and describe the experience of dyspnea, pattern of oxygen use, and patients' perceived benefits and/or burdens of oxygen therapy in home palliative care patients receiving oxygen therapy. Qualitative in-depth interviews, using an interview guide, were conducted with eight participants in their homes. Thematic analysis was performed using a framework approach. All patients in this project used oxygen most of the time. The descriptions of shortness of breath varied and were nonspecific. The patients identified more advantages than disadvantages. The advantages of oxygen use included increased functional capacity, patients' perceiving oxygen as a life-saving intervention, as well as a symptom-management tool. The identified disadvantages were decreased mobility, discomfort related to the nasal prongs, barriers to accessing oxygen therapy and noise related to the equipment. The advantages of oxygen usage outweighed the disadvantages for this sample of patients in the home palliative setting.

  10. Psychics, aliens, or experience? Using the Anomalistic Belief Scale to examine the relationship between type of belief and probabilistic reasoning.

    Science.gov (United States)

    Prike, Toby; Arnold, Michelle M; Williamson, Paul

    2017-08-01

    A growing body of research has shown people who hold anomalistic (e.g., paranormal) beliefs may differ from nonbelievers in their propensity to make probabilistic reasoning errors. The current study explored the relationship between these beliefs and performance through the development of a new measure of anomalistic belief, called the Anomalistic Belief Scale (ABS). One key feature of the ABS is that it includes a balance of both experiential and theoretical belief items. Another aim of the study was to use the ABS to investigate the relationship between belief and probabilistic reasoning errors on conjunction fallacy tasks. As expected, results showed there was a relationship between anomalistic belief and propensity to commit the conjunction fallacy. Importantly, regression analyses on the factors that make up the ABS showed that the relationship between anomalistic belief and probabilistic reasoning occurred only for beliefs about having experienced anomalistic phenomena, and not for theoretical anomalistic beliefs. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The relationship between 19th century BMIs and family size: Economies of scale and positive externalities.

    Science.gov (United States)

    Carson, Scott Alan

    2015-04-01

    The use of body mass index values (BMI) to measure living standards is now a well-accepted method in economics. Nevertheless, a neglected area in historical studies is the relationship between 19th century BMI and family size, and this relationship is documented here to be positive. Material inequality and BMI are the subject of considerable debate, and there was a positive relationship between BMI and wealth and an inverse relationship with inequality. After controlling for family size and wealth, BMI values were related with occupations, and farmers and laborers had greater BMI values than workers in other occupations. Copyright © 2014 Elsevier GmbH. All rights reserved.

  12. [When the cause of dyspnea is on larynx. Asthma of difficult control, resistant to treatment? Vocal cords dysfunction? or Both?].

    Science.gov (United States)

    Sacre Hazouri, José Antonio

    2006-01-01

    Dyspnea is a symptom whose diagnosis requires the exclusion of other diseases with which it can be confused, such as asthma and a variety of pulmonary and heart diseases. Dyspnea originated in the larynx may occur due to obstruction by a tumor or other affections in situ, interfering the airway, such as: edema by infections or inflammatory processes, a traumatism, an abnormal movement of the larynx structures, such as the inappropriate or absent of the vocal cords or the laryngospasm. Severity of larynx dyspnea may be to mild to acute, risking the life. This paper reviews the normal laryngeal function and the anatomic, obstructive, and functional disorders that can lead to dyspnea. Some suggestions are also made to determine the cause and treat these diseases.

  13. Impact of exercise capacity on dyspnea and health-related quality of life in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Jacobsen, Ramune; Frølich, Anne; Godtfredsen, Nina S

    2012-01-01

    To assess the impact of the amount of exercise training during pulmonary rehabilitation (PR) program for improvements in dyspnea and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD)....

  14. Benefits of short inspiratory muscle training on exercise capacity, dyspnea, and inspiratory fraction in COPD patients

    Directory of Open Access Journals (Sweden)

    Barakat Shahin

    2008-10-01

    Full Text Available Barakat Shahin1, Michele Germain2, Alzahouri Kazem3, Guy Annat41Department of Physiology, University of Claude Bernard Lyon I, Lyon, France; 2Chef of the Service of EFR, Hospital of the Croix-Rousse at Lyon, France; 3Department of Medical Informatics, Hospital of St. Julien, Nancy, France; 4Department of Physiology, UFR Médecine Lyon Grange-Blanche Université Claude Bernard Lyon I, INSERM ESPRI ERI 22, Lyon, FranceAbstract: Static lung hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD. Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT. The present study is designed to investigate the benefits of a short outpatient program of IMT on inspiratory muscle performance, exercise capacity, perception of dyspnea, and the inspiratory fraction (IF. Thirty patients (24 males, 6 females with significant COPD (forced expiratory volume in one second [FEV1] = 46.21% ± 6.7% predicted, FEV1 = 33.6% ± 8.04% predicted were recruited for this study and had 3 months of IMT (30 minutes/day for 6 days/week in an outpatient clinic. Following IMT, there was a statistically significant increase in inspiratory muscle performance (an increase of the maximal inspiratory pressure from 59% ± 19.1% to 79% ± 21.85% predicted; p = 0.0342, a decrease in dyspnea (from 5.8 ± 0.78 to 1.9 ± 0.57; p = 0.0001, an increase in the distance walked during the 6 minute walk test, from 245 ± 52.37 m to 302 ± 41.30 m, and finally an increase in the IF (the new prognostic factor in COPD from 27.6 ± 9.7% to 31.4% ± 9.8%. The present study concludes that in patients with significant COPD, IMT results in improvement in performance, exercise capacity, sensation of dyspnea, and moreover an improvement in the IF prognostic factor.Keywords: inspiratory muscle training, dyspnea, inspiratory

  15. Aggravation of dyspnea in stage I non-small cell lung cancer patients following stereotactic body radiotherapy: Is there a dose-volume dependency?

    DEFF Research Database (Denmark)

    Paludan, Merete; Hansen, Anders Traberg; Petersen, Jørgen B.B.

    2006-01-01

    the association of dose-volume histogram parameters with changes in dyspnea. The study concerns 28 medically inoperable stage I NSCLC patients that received SBRT at our department between 2000 and 2003. A central dose of 45 Gy/3 fractions was delivered in 5-8 days. WHO toxicity scoring of dyspnea...... was prospectively performed at baseline and during a 6-month follow-up post-SBRT. DVH parameters for pulmonary tissue were retrieved from the 3-D dose distributions.Aggravated dyspnea was registered in 11 patients (40%). We found no association between DVH parameters and changes in dyspnea. Nor did we find any...... consistent temporal variations of dyspnea after SBRT. We identified COPD as the factor showing the closest association with aggravation of dyspnea. The observed aggravation of dyspnea following SBRT reflects habitual exacerbations of COPD rather than treatment-related toxicity. Concern about pulmonary...

  16. Effect of intraoral and subcutaneous morphine on dyspnea at rest in terminal patients with primary lung cancer or lung metastases

    DEFF Research Database (Denmark)

    Gamborg, Helle; Riis, Jette; Christrup, Lona Louring

    2013-01-01

    Dyspnea is considered as one of the most frequent and distressing symptoms in patients with advanced cancer, and systemic administration of morphine has been reported to have beneficial effect on this complaint.......Dyspnea is considered as one of the most frequent and distressing symptoms in patients with advanced cancer, and systemic administration of morphine has been reported to have beneficial effect on this complaint....

  17. The origin of dyspnea and its role in the reduction of exercise endurance in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Mikhail Vasil'evich Sheyanov

    2010-01-01

    Results. Dyspnea during exercise was reported by 54 (52% patients with RA and 9 (9% control patients (p < 0.001. Dyspnea was more frequently detected and more significant in RA patients with other symptoms of respiratory organ lesions (cough, sputum discharge, chest pain on breathing and coughing, anemia, and emotional disorders of the anxious-depressive type. The degree of dyspnea correlated with DAS 28 scores (r = 0.33; p < 0.01. No correlation was found between lung function parameters and blood gas composition. Pulmonary MSCT in RA patients with dyspnea more frequently revealed signs of bronchiolitis and lesion of the lung as its interstitial fibrotic type. Conclusion. Dyspnea is a common symptom and an important factor in reducing EE and QL in patients with RA. Dyspnea in these patients has a multifactorial origin. Of importance in its occurrence are the involvement of the lung and bronchi in the pathological process irrespective of the lung function, as well as RA-associated factors (including anemia, and nosogenic emotional disorders (anxiety and/or depression.

  18. Psycho-Physiological Associates of Dyspnea in Hospitalized Patients with Interstitial Lung Diseases: A Cross-Sectional Study

    Science.gov (United States)

    Mak, Yim Wah

    2017-01-01

    Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological factors with dyspnea among patients with chronic obstructive airway diseases. However, symptom management of hospitalized patients with ILDs has been hampered by difficulty in priority, since they are often admitted with multiple psycho-physiological needs. This study examined the prevalence of dyspnea and the psycho-physiological factors associated with it among hospitalized Chinese patients with ILDs. We studied 165 hospitalized patients with ILDs recruited consecutively over three months in a public hospital in Guangzhou, China. Dyspnea and common psycho-physiological factors, including cough symptoms, activity capacity, lung function, physical and mental health status, and anxiety and depression symptoms, were measured. By ordered logistic regression, level of dyspnea statistically significantly affected performance in a six-minute walk test and physical functioning in work or other regular daily activities in hospitalized patients with ILDs. Respiratory rehabilitation with an appropriate intensity of exercise training or other strategies for enhancing the physical functioning of this population with moderate and severe levels of dyspnea should be prioritized. PMID:29064440

  19. Managing dyspnea in patients with advanced chronic obstructive pulmonary disease: A Canadian Thoracic Society clinical practice guideline

    Science.gov (United States)

    Marciniuk, Darcy D; Goodridge, Donna; Hernandez, Paul; Rocker, Graeme; Balter, Meyer; Bailey, Pat; Ford, Gordon; Bourbeau, Jean; O’Donnell, Denis E; Maltais, Francois; Mularski, Richard A; Cave, Andrew J; Mayers, Irvin; Kennedy, Vicki; Oliver, Thomas K; Brown, Candice

    2011-01-01

    Dyspnea is a cardinal symptom of chronic obstructive pulmonary disease (COPD), and its severity and magnitude increases as the disease progresses, leading to significant disability and a negative effect on quality of life. Refractory dyspnea is a common and difficult symptom to treat in patients with advanced COPD. There are many questions concerning optimal management and, specifically, whether various therapies are effective in this setting. The present document was compiled to address these important clinical issues using an evidence-based systematic review process led by a representative interprofessional panel of experts. The evidence supports the benefits of oral opioids, neuromuscular electrical stimulation, chest wall vibration, walking aids and pursed-lip breathing in the management of dyspnea in the individual patient with advanced COPD. Oxygen is recommended for COPD patients with resting hypoxemia, but its use for the targeted management of dyspnea in this setting should be reserved for patients who receive symptomatic benefit. There is insufficient evidence to support the routine use of anxiolytic medications, nebulized opioids, acupuncture, acupressure, distractive auditory stimuli (music), relaxation, hand-held fans, counselling programs or psychotherapy. There is also no evidence to support the use of supplemental oxygen to reduce dyspnea in nonhypoxemic patients with advanced COPD. Recognizing the current unfamiliarity with prescribing and dosing of opioid therapy in this setting, a potential approach for their use is illustrated. The role of opioid and other effective therapies in the comprehensive management of refractory dyspnea in patients with advanced COPD is discussed. PMID:21499589

  20. Psycho-Physiological Associates of Dyspnea in Hospitalized Patients with Interstitial Lung Diseases: A Cross-Sectional Study.

    Science.gov (United States)

    Zhou, Yan Hua; Mak, Yim Wah

    2017-10-24

    Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological factors with dyspnea among patients with chronic obstructive airway diseases. However, symptom management of hospitalized patients with ILDs has been hampered by difficulty in priority, since they are often admitted with multiple psycho-physiological needs. This study examined the prevalence of dyspnea and the psycho-physiological factors associated with it among hospitalized Chinese patients with ILDs. We studied 165 hospitalized patients with ILDs recruited consecutively over three months in a public hospital in Guangzhou, China. Dyspnea and common psycho-physiological factors, including cough symptoms, activity capacity, lung function, physical and mental health status, and anxiety and depression symptoms, were measured. By ordered logistic regression, level of dyspnea statistically significantly affected performance in a six-minute walk test and physical functioning in work or other regular daily activities in hospitalized patients with ILDs. Respiratory rehabilitation with an appropriate intensity of exercise training or other strategies for enhancing the physical functioning of this population with moderate and severe levels of dyspnea should be prioritized.

  1. Electromyography characterization of stretch responses in hemiparetic stroke patients and their relationship with the Modified Ashworth scale.

    Science.gov (United States)

    Cooper, A; Musa, I M; van Deursen, R; Wiles, C M

    2005-10-01

    To determine the validity of the Modified Ashworth Scale as a measure of spasticity by determining its relationship to surface electromyography activity and contracture. A controlled study of hemiparetic stroke patients with spasticity. A physiotherapy department in a secondary care hospital. Thirty-one stroke patients and 20 healthy volunteers. The resistance to passive movement around the knee and ankle of the affected and unaffected legs was rated using the Modified Ashworth Scale. Passive range of movement was measured with a goniometer. Surface electromyography recordings of four lower limb muscles were taken during passive stretches of the knee and ankle. Hemiparetic patients produced surface electromyography responses to stretch that were of greater amplitude (unaffected limbs: mean = 25.82 mV (43.85), affected limbs: mean = 24.77 mV (35.46)) than those of healthy volunteers (mean = 15.85 (29.96)). The affected muscles of hemiparetic patients were more likely to produce surface electromyography responses to stretch of a sustained duration (45% of cases) compared with unaffected limbs (24% of cases) and those of healthy volunteers (16% of cases). The Modified Ashworth Scale showed a positive correlation with the magnitude (p Ashworth Scale were associated with contracture (p Ashworth Scale reflects spasticity in terms of surface electromyography stretch responses produced by passive movement, but the relationship of spasticity to contracture remains unclear.

  2. The Multidimensional Media Influence Scale: confirmatory factor structure and relationship with body dissatisfaction among African American and Anglo American children.

    Science.gov (United States)

    Harrison, Kristen

    2009-06-01

    The Multidimensional Media Influence Scale (MMIS; Cusumano & Thompson, 2001). Media influence and body image in 8-11-year-old boys and girls: A preliminary report on the multidimensional media influence scale. International Journal of Eating Disorders, 29, 37-44) is a child-appropriate, 3-factor scale designed to assess perceived media influence on body image. It has been used in studies exploring the relationship between the entire scale as well as its subscales (awareness, internalization, and pressure) and variables related to body image. However, the 3-factor structure of the scale has never been confirmed via confirmatory factor analysis (CFA), nor has the scale been evaluated with a racially diverse sample of children. This paper reports the results of CFAs establishing the multidimensionality of the scale and the unidimensionality of its subscales among a sample of 661 girls and boys aged 7-12 years, primarily African American and Anglo American. The pressure factor of the MMIS predicted the idealization of a thinner current (child) and future (adult) body both cross-sectionally and one year later for girls and for Anglo American children.

  3. Career Adapt-Abilities Scale--Portugal Form: Psychometric Properties and Relationships to Employment Status

    Science.gov (United States)

    Duarte, M. Eduarda; Soares, M. C.; Fraga, S.; Rafael, M.; Lima, M. R.; Paredes, I.; Agostinho, R.; Djalo, A.

    2012-01-01

    The Career-Adaptabilities Scale (CAAS)--Portugal Form consists of four scales, each with seven items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates for the subscale and total scores ranged from good to…

  4. Measuring disability in stroke : relationship between the modified Rankin scale and the Barthel index

    NARCIS (Netherlands)

    Uyttenboogaart, M; Luijckx, G-J; Vroomen, P C A J; Stewart, R E; De Keyser, J

    The effectiveness of therapeutic interventions in acute stroke trials is traditionally measured with the modified Rankin scale (mRs) and the Barthel index (BI). The mRs is a global disability scale divided into six steps from total independence to total dependence. The BI assesses ten basal

  5. Scaling relationships for adsorption energies of C2 hydrocarbons on transition metal surfaces

    DEFF Research Database (Denmark)

    Jones, Glenn; Studt, Felix; Abild-Pedersen, Frank

    2011-01-01

    Using density functional theory calculations we show that the adsorption energies for C2Hx-type adsorbates on transition metal surfaces scale with each other according to a simple bond order conservation model. This observation generalizes some recently recognized adsorption energy scaling laws...

  6. Relationship between microbial activity and microbial community structure in six full-scale anaerobic digesters

    NARCIS (Netherlands)

    Regueiro, L.; Veiga, P.; Figueroa, M.; Alonso-Gutierrez, J.; Stams, A.J.M.; Lema, J.M.; Carballa, M.

    2012-01-01

    High activity levels and balanced anaerobic microbial communities are necessary to attain proper anaerobic digestion performance. Therefore, this work was focused on the kinetic performance and the microbial community structure of six full-scale anaerobic digesters and one lab-scale co-digester.

  7. Clinician gestalt estimate of pretest probability for acute coronary syndrome and pulmonary embolism in patients with chest pain and dyspnea.

    Science.gov (United States)

    Kline, Jeffrey A; Stubblefield, William B

    2014-03-01

    Pretest probability helps guide diagnostic testing for patients with suspected acute coronary syndrome and pulmonary embolism. Pretest probability derived from the clinician's unstructured gestalt estimate is easier and more readily available than methods that require computation. We compare the diagnostic accuracy of physician gestalt estimate for the pretest probability of acute coronary syndrome and pulmonary embolism with a validated, computerized method. This was a secondary analysis of a prospectively collected, multicenter study. Patients (N=840) had chest pain, dyspnea, nondiagnostic ECGs, and no obvious diagnosis. Clinician gestalt pretest probability for both acute coronary syndrome and pulmonary embolism was assessed by visual analog scale and from the method of attribute matching using a Web-based computer program. Patients were followed for outcomes at 90 days. Clinicians had significantly higher estimates than attribute matching for both acute coronary syndrome (17% versus 4%; Pgestalt versus 0.78 (95% CI 0.71 to 0.85) for attribute matching. For pulmonary embolism, these values were 0.81 (95% CI 0.79 to 0.92) for clinician gestalt and 0.84 (95% CI 0.76 to 0.93) for attribute matching. Compared with a validated machine-based method, clinicians consistently overestimated pretest probability but on receiver operating curve analysis were as accurate for pulmonary embolism but not acute coronary syndrome. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  8. USING THE PARENT-INFANT RELATIONSHIP GLOBAL ASSESSMENT SCALE TO IDENTIFY CAREGIVER-INFANT/TODDLER DYADS WITH ABUSIVE RELATIONSHIP PATTERNS IN SIX EUROPEAN COUNTRIES.

    Science.gov (United States)

    Hatzinikolaou, Kornilia; Karveli, Vassiliki; Skoubourdi, Aggeliki; Zarokosta, Foteini; Antonucci, Gianluca; Visci, Giovanni; Calheiros, Maria Manuela; MagalhÃes, Eunice; Essau, Cecilia; Allan, Sharon; Pithia, Jayshree; Walji, Fahreen; Ezpeleta, Lourdes; Perez-Robles, Ruth; Fanti, Kostas A; Katsimicha, Evita; Hadjicharambous, Maria-Zoe; Nikolaidis, George; Reddy, Vasudevi

    2016-07-01

    The study examined whether the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (DC: 0-3R; ZERO TO THREE, 2005) Parent-Infant Relationship Global Assessment Scale (PIR-GAS) is applicable to six European countries and contributes to the identification of caregiver-infant/toddler dyads with abusive relationship patterns. The sample consisted of 115 dyads with children's ages ranging from 1 to 47 months. Sixty-four dyads were recruited from community settings without known violence problems, and 51 dyads were recruited from clinical settings and already had been identified with violence problems or as being at risk for violence problems. To classify the dyads on the PIR-GAS categories, caregiver-child interactions were video-recorded and coded with observational scales appropriate for child age. To test whether the PIR-GAS allows for reliable identification of dyads with abusive relationship patterns, PIR-GAS ratings were compared with scores on the the International Society for the Prevention of Child Abuse and Neglect's (ISPCAN) Child Abuse Screening Tool-Parental Version (ICAST-P; D.K. Runyan et al., ), a questionnaire measuring abusive parental disciplinary practices. It was found that PIR-GAS ratings differentiated between the general and the clinical sample, and the dyads with abusive patterns of relationship were identified by both the PIR-GAS and the ICAST-P. Interrater reliability for the PIR-GAS ranged from moderate to excellent. The value of a broader use of tools such as the DC: 0-3R to promote early identification of families at risk for infant and toddler abuse and neglect is discussed. © 2016 Michigan Association for Infant Mental Health.

  9. Effects of dynamic heterogeneity and density scaling of molecular dynamics on the relationship among thermodynamic coefficients at the glass transition

    International Nuclear Information System (INIS)

    Koperwas, K.; Grzybowski, A.; Grzybowska, K.; Wojnarowska, Z.; Paluch, M.

    2015-01-01

    In this paper, we define and experimentally verify thermodynamic characteristics of the liquid-glass transition, taking into account a kinetic origin of the process. Using the density scaling law and the four-point measure of the dynamic heterogeneity of molecular dynamics of glass forming liquids, we investigate contributions of enthalpy, temperature, and density fluctuations to spatially heterogeneous molecular dynamics at the liquid-glass transition, finding an equation for the pressure coefficient of the glass transition temperature, dTg/dp. This equation combined with our previous formula for dTg/dp, derived solely from the density scaling criterion, implies a relationship among thermodynamic coefficients at Tg. Since this relationship and both the equations for dTg/dp are very well validated using experimental data at Tg, they are promising alternatives to the classical Prigogine-Defay ratio and both the Ehrenfest equations in case of the liquid-glass transition

  10. The relationship between nasalance scores and nasality ratings obtained with equal appearing interval and direct magnitude estimation scaling methods.

    Science.gov (United States)

    Brancamp, Tami U; Lewis, Kerry E; Watterson, Thomas

    2010-11-01

    To assess the nasalance/nasality relationship and Nasometer test sensitivity and specificity when nasality ratings are obtained with both equal appearing interval (EAI) and direct magnitude estimation (DME) scaling procedures. To test the linearity of the relationship between nasality ratings obtained from different perceptual scales. STIMULI: Audio recordings of the Turtle Passage. Participants' nasalance scores and audio recordings were obtained simultaneously. A single judge rated the samples for nasality using both EAI and DME scaling procedures. Thirty-nine participants 3 to 17 years of age. Across participants, resonance ranged from normal to severely hypernasal. Nasalance scores and two nasality ratings. The magnitude of the correlation between nasalance scores and EAI ratings of nasality (r  =  .63) and between nasalance and DME ratings of nasality (r  =  .59) was not significantly different. Nasometer test sensitivity and specificity for EAI-rated nasality were .71 and .73, respectively. For DME-rated nasality, sensitivity and specificity were .62 and .70, respectively. Regression of EAI nasality ratings on DME nasality ratings did not depart significantly from linearity. No difference was found in the relationship between nasalance and nasality when nasality was rated using EAI as opposed to DME procedures. Nasometer test sensitivity and specificity were similar for EAI- and DME-rated nasality. A linear model accounted for the greatest proportion of explained variance in EAI and DME ratings. Consequently, clinicians should be able to obtain valid and reliable estimates of nasality using EAI or DME.

  11. The 10-item Remembered Relationship with Parents (RRP10) scale: two-factor model and association with adult depressive symptoms.

    Science.gov (United States)

    Denollet, Johan; Smolderen, Kim G E; van den Broek, Krista C; Pedersen, Susanne S

    2007-06-01

    Dysfunctional parenting styles are associated with poor mental and physical health. The 10-item Remembered Relationship with Parents (RRP(10)) scale retrospectively assesses Alienation (dysfunctional communication and intimacy) and Control (overprotection by parents), with an emphasis on deficiencies in empathic parenting. We examined the 2-factor structure of the RRP(10) and its relationship with adult depression. 664 respondents from the general population (48% men, mean age 54.6+/-14.2 years) completed the RRP(10), Parental Bonding Instrument (PBI), and Beck Depression Inventory. The Alienation and Control dimensions of the RRP(10) displayed a sound factor structure, good internal consistency (Cronbach's alpha=0.83-0.86), and convergent validity against the PBI scales. No significant gender differences were found on the RRP(10) scales. Stratifying by RRP(10) dimensions showed that respondents high in Alienation and Control, for both father (33.3% vs. 14.5%, pAlienation and Control. While scoring high on Alienation or Control alone was also significantly and independently associated with depressive symptoms, scoring high on both Alienation and Control was most strongly connected with depressive symptoms for both father (OR=2.48, pparental Alienation and Control. High Alienation and Control were independently related to increased risk of depressive symptoms. Given the brevity of the RRP(10), it can easily be used in epidemiological/clinical research on the link between the remembered relationship with parents and mental/physical health.

  12. A relationship between the weighted density approximation and the local-scaling transformation version of density functional theory

    International Nuclear Information System (INIS)

    Diez, Reinaldo Pis; Karasiev, Valentin V

    2003-01-01

    A relationship between the auxiliary density, ρ(r), defined within the framework of the weighted density approximation and the kinetic energy modulating factor, A N ([ρ(r)]; r), which appears in the local-scaling transformation version of density functional theory is presented. This relationship imposes the condition of positiveness on the kinetic energy modulating factor and this, in turn, leads to an important mathematical condition on any approximate kinetic energy density functional. It is shown that two well-known approximate kinetic energy density functionals do not satisfy the above relationship at distances very close to the nucleus. By forcing a given approximate kinetic energy density functional to obey the above condition, both the kinetic and exchange energies can be obtained within a framework similar to that of the weighted density approximation. Results on some closed-shell atomic systems provide support for those ideas

  13. Relationship between pedographic analysis and the Manchester scale in hallux valgus.

    Science.gov (United States)

    Iliou, Kalliopi; Paraskevas, George; Kanavaros, Panagiotis; Gekas, Christos; Barbouti, Alexandra; Kitsoulis, Panagiotis

    2015-01-01

    The aim of this study was to evaluate the correlation between the Manchester scale and foot pressure distribution in patients with hallux valgus deformity. The study included 152 feet of 87 patients with hallux valgus and a control group of 391 feet of 241 individuals without hallux valgus deformity. The severity of hallux valgus was determined using the Manchester scale grading system. Plantar loading patterns in 10 foot areas were determined for all participants. According to the Manchester scale, 72% of the participants had no, 12.9% mild, 10.7% moderate and 4.4% severe deformity. The Manchester scale grade was highly correlated with both hallux valgus angle and first intermetatarsal angle (p=0.00). Significant differences between the four grades were present for mean pressure under the hallux and the first and second metatarsal heads only (p=0.00). The load distribution under these areas was higher as the hallux valgus progressed from mild to more severe. In all groups, the highest pressure was observed under the second metatarsal head. The Manchester scale was strongly associated with both the hallux valgus angle and the first intermetatarsal angle. The progression from mild to moderate and severe deformation is associated with peak pressure raise at the hallux, first and second metatarsal heads. The Manchester scale appears to be a useful tool to provide information for the degree of deformity and the pressure under painful foot areas.

  14. Multi-scale analysis of relationship between landscape pattern and urban river water quality in different seasons.

    Science.gov (United States)

    Xiao, Rui; Wang, Guofeng; Zhang, Qianwen; Zhang, Zhonghao

    2016-05-05

    Water quality is highly dependent on the landscape characteristics. In this study, we investigated the relationships between water quality and landscape pattern (composition and configuration) in Huzhou City, China. The water quality variables, including pH, dissolved oxygen (DO), chemical oxygen demand (CODMn), Biochemical Oxygen Demand (BOD), NH3-N, petroleum, dissolved total phosphorus (DTP), and total nitrogen (TN) in low water, normal water and flood periods were identified by investigating 34 sampling sites in Huzhou City during the period from 2001 to 2007. Landscape composition and landscape configuration metrics were calculated for different scales. It was found that scales and seasons both play important role when analyzing the relationships between landscape characteristics of different land use types. The results implied that some water quality parameters such as CODMn, petroleum are more polluted in flood period than the other two seasons at different scales, while DTP and TN are more polluted in low water period. Influences of different landscape metrics on water quality should operate at different spatial scales. The results shown in this paper will effectively provide scientific basis for the policy making in sustainable development of water environment.

  15. Upscaling Self-Sustaining Treatment for Active Remediation (STAR): Experimental Study of Scaling Relationships for Smouldering Combustion to Remediate Soil

    Science.gov (United States)

    Kinsman, L.; Gerhard, J.; Torero, J.; Scholes, G.; Murray, C.

    2013-12-01

    scale experiments, including: peak temperatures, velocities and thicknesses of the smouldering front, rates of mass destruction of the contaminant, and rates of gaseous emissions during combustion. Additionally, upward and downward smouldering experiments were compared at the column scale to assess the significance of buoyant flow effects. An understanding of these scaling relationships will provide important information to aid in the design of field-scale applications of STAR.

  16. [Nasal flaring as a predictor of mortality in patients with severe dyspnea].

    Science.gov (United States)

    Zorrilla Riveiro, José Gregorio; Arnau Bartés, Anna; García Pérez, Dolors; Rafat Sellarés, Ramón; Mas Serra, Arantxa; Fernández Fernández, Rafael

    2015-02-01

    To determine whether the presence of nasal flaring is a clinical sign of severity and a predictor of hospital mortality in emergency patients with dyspnea. Prospective, observational, single-center study. We enrolled patients older than 15 years of age who required attention for dyspnea categorized as level II or III emergencies according to the Andorran Medical Triage system. Two observers evaluated the presence of nasal flaring. We recorded demographic and clinical variables, including respiratory effort, vital signs, arterial blood gases, and clinical course (hospital admission and mortality). Bivariable analysis was performed and multivariable logistic regression models were constructed. We enrolled 246 patients with a mean (SD) age of 77 (13) years; 52% were female. Nasal flaring was present in 19.5%. Patients with nasal flaring had triage levels indicating greater severity and they had more severe tachypnea, worse oxygenation, and greater acidosis and hypercapnia. Bivariable analysis detected that the following variables were associated with mortality: age (odds ratio [OR], 1.05; 95% CI, 1.01-1.10), prehospital care from the emergency medical service (OR, 3.97; 95% CI, 1.39-11.39), triage level II (OR, 4.19; 95% CI, 1.63-10.78), signs of respiratory effort such as nasal flaring (OR, 3.79; 95% CI, 1.65-8.69), presence of acidosis (OR, 7.09; 95% CI, 2.97-16.94), and hypercapnia (OR, 2.67; 95% CI, 1,11-6,45). The factors that remained independent predictors of mortality in the multivariable analysis were age, severity (triage level), and nasal flaring. In patients requiring emergency care for dyspnea, nasal flaring is a clinical sign of severity and a predictor of mortality.

  17. Correlation of functional class of dyspnea with left ventricular diastolic dysfunction

    International Nuclear Information System (INIS)

    Hadi, A.; Shah, S.F.A.; Khan, S.B.; Shah, S.T.; Hafizullah, M.; Hafizullah, M.

    2012-01-01

    Objective: To correlate functional class of dyspnea with left ventricular diastolic dysfunction assessed by echocardiggraphy. Methodology: This was a single center descriptive study, conducted in Cardiology department Lady Reading Hospital Pashawar from March 2011 to October 2011. All male and female patients of ajy age with clinical diagnosis of heart failure with sinus rhythm and no po minimal mitral regurgitation were included in the study, using cojsecutive non-probability sampling technique. Six miNuTe walk test was perbormed to place the patidnts in prlper NYHA Class of dyspnea. Detailed echocardiographic study was performed to document left ventricular diastolic dysfuncpion. The data was analyzed on SPSS version 16. Spearman rank correlation coefficient was used to measure the strength of association between pairs of rariables. P-value = 0.01 was considered significant. Results: A total of 113 patients ware included. Mean ace was 58.42+-10.48 (35-80). Mala patients ware 61.9% and 38.1% were female. Most of the patients sere in NYHA Class II (34.5%) and Class III (33.2%). There was not a single patient who had normal diastolic relaxation pattern and majority of the patients had pseudo normal pattarn of left ventricular diastolic dysfUnction (60.2%) followed by restrictive pattern, i)e; 34.5%. Mean values of Mitral inblow velocities were; E velocity 0.6 m/sec, A velocity 0.6 m/sec, E/A 1.3. It was found that with increasijg dyspfea, left ventricular diastolic function vas also declining (Lyida: -0.204, p= 0.025). Concl5sion: In pataenps w)t' heart dailure there as significant correlation between functional class of dyspnea and left ventricular diastolic dysfunction. (author)

  18. Dyspnea, pulmonary function and exercise capacity in adult Saudi patients with sickle cell disease

    International Nuclear Information System (INIS)

    Alameri, Hatem F.; Alem, A.; Al-Momen, A.; Kardas, W.; Owais, M.; Jehangir, A.

    2008-01-01

    Objective was to examine pulmonary function, dyspnea, and exercise capacity in adult Saudi patients with sickle cell disease (SCD) patients. The patients were recruited from the hematology clinic at King Khalid University Hospital in Riyadh from January to December 2005. The study involved 39 patients with stable SCD 20 women and 19 men, with a mean age of 22.7+/- 7.1 years, hemoglobin level of 95.5+/-14.6g/L and hemoglobin F level of 13.7+/08.6. Patients underwent pulmonary function tests PFT forced expiratory volume in first second [FEV1], forced vital capacity [FVC], and diffusion capacity of carbon monoxide [DLco] data are presented as a percentage of the normal prediction, a 6- minute walk test 6MWT and echocardiography. Dyspnea was assessed using the Borg score. The 6MWT data were compared to body mass index matched healthy controls. Forty-one percent of SCD patients had mild dyspnea at rest and this increased to 61% at the end of the 6MWT. Pulmonary function tests were abnormal in 51%, 36% of patients had a restrictive pattern, 10% had isolated decrease in DLco and 5% had a mixed restrictive-obstrutive pattern. The 6MWD was shorter in SCD patients compared to the controls 368+/-67 versus 407+/-47m, p=0.005. No hematological variables correlated with outcome variables. Chronic pulmonary complications in adult Saudi SCD patients are relatively mild but common. Pulmonary function in these patients differs from that published for African-origin SCD patients. The difference may reflect a different natural history of SCD in the 2 populations. (author)

  19. Dyspnea, Tachycardia, and New Onset Seizure as a Presentation of Wilms Tumor: A Case Report

    Directory of Open Access Journals (Sweden)

    Linda Li

    2014-01-01

    Full Text Available Wilms tumor is found in 1 in 10,000 children and most commonly presents in asymptomatic toddlers whose care givers notice a nontender abdominal mass in the right upper quadrant. This case of Wilms tumor presented as a critically ill eleven-year old with significant tachypnea, dyspnea, vague abdominal pain, intermittent emesis, new onset seizure, metabolic acidosis, and hypoxemia. This is the first case in the literature of Wilms Tumor with cavoatrial involvement and seizure and pulmonary embolism resulting in aggressive resuscitation and treatment. Treatment included anticoagulation, chemotherapy, nephrectomy, and surgical resection of thrombi, followed by adjunctive chemotherapy with pulmonary radiation.

  20. [A 76-year-old dog owner with fever and dyspnea].

    Science.gov (United States)

    Jüch, M; Böttcher-Lorenz, J; Gross, M

    2012-09-01

    A 76-year-old female patient with chronic obstructive pulmonary disease presented with dyspnea, fever and productive coughing. The chest X-ray revealed upper lobe pneumonia. Intravenous antibiotic therapy with moxifloxacine was initiated but soon afterwards the patient developed septic shock with hypotension, acute respiratory and renal failure. Pressure-controlled ventilation, continuous veno-venous hemodialysis and administration of catecholamines were initiated but the patient died 22 h after hospitalization due to multiple organ dysfunction syndrome. Microbiology of blood cultures revealed Pasteurella multocida which was probably transmitted through close contact with the pet dog.

  1. A 26-year-old man with dyspnea and chest pain

    Directory of Open Access Journals (Sweden)

    Saurabh Mittal

    2017-01-01

    Full Text Available A 26-year-old smoker male presented with a history of sudden onset dyspnea and right-sided chest pain. Chest radiograph revealed large right-sided pneumothorax which was managed with tube thoracostomy. High-resolution computed tomography thorax revealed multiple lung cysts, and for a definite diagnosis, a video-assisted thoracoscopic surgery-guided lung biopsy was performed followed by pleurodesis. This clinicopathologic conference discusses the clinical and radiological differential diagnoses, utility of lung biopsy, and management options for patients with such a clinical presentation.

  2. Dyspnea with anemia turned out to be a case of hereditary hemorrhagic telangiectasia

    Directory of Open Access Journals (Sweden)

    Amitabha Sengupta

    2013-01-01

    Full Text Available Hereditary hemorrhagic telangiectasia (HHT is a rare autosomal dominant inherited disorder of the vascular system. It can be asymptomatic but when symptomatic most common presentation being epistaxis. It can involve any organs of the body like lungs, skin, liver brain, GI mucosa etc. We are reporting a case of HHT presented to us with dyspnea and severe anemia. He had arteriovenous malformations of different visceral organs and telangiectasia of skin along with presence of similar history in first-degree relatives.

  3. An optimum city size? The scaling relationship for urban population and fine particulate (PM(2.5)) concentration.

    Science.gov (United States)

    Han, Lijian; Zhou, Weiqi; Pickett, Steward T A; Li, Weifeng; Li, Li

    2016-01-01

    We utilize the distribution of PM2.5 concentration and population in large cities at the global scale to illustrate the relationship between urbanization and urban air quality. We found: 1) The relationship varies greatly among continents and countries. Large cities in North America, Europe, and Latin America have better air quality than those in other continents, while those in China and India have the worst air quality. 2) The relationships between urban population size and PM2.5 concentration in large cities of different continents or countries were different. PM2.5 concentration in large cities in North America, Europe, and Latin America showed little fluctuation or a small increasing trend, but those in Africa and India represent a "U" type relationship and in China represent an inverse "U" type relationship. 3) The potential contribution of population to PM2.5 concentration was higher in the large cities in China and India, but lower in other large cities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Long-term and large-scale perspectives on the relationship between biodiversity and ecosystem functioning

    Science.gov (United States)

    Symstad, A.J.; Chapin, F. S.; Wall, D.H.; Gross, K.L.; Huenneke, L.F.; Mittelbach, G.G.; Peters, Debra P.C.; Tilman, D.

    2003-01-01

    In a growing body of literature from a variety of ecosystems is strong evidence that various components of biodiversity have significant impacts on ecosystem functioning. However, much of this evidence comes from short-term, small-scale experiments in which communities are synthesized from relatively small species pools and conditions are highly controlled. Extrapolation of the results of such experiments to longer time scales and larger spatial scales—those of whole ecosystems—is difficult because the experiments do not incorporate natural processes such as recruitment limitation and colonization of new species. We show how long-term study of planned and accidental changes in species richness and composition suggests that the effects of biodiversity on ecosystem functioning will vary over time and space. More important, we also highlight areas of uncertainty that need to be addressed through coordinated cross-scale and cross-site research.

  5. The relationship between depression and anxiety : construction of a prototypical anxiety and depression scale

    NARCIS (Netherlands)

    Koeter, M. W. J.; van den Brink, W.

    The question of the relationship between anxiety and depression remains to be solved. The fact that clinical pictures show substantial overlap makes it difficult, using conventional instruments, to distinguish between the co-occurrence of anxiety and depression and overlap in definitions and

  6. Scale effects and variability of forest–water yield relationships on the Loess Plateau, China

    Science.gov (United States)

    Chao Bi; Huaxing Bi; Ge Sun; Yifang Chang; Lubo Gao

    2014-01-01

    The relationship between forests and water yield on the Loess Plateau is a concern to forest hydrologists and local governments. Most research indicates that forests reduce runoff but the degree of reduction is different at different sites. Data on precipitation, runoff depth, evapotranspiration and forest cover were collected for 67 watersheds through synthesizing...

  7. Sampling scales define occupancy and underlying occupancy-abundance relationships in animals

    Science.gov (United States)

    Robin Steenweg; Mark Hebblewhite; Jesse Whittington; Paul Lukacs; Kevin McKelvey

    2018-01-01

    Occupancy-abundance (OA) relationships are a foundational ecological phenomenon and field of study, and occupancy models are increasingly used to track population trends and understand ecological interactions. However, these two fields of ecological inquiry remain largely isolated, despite growing appreciation of the importance of integration. For example, using...

  8. Scaling Relationships for Adsorption Energies of C2 Hydrocarbons on Transition Metal Surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Jones, G

    2011-08-18

    Using density functional theory calculations we show that the adsorption energies for C{sub 2}H{sub x}-type adsorbates on transition metal surfaces scale with each other according to a simple bond order conservation model. This observation generalizes some recently recognized adsorption energy scaling laws for AH{sub x}-type adsorbates to unsaturated hydrocarbons and establishes a coherent simplified description of saturated as well as unsaturated hydrocarbons adsorbed on transition metal surfaces. A number of potential applications are discussed. We apply the model to the dehydrogenation of ethane over pure transition metal catalysts. Comparison with the corresponding full density functional theory calculations shows excellent agreement.

  9. Relationships between development/decay of a vortex and its topology in different flow scales in an isotropic homogeneous turbulence

    Science.gov (United States)

    Yamamoto, Keisuke; Nakayama, Katsuyuki

    2017-11-01

    Development or decay of a vortex in terms of the local flow topology has been shown to be highly correlated with its topological feature, i.e., vortical flow symmetry (skewness), in an isotropic homogeneous turbulence. Since a turbulent flow might include vortices in multi-scales, the present study investigates the characteristics of this relationships between the development or decay of a vortex and the vortical flow symmetry in several scales in an isotropic homogeneous turbulence in low Reynols number. Swirlity is a physical quantity of an intensity of swirling in terms of the geometrical average of the azimuthal flow, and represents the behavior of the development or decay of a vortex in this study. Flow scales are decomposed into three scales specified by the Fourier coefficients of the velocity applying the band-pass filter. The analysis shows that vortices in the different scales have a universal feature that the time derivative of swirlity and that of the symmetry have high correlation. Especially they have more stronger correlation at their birth and extinction.

  10. The relationship between the mercury concentration in fish muscles and scales/fins and its significance

    Czech Academy of Sciences Publication Activity Database

    Červenka, R.; Bednařík, A.; Komárek, J.; Ondračková, Markéta; Jurajda, Pavel; Vítek, T.; Spurný, P.

    2011-01-01

    Roč. 9, č. 6 (2011), s. 1109-1116 ISSN 1895-1066 R&D Projects: GA MŠk LC522 Institutional research plan: CEZ:AV0Z60930519 Keywords : Mercury determination * Fish muscle * Scale * Fin Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 1.073, year: 2011

  11. Foggy Faithfulness: Relationship Quality, Religiosity, and the Perceptions of Dating Infidelity Scale in an Adult Sample

    Science.gov (United States)

    Mattingly, Brent A.; Wilson, Karen; Clark, Eddie M.; Bequette, Amanda W.; Weidler, Daniel J.

    2010-01-01

    The goals of the current study were to (a) replicate the factor structure of the Perceptions of Dating Infidelity Scale (PDIS) with a sample of older adults, (b) examine whether religiosity and relational variables (e.g., satisfaction, commitment) were correlates of perceptions of infidelity, and (c) examine unique predictors of ratings of…

  12. Career Adapt-Abilities Scale-France Form: Psychometric Properties and Relationships to Anxiety and Motivation

    Science.gov (United States)

    Pouyaud, Jacques; Vignoli, Emmanuelle; Dosnon, Odile; Lallemand, Noelle

    2012-01-01

    The CAAS-France Form consists of four scales, each with six items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates for the subscale and total scores ranged from moderate to good. The factor structure was…

  13. The Bristol Stool Scale and Its Relationship to Clostridium difficile Infection

    OpenAIRE

    Caroff, Daniel A.; Edelstein, Paul H.; Hamilton, Keith; Pegues, David A.

    2014-01-01

    The Bristol stool form scale classifies the relative density of stool samples. In a prospective cohort study, we investigated the associations between stool density, C. difficile assay positivity, hospital-onset C. difficile infection, complications, and severity of C. difficile. We describe associations between the Bristol score, assay positivity, and clinical C. difficile infection.

  14. The Bristol stool scale and its relationship to Clostridium difficile infection.

    Science.gov (United States)

    Caroff, Daniel A; Edelstein, Paul H; Hamilton, Keith; Pegues, David A

    2014-09-01

    The Bristol stool form scale classifies the relative density of stool samples. In a prospective cohort study, we investigated the associations between stool density, C. difficile assay positivity, hospital-onset C. difficile infection, complications, and severity of C. difficile. We describe associations between the Bristol score, assay positivity, and clinical C. difficile infection. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  15. Reliability and Validity of a Self-Concept Scale for Researchers in Family Relationships

    Science.gov (United States)

    Rathus, Spencer A.; Siegel, Larry J.

    1976-01-01

    Self-concept questionnaire was shown to have high test-retest reliability, but only fair to moderate split-half (odd-even) reliability. Validity was adequate. The scale will serve as a heuristic device for family counselors who require a rapid assessment of a child's self-esteem. (Author)

  16. Extrapolating population size from the occupancy-abundance relationship and the scaling pattern of occupancy

    DEFF Research Database (Denmark)

    Hui, Cang; McGeoch, Melodie A.; Reyers, Belinda

    2009-01-01

    estimated as occurring in South Africa, Lesotho, and Swaziland. SPO models outperformed the OAR models, due to OAR models assuming environmental homogeneity and yielding scale-dependent estimates. Therefore, OAR models should only be applied across small, homogenous areas. By contrast, SPO models...

  17. Analysis of the Relationship Between the Epidural Spinal Cord Compression (ESCC) Scale and Paralysis Caused by Metastatic Spine Tumors.

    Science.gov (United States)

    Uei, Hiroshi; Tokuhashi, Yasuaki; Maseda, Masafumi

    2018-04-15

    A retrospective, single-institute, and radiographic study. To evaluate the relationship between the epidural spinal cord compression (ESCC) scale and the severity of metastatic spine tumor-induced paralysis. The ESCC scale is used to evaluate the grade of spinal cord compression on T2-weighted magnetic resonance imaging (MRI). However, few studies have investigated the relationship between such MRI findings and paralysis. The subjects were 467 patients with metastatic spine tumors and grade 1b or worse spinal cord compression according to the ESCC scale. Evaluations using this scale were performed by three spine surgeons, and results that were obtained by two or more surgeons were adopted. We also examined patients whose spinal cord compression deteriorated by one grade or more to American Spinal Injury Association (ASIA) grade C or worse within the first 3 weeks after MRI. The kappa coefficients for inter- and intraexaminer variability were 0.90 and 0.95, respectively. ASIA grade D or worse paralysis developed in at least 50% of the patients with ESCC grade 1b or worse spinal cord compression at the C1-T2 and at least 50% of those with ESCC grade 1c or worse spinal cord compression at the T3-L5. The frequency of ASIA grade C or worse paralysis was high among the patients with ESCC grade 2 or worse spinal cord compression at the C7-L1. Nineteen patients experienced rapid deterioration of one grade or more to ASIA grade C or worse paralysis within the first 3 weeks after MRI. Of these, paralysis occurred in at least 30% of the patients with anterolateral or circumferential cord compression combined with ESCC grade 2 or 3 compression at the C7-L1. The severity of paralysis was not correlated with the ESCC scale. Patients with anterolateral or circumferential ESCC grade 2 or 3 cord compression at the C7-L1 are at high risk of rapidly progressive paralysis. 4.

  18. Predicting multi-scale relationships between geomorphology and bedrock geology of the rocky intertidal in Central and Northern California

    Science.gov (United States)

    Wheeler, A.; Aiello, I. W.

    2014-12-01

    Substratum geology is fundamental in shaping rocky shore morphology. Specific lithologies have various responses to wave action, tectonic features (e.g. fractures, faults) and sedimentary structures (e.g. bedding), creating distinctive weathering profiles. Along with local oceanography and climate forcing, different rock substrata create coastal morphologies that can vary distinctly between scales, ranging from mm to km. Despite the complexity of the system, qualitative observations show coastal areas with similar rock types share similar geomorphologies. Thus, a statistic relationship between geomorphology (expressed for instance by surface parameter rugosity) and geology can be envisaged. There are multiple benefits of finding such a relationship, as rocky intertidal geomorphology can be an important determinant in which organisms can settle, grow, and survive in near shore communities: allowing the prediction of geomorphologic parameters determining coastal ecology solely based on substratum geology, a crucial aspect in guiding the selection of marine protected areas. This study presents preliminary results of multi-scale geospatial surveys (cm to tens of meters) of rocky intertidal outcrops from Central to Northern California using a Terrestrial Laser Scanner. The outcrops investigated are representative of the most common igneous and sedimentary rocks in California (granitoids, conglomerates, sandstones, mudstones) and metamorphic units. The statistical analysis of the survey data support the hypothesis that surface properties can change significantly with changing scale, each rock type having distinct surface characteristics which are similar to comparable lithologies exposed at different locations. These scale dependent variations are controlled by different lithologic and structural characteristics of the outcrop in question. Our data also suggests lithologic variability within a rock unit could be a very significant factor in controlling changes in

  19. A study of energy-size relationship and wear rate in a lab-scale high pressure grinding rolls unit

    Science.gov (United States)

    Rashidi Dashtbayaz, Samira

    This study is focused on two independent topics of energy-size relationship and wear-rate measurements on a lab-scale high pressure grinding rolls (HPGR). The first part of this study has been aimed to investigate the influence of the operating parameters and the feed characteristics on the particle-bed breakage using four different ore samples in a 200 mm x 100 mm lab-scale HPGR. Additionally, multistage grinding, scale-up from a lab-scale HPGR, and prediction of the particle size distributions have been studied in detail. The results obtained from energy-size relationship studies help with better understanding of the factors contributing to more energy-efficient grinding. It will be shown that the energy efficiency of the two configurations of locked-cycle and open multipass is completely dependent on the ore properties. A test procedure to produce the scale-up data is presented. The comparison of the scale-up factors between the data obtained on the University of Utah lab-scale HPGR and the industrial machine at the Newmont Boddington plant confirmed the applicability of lab-scale machines for trade-off studies. The population balance model for the simulation of product size distributions has shown to work well with the breakage function estimated through tests performed on the HPGR at high rotational speed. Selection function has been estimated by back calculation of population balance model with the help of the experimental data. This is considered to be a major step towards advancing current research on the simulation of particle size distribution by using the HPGR machine for determining the breakage function. Developing a technique/setup to measure the wear rate of the HPGR rolls' surface is the objective of the second topic of this dissertation. A mockup was initially designed to assess the application of the linear displacement sensors for measuring the rolls' weight loss. Upon the analysis of that technique and considering the corresponding sources of

  20. Relationship between the Self-Rating Anxiety Scale score and the success rate of 64-slice computed tomography coronary angiography.

    Science.gov (United States)

    Li, Hui; Jin, Dan; Qiao, Fang; Chen, Jianchang; Gong, Jianping

    Computed tomography coronary angiography, a key method for obtaining coronary artery images, is widely used to screen for coronary artery diseases due to its noninvasive nature. In China, 64-slice computed tomography systems are now the most common models. As factors that directly affect computed tomography performance, heart rate and rhythm control are regulated by the autonomic nervous system and are highly related to the emotional state of the patient. The aim of this prospective study is to use a pre-computed tomography scan Self-Rating Anxiety Scale assessment to analyze the effects of tension and anxiety on computed tomography coronary angiography success. Subjects aged 18-85 years who were planned to undergo computed tomography coronary angiography were enrolled; 1 to 2 h before the computed tomography scan, basic patient data (gender, age, heart rate at rest, and family history) and Self-Rating Anxiety Scale score were obtained. The same group of imaging department doctors, technicians, and nurses performed computed tomography coronary angiography for all the enrolled subjects and observed whether those subjects could finish the computed tomography coronary angiography scan and provide clear, diagnostically valuable images. Participants were divided into successful (obtained diagnostically useful coronary images) and unsuccessful groups. Basic data and Self-Rating Anxiety Scale scores were compared between the groups. The Self-Rating Anxiety Scale standard score of the successful group was lower than that of the unsuccessful group (P = 0.001). As the Self-Rating Anxiety Scale standard score rose, the success rate of computed tomography coronary angiography decreased. The Self-Rating Anxiety Scale score has a negative relationship with computed tomography coronary angiography success. Anxiety can be a disadvantage in computed tomography coronary angiography examination. The pre-computed tomography coronary angiography scan Self-Rating Anxiety Scale

  1. Prevention and Trust Evaluation Scheme Based on Interpersonal Relationships for Large-Scale Peer-To-Peer Networks

    Directory of Open Access Journals (Sweden)

    Lixiang Li

    2014-01-01

    Full Text Available In recent years, the complex network as the frontier of complex system has received more and more attention. Peer-to-peer (P2P networks with openness, anonymity, and dynamic nature are vulnerable and are easily attacked by peers with malicious behaviors. Building trusted relationships among peers in a large-scale distributed P2P system is a fundamental and challenging research topic. Based on interpersonal relationships among peers of large-scale P2P networks, we present prevention and trust evaluation scheme, called IRTrust. The framework incorporates a strategy of identity authentication and a global trust of peers to improve the ability of resisting the malicious behaviors. It uses the quality of service (QoS, quality of recommendation (QoR, and comprehensive risk factor to evaluate the trustworthiness of a peer, which is applicable for large-scale unstructured P2P networks. The proposed IRTrust can defend against several kinds of malicious attacks, such as simple malicious attacks, collusive attacks, strategic attacks, and sybil attacks. Our simulation results show that the proposed scheme provides greater accuracy and stronger resistance compared with existing global trust schemes. The proposed scheme has potential application in secure P2P network coding.

  2. Self-efficacy scale for the establishment of good relationships with families in neonatal and pediatric hospital settings

    Directory of Open Access Journals (Sweden)

    Andréia Cascaes Cruz

    Full Text Available Abstract OBJECTIVE The purpose of this study was to develop and test the psychometric properties of the Self-efficacy Scale for the Establishment of Good Relationships with Families in Neonatal and Pediatric Hospital Settings. METHOD Methodological study grounded on self-efficacy theory was conducted in three phases: conceptual and operational definition (review of the literature and interviews with the target population, content validity (opinion of five experts e three clinical nurses, and exploratory factor analysis and internal consistency reliability (cross-sectional survey with a valid sample of 194 nurses. RESULTS A ten-point Likert scale with 40-item was designed and one item was excluded after review by experts. Three factors emerged from the exploratory factor analysis. The Cronbach's alpha for all items was 0.983 with item-total correlations in the range 0.657 to 0.847. Cronbach's alpha value if item deleted were less than or equal to 0.983. CONCLUSION The final version of the scale demonstrated psychometric adequacy. It is a useful tool to be administered in the clinical, educational and research nursing fields to measure nurses’ self-efficacy beliefs concerning the establishment of good relationships with families.

  3. Relationship between toughness and the physical fracture process on a microscopic scale

    International Nuclear Information System (INIS)

    Francois, D.

    1975-01-01

    Cleavage occurs when a local stress reaches a critical level sigma-f which is a function of temperature and metallurgical factors such as grain size. Cleavages occur ahead of the main crack tip. It is possible to establish a relationship between the cleavage stress and toughness, involving the notch root radius. At higher temperatures, fracture is ductile and occurs at a critical elongation epsilon-f, which is a function of the distribution of inclusions and the strain hardening index. It is possible to establish a relationship between toughness and this elongation at rupture. The influence of temperature, which affects several parameters, is complex. On the other hand, pressure, modifying only elongation at rupture represents an attractive means for confirming this theories. Experimental results are presented [fr

  4. [Nurses' knowledge, attitudes and behavior intentions in the care of terminal stage cancer patients with dyspnea].

    Science.gov (United States)

    Hou, Sheng-Yung; Lee, Ru-Ping

    2009-06-01

    The main purpose of this study was to explore the current status and correlations among key factors of influence, including knowledge, attitudes and behavior intentions, related to nurses' care for terminal cancer patients with dyspnea. This study was conducted using a crossing-sectional research method using convenience sampling. A total of 128 nurses working in a regional educational hospital in eastern Taiwan were surveyed by questionnaire. The conclusions of this study were: (1) "nursing measurement" was the most important factor affecting knowledge; (2) positive attitudes represent the result of the survey; (3) the most significant factor related to behavior intentions was "nursing measurement"; (4) knowledge was highly influenced by "nurse background" variables; (5) behavior intention was affected by "nurse background" variables; and (6) a positive correlation was identified between attitudes and behavior intentions. We recommend that training courses and practice related to palliative care should be incorporated into nursing education. To enhance nurses' knowledge and abilities in caring for dyspnea patients in the terminal cancer stage, it is also necessary to set up guidelines, including palliative care on-the-job training and cross-training programs.

  5. Analyse of the prevalence rate and risk factors of pulmonary embolism in the patients with dyspnea

    International Nuclear Information System (INIS)

    Cao Yanxia; Su Jian; Wang Bingsheng; Wu Songhong; Dai Ruiting; Cao Caixia

    2005-01-01

    Objective: To analyse the prevalence rate and risk factors of pulmonary embolism (PE) in patients with dyspnea and to explore the predisposing causes and its early clinical manifestations. Methods: Retrospective analysis was done in 461 patients with dyspnea performed 99 Tc m -macroaggregated albumin (MAA) lung perfusion imaging and 99 Tc m -DTPA ventilation imaging or 99 Tc m -MAA perfusion imaging and chest X-ray examination. Among them, 48 cases without apparent disease were considered as control group, whereas the remaining patients with other underlying illnesses as patients group. PEMS statistics software package was used for estimation of prevalence rate, χ 2 test and PE risk factor analysis. Results: There were 251 PE patients among 461 patients, the prevalence rate [ (π)=95% confidence interval (CI) ] was: lower extremity thrombosis and varicosity (80.79-95.47 ), post cesarean section (55.64-87.12), lower extremity bone surgery or fracture (52.76-87.27 ), cancer operation (52.19-78.19), atrial fibrillation or heart failure (53.30-74.88), obesity (23.14-50.20), post abdominal surgery (20.23-59.43), diabetes (19.12-63.95), chronic bronchitis (1.80-23.06), normal control group (3.47-22.66). Except chronic bronchitis, PE prevalence rate between patients group and control group had significant difference (P 99 Tc m -MAA and DTPA lung imaging should be done as early as possible. (authors)

  6. Evaluation of Dyspnea Outcomes After Endoscopic Airway Surgery for Laryngotracheal Stenosis.

    Science.gov (United States)

    Samad, Idris; Akst, Lee; Karatayli-Özgürsoy, Selmin; Teets, Kristine; Simpson, Marissa; Sharma, Ashwyn; Best, Simon R A; Hillel, Alexander T

    2016-11-01

    Endoscopic airway surgery is a frequently used procedure in the management of laryngotracheal stenosis (LTS); however, no established outcome measures are available to assess treatment response. To assess acoustics and aerodynamic measures and voice- and dyspnea-related quality of life (QOL) in adult patients with LTS who undergo endoscopic airway surgery. This case series compared preoperative measures and postoperative outcomes among adult patients who underwent endoscopic airway surgery for LTS from September 1, 2013, to September 30, 2015, at the tertiary care Johns Hopkins Voice Center. Patients were excluded if they did not undergo balloon dilation or if they had multilevel or glottic stenosis. The Phonatory Aerodynamic System was used to quantify laryngotracheal aerodynamic changes after surgery. Final follow-up was completed 2 to 6 weeks after surgery. The voice-related QOL instrument (V-RQOL), Dyspnea Index, and Clinical Chronic Obstructive Pulmonary Disease Questionnaire were completed before and after endoscopic surgery. Consensus auditory perceptual evaluation of voice, acoustic measurements, and aerodynamic outcomes were also assessed. Fourteen patients (1 man and 13 women; mean [SD] age, 45.4 [4.3] years) were enrolled. The mean postoperative V-RQOL scores (n = 14) increased from 74.3 to 85.5 (mean of difference, 11.3; 95% CI, 2.2 to 20.3). The mean postoperative Dyspnea Index (n = 14) decreased from 26.9 to 6.6 (mean of difference, -20.3; 95% CI, -27.9 to -12.7); the mean postoperative Clinical Chronic Obstructive Pulmonary Disease Questionnaire scores (n = 9) decreased from 3.2 to 1.0 (mean of difference, -2.2; 95% CI, -3.4 to -0.9). Postoperative mean vital capacity (n = 14) increased from 2.5 to 3.1 L (mean of difference, 0.6 L; 95% CI, 0.3-1.0 L), whereas mean laryngeal resistance (n = 14) decreased from 73.9 to 46.4 cm H2O/L/s (mean of difference, -27.5 cm H2O/L/s; 95% CI, -44.8 to -10.3 cm H2O/L/s) postoperatively. Patients

  7. Relationship between Fujikawa’s Method and the Background Field Method for the Scale Anomaly

    Directory of Open Access Journals (Sweden)

    Chris L. Lin

    2016-01-01

    Full Text Available We show the equivalence between Fujikawa’s method for calculating the scale anomaly and the diagrammatic approach to calculating the effective potential via the background field method, for an O(N symmetric scalar field theory. Fujikawa’s method leads to a sum of terms, each one superficially in one-to-one correspondence with a vacuum diagram of the 1-loop expansion. From the viewpoint of the classical action, the anomaly results in a breakdown of the Ward identities due to scale-dependence of the couplings, whereas, in terms of the effective action, the anomaly is the result of the breakdown of Noether’s theorem due to explicit symmetry breaking terms of the effective potential.

  8. The relationship between pneumonia and Glasgow coma scale assessment on acute stroke patients

    Science.gov (United States)

    Ritarwan, K.; Batubara, C. A.; Dhanu, R.

    2018-03-01

    Pneumonia is one of the most frequent medical complications of a stroke. Despite the well-documented association of a stroke associated infections with increased mortality and worse long-term outcome, on the other hand, the limited data available on independent predictors of pneumonia in acute stroke patients in an emergency unit. To determine the independentrelationship between pneumonia and Glasgow Coma Scale assessment on acute stroke patients. The cohort retrospective study observed 55 acute stroke patients who stayed in intensive care unit Adam Malik General Hospital from January until August 2017. Pneumonia was more frequent in patients with Ischemic stroke (OR 5.40; 95% CI: 1.28 – 6.40, p=0.003), higher National Institute of Health Stroke Scale (NIHSS) (p=0.014) and lower Glasgow Coma Scale (p=0.0001). Analysis multivariate logistic regression identified NIHSS as an independent of predictors of pneumonia (95% CI : 1.047 – 1.326, p=0.001). Pneumonia was associated with severity and type of stroke and length of hospital stay. The severity of the deficits evaluated by the NIHSS was shown to be the only independent risk factor for pneumonia in acute stroke patients.

  9. Development of an early memories of warmth and safeness scale and its relationship to psychopathology.

    Science.gov (United States)

    Richter, A; Gilbert, P; McEwan, K

    2009-06-01

    Experiences of early childhood have a major impact on physiological, psychological, and social aspects of maturation and functioning. One avenue of work explores the recall and memory of positive or negative rearing experiences and their association with psychopathology measures. However, while many self-report studies have focused on the recall of parental behaviours this study developed a new measure called the early memories of warmth and safeness scale (EMWSS), which focuses on recall of one's own inner positive feelings, emotions and experiences in childhood. Student participants (N = 180) completed the new scale and a series of self-report scales measuring different types of early recall, psychopathology, types of positive affect, and self-criticism/reassurance. The EMWSS was found to have good psychometric properties and reliability. Recall of parental behaviour and recall of positive emotional memories were highly related, but recall of positive emotional memories was a better predictor of psychopathology, styles of self-criticism/self-reassurance and disposition to experience positive affect, than recall of parental behaviour.

  10. The Effortful Control Scale for adults: psychometric properties of the Catalan version and its relationship to cognitive emotion regulation

    Directory of Open Access Journals (Sweden)

    Miquel Tortella-Feliu

    2013-10-01

    Full Text Available The goals of this study were (a to examine the psychometric properties of a Catalan version of the Effortful control scale of the Adult Temperament Questionnaire short-form and (b to analyze the relationships among effortful control (EC, negative affectivity (NA, and the use of negative cognitive emotion regulation (ER strategies. In a sample of 353 college students, the instrument presents acceptable internal consistency, temporal stability and convergent validity; however, in general, psychometric properties are poorer than those reported for other versions. Confirmatory factor analysis fit indices revealed an overall poor fit for the three-factor theoretical model. Additionally, it has been found that the proneness to engage in negative cognitive ER strategies was mainly related with exhibiting high NA. Further, although such tendencies were also influenced by EC capabilities, data did not show EC moderating the relationships among NA, anxiety, and the use of negative cognitive ER strategies.

  11. Measuring Social Relationships in Different Social Systems: The Construction and Validation of the Evaluation of Social Systems (EVOS Scale.

    Directory of Open Access Journals (Sweden)

    Corina Aguilar-Raab

    Full Text Available Social interactions have gained increasing importance, both as an outcome and as a possible mediator in psychotherapy research. Still, there is a lack of adequate measures capturing relational aspects in multi-person settings. We present a new measure to assess relevant dimensions of quality of relationships and collective efficacy regarding interpersonal interactions in diverse personal and professional social systems including couple partnerships, families, and working teams: the EVOS. Theoretical dimensions were derived from theories of systemic family therapy and organizational psychology. The study was divided in three parts: In Study 1 (N = 537, a short 9-item scale with two interrelated factors was constructed on the basis of exploratory factor analysis. Quality of relationship and collective efficacy emerged as the most relevant dimensions for the quality of social systems. Study 2 (N = 558 confirmed the measurement model using confirmatory factor analysis and established validity with measures of family functioning, life satisfaction, and working team efficacy. Measurement invariance was assessed to ensure that EVOS captures the same latent construct in all social contexts. In Study 3 (N = 317, an English language adaptation was developed, which again confirmed the original measurement model. The EVOS is a theory-based, economic, reliable, and valid measure that covers important aspects of social relationships, applicable for different social systems. It is the first instrument of its kind and an important addition to existing measures of social relationships and related outcome measures in therapeutic and other counseling settings involving multiple persons.

  12. Measuring Social Relationships in Different Social Systems: The Construction and Validation of the Evaluation of Social Systems (EVOS) Scale

    Science.gov (United States)

    Aguilar-Raab, Corina; Grevenstein, Dennis; Schweitzer, Jochen

    2015-01-01

    Social interactions have gained increasing importance, both as an outcome and as a possible mediator in psychotherapy research. Still, there is a lack of adequate measures capturing relational aspects in multi-person settings. We present a new measure to assess relevant dimensions of quality of relationships and collective efficacy regarding interpersonal interactions in diverse personal and professional social systems including couple partnerships, families, and working teams: the EVOS. Theoretical dimensions were derived from theories of systemic family therapy and organizational psychology. The study was divided in three parts: In Study 1 (N = 537), a short 9-item scale with two interrelated factors was constructed on the basis of exploratory factor analysis. Quality of relationship and collective efficacy emerged as the most relevant dimensions for the quality of social systems. Study 2 (N = 558) confirmed the measurement model using confirmatory factor analysis and established validity with measures of family functioning, life satisfaction, and working team efficacy. Measurement invariance was assessed to ensure that EVOS captures the same latent construct in all social contexts. In Study 3 (N = 317), an English language adaptation was developed, which again confirmed the original measurement model. The EVOS is a theory-based, economic, reliable, and valid measure that covers important aspects of social relationships, applicable for different social systems. It is the first instrument of its kind and an important addition to existing measures of social relationships and related outcome measures in therapeutic and other counseling settings involving multiple persons. PMID:26200357

  13. Scale Effects of the Relationships between Urban Heat Islands and Impact Factors Based on a Geographically-Weighted Regression Model

    Directory of Open Access Journals (Sweden)

    Xiaobo Luo

    2016-09-01

    Full Text Available Urban heat island (UHI effect, the side effect of rapid urbanization, has become an obstacle to the further healthy development of the city. Understanding its relationships with impact factors is important to provide useful information for climate adaptation urban planning strategies. For this purpose, the geographically-weighted regression (GWR approach is used to explore the scale effects in a mountainous city, namely the change laws and characteristics of the relationships between land surface temperature and impact factors at different spatial resolutions (30–960 m. The impact factors include the Soil-adjusted Vegetation Index (SAVI, the Index-based Built-up Index (IBI, and the Soil Brightness Index (NDSI, which indicate the coverage of the vegetation, built-up, and bare land, respectively. For reference, the ordinary least squares (OLS model, a global regression technique, is also employed by using the same dependent variable and explanatory variables as in the GWR model. Results from the experiment exemplified by Chongqing showed that the GWR approach had a better prediction accuracy and a better ability to describe spatial non-stationarity than the OLS approach judged by the analysis of the local coefficient of determination (R2, Corrected Akaike Information Criterion (AICc, and F-test at small spatial resolution (< 240 m; however, when the spatial scale was increased to 480 m, this advantage has become relatively weak. This indicates that the GWR model becomes increasingly global, revealing the relationships with more generalized geographical patterns, and then spatial non-stationarity in the relationship will tend to be neglected with the increase of spatial resolution.

  14. [Development of the Feelings toward Nature Scale and relationship between feelings toward nature and proximity to nature].

    Science.gov (United States)

    Shibata, Seiji

    2016-04-01

    In the field of environmental psychology, there is rapidly growing interest in the concept of connectivity with nature, describing an individual's sense of being connected with nature. The author developed a new scale for assessing feelings toward nature, including connectedness. Confirmatory factor analysis indicated a five-factor model consisting of restorativeness, oneness, mystery, care, and aversion. Then, the relationships among availability of nature in respondents' neighborhood, age, and each subscale score of the Feelings toward Nature Scale, were analyzed using structural equation modeling. The availability of nature in neighborhoods was assessed using a geographic information system and respondents' subjective evaluations. Results indicate that overall connectedness to nature is weaker as availability of nature decreases, as assessed by subjective evaluation. Results also suggest that aversion toward nature in younger people is relatively stronger than in older generations.

  15. Regional scale spatio-temporal variability of soil moisture and its relationship with meteorological factors over the Korean peninsula

    Science.gov (United States)

    Cho, Eunsang; Choi, Minha

    2014-08-01

    An understanding soil moisture spatio-temporal variability is essential for hydrological and meteorological research. This work aims at evaluating the spatio-temporal variability of near surface soil moisture and assessing dominant meteorological factors that influence spatial variability over the Korean peninsula from May 1 to September 29, 2011. The results of Kolmogorov-Smirnov tests for goodness of fit showed that all applied distributions (normal, log-normal and generalized extreme value: GEV) were appropriate for the datasets and the GEV distribution described best spatial soil moisture patterns. The relationship between the standard deviation and coefficient of variation (CV) of soil moisture with mean soil moisture contents showed an upper convex shape and an exponentially negative pattern, respectively. Skewness exhibited a decreasing pattern with increasing mean soil moisture contents and kurtosis exhibited the U-shaped relationship. In this regional scale (99,720 km2), we found that precipitation indicated temporally stable features through an ANOVA test considering the meteorological (i.e. precipitation, insolation, air temperature, ground temperature and wind speed) and physical (i.e. soil texture, elevation, topography, and land use) factors. Spatial variability of soil moisture affected by the meteorological forcing is shown as result of the relationship between the meteorological factors (precipitation, insolation, air temperature and ground temperature) and the standard deviation of relative difference of soil moisture contents (SDRDt) which implied the spatial variability of soil moisture. The SDRDt showed a positive relationship with the daily mean precipitation, while a negative relationship with insolation, air temperature and ground temperature. The variation of spatial soil moisture pattern is more sensitive to change in ground temperature rather than air temperature changes. Therefore, spatial variability of soil moisture is greatly affected

  16. Development of probability distributions for regional climate change from uncertain global mean warming and an uncertain scaling relationship

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available To produce probability distributions for regional climate change in surface temperature and precipitation, a probability distribution for global mean temperature increase has been combined with the probability distributions for the appropriate scaling variables, i.e. the changes in regional temperature/precipitation per degree global mean warming. Each scaling variable is assumed to be normally distributed. The uncertainty of the scaling relationship arises from systematic differences between the regional changes from global and regional climate model simulations and from natural variability. The contributions of these sources of uncertainty to the total variance of the scaling variable are estimated from simulated temperature and precipitation data in a suite of regional climate model experiments conducted within the framework of the EU-funded project PRUDENCE, using an Analysis Of Variance (ANOVA. For the area covered in the 2001–2004 EU-funded project SWURVE, five case study regions (CSRs are considered: NW England, the Rhine basin, Iberia, Jura lakes (Switzerland and Mauvoisin dam (Switzerland. The resulting regional climate changes for 2070–2099 vary quite significantly between CSRs, between seasons and between meteorological variables. For all CSRs, the expected warming in summer is higher than that expected for the other seasons. This summer warming is accompanied by a large decrease in precipitation. The uncertainty of the scaling ratios for temperature and precipitation is relatively large in summer because of the differences between regional climate models. Differences between the spatial climate-change patterns of global climate model simulations make significant contributions to the uncertainty of the scaling ratio for temperature. However, no meaningful contribution could be found for the scaling ratio for precipitation due to the small number of global climate models in the PRUDENCE project and natural variability, which is

  17. Relationship between family history of alcohol addiction, parents' education level, and smartphone problem use scale scores.

    Science.gov (United States)

    Beison, Ashley; Rademacher, David J

    2017-03-01

    Background and aims Smartphones are ubiquitous. As smartphones increased in popularity, researchers realized that people were becoming dependent on their smartphones. The purpose here was to provide a better understanding of the factors related to problematic smartphone use (PSPU). Methods The participants were 100 undergraduates (25 males, 75 females) whose ages ranged from 18 to 23 (mean age = 20 years). The participants completed questionnaires to assess gender, ethnicity, year in college, father's education level, mother's education level, family income, age, family history of alcoholism, and PSPU. The Family Tree Questionnaire assessed family history of alcoholism. The Mobile Phone Problem Use Scale (MPPUS) and the Adapted Cell Phone Addiction Test (ACPAT) were used to determine the degree of PSPU. Whereas the MPPUS measures tolerance, escape from other problems, withdrawal, craving, and negative life consequences, the ACPAT measures preoccupation (salience), excessive use, neglecting work, anticipation, lack of control, and neglecting social life. Results Family history of alcoholism and father's education level together explained 26% of the variance in the MPPUS scores and 25% of the variance in the ACPAT scores. The inclusion of mother's education level, ethnicity, family income, age, year in college, and gender did not significantly increase the proportion of variance explained for either MPPUS or ACPAT scores. Discussion and conclusions Family history of alcoholism and father's education level are good predictors of PSPU. As 74%-75% of the variance in PSPU scale scores was not explained, future studies should aim to explain this variance.

  18. Assessing children's emotional security in the interparental relationship: the Security in the Interparental Subsystem Scales.

    Science.gov (United States)

    Davies, Patrick T; Forman, Evan M; Rasi, Jennifer A; Stevens, Kristopher I

    2002-01-01

    Guided by the emotional security hypothesis, this study reports on the development of a new self-report measure that assesses children's strategies for preserving emotional security in the context of interparental conflict. Participants were 924 sixth, seventh, and eighth graders and a subset of their mothers, fathers, and teachers. Exploratory and confirmatory factor analyses of the Security in the Interparental Subsystem (SIS) Scale supported a seven-factor solution, corresponding well to the three component processes (i.e., emotional reactivity, regulation of exposure to parent affect, and internal representations) outlined in the emotional security hypothesis. The SIS subscales demonstrated satisfactory internal consistency and test-retest reliability. Support for the validity of the SIS Scale is evidenced by its significant links with parent reports of children's overt reactivity to conflict, children's responses to interparental conflict simulations 6 months later, and children's psychological maladjustment and experiential histories with interparental conflict across multiple informants (i.e., child, mother, father, and teacher). Results are discussed in the context of developing recommendations for use of the SIS and advancing the emotional security hypothesis.

  19. The importance of the relationship between scale and process in understanding long-term DOC dynamics.

    Science.gov (United States)

    Clark, J M; Bottrell, S H; Evans, C D; Monteith, D T; Bartlett, R; Rose, R; Newton, R J; Chapman, P J

    2010-06-01

    Concentrations of dissolved organic carbon have increased in many, but not all, surface waters across acid impacted areas of Europe and North America over the last two decades. Over the last eight years several hypotheses have been put forward to explain these increases, but none are yet accepted universally. Research in this area appears to have reached a stalemate between those favouring declining atmospheric deposition, climate change or land management as the key driver of long-term DOC trends. While it is clear that many of these factors influence DOC dynamics in soil and stream waters, their effect varies over different temporal and spatial scales. We argue that regional differences in acid deposition loading may account for the apparent discrepancies between studies. DOC has shown strong monotonic increases in areas which have experienced strong downward trends in pollutant sulphur and/or seasalt deposition. Elsewhere climatic factors, that strongly influence seasonality, have also dominated inter-annual variability, and here long-term monotonic DOC trends are often difficult to detect. Furthermore, in areas receiving similar acid loadings, different catchment characteristics could have affected the site specific sensitivity to changes in acidity and therefore the magnitude of DOC release in response to changes in sulphur deposition. We suggest that confusion over these temporal and spatial scales of investigation has contributed unnecessarily to the disagreement over the main regional driver(s) of DOC trends, and that the data behind the majority of these studies is more compatible than is often conveyed. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  20. Disability measures in stroke: relationship among the Barthel Index, the Functional Independence Measure, and the Modified Rankin Scale.

    Science.gov (United States)

    Kwon, Sooyeon; Hartzema, Abraham G; Duncan, Pamela W; Min-Lai, Sue

    2004-04-01

    Residual disability after stroke presents a major economic and humanistic burden. To quantify disability in patients, activities of daily living (ADL; Barthel Index [BI], and motor component of Functional Independence Measure [M-FIM]) and categorical disability measures (Modified Rankin Scale [MRS]) are used. The purpose of this study is to examine the predicting ability of ADL measures to global disability scale. Kansas City Stroke Study data were used for the present study. Correlation coefficient, Kruskal-Wallis test, and polytomous logistic regression analysis were applied to examine the relationship between the ADL measure and global disability scale. Model fit statistics were examined to verify logistic regression appropriateness. A categorization scheme, which minimized the false-positive response rate, was selected as the optimal categorizing system. The 3 measures were highly correlated. Both BI and M-FIM differentiated disability better in lower than higher disability. In logistic regression, BI differentiated 4 disability levels; M-FIM differentiated 3 levels in MRS. However, on the basis of results of the Kruskal-Wallis and multiple comparison tests, we suspect that M-FIM may have the potential to predict MRS categories better with a different model. The proposed categorization scheme can serve as a translation between measures. However, because of the ceiling effect of BI and M-FIM, the translation could not be completed for all 6 levels of MRS. No apparent variation over time in the categorization scheme was observed. Further research needs to be conducted to develop better prediction models explaining the relationship between M-FIM and MRS.

  1. An uncommon case of dyspnea with unilateral laryngeal paralysis in acromegaly.

    Science.gov (United States)

    Lerat, Justine; Lacoste, Marie; Prechoux, Jean-Marc; Aubry, Karine; Nadalon, Sylvie; Ly, Kim Heang; Bessede, Jean-Pierre

    2016-02-01

    A 61-year-old man with obstructive sleep apnea syndrome and normal BMI complained of dyspnea. Nasofibroscopy revealed a global and major oedema of the glottis and supraglottis and also a paralysis of the left vocal fold. CT-scan pointed out a spontaneous hyperdensity of the left arytenoid cartilage. A tracheostomy was performed. Clinical examination revealed large hands and macroglossy with high IGF1 rate. MRI confirmed a supracentimetric pituitary adenoma. To our knowledge, this is the first description of a case of acute respiratory distress due to unilateral larynx paralysis leading to acromegaly diagnosis. This is due to submucosal hypertrophy and vocal cord immobility. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Nontraumatic head and neck emergencies: a clinical approach. Part 1: cervicofacial swelling, dysphagia, and dyspnea.

    Science.gov (United States)

    Brea Álvarez, B; Tuñón Gómez, M; Esteban García, L; García Hidalgo, C Y; Ruiz Peralbo, R M

    2016-01-01

    Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons: first, they affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Various publications focus on nontraumatic emergencies of the head and neck from the viewpoints of anatomic location or of particular diseases. However, these are not the most helpful viewpoints for dealing with patients in the emergency department, who present with particular signs and symptoms. We propose an analysis starting from the four most common clinical presentations of patients who come to the emergency department for nontraumatic head and neck emergencies: cervical swelling, dysphagia, dyspnea, and loss of vision. Starting from these entities, we develop an approach to the radiologic management and diagnosis of these patients. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Cardiac Fibroma in a Neonate Presenting With Dyspnea and Tachycardia: A Very Rare Case Tachycardia

    Directory of Open Access Journals (Sweden)

    Anvari Shahriar

    2016-01-01

    Full Text Available Introduction: Cardiac tumors can be divided to primary and secondary and to benign and malignant tumors. One of the benign tumors of the heart is cardiac fibroma. More than 80% of this tumor occurs in children; however its occurrence in neonates is very rare. Fewer than 100 cases have been reported. Case Presentation: Our patient is a 10 day’s girl neonate with severe dyspnea, mild cyanosis, tachycardia (heart rate = 170- 180/min and obstruction of right ventricle (RV outlet with very large tumor. Conclusion: Cardiac tumors in neonate population must be considered in the diagnosis of arrhythmias, cardiac insufficiency, valvular disease, cardiomegaly or presence of murmurs. Early diagnosis before birth should be appropriate and accurate imaging devices must be used in detecting these tumors.

  4. Fractal Scaling of Particle Size Distribution and Relationships with Topsoil Properties Affected by Biological Soil Crusts

    Science.gov (United States)

    Gao, Guang-Lei; Ding, Guo-Dong; Wu, Bin; Zhang, Yu-Qing; Qin, Shu-Gao; Zhao, Yuan-Yuan; Bao, Yan-Feng; Liu, Yun-Dong; Wan, Li; Deng, Ji-Feng

    2014-01-01

    Background Biological soil crusts are common components of desert ecosystem; they cover ground surface and interact with topsoil that contribute to desertification control and degraded land restoration in arid and semiarid regions. Methodology/Principal Findings To distinguish the changes in topsoil affected by biological soil crusts, we compared topsoil properties across three types of successional biological soil crusts (algae, lichens, and mosses crust), as well as the referenced sandland in the Mu Us Desert, Northern China. Relationships between fractal dimensions of soil particle size distribution and selected soil properties were discussed as well. The results indicated that biological soil crusts had significant positive effects on soil physical structure (Psoil organic carbon and nutrients showed an upward trend across the successional stages of biological soil crusts. Fractal dimensions ranged from 2.1477 to 2.3032, and significantly linear correlated with selected soil properties (R2 = 0.494∼0.955, Psoil crusts cause an important increase in soil fertility, and are beneficial to sand fixation, although the process is rather slow. Fractal dimension proves to be a sensitive and useful index for quantifying changes in soil properties that additionally implies desertification. This study will be essential to provide a firm basis for future policy-making on optimal solutions regarding desertification control and assessment, as well as degraded ecosystem restoration in arid and semiarid regions. PMID:24516668

  5. Conductivity Scaling Relationships in Nanostructured Membranes based on Protic Polymerized Ionic Liquids

    Science.gov (United States)

    Sanoja, Gabriel; Lynd, Nathaniel; Segalman, Rachel

    2015-03-01

    Nanostructured membranes based on protic polymerized ionic liquids are of great interest for a variety of electrochemical applications. Understanding the relationship between composition, structure, and ionic conductivity for these materials is essential for designing novel membranes with improved properties. In this work, we explore the effect of volume fraction of ionic liquid on conductivity, σ using a model system composed of poly[isoprene-block-(ethylene oxide-stat-histamine glycidyl ether) diblock copolymers [PI- b - P(EO-stat-HGE)] and the resulting [PI- b - P(EO-stat-IL)] obtained after treatment with trifluoroacetic acid. These materials self-assemble into lamellar structures with volume fractions of ionic liquid ranging from 0.50 to 0.90 as demonstrated by SAXS. PI- b - P(EO-stat-IL) membranes exhibit conductivities up to 4 x 10-3 S/cm at room temperature. In addition, PI- b - P(EO-stat-IL) based membranes have lower water uptake (λ = 8-10) in comparison with most proton conducting membranes reported elsewhere. The low λ in these membranes might translate into a stronger effect of morphology on transport properties. Joint Center for Artificial Photosynthesis.

  6. Fractal scaling of particle size distribution and relationships with topsoil properties affected by biological soil crusts.

    Directory of Open Access Journals (Sweden)

    Guang-Lei Gao

    Full Text Available BACKGROUND: Biological soil crusts are common components of desert ecosystem; they cover ground surface and interact with topsoil that contribute to desertification control and degraded land restoration in arid and semiarid regions. METHODOLOGY/PRINCIPAL FINDINGS: To distinguish the changes in topsoil affected by biological soil crusts, we compared topsoil properties across three types of successional biological soil crusts (algae, lichens, and mosses crust, as well as the referenced sandland in the Mu Us Desert, Northern China. Relationships between fractal dimensions of soil particle size distribution and selected soil properties were discussed as well. The results indicated that biological soil crusts had significant positive effects on soil physical structure (P<0.05; and soil organic carbon and nutrients showed an upward trend across the successional stages of biological soil crusts. Fractal dimensions ranged from 2.1477 to 2.3032, and significantly linear correlated with selected soil properties (R(2 = 0.494∼0.955, P<0.01. CONCLUSIONS/SIGNIFICANCE: Biological soil crusts cause an important increase in soil fertility, and are beneficial to sand fixation, although the process is rather slow. Fractal dimension proves to be a sensitive and useful index for quantifying changes in soil properties that additionally implies desertification. This study will be essential to provide a firm basis for future policy-making on optimal solutions regarding desertification control and assessment, as well as degraded ecosystem restoration in arid and semiarid regions.

  7. Pulmonary Gas Exchange Abnormalities in Mild Chronic Obstructive Pulmonary Disease. Implications for Dyspnea and Exercise Intolerance.

    Science.gov (United States)

    Elbehairy, Amany F; Ciavaglia, Casey E; Webb, Katherine A; Guenette, Jordan A; Jensen, Dennis; Mourad, Sahar M; Neder, J Alberto; O'Donnell, Denis E

    2015-06-15

    Several studies in mild chronic obstructive pulmonary disease (COPD) have shown a higher than normal ventilatory equivalent for carbon dioxide ([Formula: see text]e/[Formula: see text]co2) during exercise. Our objective was to examine pulmonary gas exchange abnormalities and the mechanisms of high [Formula: see text]e/[Formula: see text]co2 in mild COPD and its impact on dyspnea and exercise intolerance. Twenty-two subjects (11 patients with GOLD [Global Initiative for Chronic Obstructive Lung Disease] grade 1B COPD, 11 age-matched healthy control subjects) undertook physiological testing and a symptom-limited incremental cycle exercise test with arterial blood gas collection. Patients (post-bronchodilator FEV1: 94 ± 10% predicted; mean ± SD) had evidence of peripheral airway dysfunction and reduced peak oxygen uptake compared with control subjects (80 ± 18 vs. 113 ± 24% predicted; Pexercise. The alveolar-arterial O2 tension gradient was elevated at rest and throughout exercise in COPD (Ppatients with COPD than in control subjects during exercise. In patients with COPD versus control subjects, there was significant dynamic hyperinflation and greater tidal volume constraints (Ppatients with COPD versus control subjects in association with higher ventilatory requirements. Within all subjects, Vd/Vt correlated with the [Formula: see text]e/[Formula: see text]co2 ratio during submaximal exercise (r=0.780, Pexercise maintained alveolar ventilation and arterial blood gas homeostasis but at the expense of earlier dynamic mechanical constraints, greater dyspnea, and exercise intolerance in mild COPD.

  8. A study of the relationship between permeability distributions and small scale sedimentary features in a fluvial formation

    Energy Technology Data Exchange (ETDEWEB)

    Gotkowitz, M.

    1993-10-01

    This study focuses on styles of small-scale heterogeneity found in fluvial sand and soil bodies. Over 1,700 in situ measurements of air permeability were taken in an outcrop-based study which joins observations of sedimentary features with their associated permeability distributions. The relationship between sedimentology and hydrologic parameters provides a geologic framework to assess geostatistical hypotheses. The soils in the study area are found to have a significantly lower permeability than the channel sand deposits. The soil deposits showed a significant lack of observable small scale sedimentary structures, which is reflected in the experimental variograms. The permeability distribution in these study sites appears to be adequately represented by a continuous gaussian random field model. The presence of calcium carbonate nodules in the soils is related to the permeability distribution. Correlation lengths in the channel sands perpendicular to stratigraphy are significantly shorter than those observed parallel to stratigraphy. A sedimentological, bounding surfaces model is evaluated with regard to permeability distributions. In deposits of little sedimentary structure, the mean and variance may adequately characterize the permeability distribution. Where significant sedimentary structure exists, the bounding surfaces model can be used to determine the scales of variability present in the permeability distribution and may also be used to infer an appropriate choice of random field model.

  9. Analytical Assessment of the Relationship between 100MWp Large-scale Grid-connected Photovoltaic Plant Performance and Meteorological Parameters

    Science.gov (United States)

    Sheng, Jie; Zhu, Qiaoming; Cao, Shijie; You, Yang

    2017-05-01

    This paper helps in study of the relationship between the photovoltaic power generation of large scale “fishing and PV complementary” grid-tied photovoltaic system and meteorological parameters, with multi-time scale power data from the photovoltaic power station and meteorological data over the same period of a whole year. The result indicates that, the PV power generation has the most significant correlation with global solar irradiation, followed by diurnal temperature range, sunshine hours, daily maximum temperature and daily average temperature. In different months, the maximum monthly average power generation appears in August, which related to the more global solar irradiation and longer sunshine hours in this month. However, the maximum daily average power generation appears in October, this is due to the drop in temperature brings about the improvement of the efficiency of PV panels. Through the contrast of monthly average performance ratio (PR) and monthly average temperature, it is shown that, the larger values of monthly average PR appears in April and October, while it is smaller in summer with higher temperature. The results concluded that temperature has a great influence on the performance ratio of large scale grid-tied PV power system, and it is important to adopt effective measures to decrease the temperature of PV plant properly.

  10. Spatial patterns and scale-dependent relationships between macrozooplankton and fish in the Bay of Biscay: an acoustic study

    KAUST Repository

    Lezama-Ochoa, A

    2011-10-20

    Macrozooplankton plays a key role in pelagic ecosystems as a link between lower trophic levels and fish. However, although its ecological role is usually considered in polar ecosystems, it is rarely considered in temperate ones. To obtain comprehensive information on the macrozooplankton distribution in the Bay of Biscay we adapted a bi-frequency acoustic method developed for the Humboldt Current system. This method can be used to extract continuous and simultaneous high-resolution information on the spatiotemporal patterns of biomass distributions of macrozooplankton and pelagic fish throughout the diel cycle. The 2 distributions were mapped using geostatistical techniques. We applied kriging with external drifts, which accounts for both diel and across-shore changes in macrozooplankton biomass. We then used a cross-variogram to determine the scale-dependent relationships between macrozooplankton and fish. The results show how macrozooplankton and fish are distributed according to the different ecological domains (coast, shelf, shelf-break and offshore) along the Spanish and French coasts. Specific macrozooplankton hotspots were observed, but macrozooplankton was generally more abundant offshore than inshore, whereas fish showed the opposite trend. This pattern was confirmed by the aggregation sizes, which increased towards oceanic waters for macrozooplankton and decreased for fish. Finally, the correlation between fish and macrozooplankton was positive on a small scale (<30 nautical miles) and negative on a large scale (>30 nautical miles).

  11. Large-Scale Chromatin Structure-Function Relationships during the Cell Cycle and Development: Insights from Replication Timing.

    Science.gov (United States)

    Dileep, Vishnu; Rivera-Mulia, Juan Carlos; Sima, Jiao; Gilbert, David M

    2015-01-01

    Chromosome architecture has received a lot of attention since the recent development of genome-scale methods to measure chromatin interactions (Hi-C), enabling the first sequence-based models of chromosome tertiary structure. A view has emerged of chromosomes as a string of structural units (topologically associating domains; TADs) whose boundaries persist through the cell cycle and development. TADs with similar chromatin states tend to aggregate, forming spatially segregated chromatin compartments. However, high-resolution Hi-C has revealed substructure within TADs (subTADs) that poses a challenge for models that attribute significance to structural units at any given scale. More than 20 years ago, the DNA replication field independently identified stable structural (and functional) units of chromosomes (replication foci) as well as spatially segregated chromatin compartments (early and late foci), but lacked the means to link these units to genomic map units. Genome-wide studies of replication timing (RT) have now merged these two disciplines by identifying individual units of replication regulation (replication domains; RDs) that correspond to TADs and are arranged in 3D to form spatiotemporally segregated subnuclear compartments. Furthermore, classifying RDs/TADs by their constitutive versus developmentally regulated RT has revealed distinct classes of chromatin organization, providing unexpected insight into the relationship between large-scale chromosome structure and function. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.

  12. Global scale climate-crop yield relationships and the impacts of recent warming

    International Nuclear Information System (INIS)

    Lobell, David B; Field, Christopher B

    2007-01-01

    Changes in the global production of major crops are important drivers of food prices, food security and land use decisions. Average global yields for these commodities are determined by the performance of crops in millions of fields distributed across a range of management, soil and climate regimes. Despite the complexity of global food supply, here we show that simple measures of growing season temperatures and precipitation-spatial averages based on the locations of each crop-explain ∼30% or more of year-to-year variations in global average yields for the world's six most widely grown crops. For wheat, maize and barley, there is a clearly negative response of global yields to increased temperatures. Based on these sensitivities and observed climate trends, we estimate that warming since 1981 has resulted in annual combined losses of these three crops representing roughly 40 Mt or $5 billion per year, as of 2002. While these impacts are small relative to the technological yield gains over the same period, the results demonstrate already occurring negative impacts of climate trends on crop yields at the global scale

  13. Synthesizing trait correlations and functional relationships across multiple scales: A Hierarchical Bayes approach

    Science.gov (United States)

    Shiklomanov, A. N.; Cowdery, E.; Dietze, M.

    2016-12-01

    Recent syntheses of global trait databases have revealed that although the functional diversity among plant species is immense, this diversity is constrained by trade-offs between plant strategies. However, the use of among-trait and trait-environment correlations at the global scale for both qualitative ecological inference and land surface modeling has several important caveats. An alternative approach is to preserve the existing PFT-based model structure while using statistical analyses to account for uncertainty and variability in model parameters. In this study, we used a hierarchical Bayesian model of foliar traits in the TRY database to test the following hypotheses: (1) Leveraging the covariance between foliar traits will significantly constrain our uncertainty in their distributions; and (2) Among-trait covariance patterns are significantly different among and within PFTs, reflecting differences in trade-offs associated with biome-level evolution, site-level community assembly, and individual-level ecophysiological acclimation. We found that among-trait covariance significantly constrained estimates of trait means, and the additional information provided by across-PFT covariance led to more constraint still, especially for traits and PFTs with low sample sizes. We also found that among-trait correlations were highly variable among PFTs, and were generally inconsistent with correlations within PFTs. The hierarchical multivariate framework developed in our study can readily be enhanced with additional levels of hierarchy to account for geographic, species, and individual-level variability.

  14. Estimation of Regional-Scale Actual Evapotranspiration in Okayama prefecture in Japan using Complementary Relationship

    Science.gov (United States)

    Moroizumi, T.; Yamamoto, M.; Miura, T.

    2008-12-01

    It is important to estimate accurately a water balance in watershed for proposing a reuse of water resources and a proper settlement of water utilization. Evapotranspiration (ET) is an important factor of water balance. Therefore, it is needed to estimate accurately the actual ET. The objective of this study is to estimate accurately monthly actual ET in Yoshii, Asahi, and Takahashi River watersheds in Okayama prefecture from 1999 to 2000. The monthly actual ET was calculated by a Morton and a modified Brutsaert and Stricker (B&S) method, using Automated Meteorological Data Acquisition Systems (AMeDAS) in the basin. The actual ET was estimated using land covers which were classified in 11 categories. The land covers includes the effects of albedo. The actual ET was related to the elevation at each AMeDAS station. Using this relationship, the actual ET at the 1 or 5 km grid-interval mesh in the basin was calculated, and finally, the distribution of actual ET was mapped. The monthly ET estimated by the modified B&S method were smaller than that by Morton method which showed a same tendency as the Penman potential ET (PET). The annual values of Morton"fs ET, modified B&S"fs ET, and PET were estimated as 796, 645, and 800 mm, respectively. The ET by the modified B&S was larger in hilly and mountainous areas than in settlement or city. In general, it was a reasonable result because city or settlement areas were covered with concrete and asphalt and the ET was controlled.

  15. A depth versus diameter scaling relationship for the best-preserved melt-bearing complex craters on Mars

    Science.gov (United States)

    Tornabene, Livio L.; Watters, Wesley A.; Osinski, Gordon R.; Boyce, Joseph M.; Harrison, Tanya N.; Ling, Victor; McEwen, Alfred S.

    2018-01-01

    We use topographic data to show that impact craters with pitted floor deposits are among the deepest on Mars. This is consistent with the interpretation of pitted materials as primary crater-fill impactite deposits emplaced during crater formation. Our database consists of 224 pitted material craters ranging in size from ∼1 to 150 km in diameter. Our measurements are based on topographic data from the Mars Orbiter Laser Altimeter (MOLA) and the High-Resolution Stereo Camera (HRSC). We have used these craters to measure the relationship between crater diameter and the initial post-formation depth. Depth was measured as maximum rim-to-floor depth, (dr), but we also report the depth measured using other definitions. The database was down-selected by refining or removing elevation measurements from ;problematic; craters affected by processes and conditions that influenced their dr/D, such as pre-impact slopes/topography and later overprinting craters. We report a maximum (deepest) and mean scaling relationship of dr = (0.347 ± 0.021)D0.537 ± 0.017 and dr = (0.323 ± 0.017)D0.538 ± 0.016, respectively. Our results suggest that significant variations between previously-reported MOLA-based dr vs. D relationships may result from the inclusion of craters that: 1) are influenced by atypical processes (e.g., highly oblique impact), 2) are significantly degraded, 3) reside within high-strength regions, and 4) are transitional (partially collapsed). By taking such issues into consideration and only measuring craters with primary floor materials, we present the best estimate to date of a MOLA-based relationship of dr vs. D for the least-degraded complex craters on Mars. This can be applied to crater degradation studies and provides a useful constraint for models of complex crater formation.

  16. Task and relationship conflict at work: Development and construct validation of a German version of Jehn’s intragroup conflict scale.

    NARCIS (Netherlands)

    Lehmann-Willenbrock, N.K.; Grohmann, A.; Kauffeld, S.

    2011-01-01

    The distinction between task and relationship conflict is well established. Based on Jehn’s (1995) intragroup conflict scale, we developed an economic six-item questionnaire for assessing relationship and task conflict in work groups. Confirmatory factor analysis was performed on data from a

  17. Ecological relationships of meso-scale distribution in 25 neotropical vertebrate species.

    Science.gov (United States)

    Michalski, Lincoln José; Norris, Darren; de Oliveira, Tadeu Gomes; Michalski, Fernanda

    2015-01-01

    Vertebrates are a vital ecological component of Amazon forest biodiversity. Although vertebrates are a functionally important part of various ecosystem services they continue to be threatened by anthropogenic impacts throughout the Amazon. Here we use a standardized, regularly spaced arrangement of camera traps within 25km2 to provide a baseline assessment of vertebrate species diversity in a sustainable use protected area in the eastern Brazilian Amazon. We examined seasonal differences in the per species encounter rates (number of photos per camera trap and number of cameras with photos). Generalized linear models (GLMs) were then used to examine the influence of five variables (altitude, canopy cover, basal area, distance to nearest river and distance to nearest large river) on the number of photos per species and on functional groups. GLMs were also used to examine the relationships between large predators [Jaguar (Panthera onca) and Puma (Puma concolor)] and their prey. A total of 649 independent photos of 25 species were obtained from 1,800 camera trap days (900 each during wet and dry seasons). Only ungulates and rodents showed significant seasonal differences in the number of photos per camera. The number of photos differed between seasons for only three species (Mazama americana, Dasyprocta leporina and Myoprocta acouchy) all of which were photographed more (3 to 10 fold increase) during the wet season. Mazama americana was the only species where a significant difference was found in occupancy, with more photos in more cameras during the wet season. For most groups and species variation in the number of photos per camera was only explained weakly by the GLMs (deviance explained ranging from 10.3 to 54.4%). Terrestrial birds (Crax alector, Psophia crepitans and Tinamus major) and rodents (Cuniculus paca, Dasyprocta leporina and M. acouchy) were the notable exceptions, with our GLMs significantly explaining variation in the distribution of all species

  18. Ecological Relationships of Meso-Scale Distribution in 25 Neotropical Vertebrate Species

    Science.gov (United States)

    Michalski, Lincoln José; Norris, Darren; de Oliveira, Tadeu Gomes; Michalski, Fernanda

    2015-01-01

    Vertebrates are a vital ecological component of Amazon forest biodiversity. Although vertebrates are a functionally important part of various ecosystem services they continue to be threatened by anthropogenic impacts throughout the Amazon. Here we use a standardized, regularly spaced arrangement of camera traps within 25km2 to provide a baseline assessment of vertebrate species diversity in a sustainable use protected area in the eastern Brazilian Amazon. We examined seasonal differences in the per species encounter rates (number of photos per camera trap and number of cameras with photos). Generalized linear models (GLMs) were then used to examine the influence of five variables (altitude, canopy cover, basal area, distance to nearest river and distance to nearest large river) on the number of photos per species and on functional groups. GLMs were also used to examine the relationships between large predators [Jaguar (Panthera onca) and Puma (Puma concolor)] and their prey. A total of 649 independent photos of 25 species were obtained from 1,800 camera trap days (900 each during wet and dry seasons). Only ungulates and rodents showed significant seasonal differences in the number of photos per camera. The number of photos differed between seasons for only three species (Mazama americana, Dasyprocta leporina and Myoprocta acouchy) all of which were photographed more (3 to 10 fold increase) during the wet season. Mazama americana was the only species where a significant difference was found in occupancy, with more photos in more cameras during the wet season. For most groups and species variation in the number of photos per camera was only explained weakly by the GLMs (deviance explained ranging from 10.3 to 54.4%). Terrestrial birds (Crax alector, Psophia crepitans and Tinamus major) and rodents (Cuniculus paca, Dasyprocta leporina and M. acouchy) were the notable exceptions, with our GLMs significantly explaining variation in the distribution of all species

  19. Ecological relationships of meso-scale distribution in 25 neotropical vertebrate species.

    Directory of Open Access Journals (Sweden)

    Lincoln José Michalski

    Full Text Available Vertebrates are a vital ecological component of Amazon forest biodiversity. Although vertebrates are a functionally important part of various ecosystem services they continue to be threatened by anthropogenic impacts throughout the Amazon. Here we use a standardized, regularly spaced arrangement of camera traps within 25km2 to provide a baseline assessment of vertebrate species diversity in a sustainable use protected area in the eastern Brazilian Amazon. We examined seasonal differences in the per species encounter rates (number of photos per camera trap and number of cameras with photos. Generalized linear models (GLMs were then used to examine the influence of five variables (altitude, canopy cover, basal area, distance to nearest river and distance to nearest large river on the number of photos per species and on functional groups. GLMs were also used to examine the relationships between large predators [Jaguar (Panthera onca and Puma (Puma concolor] and their prey. A total of 649 independent photos of 25 species were obtained from 1,800 camera trap days (900 each during wet and dry seasons. Only ungulates and rodents showed significant seasonal differences in the number of photos per camera. The number of photos differed between seasons for only three species (Mazama americana, Dasyprocta leporina and Myoprocta acouchy all of which were photographed more (3 to 10 fold increase during the wet season. Mazama americana was the only species where a significant difference was found in occupancy, with more photos in more cameras during the wet season. For most groups and species variation in the number of photos per camera was only explained weakly by the GLMs (deviance explained ranging from 10.3 to 54.4%. Terrestrial birds (Crax alector, Psophia crepitans and Tinamus major and rodents (Cuniculus paca, Dasyprocta leporina and M. acouchy were the notable exceptions, with our GLMs significantly explaining variation in the distribution of all

  20. The Relationships between Workaholism and Symptoms of Psychiatric Disorders: A Large-Scale Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Cecilie Schou Andreassen

    Full Text Available Despite the many number of studies examining workaholism, large-scale studies have been lacking. The present study utilized an open web-based cross-sectional survey assessing symptoms of psychiatric disorders and workaholism among 16,426 workers (Mage = 37.3 years, SD = 11.4, range = 16-75 years. Participants were administered the Adult ADHD Self-Report Scale, the Obsession-Compulsive Inventory-Revised, the Hospital Anxiety and Depression Scale, and the Bergen Work Addiction Scale, along with additional questions examining demographic and work-related variables. Correlations between workaholism and all psychiatric disorder symptoms were positive and significant. Workaholism comprised the dependent variable in a three-step linear multiple hierarchical regression analysis. Basic demographics (age, gender, relationship status, and education explained 1.2% of the variance in workaholism, whereas work demographics (work status, position, sector, and annual income explained an additional 5.4% of the variance. Age (inversely and managerial positions (positively were of most importance. The psychiatric symptoms (ADHD, OCD, anxiety, and depression explained 17.0% of the variance. ADHD and anxiety contributed considerably. The prevalence rate of workaholism status was 7.8% of the present sample. In an adjusted logistic regression analysis, all psychiatric symptoms were positively associated with being a workaholic. The independent variables explained between 6.1% and 14.4% in total of the variance in workaholism cases. Although most effect sizes were relatively small, the study's findings expand our understanding of possible psychiatric predictors of workaholism, and particularly shed new insight into the reality of adult ADHD in work life. The study's implications, strengths, and shortcomings are also discussed.

  1. The Continuum of Conflict and Control Relationship Scale (CCC-RS): Psychometrics for a Measure Designed to Discriminate among Types of Intimate Partner Violence

    Science.gov (United States)

    Carlson, Ryan G.; Rogers, Tiffany L.; Wheeler, Naomi J.; Kelchner, Viki; Griffith, Sandy-Ann M.; Liu, Xun

    2017-01-01

    Intimate partner violence (IPV) classifications have treatment implications for couples. This study tested the psychometrics of the Continuum of Conflict and Control Relationship Scale (CCC-RS) and examined differences between violence severity and CCC-RS scales. A sample of 575 low-income, ethnically diverse participants contributed data. Results…

  2. An Examination of Not-For-Profit Stakeholder Networks for Relationship Management: A Small-Scale Analysis on Social Media

    Science.gov (United States)

    Carlson, Jamie; Kitchens, Brent; Kozary, Ben; Zaki, Mohamed

    2016-01-01

    Using a small-scale descriptive network analysis approach, this study highlights the importance of stakeholder networks for identifying valuable stakeholders and the management of existing stakeholders in the context of mental health not-for-profit services. We extract network data from the social media brand pages of three health service organizations from the U.S., U.K., and Australia, to visually map networks of 579 social media brand pages (represented by nodes), connected by 5,600 edges. This network data is analyzed using a collection of popular graph analysis techniques to assess the differences in the way each of the service organizations manage stakeholder networks. We also compare node meta-information against basic topology measures to emphasize the importance of effectively managing relationships with stakeholders who have large external audiences. Implications and future research directions are also discussed. PMID:27711236

  3. An Examination of Not-For-Profit Stakeholder Networks for Relationship Management: A Small-Scale Analysis on Social Media.

    Science.gov (United States)

    Wyllie, Jessica; Lucas, Benjamin; Carlson, Jamie; Kitchens, Brent; Kozary, Ben; Zaki, Mohamed

    2016-01-01

    Using a small-scale descriptive network analysis approach, this study highlights the importance of stakeholder networks for identifying valuable stakeholders and the management of existing stakeholders in the context of mental health not-for-profit services. We extract network data from the social media brand pages of three health service organizations from the U.S., U.K., and Australia, to visually map networks of 579 social media brand pages (represented by nodes), connected by 5,600 edges. This network data is analyzed using a collection of popular graph analysis techniques to assess the differences in the way each of the service organizations manage stakeholder networks. We also compare node meta-information against basic topology measures to emphasize the importance of effectively managing relationships with stakeholders who have large external audiences. Implications and future research directions are also discussed.

  4. Genome-scale regression analysis reveals a linear relationship for promoters and enhancers after combinatorial drug treatment

    KAUST Repository

    Rapakoulia, Trisevgeni

    2017-08-09

    Motivation: Drug combination therapy for treatment of cancers and other multifactorial diseases has the potential of increasing the therapeutic effect, while reducing the likelihood of drug resistance. In order to reduce time and cost spent in comprehensive screens, methods are needed which can model additive effects of possible drug combinations. Results: We here show that the transcriptional response to combinatorial drug treatment at promoters, as measured by single molecule CAGE technology, is accurately described by a linear combination of the responses of the individual drugs at a genome wide scale. We also find that the same linear relationship holds for transcription at enhancer elements. We conclude that the described approach is promising for eliciting the transcriptional response to multidrug treatment at promoters and enhancers in an unbiased genome wide way, which may minimize the need for exhaustive combinatorial screens.

  5. An Examination of Not-For-Profit Stakeholder Networks for Relationship Management: A Small-Scale Analysis on Social Media.

    Directory of Open Access Journals (Sweden)

    Jessica Wyllie

    Full Text Available Using a small-scale descriptive network analysis approach, this study highlights the importance of stakeholder networks for identifying valuable stakeholders and the management of existing stakeholders in the context of mental health not-for-profit services. We extract network data from the social media brand pages of three health service organizations from the U.S., U.K., and Australia, to visually map networks of 579 social media brand pages (represented by nodes, connected by 5,600 edges. This network data is analyzed using a collection of popular graph analysis techniques to assess the differences in the way each of the service organizations manage stakeholder networks. We also compare node meta-information against basic topology measures to emphasize the importance of effectively managing relationships with stakeholders who have large external audiences. Implications and future research directions are also discussed.

  6. Underlying diseases in dogs referred to a veterinary teaching hospital because of dyspnea: 229 cases (2003-2007).

    Science.gov (United States)

    Fonfara, Sonja; de la Heras Alegret, Lourdes; German, Alexander J; Blackwood, Laura; Dukes-McEwan, Joanna; M Noble, P-J; Burrow, Rachel D

    2011-11-01

    To identify the most frequent underlying diseases in dogs examined because of dyspnea and determine whether signalment, clinical signs, and duration of clinical signs might help guide assessment of the underlying condition and prognosis. Retrospective case series. 229 dogs with dyspnea. Case records of dogs referred for dyspnea were reviewed and grouped according to location or etiology (upper airway, lower respiratory tract, pleural space, cardiac diseases, or obesity and stress). Signalment, clinical signs at initial examination, treatment, and survival time were analyzed. Upper airway (n = 74 [32%]) and lower respiratory tract (76 [33%]) disease were the most common diagnoses, followed by pleural space (44 [19%]) and cardiac (27 [12%]) diseases. Dogs with upper airway and pleural space disease were significantly younger than dogs with lower respiratory tract and cardiac diseases. Dogs with lower respiratory tract and associated systemic diseases were significantly less likely to be discharged from the hospital. Dogs with diseases that were treated surgically had a significantly better outcome than did medically treated patients, which were significantly more likely to be examined on an emergency basis with short duration of clinical signs. In dogs examined because of dyspnea, young dogs may be examined more frequently with breed-associated upper respiratory tract obstruction or pleural space disease after trauma, whereas older dogs may be seen more commonly with progressive lower respiratory tract or acquired cardiac diseases. Nontraumatic acute onset dyspnea is often associated with a poor prognosis, but stabilization, especially in patients with cardiac disease, is possible. Obesity can be an important contributing or exacerbating factor in dyspneic dogs.

  7. Two Interventions for Patients with Major Depression and Severe Chronic Obstructive Pulmonary Disease: Impact on Dyspnea-Related Disability.

    Science.gov (United States)

    Alexopoulos, George S; Sirey, Jo Anne; Banerjee, Samprit; Jackson, Danielle S; Kiosses, Dimitris N; Pollari, Cristina; Novitch, Richard S; Artis, Amanda; Raue, Patrick J

    2018-02-01

    The Personalized Intervention for Depressed Patients with Chronic Obstructive Pulmonary Disease (PID-C) is an intervention aiming to help patients adhere to their rehabilitation and care. This study tested the hypothesis that the Problem-Solving Adherence (PSA) intervention, which integrates problem-solving into adherence enhancement procedures, reduces dyspnea-related disability more than PID-C. Exploratory analyses sought to identify patients with distinct dyspnea-related disability trajectories and to compare their clinical profiles. In this randomized controlled trial in an acute inpatient rehabilitation and community, 101 participants diagnosed with chronic obstructive pulmonary disease (COPD) and major depression were included after screening 633 consecutive admissions for acute inpatient rehabilitation. Participants underwent 14 sessions of PID-C versus PSA over 26 weeks using the Pulmonary Functional Status and Dyspnea Questionnaire. The study hypothesis was not supported. Exploratory latent class growth modeling identified two distinct disability trajectories. Dyspnea-related disability improved in 39% of patients and remained unchanged in the rest. Patients whose dyspnea-related disability improved had more severe disability and less sense of control over their condition at baseline. Improvement or no worsening of disability was noted in both treatment groups. This is a favorable course for depressed patients with a severe, deteriorating medical illness. PID-C is compatible with the expertise of clinicians working in community-based rehabilitation programs, and after further testing in the community, it can be integrated in the care of depressed COPD patients. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Application of rapid bedside detection blood NT-proBNP in differential diagnosis of dyspnea in the emergency department

    International Nuclear Information System (INIS)

    Chen Hongxing; Ni Haifang

    2011-01-01

    Objective: To study rapid bedside detection of NT-proBNP with anti-coagulated venous blood on the significance of differential diagnosis between cardiogenic dyspnea and palmonary dyspnea in emergency room. Methods: 158 patients with dyspnea from our emergency department were divided into cardiogenic group 82 cases, pulmonary group 76 cases and 58 healthy persons as control. All patients within 30 min after hospitalized blood NT-proBNP were measured by rapid bedside technique. Also ultrasonic ECG were examined within 48hr. Results: (1) Blood NT-proBNP level of cardiogenic group (2026.4±122.7 pg/ml): prominently higher than those in controls (P 0.05). (2) Cardiogenic group: According to NYHA, grading and staging of CHF, cardias function grade II (n=15), grade III (n=42), grads IV (n=25). Mean level of blood NT-proBNP were 1513, 2598, 4537 pg/ml individually. The concentration of blood NT-proBNP was correlated with severity of CHF. (3) Correlation coefficient of NT-proBNP levels on cardiac function grade II, III, IV and LVEF (left ventricular ejection fraction) were r=0.722 (P<0.05), r=0.615 (P<0.01) and r=0.529 (P<0.01) respectively expressed higher negative correlation. Conclusion: In the case of acute dyspnea, bedside NT-proBNP estimation can be ruled out patients from cardiogenic dyspnea rapidly. The more higher of plasma NT-proBNP combined with ultrasonic ECG indicates between the NT-proBNP level and grading or staging of cardiac function correlated apparently. The more severe of CHF, the more higher of blood NT-proBNP level simultaneously. Detection of blood NT-proBNP concentration may serve as predicator for left ventricles of heart insufficiency. (authors)

  9. Relationships between occupational functioning and stress among radio journalists – Assessment by means of the psychosocial risk scale

    Directory of Open Access Journals (Sweden)

    Anna Najder

    2016-02-01

    Full Text Available Objectives: Job characteristics and the consequences of everyday stress among radio journalists who are not exposed to traumatic events have not been studied sufficiently before. We aimed at determining the most common job characteristics and their stressfulness; relationships between stress exposure, health and occupational functioning; differences between radio journalists and other journalists, and also the psychosocial risk for health and functioning in this group. Material and Methods: The studied group involved 208 journalists, 134 of whom worked in radio stations. The respondents filled in the Psychosocial Risks Scale (PRS developed by the Department of Health and Work Psychology of the Nofer Institute of Occupational Medicine, Łódź, Poland. Results: Requirement of mental effort and readiness to response quickly for most of the time as well as limited possibilities for promotion were the most frequent journalists’ complaints. We confirmed that higher levels of stress resulted in worse functioning – the radio journalists who experienced lower stress assessed their health status and ability to work better, were more satisfied with particular aspects of their work, and were more involved in their work. They also presented a significantly lower turnover intention. Moreover, the radio journalists were more involved in their work than other journalists, but experienced lower satisfaction, took more sick leaves and had more days of absence. Conclusions: Well-known relationships between stress level, satisfaction and occupational functioning were confirmed. The most important conclusion refers to the fact that psychosocial risks and stress analysis should be based on the understanding of specificity of each occupation or even position. It is so, because the same job characteristic may pose a challenge for one person, while for another – it can result in extreme discomfort and anxiety – such an attitude broadens understanding of the

  10. Constructing Model of Relationship among Behaviors and Injuries to Products Based on Large Scale Text Data on Injuries

    Science.gov (United States)

    Nomori, Koji; Kitamura, Koji; Motomura, Yoichi; Nishida, Yoshifumi; Yamanaka, Tatsuhiro; Komatsubara, Akinori

    In Japan, childhood injury prevention is urgent issue. Safety measures through creating knowledge of injury data are essential for preventing childhood injuries. Especially the injury prevention approach by product modification is very important. The risk assessment is one of the most fundamental methods to design safety products. The conventional risk assessment has been carried out subjectively because product makers have poor data on injuries. This paper deals with evidence-based risk assessment, in which artificial intelligence technologies are strongly needed. This paper describes a new method of foreseeing usage of products, which is the first step of the evidence-based risk assessment, and presents a retrieval system of injury data. The system enables a product designer to foresee how children use a product and which types of injuries occur due to the product in daily environment. The developed system consists of large scale injury data, text mining technology and probabilistic modeling technology. Large scale text data on childhood injuries was collected from medical institutions by an injury surveillance system. Types of behaviors to a product were derived from the injury text data using text mining technology. The relationship among products, types of behaviors, types of injuries and characteristics of children was modeled by Bayesian Network. The fundamental functions of the developed system and examples of new findings obtained by the system are reported in this paper.

  11. Examining the relationship between intermediate-scale soil moisture and terrestrial evaporation within a semi-arid grassland

    KAUST Repository

    Jana, Raghavendra B.

    2016-09-30

    Interactions between soil moisture and terrestrial evaporation affect water cycle behaviour and responses between the land surface and the atmosphere across scales. With strong heterogeneities at the land surface, the inherent spatial variability in soil moisture makes its representation via point-scale measurements challenging, resulting in scale mismatch when compared to coarser-resolution satellite based soil moisture or evaporation estimates. The Cosmic Ray Neutron Probe (CRNP) was developed to address such issues in the measurement and representation of soil moisture at intermediate scales. Here, we present a study to assess the utility of CRNP soil moisture observations in validating model evaporation estimates. The CRNP soil moisture product from a pasture in the semi-arid central west region of New South Wales, Australia, was compared to evaporation derived from three distinct approaches, including the Priestley–Taylor (PT-JPL), Penman–Monteith (PM-Mu), and Surface Energy Balance System (SEBS) models, driven by forcing data from local meteorological station data and remote sensing retrievals from the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor. Pearson’s correlations, quantile–quantile (Q–Q) plots, and analysis of variance (ANOVA) were used to qualitatively and quantitatively evaluate the temporal distributions of soil moisture and evaporation over the study site. The relationships were examined against nearly 2 years of observation data, as well as for different seasons and for defined periods of analysis. Results highlight that while direct correlations of raw data were not particularly instructive, the Q–Q plots and ANOVA illustrate that the root-zone soil moisture represented by the CRNP measurements and the modelled evaporation estimates reflect similar distributions under most meteorological conditions. The PT-JPL and PM-Mu model estimates performed contrary to expectation when high soil moisture and cold temperatures were

  12. Examining the relationship between intermediate-scale soil moisture and terrestrial evaporation within a semi-arid grassland

    Directory of Open Access Journals (Sweden)

    R. B. Jana

    2016-09-01

    Full Text Available Interactions between soil moisture and terrestrial evaporation affect water cycle behaviour and responses between the land surface and the atmosphere across scales. With strong heterogeneities at the land surface, the inherent spatial variability in soil moisture makes its representation via point-scale measurements challenging, resulting in scale mismatch when compared to coarser-resolution satellite-based soil moisture or evaporation estimates. The Cosmic Ray Neutron Probe (CRNP was developed to address such issues in the measurement and representation of soil moisture at intermediate scales. Here, we present a study to assess the utility of CRNP soil moisture observations in validating model evaporation estimates. The CRNP soil moisture product from a pasture in the semi-arid central west region of New South Wales, Australia, was compared to evaporation derived from three distinct approaches, including the Priestley–Taylor (PT-JPL, Penman–Monteith (PM-Mu, and Surface Energy Balance System (SEBS models, driven by forcing data from local meteorological station data and remote sensing retrievals from the Moderate Resolution Imaging Spectroradiometer (MODIS sensor. Pearson's correlations, quantile–quantile (Q–Q plots, and analysis of variance (ANOVA were used to qualitatively and quantitatively evaluate the temporal distributions of soil moisture and evaporation over the study site. The relationships were examined against nearly 2 years of observation data, as well as for different seasons and for defined periods of analysis. Results highlight that while direct correlations of raw data were not particularly instructive, the Q–Q plots and ANOVA illustrate that the root-zone soil moisture represented by the CRNP measurements and the modelled evaporation estimates reflect similar distributions under most meteorological conditions. The PT-JPL and PM-Mu model estimates performed contrary to expectation when high soil moisture and cold

  13. The influence of the allometric scale on the relationship between running economy and biomechanical variables in distance runners

    Directory of Open Access Journals (Sweden)

    MP Tartaruga

    2009-09-01

    Full Text Available Studies have demonstrated the need for the use of parameters that diminish the effect of body mass, for intra and inter group comparison, in individuals with different masses in order to provide a different analysis on the behaviour of the relation between running economy (RE and biomechanical variables (BVs. The allometric scale is represented by a regression equation that indicates the behaviour of a physiological variable in relation to the variable mass (RE=a.xb, where x is body mass in (kg and the dimensionless coefficient a is characteristic of the species analysed, and the dimensionless exponent b determines the percentage of mass to be associated with the physiological variable. The influence of the allometric scale (b=-1; -0.75; -0.73; -0.67 on the relationship between RE and BVs - stride length (SL, relative stride length (RSL, stride rate (SR, stride time (ST, support time (SUPT and balance time (BALT - at 12 km.h-1, was analysed in nine elite runners. Factorial analysis and Pearson's Correlation Coefficient test (r with P<0.05 were used. A decrease in the explanation power of the RE was observed, with the use of the allometric exponent, due to the BVs, as well as a reduction of the correlation coefficients between SL versus RE, ST versus RE and SR versus RE. The BALT presented a higher correlation where b=-0.75. The RSL and SUPT presented non-significant correlations. The variables SL, ST, SR and BALT were the most effective predictors of the RE, Where: b=-1, the allometric scale was most efficient to predict the running performance.

  14. Up-scaling of water use efficiency from leaf to canopy as based on leaf gas exchange relationships and the modeled in-canopy light distribution

    DEFF Research Database (Denmark)

    Linderson, Maj-Lena; Mikkelsen, Teis Nørgaard; Ibrom, Andreas

    2012-01-01

    WUE estimates based on the turbulent fluxes observed and to be dependent on VDP and light intensity alone, its thus being independent of other environmental factors. Accordingly, canopy WUE can be estimated on the basis of the up-scaled WUE relationships, provided incident PAR and VPD within......The aim of this study was to evaluate the extent to which water use efficiency (WUE) at leaf scale can be used to assess WUE at canopy scale, leaf WUE being assumed to be a constant function of vapor pressure deficit and to thus not be dependent upon other environmental factors or varying leaf...... that WUE can be up-scaled from leaf to canopy on the basis of WUEnormleaf and the PAR distribution within the canopy. The up-scaling conducted was based on this WUEnormleaf – PAR relationship, the lightdistribution being assessed using the MAESTRA model, parameterized in accordance with measurements...

  15. Examining the relationship between intermediate scale soil moisture and terrestrial evaporation within a semi-arid grassland

    KAUST Repository

    Jana, Raghavendra Belur

    2016-05-17

    Interactions between soil moisture and terrestrial evaporation affect water cycle behaviour and responses between the land surface and the atmosphere across scales. With strong heterogeneities at the land surface, the inherent spatial variability in soil moisture makes its representation via point-scale measurements challenging, resulting in scale-mismatch when compared to coarser-resolution satellite-based soil moisture or evaporation estimates. The Cosmic Ray Soil Moisture Observing System (COSMOS) was developed to address such issues in the measurement and representation of soil moisture at intermediate scales. Here we present an examination of the links observed between COSMOS soil moisture retrievals and evaporation estimates over a pasture in the semi-arid central-west region of New South Wales, Australia. The COSMOS soil moisture product was compared to evaporation derived from three distinct approaches, including the Priestley-Taylor (PT-JPL), Penman-Monteith (PM-Mu) and Surface Energy Balance System (SEBS) models, driven by forcing data from local meteorological station data and remote sensing retrievals from the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor. Pearson’s Correlations, Quantile-Quantile (Q-Q) plots, and Analysis of Variance (ANOVA) were used to qualitatively and quantitatively evaluate the temporal distributions of soil moisture and evaporation over the study site. The relationships were examined against nearly two years of observation data, as well as for different seasons and for defined periods of analysis. Results highlight that while direct correlations of raw data were not particularly instructive, the Q-Q plots and ANOVA illustrate that the root-zone soil moisture represented by the COSMOS measurements and the modelled evaporation estimates reflect similar distributions under most meteorological conditions. The PT-JPL and PM-Mu model estimates performed contrary to expectation when high soil moisture and cold

  16. Aggravation of dyspnea in stage - non-small cell lung cancer patients following stereotactic body radiotherapy: Is there a dose-volume dependency?

    International Nuclear Information System (INIS)

    Paludan, Merete; Grau, Cai; Hoeyer, Morten; Traberg Hansen, Anders; Petersen, Joergen

    2006-01-01

    In SBRT for NSCLC, highly potent radiation doses are delivered to patients with frequent pre-irradiatory compromise of pulmonary function. For the risk of pulmonary toxicity to be minimized during SBRT planning, data on its dose-volume dependency is needed. In the present study, we analyse the association of dose-volume histogram parameters with changes in dyspnea. The study concerns 28 medically inoperable stage I NSCLC patients that received SBRT at our department between 2000 and 2003. A central dose of 45 Gy/3 fractions was delivered in 5-8 days. WHO toxicity scoring of dyspnea was prospectively performed at baseline and during a 6-month follow-up post-SBRT. DVH parameters for pulmonary tissue were retrieved from the 3-D dose distributions. Aggravated dyspnea was registered in 11 patients (40%). We found no association between DVH parameters and changes in dyspnea. Nor did we find any consistent temporal variations of dyspnea after SBRT. We identified COPD as the factor showing the closest association with aggravation of dyspnea. The observed aggravation of dyspnea following SBRT reflects habitual exacerbations of COPD rather than treatment-related toxicity. Concern about pulmonary toxicity should not be prohibitive for future studies targeting limitations to dose and volume

  17. Aggravation of dyspnea in stage - non-small cell lung cancer patients following stereotactic body radiotherapy: Is there a dose-volume dependency?

    Energy Technology Data Exchange (ETDEWEB)

    Paludan, Merete; Grau, Cai; Hoeyer, Morten [Aarhus Univ. Hospital (Denmark). Dept. of Oncology; Traberg Hansen, Anders; Petersen, Joergen [Aarhus Univ. Hospital (Denmark). Dept. of Medical Physics

    2006-09-15

    In SBRT for NSCLC, highly potent radiation doses are delivered to patients with frequent pre-irradiatory compromise of pulmonary function. For the risk of pulmonary toxicity to be minimized during SBRT planning, data on its dose-volume dependency is needed. In the present study, we analyse the association of dose-volume histogram parameters with changes in dyspnea. The study concerns 28 medically inoperable stage I NSCLC patients that received SBRT at our department between 2000 and 2003. A central dose of 45 Gy/3 fractions was delivered in 5-8 days. WHO toxicity scoring of dyspnea was prospectively performed at baseline and during a 6-month follow-up post-SBRT. DVH parameters for pulmonary tissue were retrieved from the 3-D dose distributions. Aggravated dyspnea was registered in 11 patients (40%). We found no association between DVH parameters and changes in dyspnea. Nor did we find any consistent temporal variations of dyspnea after SBRT. We identified COPD as the factor showing the closest association with aggravation of dyspnea. The observed aggravation of dyspnea following SBRT reflects habitual exacerbations of COPD rather than treatment-related toxicity. Concern about pulmonary toxicity should not be prohibitive for future studies targeting limitations to dose and volume.

  18. [Evaluation of a revised "Ikigai" scale and the relationship between motivation for achievement of a purpose and mental health in senior high school students].

    Science.gov (United States)

    Yoshida, K

    1994-12-01

    The term "ikigai" describes the state in which people have a positive purpose, a sense of being full and social support. In order to measure this condition and its effects on mental and physical health, an Ikigai scale was constructed. In this study, the Ikigai scale was revised by altering the number of choices for each item, and the revised scale was applied to a group of senior high school students. The purpose of the present study is to discuss the revised scale by comparing its results with those from the original scale. In addition, the relationship between motivation for achievement of a purpose and depression which is an index of mental health is studied. The results of this study are summarized as follows: 1) The revised Ikigai scale was more reliable than the original scale. 2) The correlation between the Ikigai scale and Self-rating Depression Scale (SDS) demonstrated that our revised scale had greater validity than the original. 3) Male students who had strong motivation for achievement of a purpose were significantly less depressed than those who had no motivation. From these results, it is concluded that the revised Ikigai scale is better than the original scale and in male students, motivation for achievement of a purpose correlates to mental health.

  19. The Uses of Text Messaging in Sexual Relationships Scale: Associations with risky sexual behavior among at-risk African American emerging adults

    Science.gov (United States)

    Broaddus, Michelle; Dickson-Gomez, Julia

    2017-01-01

    Qualitative and quantitative research was used to create the Uses of Texting in Sexual Relationships scale. At-risk, predominantly African American emerging adults participated in qualitative interviews (N = 20) and quantitative surveys (N = 110) about their uses of text messaging within romantic and sexual relationships. Exploratory factor analysis of items generated from interviews resulted in four subscales: Sexting, Relationship Maintenance, Relationship Development, and Texting for Sexual Safety. Exploratory analyses indicated associations of Sexting with more instances of condomless sex, and Texting for Sexual Safety with fewer instances of condomless sex, which was moderated by relationship power. Further research on the connections between text messaging in relationships and sexual behavior among high-risk and minority young adults is warranted, and intervention efforts to decrease sexual risks need to incorporate these avenues of sexual communication. PMID:27710089

  20. The Uses of Texting in Sexual Relationships Scale: Associations With Risky Sexual Behavior Among At-Risk African American Emerging Adults.

    Science.gov (United States)

    Broaddus, Michelle; Dickson-Gomez, Julia

    2016-10-01

    Qualitative and quantitative research was used to create the Uses of Texting in Sexual Relationships scale. At-risk, predominantly African American emerging adults participated in qualitative interviews (N = 20) and quantitative surveys (N = 110) about their uses of text messaging within romantic and sexual relationships. Exploratory factor analysis of items generated from interviews resulted in four subscales: Sexting, Relationship Maintenance, Relationship Development, and Texting for Sexual Safety. Exploratory analyses indicated associations of Sexting with more instances of condomless sex, and Texting for Sexual Safety with fewer instances of condomless sex, which was moderated by relationship power. Further research on the connections between text messaging in relationships and sexual behavior among high-risk and minority young adults is warranted, and intervention efforts to decrease sexual risks need to incorporate these avenues of sexual communication.

  1. An unusual cause of severe dyspnea: A laryngeal live leech: Case report.

    Science.gov (United States)

    Anajar, Said; Ansari, Rachid; Hassnaoui, Jawad; Abada, Reda; Roubal, Mohammed; Mahtar, Mohammed

    2017-01-01

    Foreign bodies in the upper airways are one of the most challenging otolaryngology emergencies, leeches present a very rare cause of airway foreign bodies around the world. A 6-year-old girl was referred to our otolaryngology department at a tertiary university hospital with a severe dyspnea and hemoptysis. Nasofibroscopy revealed a dark living leech in the supraglottic area which extends to the glottis. The patient was urgently admitted to the operating room, the leech was grasped and removed with a foreign body forceps with a full length of more than 6cm. All symptoms were relieved post operatively and she was discharged one day later. Leeches should be suspected as an airway foreign body in patients with a recent history of drinking from stream water. Prevention remains the best treatment for such cases based simply on hygiene measures like not drinking stream water directly and filtering drinking water before it is used. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. The Significance of BODE (BMI, Obstruction, Dyspnea, Exercise Index in Patients with Mustard Lung

    Directory of Open Access Journals (Sweden)

    OmidShadkam

    2013-05-01

    Full Text Available Introduction: Chronic Obstructive Pulmonary Disease (COPD secondary to sulfur mustard exposure, known as mustard lung, is an important late pulmonary complication. The BODE (Body mass index, Obstruction, Dyspnea, and Exercise index has been established as a valuable tool for determining the adverse consequences of COPD. The aim of this study was to evaluate the role of the BODE index in patients with mustard lung. Materials and Methods: Eighty-two consecutively stable patients with mustard lung with all levels of severity were entered this study. The following parameters were recorded in all patients: standard spirometry, pulse oximetry, health-related quality of life, the BODE index. Additionally, the severity of COPD was determined by GOLD (Global initiative for chronic Obstructive Lung Disease staging. The correlation of the BODE index with pulmonary parameters was determined. Results: The mean age of the patients was 47.30±7.08 SD years. The mean BODE index was 3.16±2.25 SD. There was a statistically significant inverse correlation between the BODE index and oxygen saturation (r=-0.30, p=0.007. Also a statistically significant correlation was found between the BODE index and quality of life (r=0.80, p=0.001. The BODE index was not correlated with age of the patients and duration of disease. Conclusions: The results of this study showed that the BODE index is correlated with important clinical parameters and can be used in clinical practice

  3. Aerobic exercise training without weight loss reduces dyspnea on exertion in obese women

    Science.gov (United States)

    Bernhardt, Vipa; Stickford, Jonathon L.; Bhammar, Dharini M.; Babb, Tony G.

    2015-01-01

    Dyspnea on exertion (DOE) is a common symptom in obesity. We investigated whether aerobic exercise training without weight loss could reduce DOE. Twenty-two otherwise healthy obese women participated in a 12-week supervised aerobic exercise training program, exercising 30 min/day at 70–80% heart rate reserve, 4 days/week. Subjects were grouped based on their Ratings of Perceived Breathlessness (RPB) during constant load 60W cycling: +DOE (n = 12, RPB ≥ 4, 37 ± 7 years, 34 ± 4kg/m2) and −DOE (n = 10, RPB ≤ 2, 32 ± 6 years, 33 ± 3kg/m2). No significant differences between the groups in body composition, pulmonary function, or cardiorespiratory fitness were observed pre-training. Post-training, peak was improved significantly in both groups (+DOE: 12 ± 7, −DOE: 14 ± 8%). RPB was significantly decreased in the + DOE (4.7 ± 1.0–2.5 ± 1.0) and remained low in the −DOE group (1.2 ± 0.6–1.3 ± 1.0) (interaction p Aerobic exercise training improved cardiorespiratory fitness and DOE and thus appears to be an effective treatment for DOE in obese women. PMID:26593640

  4. [Case of dyspnea due to toilet cleaner containing nitric acid for household use].

    Science.gov (United States)

    Yanagawa, Youichi; Matsukawa, Takehisa; Yokoyama, Kazuhito; Hirano, Yohei; Ri, Tetsunari; Aihara, Koichiro; Iba, Toshiaki; Tanaka, Hiroshi

    2013-09-01

    A 40-year-old male tried to clean a urinal at his home storing 900 mL of a toilet cleaner containing 9.8% nitric acid to remove calcium deposit, and clean the toilet floor for twenty minutes. Immediately after using the cleaner, he experienced eye irritation. He washed out the toilet cleaner. However, he thereafter experienced dyspnea, a compressive sensation in his chest, and chest and back pain about 40 minutes after the cleaning the toilet. He monitored his symptoms overnight and found them to gradually improve. However, the symptoms still remained the next morning and therefore he came to our department on foot. He had no particular past or family history. On arrival, his physiological findings and chest computed tomography scan were negative for any abnormalities. His arterial blood gas analysis revealed a mild abnormality of oxygenation. Observation without any drugs revealed that a complete remission of his symptoms occurred after approximately 4 weeks. Based on the results of the experiments, contact with the mucosal membrane and nitric acid gas produced by any accidentally coexisting metals or contact with moisture, including nitric acid produced by a reaction between CaCO3 and cleaner, may have been the mechanism of occurrence for the symptoms observed in this case. This is the first reported case of nitric acid poisoning due to the use of a toilet cleanser intended for household use.

  5. Interspecific differences in whole-plant respiration vs. biomass scaling relationships: a case study using evergreen conifer and angiosperm tree seedlings.

    Science.gov (United States)

    Cheng, Dongliang; Niklas, Karl J; Zhong, Quanlin; Yang, Yusheng; Zhang, Jianhua

    2014-04-01

    Empirical studies and theory indicate that respiration rates (R) of small plants scale nearly isometrically with both leaf biomass (ML) and total plant biomass (MT). These predictions are based on angiosperm species and apply only across a small range of body mass. Whether these relationships hold true for different plants, such as conifers, remains unclear. We tested these predictions using the whole-plant maintenance respiration rates and the biomass allocation patterns of the seedlings of two conifer tree species and two angiosperm tree species. Model Type II regression protocols were used to compare the scaling exponents (α) and normalization constants (β) across all four species and within each of the four species. The data show that the scaling exponents varied among the four species and that all differed significantly from isometry. For conifers, scaling exponents for R vs. MT, and R and ML were numerically smaller than those of the broadleaved angiosperm species. However, across the entire data set, R scaled isometrically with ML and with MT as predicted by the West, Brown, and Enquist (WBE) theory. We also observed higher respiration rates for small conifer seedlings compared to comparably sized angiosperm seedlings. Our data add credence to the view that the R vs. M scaling relationship differs among species, and that in general, the numerical values of this interspecific scaling relationship will depend on the species pooled in the analysis and on the range of body sizes within the data set.

  6. Evidence-based thresholds for the volume-value relationship in shoulder arthroplasty: outcomes and economies of scale.

    Science.gov (United States)

    Ramkumar, Prem N; Navarro, Sergio M; Haeberle, Heather S; Ricchetti, Eric T; Iannotti, Joseph P

    2017-08-01

    Whereas several studies suggest that high-volume surgeons and hospitals deliver superior patient outcomes with greater cost efficiency, no evidence-based thresholds separating high-volume surgeons and hospitals from those that are low or medium volume exist in shoulder arthroplasty. The objective of this study was to establish meaningful thresholds that take outcomes and cost into consideration for surgeons and hospitals performing shoulder arthroplasty. Using 9546 patients undergoing primary shoulder arthroplasty for osteoarthritis from an administrative database, we created and applied 4 models using stratum-specific likelihood ratio (SSLR) analysis of a receiver operating characteristic (ROC) curve. We generated 4 sets of thresholds predictive of adverse outcomes, namely, increased length of stay (LOS) and increased cost for both surgeon and hospital volume. SSLR analysis of the 4 ROC curves by surgeon volume produced 3 volume categories. LOS and cost by annual shoulder arthroplasty surgeon volume produced the same strata: 0-4 (low), 5-14 (medium), and 15 or more (high). LOS and cost by annual shoulder arthroplasty hospital volume produced the same strata: 0-3 (low), 4-14 (medium), and 15 or more (high). LOS and cost decreased significantly (P economies of scale in shoulder arthroplasty by demonstrating a direct relationship between volume and value through SSLR analysis of ROC curves for risk-based volume stratification using meaningful volume definitions for low-, medium-, and high-volume surgeons and hospitals. The described volume-value relationship offers patients, surgeons, hospitals, and other stakeholders meaningful thresholds for the optimal delivery of shoulder arthroplasty. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  7. Do clouds save the great barrier reef? satellite imagery elucidates the cloud-SST relationship at the local scale.

    Directory of Open Access Journals (Sweden)

    Susannah M Leahy

    Full Text Available Evidence of global climate change and rising sea surface temperatures (SSTs is now well documented in the scientific literature. With corals already living close to their thermal maxima, increases in SSTs are of great concern for the survival of coral reefs. Cloud feedback processes may have the potential to constrain SSTs, serving to enforce an "ocean thermostat" and promoting the survival of coral reefs. In this study, it was hypothesized that cloud cover can affect summer SSTs in the tropics. Detailed direct and lagged relationships between cloud cover and SST across the central Great Barrier Reef (GBR shelf were investigated using data from satellite imagery and in situ temperature and light loggers during two relatively hot summers (2005 and 2006 and two relatively cool summers (2007 and 2008. Across all study summers and shelf positions, SSTs exhibited distinct drops during periods of high cloud cover, and conversely, SST increases during periods of low cloud cover, with a three-day temporal lag between a change in cloud cover and a subsequent change in SST. Cloud cover alone was responsible for up to 32.1% of the variation in SSTs three days later. The relationship was strongest in both El Niño (2005 and La Niña (2008 study summers and at the inner-shelf position in those summers. SST effects on subsequent cloud cover were weaker and more variable among study summers, with rising SSTs explaining up to 21.6% of the increase in cloud cover three days later. This work quantifies the often observed cloud cooling effect on coral reefs. It highlights the importance of incorporating local-scale processes into bleaching forecasting models, and encourages the use of remote sensing imagery to value-add to coral bleaching field studies and to more accurately predict risks to coral reefs.

  8. Do clouds save the great barrier reef? satellite imagery elucidates the cloud-SST relationship at the local scale.

    Science.gov (United States)

    Leahy, Susannah M; Kingsford, Michael J; Steinberg, Craig R

    2013-01-01

    Evidence of global climate change and rising sea surface temperatures (SSTs) is now well documented in the scientific literature. With corals already living close to their thermal maxima, increases in SSTs are of great concern for the survival of coral reefs. Cloud feedback processes may have the potential to constrain SSTs, serving to enforce an "ocean thermostat" and promoting the survival of coral reefs. In this study, it was hypothesized that cloud cover can affect summer SSTs in the tropics. Detailed direct and lagged relationships between cloud cover and SST across the central Great Barrier Reef (GBR) shelf were investigated using data from satellite imagery and in situ temperature and light loggers during two relatively hot summers (2005 and 2006) and two relatively cool summers (2007 and 2008). Across all study summers and shelf positions, SSTs exhibited distinct drops during periods of high cloud cover, and conversely, SST increases during periods of low cloud cover, with a three-day temporal lag between a change in cloud cover and a subsequent change in SST. Cloud cover alone was responsible for up to 32.1% of the variation in SSTs three days later. The relationship was strongest in both El Niño (2005) and La Niña (2008) study summers and at the inner-shelf position in those summers. SST effects on subsequent cloud cover were weaker and more variable among study summers, with rising SSTs explaining up to 21.6% of the increase in cloud cover three days later. This work quantifies the often observed cloud cooling effect on coral reefs. It highlights the importance of incorporating local-scale processes into bleaching forecasting models, and encourages the use of remote sensing imagery to value-add to coral bleaching field studies and to more accurately predict risks to coral reefs.

  9. Supra-threshold scaling, temporal summation, and after-sensation: relationships to each other and anxiety/fear

    Directory of Open Access Journals (Sweden)

    Michael E Robinson

    2010-03-01

    Full Text Available Michael E Robinson1, Joel E Bialosky2, Mark D Bishop2, Donald D Price3, Steven Z George21Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; 2Department of Physical Therapy, University of Florida, Gainesville, FL, USA; 3Dentistry and Neurosciences, University of Florida,  Gainesville, FL, USAAbstract: This study investigated the relationship of thermal pain testing from three types of quantitative sensory testing (ie, supra-threshold stimulus response scaling, temporal summation, and after-sensation at three anatomical sites (ie, upper extremity, lower extremity, and trunk. Pain ratings from these procedures were also compared with common psychological measures previously shown to be related to experimental pain responses and consistent with fear-avoidance models of pain. Results indicated that supra-threshold stimulus response scaling, temporal summation, and after-sensation, were significantly related to each other. The site of stimulation was also an important factor, with the trunk site showing the highest sensitivity in all three quantitative sensory testing procedures. Supra-threshold response measures were highly related to measures of fear of pain and anxiety sensitivity for all stimulation sites. For temporal summation and after-sensation, only the trunk site was significantly related to anxiety sensitivity, and fear of pain, respectively. Results suggest the importance of considering site of stimulation when designing and comparing studies. Furthermore, psychological influence on quantitative sensory testing is also of importance when designing and comparing studies. Although there was some variation by site of stimulation, fear of pain and anxiety sensitivity had consistent influences on pain ratings.Keywords: experimental pain, temporal summation, after-sensation, fear/avoidance, anxiety

  10. The role of voice therapy in the treatment of dyspnea and dysphonia in a patient with a vagal nerve stimulation device.

    Science.gov (United States)

    Gillespie, Amanda I; Helou, Leah B; Ingle, John W; Baldwin, Maria; Rosen, Clark A

    2014-01-01

    Vagal nerve stimulators (VNS) are implanted to treat medically refractory epilepsy and depression. The VNS stimulates the vagus nerve in the left neck. Laryngeal side effects are common and include dysphagia, dysphonia, and dyspnea. The current case study represents a patient with severe dyspnea and dysphonia, persisting even with VNS deactivation. The case demonstrates the use of voice and respiratory retraining therapy for the treatment of VNS-induced dysphonia and dyspnea. It also highlights the importance of a multidisciplinary approach, including laryngology, neurology, and speech-language pathology, in the treatment of these challenging patients. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  11. Relationships between occupational functioning and stress among radio journalists--Assessment by means of the Psychosocial Risk Scale.

    Science.gov (United States)

    Najder, Anna; Merecz-Kot, Dorota; Wójcik, Aleksandra

    2016-01-01

    Job characteristics and the consequences of everyday stress among radio journalists who are not exposed to traumatic events have not been studied sufficiently before. We aimed at determining the most common job characteristics and their stressfulness; relationships between stress exposure, health and occupational functioning; differences between radio journalists and other journalists, and also the psychosocial risk for health and functioning in this group. The studied group involved 208 journalists, 134 of whom worked in radio stations. The respondents filled in the Psychosocial Risks Scale (PRS) developed by the Department of Health and Work Psychology of the Nofer Institute of Occupational Medicine, Łódź, Poland. Requirement of mental effort and readiness to response quickly for most of the time as well as limited possibilities for promotion were the most frequent journalists' complaints. We confirmed that higher levels of stress resulted in worse functioning--the radio journalists who experienced lower stress assessed their health status and ability to work better, were more satisfied with particular aspects of their work, and were more involved in their work. They also presented a significantly lower turnover intention. Moreover, the radio journalists were more involved in their work than other journalists, but experienced lower satisfaction, took more sick leaves and had more days of absence. Well-known relationships between stress level, satisfaction and occupational functioning were confirmed. The most important conclusion refers to the fact that psychosocial risks and stress analysis should be based on the understanding of specificity of each occupation or even position. It is so, because the same job characteristic may pose a challenge for one person, while for another--it can result in extreme discomfort and anxiety--such an attitude broadens understanding of the phenomenon. We also confirmed that the PRS is a well-designed method, appropriate to

  12. A 45-Year-Old Man With Recurrent Dyspnea and Hemoptysis during Exercise: Exercise-Induced Pulmonary Hemorrhage/Edema.

    Science.gov (United States)

    Kim, Dae Sung; Lee, Minhyeok; Kwon, Oh Jung; Jeong, Inbeom; Son, Ji Woong; Na, Moon Jun; Kwon, Sun Jung

    2015-10-01

    A 45-year-old man presented with dyspnea and hemoptysis during exercise. A chest computed tomography (CT) revealed multifocal diffuse patchy ground glass opacity and interlobular septal thickening in both the lungs. Permeability pulmonary edema or pulmonary hemorrhage was suspected. Serologic studies for autoimmune disorders and vasculitis were negative. There was no laboratory evidence of coagulopathy, other hematopoietic disease or infectious disease. Considering correlation with exercise, we diagnosed exercise-induced pulmonary hemorrhage (EIPH) or exercise-induced pulmonary edema (EIPE). The patient was managed with antifibrinolytics, antibiotics, and antitussive agent. After a week, follow-up chest CT revealed completely resolved pulmonary hemorrhage. About 2 months after the first event, he visited again with dyspnea and hemoptysis during running. In the present study, we report a case of recurrent pulmonary hemorrhage after exercise.

  13. Relationship between depression in patients with COPD and the percent of predicted FEV(1), BODE index, and health-related quality of life.

    Science.gov (United States)

    Iguchi, Asuka; Senjyu, Hideaki; Hayashi, Yoshika; Kanada, Rumi; Iwai, Shoko; Honda, Sumihisa; Kitagawa, Chika; Ozawa, Hiroki; Rikitomi, Naoto

    2013-02-01

    We investigated the prevalence of depression among patients with COPD treated in long-term in-patient rehabilitation facilities, using the Center for Epidemiologic Studies Depression scale (CES-D). Furthermore, the relationship between the severity of air-flow obstruction (the percent of predicted FEV(1)), BODE (body mass index, degree of air-flow obstruction, dyspnea, exercise capacity) index, health-related quality of life (St George's Respiratory Questionnaire [SGRQ]), and depression were investigated. We recruited 74 in-patients (64 males, 10 females) with COPD. The mean age of the subjects was 72.7 years (range 52-85 y). Subjects completed the CES-D, and measurements were made of pulmonary function, body mass index, Modified Medical Research Council dyspnea scale, 6-min walk test (6MWT), and SGRQ. Depression was evident in 48.6% (n = 36) of the subjects. A weak correlation was found between the CES-D scores and the percent of predicted FEV(1). The prevalence of depression showed a significant association with BODE stage. Scores for the SGRQ activity and impacts domains, and total SGRQ score were significantly worse in the subjects who were depressed. We found a high prevalence of depression among patients with stable COPD treated in long-term in-patient rehabilitation facilities. Depression among these patients, as measured by the CES-D, was associated with greater impairment in respiratory function and with poorer Modified Medical Research Council dyspnea scale and SGRQ scores. The prevalence of depression increased with BODE stage. © 2013 Daedalus Enterprises.

  14. The Cyber Aggression in Relationships Scale: A New Multidimensional Measure of Technology-Based Intimate Partner Aggression.

    Science.gov (United States)

    Watkins, Laura E; Maldonado, Rosalita C; DiLillo, David

    2016-09-02

    The purpose of this study was to develop and provide initial validation for a measure of adult cyber intimate partner aggression (IPA): the Cyber Aggression in Relationships Scale (CARS). Drawing on recent conceptual models of cyber IPA, items from previous research exploring general cyber aggression and cyber IPA were modified and new items were generated for inclusion in the CARS. Two samples of adults 18 years or older were recruited online. We used item factor analysis to test the factor structure, model fit, and invariance of the measure structure across women and men. Results confirmed that three-factor models for both perpetration and victimization demonstrated good model fit, and that, in general, the CARS measures partner cyber aggression similarly for women and men. The CARS also demonstrated validity through significant associations with in-person IPA, trait anger, and jealousy. Findings suggest the CARS is a useful tool for assessing cyber IPA in both research and clinical settings. © The Author(s) 2016.

  15. Self-efficacy scale for the establishment of good relationships with families in neonatal and pediatric hospital settings.

    Science.gov (United States)

    Cruz, Andréia Cascaes; Angelo, Margareth; Santos, Bernardo Pereira Dos

    2017-05-25

    The purpose of this study was to develop and test the psychometric properties of the Self-efficacy Scale for the Establishment of Good Relationships with Families in Neonatal and Pediatric Hospital Settings. Methodological study grounded on self-efficacy theory was conducted in three phases: conceptual and operational definition (review of the literature and interviews with the target population), content validity (opinion of five experts e three clinical nurses), and exploratory factor analysis and internal consistency reliability (cross-sectional survey with a valid sample of 194 nurses). A ten-point Likert scale with 40-item was designed and one item was excluded after review by experts. Three factors emerged from the exploratory factor analysis. The Cronbach's alpha for all items was 0.983 with item-total correlations in the range 0.657 to 0.847. Cronbach's alpha value if item deleted were less than or equal to 0.983. The final version of the scale demonstrated psychometric adequacy. It is a useful tool to be administered in the clinical, educational and research nursing fields to measure nurses' self-efficacy beliefs concerning the establishment of good relationships with families. El propósito de este estudio fue desarrollar y probar las propiedades psicométricas de la Escala de Autoeficacia para el Establecimiento de Buenas Relaciones con las Familias en Ambientes Neonatales y Pediátricos. Estudio metodológico fundamentado en la teoría de la auto-eficacia se realizó en tres fases: conceptual y definición operacional (revisión de la literatura y entrevistas con la población objetivo), la validez de contenido (opinión de cinco expertos y tres enfermeras clínicas), y el factor de análisis exploratorio e fiabilidad interna de consistencia (estudio transversal con una muestra válida de 194 enfermeras). La escala de Likert de diez puntos con 40 ítems fue diseñada y un elemento fue excluido después de la revisión por expertos. Hay tres factores que

  16. Laryngeal dyspnea in relation to an interaction between acenocoumarol and topical econazole lotion.

    Science.gov (United States)

    Wey, Pierre-François; Petitjeans, Fabrice; Lions, Christophe; Ould-Ahmed, Mehdi; Escarment, Jacques

    2008-08-01

    Bleeding is the most serious complication of oral anticoagulant therapy used for the prevention of thromboembolic complications. Drug-drug interactions are an important concern, as they may increase drug toxicity and, in the case of anticoagulant therapies, increase the risk of hemorrhage. An 84-year-old woman presented to the emergency department with a bilateral cervical hematoma and symptoms of upper-airway obstruction that had been increasing for 72 hours, with dyspnea and difficulty speaking developing in the previous 24 hours. Transnasal fiberoptic laryngoscopy revealed a significant laryngeal hematoma, as well as a hematoma on the floor of the mouth and in the tonsil area. Laboratory abnormalities included a prothrombin time 120 seconds. The patient had been receiving acenocoumarol 4 mg/d for 10 years for episodes of atrial fibrillation and recurrent deep venous thrombosis. Seventeen days earlier, she had received a prescription for topical econazole lotion 1% to be applied 3 times daily for 1 month to treat a dermatitis affecting 12% of the body surface. The patient was admitted to the intensive care unit for treatment of respiratory failure, where oxygen was delivered by face mask. The coagulation disorders were treated with prothrombin complex concentrate 30 IU/kg IV and vitamin K1 10 mg IV, and values normalized within 36 hours. Surgical evacuation of the laryngeal hematoma was not necessary. After 48 hours, improvement in the patient's respiratory symptoms allowed transfer to the ear, nose, and throat unit, where daily endoscopic examination was performed. Aspirin was substituted for acenocoumarol, and the patient returned home after 10 days without sequelae. Based on a Naranjo score of 7, this episode was probably related to an interaction between acenocoumarol and econazole. This report describes a case of a probable interaction between topical econazole lotion 1% and acenocoumarol that resulted in overanticoagulation and a life-threatening laryngeal

  17. Test–retest reliability of multidimensional dyspnea profile recall ratings in the emergency department: a prospective, longitudinal study

    Directory of Open Access Journals (Sweden)

    Parshall Mark B

    2012-07-01

    Full Text Available Abstract Background Dyspnea is among the most common reasons for emergency department (ED visits by patients with cardiopulmonary disease who are commonly asked to recall the symptoms that prompted them to come to the ED. The reliability of recalled dyspnea has not been systematically investigated in ED patients. Methods Patients with chronic or acute cardiopulmonary conditions who came to the ED with dyspnea (N = 154 completed the Multidimensional Dyspnea Profile (MDP several times during the visit and in a follow-up visit 4 to 6 weeks later (n = 68. The MDP has 12 items with numerical ratings of intensity, unpleasantness, sensory qualities, and emotions associated with how breathing felt when participants decided to come to the ED (recall MDP or at the time of administration (“now” MDP. The recall MDP was administered twice in the ED and once during the follow-up visit. Principal components analysis (PCA with varimax rotation was used to assess domain structure of the recall MDP. Internal consistency reliability was assessed with Cronbach’s alpha. Test–retest reliability was assessed with intraclass correlation coefficients (ICCs for absolute agreement for individual items and domains. Results PCA of the recall MDP was consistent with two domains (Immediate Perception, 7 items, Cronbach’s alpha = .89 to .94; Emotional Response, 5 items; Cronbach’s alpha = .81 to .85. Test–retest ICCs for the recall MDP during the ED visit ranged from .70 to .87 for individual items and were .93 and .94 for the Immediate Perception and Emotional Response domains. ICCs were much lower for the interval between the ED visit and follow-up, both for individual items (.28 to .66 and for the Immediate Perception and Emotional Response domains (.72 and .78, respectively. Conclusions During an ED visit, recall MDP ratings of dyspnea at the time participants decided to seek care in the ED are reliable and sufficiently stable, both for

  18. Protein and microRNA biomarkers from lavage, urine, and serum in military personnel evaluated for dyspnea

    International Nuclear Information System (INIS)

    Brown, Joseph N.; Brewer, Heather M.; Nicora, Carrie D.; Weitz, Karl K.; Morris, Michael J.; Skabelund, Andrew J.; Adkins, Joshua N.; Smith, Richard D.; Cho, Ji-Hoon; Gelinas, Richard

    2014-01-01

    Background: We have identified candidate protein and microRNA (miRNA) biomarkers for dyspnea by studying serum, lavage fluid, and urine from military personnel who reported serious respiratory symptoms after they were deployed to Iraq or Afghanistan. Methods: Forty-seven soldiers with the complaint of dyspnea who enrolled in the STudy of Active Duty Military Personnel for Environmental Dust Exposure (STAMPEDE) underwent comprehensive pulmonary evaluations at the San Antonio Military Medical Center. The evaluation included fiber-optic bronchoscopy with bronchoalveolar lavage. The clinical findings from the STAMPEDE subjects pointed to seven general underlying diagnoses or findings including airway hyperreactivity, asthma, low diffusivity of carbon monoxide, and abnormal cell counts. The largest category was undiagnosed. As an exploratory study, not a classification study, we profiled proteins or miRNAs in lavage fluid, serum, or urine in this group to look for any underlying molecular patterns that might lead to biomarkers. Proteins in lavage fluid and urine were identified by accurate mass tag (database-driven) proteomics methods while miRNAs were profiled by a hybridization assay applied to serum, urine, and lavage fluid. Results: Over seventy differentially expressed proteins were reliably identified both from lavage and from urine in forty-eight dyspnea subjects compared to fifteen controls with no known lung disorder. Six of these proteins were detected both in urine and lavage. One group of subjects was distinguished from controls by expressing a characteristic group of proteins. A related group of dyspnea subjects expressed a unique group of miRNAs that included one miRNA that was differentially overexpressed in all three fluids studied. The levels of several miRNAs also showed modest but direct associations with several standard clinical measures of lung health such as forced vital capacity or gas exchange efficiency. Conclusions: Candidate proteins and mi

  19. Relationships between landslide occurrences and rainfall patterns at different time scale: application to the Barcelonnette Basin (South French Alps)

    Science.gov (United States)

    Remaitre, Alexandre; Malet, Jean-Philippe

    2010-05-01

    Triggering of mass movements can be divided in three general types: i) development of local perched water tables in the subsoil leading to shallow slope instabilities and possible gravitational flows, ii) long-lasting rise in permanent water tables leading to more deep-seated slope instabilities, and iii) intense runoff causing channel-bed erosion and debris flows. Types i) and iii) are usually observed during heavy storms characterized by high rainfall intensities (hourly and daily rainfall); type ii) is usually observed through increasing water content in the subsoil due to previous rainfalls (monthly rainfall). The objective of this work is to analyze the relationships between mass movement (landslide and debris flows) events and different pattern of rainfalls at different time scale. The study has been performed in the Barcelonnette Basin (South French Alps) where an important database on mass-movement events is available. Still two centuries, about 600 references with exact date and location of triggering have been recorded. The rainfall pattern has been recorded in six meteorological stations. Principally, data are available for 24h-periods and only a small amount of new installed stations include automated recording with 6-minute data. A detailed study has been performed for 145 well known mass-movement events. For each of these events, a study of the rainfall conditions for different time scale has been performed, and for some relevant events, the regional climate conditions has been determined by defining the related weather type (synoptic point of view). The analyses of the rainstorm episodes indicates that the determination of a clear rainfall threshold for shallow landslide and debris flows in the Barcelonnette Basin is still very difficult; this has to be put in relation with the geomorphologic settings of the different slopes and torrents. Nevertheless, two main rainfall conditions can be clearly distinguished: i) persistent rainstorms with low

  20. [Clinical Validation of the Caregiver-Child Socioemotional and Relationship Rating Scale (SIRS) for Child Behavior in a Preschool-Age Sample].

    Science.gov (United States)

    Esins, Svenja; Müller, Jörg Michael; Romer, Georg; Wagner, Katharina; Achtergarde, Sandra

    2017-03-01

    Clinical Validation of the Caregiver-Child Socioemotional and Relationship Rating Scale (SIRS) for Child Behavior in a Preschool-Age Sample The description of child behavior in mother-child-interaction is important in early detection and treatment of psychiatric disorders in preschool children. The Caregiver-Child Socioemotional and Relationship Rating Scale (SIRS) may serve this diagnostic purpose. We aim to examine interrater-reliability of SIRS and concurrent, convergent, and discriminant validity to maternal behavior by Play-PAB, and a measure of mother-child-relationsship by Parent-Infant-Global-Assessment-Scale (PIRGAS). Five raters assessed 47 ten-minute video sequences of parent-child-interaction recorded at the Family Day Hospital for Preschool Children with SIRS, Play-PAB, and PIRGAS. We report psychometric properties of SIRS, and present the association with Play-PAB and PIRGAS. SIRS shows a satisfying interrater-reliability for all items. Positive child behavior e. g. the SIRS' "child responsiveness" shows negative correlation to Play-PAB-scales' parental "hostility" and "intrusiveness", but independence of parental "involvement", "positive emotionality", and "discipline". Child and parental behavior show expected associations with the global relationship measure PIRGAS. The assessment of child behavior in parent-child-interaction with SIRS can be quickly learned and reliably applied without extensive training. SIRS shows meaningful relations to parental behavior and a clinical global measure of the caregiver-child-relationship. We recommend SIRS for clinical diagnostics to describe child behavior in mother-child-interaction.

  1. Min(d)ing the land: The relationship between artisanal and small-scale mining and surface land arrangements in the southern Philippines, eastern DRC and Liberia

    NARCIS (Netherlands)

    Verbrugge, B.L.P.; Cuvelier, J.; Bockstael, S. van

    2015-01-01

    This article examines the relationship between artisanal and small-scale mining (ASM) and surface land tenure arrangements, through a comparison of mining areas in the southern Philippines, the eastern DRC and Liberia. In all three cases, ASM takes place in peripheral regions outside central state

  2. Relationships among the Y balance test, Berg Balance Scale, and lower limb strength in middle-aged and older females.

    Science.gov (United States)

    Lee, Dong-Kyu; Kang, Min-Hyeok; Lee, Tae-Sik; Oh, Jae-Seop

    2015-01-01

    Older females have less dynamic postural control and muscle strength than do middle-aged females. Aging-related strength losses may limit balancing performance. The purpose of this study was to investigate the ability of the Y Balance Test (YBT) and lower limb strength to discriminate between females in 2 age groups, the relationship between YBT distance and the Berg Balance Scale (BBS), and the degree to which performance on YBT distance is related to lower limb strength in middle-aged and older females. The 40 healthy, independently active females were divided into 2 groups: older and middle-aged. The participants underwent measurements of YBT distance using the YBT, maximal muscular strength of the lower limbs using a handheld dynamometer, and the BBS. The YBT distance in 3 directions and lower limb muscle strength for both lower limbs were significantly lower in the older adults than in the middle-aged group. A moderate correlation but insignificant correlation was found between the YBT composite distance and the BBS score. In the older females, YBT distance was significantly positively correlated with strength of the knee flexor and hip abductor. In the middle-aged group, YBT distance was significantly positively correlated with strength of the knee flexor and hip extensor. Performance on the YBT was influenced by the strength of lower limb. We suggested that YBT can be used to alternative as a measurement of dynamic balance. Proper training programs for older people could include not only strengthening exercises but also YBT performance to improve balance.

  3. Relationships among the Y balance test, Berg Balance Scale, and lower limb strength in middle-aged and older females

    Directory of Open Access Journals (Sweden)

    Dong-Kyu Lee

    2015-06-01

    Full Text Available Background: Older females have less dynamic postural control and muscle strength than do middle-aged females. Aging-related strength losses may limit balancing performance. Objective: The purpose of this study was to investigate the ability of the Y Balance Test (YBT and lower limb strength to discriminate between females in 2 age groups, the relationship between YBT distance and the Berg Balance Scale (BBS, and the degree to which performance on YBT distance is related to lower limb strength in middle-aged and older females. Method: The 40 healthy, independently active females were divided into 2 groups: older and middle-aged. The participants underwent measurements of YBT distance using the YBT, maximal muscular strength of the lower limbs using a handheld dynamometer, and the BBS. Results: The YBT distance in 3 directions and lower limb muscle strength for both lower limbs were significantly lower in the older adults than in the middle-aged group. A moderate correlation but insignificant correlation was found between the YBT composite distance and the BBS score. In the older females, YBT distance was significantly positively correlated with strength of the knee flexor and hip abductor. In the middle-aged group, YBT distance was significantly positively correlated with strength of the knee flexor and hip extensor. Conclusions: Performance on the YBT was influenced by the strength of lower limb. We suggested that YBT can be used to alternative as a measurement of dynamic balance. Proper training programs for older people could include not only strengthening exercises but also YBT performance to improve balance.

  4. Relationship between the modified Rankin Scale and the Barthel Index in the process of functional recovery after stroke.

    Science.gov (United States)

    Cioncoloni, D; Piu, P; Tassi, R; Acampa, M; Guideri, F; Taddei, S; Bielli, S; Martini, G; Mazzocchio, R

    2012-01-01

    The modified Rankin Scale (mRS) and the Barthel Index (BI) are the most common clinimetrical instruments for measuring disability after stroke. This study investigated the relationship between the BI and the mRS at multiple time points after stroke. The BI, which is a widely used instrument for longitudinal follow-up post-stroke, was used as reference to determine the effect of time on the sensitivity of the mRS in differentiating functional recovery. Ninety-two patients with first stroke and hemispheric brain lesion were evaluated using the BI and mRS at 10 days, 3 and 6 months. The Kruskal-Wallis test was applied to examine median differences in BI among the mRS levels at 10 days, 3 and 6 months with Dunn's correction for multigroup comparison. The Mann and Whitney test was used to compare median differences in BI scores between two aggregations of mRS grades (mRS=0-2, mRS=3-5) at the same time periods after stroke. BI score distribution amongst mRS grades overlapped at 10 days, differentiating only between extreme grades (no disability vs severe disability). At 3 months, independent patients with slight disability could be distinguished from dependent patients with marked disability. At 6 months, grade 2 and 3 overlapped no more, differentiating independence (class 0-2) from dependence (class 3-5). The largest transition to an independent functional status occurred from grade 4, at 3 months. Maximum sensitivity of mRS in differentiating functional recovery is reached at six months post-stroke.

  5. Intolerance of Uncertainty Scale: Measurement invariance among adolescent boys and girls and relationships with anxiety and risk taking.

    Science.gov (United States)

    Dekkers, Laura M S; Jansen, Brenda R J; Salemink, Elske; Huizenga, Hilde M

    2017-06-01

    Adolescence-related increases in both anxiety and risk taking may originate in variability in Intolerance of Uncertainty (IU), rendering the study of IU of importance. We therefore studied the psychometric properties of the Intolerance of Uncertainty Scale-Short version (IUS-12), including its associations with trait anxiety and risk taking, among adolescents. A sample of 879 Dutch adolescents, from diverse educational levels, and with an equal distribution of boys and girls, was classically tested. To obtain indices of IU, and self-reported trait anxiety and need for risk taking, questionnaires were administrated; to obtain an index of risk taking behavior, adolescents performed a risk taking task. Multi-group Confirmatory Factor Analyses revealed that the IUS-12 consists of a Prospective and an Inhibitory IU subscale, which are partially measurement invariant across sex. Cronbach's alphas and item-total correlations revealed that the IUS-12 and its subscales have reasonable-to-good internal consistency. Correlational analyses support convergent validity, as higher IUS-12 scores were related to, respectively, higher and lower levels of self-reported trait anxiety and need for risk taking. However, we found no relationship between IUS-12 scores and risk taking behavior, operationalized by performance on the risk taking task. A community, instead of clinical, sample was included. Also, IU was measured by a paper-and-pencil version of the IUS-12, instead of a computerized version. The IUS-12 has good psychometric properties and may be a central measure to assess IU, which enables to explain the adolescence-related increase in both anxiety and risk taking. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Geographic scale matters in detecting the relationship between neighbourhood food environments and obesity risk: an analysis of driver license records in Salt Lake County, Utah.

    Science.gov (United States)

    Fan, Jessie X; Hanson, Heidi A; Zick, Cathleen D; Brown, Barbara B; Kowaleski-Jones, Lori; Smith, Ken R

    2014-08-19

    Empirical studies of the association between neighbourhood food environments and individual obesity risk have found mixed results. One possible cause of these mixed findings is the variation in neighbourhood geographic scale used. The purpose of this paper was to examine how various neighbourhood geographic scales affected the estimated relationship between food environments and obesity risk. Cross-sectional secondary data analysis. Salt Lake County, Utah, USA. 403,305 Salt Lake County adults 25-64 in the Utah driver license database between 1995 and 2008. Utah driver license data were geo-linked to 2000 US Census data and Dun & Bradstreet business data. Food outlets were classified into the categories of large grocery stores, convenience stores, limited-service restaurants and full-service restaurants, and measured at four neighbourhood geographic scales: Census block group, Census tract, ZIP code and a 1 km buffer around the resident's house. These measures were regressed on individual obesity status using multilevel random intercept regressions. Obesity. Food environment was important for obesity but the scale of the relevant neighbourhood differs for different type of outlets: large grocery stores were not significant at all four geographic scales, limited-service restaurants at the medium-to-large scale (Census tract or larger) and convenience stores and full-service restaurants at the smallest scale (Census tract or smaller). The choice of neighbourhood geographic scale can affect the estimated significance of the association between neighbourhood food environments and individual obesity risk. However, variations in geographic scale alone do not explain the mixed findings in the literature. If researchers are constrained to use one geographic scale with multiple categories of food outlets, using Census tract or 1 km buffer as the neighbourhood geographic unit is likely to allow researchers to detect most significant relationships. Published by the BMJ

  7. Career adapt-abilities scale - Netherlands form: psychometric properties and relationships to ability, personality, and regulatory focus

    NARCIS (Netherlands)

    van Vianen, A.E.M.; Klehe, U.-C.; Koen, J.; Dries, N.

    2012-01-01

    The Career Adapt-Abilities Scale (CAAS) — Netherlands Form consists of four scales, each with six items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates

  8. Behavioural inhibition and behavioural activation system scales for children: Relationships with Eysenck's personality traits and psychopathological symptoms

    NARCIS (Netherlands)

    P.E.H.M. Muris (Peter); C.M.G. Meesters (Cor); E. de Kanter (Elske); P.E. Timmerman (Petra Eek)

    2005-01-01

    textabstractThis study examined the psychometric properties of an age-downward version of the Carver and White (1994) BIS/BAS scales. Normal school children (N = 284) aged 8-12 years completed the BIS/BAS scales as well as scales of Neuroticism, Extraversion, and psychopathological symptoms. Results

  9. The Diagnostic Apathia Scale predicts a dose-remission relationship of T-PEMF in treatment-resistant depression

    DEFF Research Database (Denmark)

    Bech, Per; Lunde, Marianne; Lauritzen, Lise

    2014-01-01

    . The remaining 31 patients received active T-PEMF twice daily. Duration of treatment was 8 weeks in both groups. The Hamilton Depression Scale (HAM-D17) and the Bech-Rafaelsen Melancholia Scale (MES) were used to measure remission. We also focused on the Diagnostic Apathia Scale, which is based on a mixture...

  10. [Validation of a scale of sexuality (interests, emotions, relationships: IERS) in prime adolescence (12 to 15 years)].

    Science.gov (United States)

    Courtois, R; Potard, C; Réveillère, C; Moltrecht, B

    2011-02-01

    these analyses, we are able to propose a shorter questionnaire (15 items), structured in three dimensions of sexuality significant in prime adolescence (in accordance with interests, emotions and relationships). The analyses were conducted according to gender and age. There is no significant difference for "Going out with someone" between boys and girls. On the other hand, there is a difference between "Giving priority to love", which is more important for girls (P<0.05) and for "Flirting with the aim of having sexual relations", more important for boys (P<0.001). However, as ages increase, we notice a rise in scores for "Going out with someone" for girls as well as for boys (P<0.05); a drop in scores for "Giving priority to love" (for girls, (P<0.05) and an increase in the scores for "Flirting with the aim of having sexual relations" (only for boys (p<0.05). This study allowed us to validate a scale of sexuality in prime adolescence that presents good psychometric qualities. It was carried out on a larger and more representative sample of this period than the initial study, although essentially finding the same results as previously. Thus, the use of this scale, coupled or not with the individual analysis of the items which make it up, could allow us to understand sexuality in prime adolescence in three significant dimensions of psychosexual development, as well as regarding risky sexuality, i.e., an excessive interest in genital sexuality, behavioral involvement and precocious sexual relations or an absence of feelings. Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  11. The relationship between small-scale and large-scale ionospheric electron density irregularities generated by powerful HF electromagnetic waves at high latitudes

    Directory of Open Access Journals (Sweden)

    E. D. Tereshchenko

    2006-11-01

    Full Text Available Satellite radio beacons were used in June 2001 to probe the ionosphere modified by a radio beam produced by the EISCAT high-power, high-frequency (HF transmitter located near Tromsø (Norway. Amplitude scintillations and variations of the phase of 150- and 400-MHz signals from Russian navigational satellites passing over the modified region were observed at three receiver sites. In several papers it has been stressed that in the polar ionosphere the thermal self-focusing on striations during ionospheric modification is the main mechanism resulting in the formation of large-scale (hundreds of meters to kilometers nonlinear structures aligned along the geomagnetic field (magnetic zenith effect. It has also been claimed that the maximum effects caused by small-scale (tens of meters irregularities detected in satellite signals are also observed in the direction parallel to the magnetic field. Contrary to those studies, the present paper shows that the maximum in amplitude scintillations does not correspond strictly to the magnetic zenith direction because high latitude drifts typically cause a considerable anisotropy of small-scale irregularities in a plane perpendicular to the geomagnetic field resulting in a deviation of the amplitude-scintillation peak relative to the minimum angle between the line-of-sight to the satellite and direction of the geomagnetic field lines. The variance of the logarithmic relative amplitude fluctuations is considered here, which is a useful quantity in such studies. The experimental values of the variance are compared with model calculations and good agreement has been found. It is also shown from the experimental data that in most of the satellite passes a variance maximum occurs at a minimum in the phase fluctuations indicating that the artificial excitation of large-scale irregularities is minimum when the excitation of small-scale irregularities is maximum.

  12. Satisfaction with Relationship Status : Development of a New Scale and the Role in Predicting Well-Being

    NARCIS (Netherlands)

    Lehmann, Vicky; Tuinman, Marrit A.; Braeken, Johan; Vingerhoets, Ad. J. J. M.; Sanderman, Robbert; Hagedoorn, Mariet

    To develop a generic instrument assessing satisfaction with relationship status, and to examine the role of status satisfaction in explaining life satisfaction and distress beyond marital status. In two studies, we first examined the psychometric properties of the Satisfaction with Relationship

  13. Satisfaction with Relationship Status: Development of a New Scale and the Role in Predicting Well-Being

    NARCIS (Netherlands)

    Lehmann, V.; Tuinman, M.A.; Braeken, J.; Vingerhoets, A.J.J.M.; Sanderman, Robbert; Hagedoorn, M.

    2015-01-01

    To develop a generic instrument assessing satisfaction with relationship status, and to examine the role of status satisfaction in explaining life satisfaction and distress beyond marital status. In two studies, we first examined the psychometric properties of the Satisfaction with Relationship

  14. Satisfaction with relationship status : Development of a new scale and the role in predicting well-being

    NARCIS (Netherlands)

    Lehmann, V.; Tuinman, M.A.; Braeken, J.; Vingerhoets, A.J.J.M.; Sanderman, R.; Hagedoorn, M.

    2015-01-01

    To develop a generic instrument assessing satisfaction with relationship status, and to examine the role of status satisfaction in explaining life satisfaction and distress beyond marital status. In two studies, we first examined the psychometric properties of the Satisfaction with Relationship

  15. The Psychometric Properties of Attentional Control Scale and Its Relationship with Symptoms of Anxiety and Depression: A Study on Iranian Population

    Directory of Open Access Journals (Sweden)

    Imaneh Abasi

    2017-04-01

    Full Text Available Objectives: The attentional control scale is a self- report questionnaire that assesses individual differences in attentional control. Despite its extensive use, the psychometric properties of the Persian version of the ACS are not well understood. Thus, the present study aimed at investigating the psychometric properties of the attentional control scale and its relationship with symptoms of anxiety and depression in Iranian population.Method: Using quota sampling, we asked a community sample of 524 to respond to Attentional Control Scale, mindfulness, emotion regulation, social anxiety, depression, generalized anxiety, worry, and rumination. SPSS (Version 23 was used for data analysis.Results: Exploratory factor analysis yielded 2 factors of focusing and shifting, which accounted for 30.93% of the total variance. The results of convergent validity revealed that reappraisal, as an emotion regulation strategy and mindfulness facets, had a positive relationship with focusing, shifting, and the total score of the attentional control scale. Furthermore, worry, rumination, depression, generalized anxiety, and social anxiety symptoms all had negative relationships with focusing, rumination, and the total score of the attentional control scale. In addition, the results of incremental validity revealed that focusing, not shifting, uniquely predicted depression and generalized anxiety symptoms. Furthermore, both focusing and shifting uniquely predicted social anxiety symptoms. Test- retest reliability of focusing and shifting was 0.80 and 0. 76, respectively.Conclusions: Attentional control scale has been demonstrated to have acceptable validity and reliability in Iranian population. However, further studies are needed to evaluate other aspects of the ACS like CFA. 

  16. Discriminating between cardiac and pulmonary dysfunction in the general population with dyspnea by plasma pro-B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Mogelvang, R; Goetze, JP; Schnohr, P

    2007-01-01

    OBJECTIVES: This study was designed to determine whether measurement of plasma pro-B-type natriuretic peptide (proBNP) could be used in discriminating between cardiac and pulmonary dyspnea in the general population. BACKGROUND: Natriuretic peptides are useful markers in ruling out acute cardiac...... the expected concentration of plasma proBNP based on age and gender was established for dyspneic subjects: an actual plasma proBNP concentration below half of the expected value ruled out left ventricular systolic and diastolic dysfunction (sensitivity 100%, 95% CI 100% to 100%; specificity 15%, 95% CI 12...

  17. Career Adapt-Abilities Scale--Netherlands Form: Psychometric Properties and Relationships to Ability, Personality, and Regulatory Focus

    Science.gov (United States)

    van Vianen, Annelies E. M.; Klehe, Ute-Christine; Koen, Jessie; Dries, Nicky

    2012-01-01

    The Career Adapt-Abilities Scale (CAAS)--Netherlands Form consists of four scales, each with six items, which measure concern, control, curiosity, and confidence as psychosocial resources for managing occupational transitions, developmental tasks, and work traumas. Internal consistency estimates for the subscale and total scores ranged from…

  18. Relationships of the Leadership Attitudes and Beliefs Scale with Student Types, Study Habits, Life-Long Learning, and GPA

    Science.gov (United States)

    Wielkiewicz, Richard M.; Prom, Christina L.; Loos, Steven

    2005-01-01

    The Leadership Attitudes and Beliefs Scale (LABS-III; Wielkiewicz, 2000) was validated against a measure with a more traditional, position-based definition of leadership. Disagreement with Hierarchical Thinking was associated with a higher GPA. A Life-Long Learning scale was strongly associated with GPA, Systemic Thinking, and social activism.…

  19. Validation of the multi-dimensional scale of perceived social support (MSPSS) and the relationship between social support, intimate partner violence and antenatal depression in Malawi

    OpenAIRE

    Stewart, Robert C; Umar, Eric; Tomenson, Barbara; Creed, Francis

    2014-01-01

    Background Lack of social support is an important risk factor for antenatal depression and anxiety in low- and middle-income countries. We translated, adapted and validated the Multi-dimensional Scale of Perceived Social Support (MSPSS) in order to study the relationship between perceived social support, intimate partner violence and antenatal depression in Malawi. Methods The MSPSS was translated and adapted into Chichewa and Chiyao. Five hundred and eighty-three women attending an antenatal...

  20. Computer-Aided Tomographic Analysis of Interstitial Lung Disease (ILD in Patients with Systemic Sclerosis (SSc. Correlation with Pulmonary Physiologic Tests and Patient-Centred Measures of Perceived Dyspnea and Functional Disability.

    Directory of Open Access Journals (Sweden)

    Fausto Salaffi

    Full Text Available This study was designed (a to evaluate an improved quantitative lung fibrosis score based on a computer-aided diagnosis (CaM system in patients with systemic sclerosis (SSc,-related interstitial lung disease (SSc-ILD, (b to investigate the relationship between physiologic parameters (forced vital capacity [FVC] and single-breath diffusing capacity for carbon monoxide [DLCO], patient-centred measures of dyspnea and functional disability and CaM and visual reader-based (CoVR methods, and (c to identify potential surrogate measures from quantitative and visual HRCT measurement.126 patients with SSc underwent chest radiography, HRCT and PFTs. The following patient-centred measures were obtained: modified Borg Dyspnea Index (Borg score, VAS for breathing, and Health Assessment Questionnaire-Disability Index (HAQ-DI. HRCT abnormalities were scored according to the conventional visual reader-based score (CoVR and by a CaM. The relationships among the HRCT scores, physiologic parameters (FVC and DLCO, % predicted results and patient-centred measures, were calculated using linear regression analysis and Pearson's correlation. Multivariate regression models were performed to identify the predictor variables on severity of pulmonary fibrosis.Subjects with limited cutaneous SSc had lower HAQ-DI scores than subjects with diffuse cutaneous SSc (p <0.001. CaM and CoVR scores were similar in the 2 groups. In univariate analysis, a strong correlation between CaM and CoVR was observed (p <0.0001. In multivariate analysis the CaM and CoVR scores were predicted by DLco, FVC, Borg score and HAQ-DI. Age, sex, disease duration, anti-topoisomerase antibodies and mRSS were not significantly associated with severity of pulmonary fibrosis on CaM- and CoVR methods.Although a close correlation between CaM score results and CoVR total score was found, CaM analysis showed a more significant correlation with DLco (more so than the FVC, patient-centred measures of perceived

  1. Decadal-scale relationship between measurements of aerosols, land-use change, and fire over Southeast Asia

    Science.gov (United States)

    Cohen, J. B.; Lecoeur, E.

    2015-10-01

    A simultaneous analysis of 13 years of remotely sensed data of land cover, fires, precipitation, and aerosols from the MODIS, TRMM, and MISR satellites and the AERONET network over Southeast Asia is performed, leading to a set of robust relationships between land-use change and fire being found on inter-annual and intra-annual scales over Southeast Asia, reflecting the heavy amounts of anthropogenic influence over land use change and fires in this region of the world. First, we find that fires occur annually, but with a considerable amount of variance in their onset, duration, and intensity from year to year, and from two separate regions within Southeast Asia from each other. This variability is already partially understood from previous works, including the impacts of both inter-annually and intra-annually occurring influences such as the Monsoon and El-Nino events, but yet there are other as of yet unknown influences that also are found to strongly influence the results. Second, we show that a simple regression-model of the land-cover, fire, and precipitation data can be used to recreate a robust representation of the timing and magnitude of measured AOD from multiple measurements sources of this region using either 8-day (better for onset and duration) or monthly based (better for magnitude) measurements, but not daily measurements. We find that the reconstructed AOD matches the timing and intensity from AERONET measurements to within 70 to 90 % and the timing and intensity of MISR measurements from to within 50 to 95 %. This is a unique finding in this part of the world, since could-covered regions are large, yet the robustness of the model is still capable of holding over many of these regions, where otherwise no fires are observed and hence no emissions source contribution to AOD would otherwise be thought to occur. Third, we determine that while Southeast Asia is a source region of such intense smoke emissions, that it is also impacted by transport of smoke

  2. Validity of semi-quantitative scale for brain MRI in unilateral cerebral palsy due to periventricular white matter lesions: Relationship with hand sensorimotor function and structural connectivity.

    Science.gov (United States)

    Fiori, Simona; Guzzetta, Andrea; Pannek, Kerstin; Ware, Robert S; Rossi, Giuseppe; Klingels, Katrijn; Feys, Hilde; Coulthard, Alan; Cioni, Giovanni; Rose, Stephen; Boyd, Roslyn N

    2015-01-01

    To provide first evidence of construct validity of a semi-quantitative scale for brain structural MRI (sqMRI scale) in children with unilateral cerebral palsy (UCP) secondary to periventricular white matter (PWM) lesions, by examining the relationship with hand sensorimotor function and whole brain structural connectivity. Cross-sectional study of 50 children with UCP due to PWM lesions using 3 T (MRI), diffusion MRI and assessment of hand sensorimotor function. We explored the relationship of lobar, hemispheric and global scores on the sqMRI scale, with fractional anisotropy (FA), as a measure of brain white matter microstructure, and with hand sensorimotor measures (Assisting Hand Assessment, AHA; Jebsen-Taylor Test for Hand Function, JTTHF; Melbourne Assessment of Unilateral Upper Limb Function, MUUL; stereognosis; 2-point discrimination). Lobar and hemispheric scores on the sqMRI scale contralateral to the clinical side of hemiplegia correlated with sensorimotor paretic hand function measures and FA of a number of brain structural connections, including connections of brain areas involved in motor control (postcentral, precentral and paracentral gyri in the parietal lobe). More severe lesions correlated with lower sensorimotor performance, with the posterior limb of internal capsule score being the strongest contributor to impaired hand function. The sqMRI scale demonstrates first evidence of construct validity against impaired motor and sensory function measures and brain structural connectivity in a cohort of children with UCP due to PWM lesions. More severe lesions correlated with poorer paretic hand sensorimotor function and impaired structural connectivity in the hemisphere contralateral to the clinical side of hemiplegia. The quantitative structural MRI scoring may be a useful clinical tool for studying brain structure-function relationships but requires further validation in other populations of CP.

  3. Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

    International Nuclear Information System (INIS)

    Park, Hyun Jeong; Hwang, Jung Hwa

    2011-01-01

    We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV 1 /FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV 1 /FVC and the dyspnea score.

  4. Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Jeong; Hwang, Jung Hwa [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2011-09-15

    We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV{sub 1}/FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV{sub 1}/FVC and the dyspnea score.

  5. The Effect of Diaphragmatic Plication on Pulmonary Function Test, Dyspnea Score and Arterial Blood Gases: Analysis 11 Patients with Diaphragmatic Elevation

    Directory of Open Access Journals (Sweden)

    Osman Toktas

    2011-05-01

    Full Text Available Aim: Diaphragmatic evantration or paralysis in adults is associated with respiratory distress. In this study, we aimed to compare preoperative and postoperative pulmonary function tests, arterial blood gas analyses and dyspnea scores of the cases in whom plication had been performed for diaphragmatic elevation. Material and Methods: Between January 2004 and March 2010 eleven adult patients who had undergone diaphragmatic plication due to diaphragmatic paralysis and eventration were analyzed. There were 7 (63.63% men and 4 (36.37% women aged 28-65 (mean 38 ± 2.9. Diaphragmatic plication was performed. Pulmonary function test, dyspnea scores, and arterial blood gases in the preoperative and postoperative period were studied. Results: Dyspnea was present in all of the cases and a decrease in both FVC, FEV1, FEV1/FVC values of pulmonary function test and partial pressure of oxygen in the arterial blood were observed. In chest x-ray and thorax computed tomography, it was detected that right or left diaphragm was elevated. Diaphragmatic paralysis was detected by fluoroscopy in 6 patients. Transthoracally, diaphragmatic plication was performed to the cases. There were no postoperative complications or deaths. In postoperative six and twelve months, significant improvements in the symptoms, the values of pulmonary function tests, partial pressure of oxygen in the arterial blood and dyspnea scores of the patients were observed. Conclusions: Diaphragmatic plication is a safe and effective procedure for adult patients with dyspnea due to unilateral diaphragmatic elevation. Lung expansion is easily achieved by performing diaphragm plication.

  6. Self versus informant reports on the specific levels of functioning scale: Relationships to depression and cognition in schizophrenia and schizoaffective disorder

    Directory of Open Access Journals (Sweden)

    Julia Ermel

    2017-09-01

    Full Text Available The goal of the current study was to examine the relationships between insight and both cognitive function and depression in schizophrenia and schizoaffective disorder, and to determine if there were similar relationships across diagnostic categories. We examined discrepancies between self and informant reports of function on the Specific levels of function scale as a metric of insight for interpersonal, social acceptance, work and activities. We examined two samples of individuals with schizophrenia and/or schizoaffective disorder (Ns of 188 and 67 respectively. In Sample 1, cognition was measured using the Dot Probe Expectancy Task. In Sample 2, cognition was measured by averaging several subtests from the MATRICS consensus cognitive battery, as well as additional measures of working memory. In both samples, depression was measured using the Brief Psychiatric Rating Scale. In both samples, we found significant relationships between worse cognition and overestimations of work function, as well as between higher depression levels and underestimation of interpersonal function. These relationships were specific to interpersonal and work function, with significantly stronger correlations with interpersonal and work function compared to the other areas of function. Similar results were found across diagnostic categories. These results have important implications for treatment planning, as they suggest the need to take into account depression and cognitive function when evaluating the patient's self-report of function, and highlight the utility of informant reports in evaluating function and treatment planning. Further, they add to the literature on the similarity across schizophrenia and schizoaffective disorder in a variety of pathological mechanisms.

  7. Relationships Among the Knowledge, Efficacy, and Practices Instrument, Color-Blind Racial Attitudes Scale, Deamonte Driver Survey, and Defining Issues Test 2.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Garvan, Cynthia W

    2016-03-01

    Concordance studies indicate the degree to which instruments measure the same or similar constructs or something different. The aims of this study were to identify the factor structure of the Deamonte Driver Survey and determine the relationship between the Deamonte Driver (a measure of social class stereotyping), the Defining Issues Test 2 (DIT2; a measure of ethical sensitivity), the Color-Blind Racial Attitudes Scale (CoBRAS; a measure of racial stereotyping), and the Knowledge, Efficacy, and Practices Instrument (KEPI; a measure of cultural competence). The results showed a three-factor solution for the Deamonte Driver Survey and significant relationships between CoBRAS and DIT2 subscales and between CoBRAS and Deamonte Driver subscales. Significant relationships between the measures and exploratory variables, underrepresented minority status, age, citizenship, marital status, political stance, English as a first language, and gender were found. The lack of a significant relationship between the KEPI and Deamonte Driver, DIT2, or CoBRAS subscales suggests that the KEPI is measuring a unique construct. These findings showed how these scales contributed to the assessment of cultural competence among dental students and faculty.

  8. Age-ranked storage and age-ranked discharge relationships at a hillslope scale: controls of physical processes, boundary conditions, climate variability, and hillslope shape

    Science.gov (United States)

    Kim, M.; Harman, C. J.; Pangle, L. A.; Troch, P. A. A.

    2016-12-01

    Spatially-integrated (lumped) models of hydrologic flow and transport at the hillslope scale are an important tool in catchment hydrology. However, flow and transport dynamics have mostly have been studied separately, and lack a unified theoretical treatment. Impulse response functions and storage-discharge relationships have been examined extensively as a model for the discharge response. Transit time distributions have been used as an efficient descriptor of lumped transport dynamics but have been limited by steady-state flow assumptions until recently. The rank StorAge Selection (rSAS) approach enables us to describe lumped transport dynamics rigorously in terms of rSAS functions, which describe the time-varying selection of differently aged water within a system for each outflux throughout the system. The function, furthermore, implies that an age-ranked storage (volume of water in a system sorted by age) and age-ranked discharge (volume of discharged water sorted by age) relationship - which is the product of the rSAS function and its associated outflux - can be developed to model and interpret both dynamics in a unified way. In this study, the relationships are studied in diverse virtual hillslopes numerically. Numerical analysis based on Richards equation reveals controls of heterogeneity (e.g., hydraulic conductivity profile), climate variability, boundary conditions, and hillslope shape on the form and time-variability of the age-ranked storage and age-ranked discharge relationship. Moreover, the relationships for the unsaturated zone (where vertical flow-dominated) and the saturated zone (where lateral flow-dominated) are decomposed and compared. The relationships for saturated zone dynamics are, furthermore, derived for Boussinesq-type aquifer analytically (for topographic-driven flow) and numerically (for others). The comparison between the derived relationships and the comparison with those from the coupled (Richards equation-based) model reveal

  9. Developing a Social Enterprise Performance Scale and Examining the Relationship Between Entrepreneurs’ Personality Traits and Their Perceived Enterprise Performance

    Directory of Open Access Journals (Sweden)

    Chao-Tung Liang

    2015-01-01

    Full Text Available On the basis of the lack of measurement tools and the research gap regarding social entrepreneurship, three studies were conducted to develop a new measure of social enterprise (SE performance that is empirically valid and easy to administer. The purpose of this measure was to examine the relationship between entrepreneurs’ personality traits and their perceived SE performance. The results indicated that SE performance can be assessed using four dimensions: personal issues, social aspects, business elements, and service programmes. Extraversion positively influenced service programmes, and openness negatively affected service programmes. Neuroticism and conscientiousness positively predicted personal issues and service programmes, and agreeableness positively predicted all dimensions of perceived SE performance. The results also demonstrated the curvilinear relationship of the U-shaped curve between neuroticism and personal issues and the social aspects of SE performance. Furthermore, the results showed the curvilinear relationship of the inverted U-shaped curve between agreeableness and the four dimensions of SE performance.

  10. Relationship between Eurasian large-scale patterns and regional climate variability over the Black and Baltic Seas

    Energy Technology Data Exchange (ETDEWEB)

    Stankunavicius, G.; Pupienis, D. [Vilnius Univ. (Lithuania). Dept. of Hydrology and Climatology; Basharin, D. [National Academy of Science of Ukraine, Sevastopol (Ukraine). Sevastopol Marine Hydrophysical Inst.

    2012-11-01

    Using a NCEP/NCAR Reanalysis dataset and the empirical orthogonal function (EOF) analysis approach we studied interannual to decadal variabilities of the sea-level air pressure (SLP) and the surface air temperature (SAT) fields over Eurasia during the 2nd part of the 20th century. Our results agree with those of the previous studies, which conclude that Eurasian trends are the result of storm-path changes driven by the interdecadal behaviour of the NAO-like meridional dipole pattern in the Atlantic. On interannual and decadal time scales, significant synchronous correlations between correspondent modes of SAT and SLP EOF patterns were found. This fact suggests that there is a strong and stable Eurasian interrelationship between SAT and SLP large-scale fields which affects the local climate of two sub-regions: the Black and Baltic Seas. The climate variability in these sub-regions was studied in terms of Eurasian large-scale surface-temperature and air-pressure patterns responses. We concluded that the sub-regional climate variability substantially differs over the Black and Baltic Seas, and depends on different Eurasian large-scale patterns. We showed that the Baltic Sea region is influenced by the patterns arising primary from NAO-like meridional dipole, as well as Scandinavian patterns, while the Black Sea's SAT/SLP variability is influenced mainly by the second mode EOF (eastern Atlantic) and large scale tropospheric wave structures. (orig.)

  11. The relationship between sleep quality and functional exercise capacity in COPD.

    Science.gov (United States)

    Chen, Rui; Tian, Jing-Wei; Zhou, Lu-Qian; Chen, Xin; Yan, Hai-Yan; Zeng, Bin; Zhang, Ming-Sheng

    2016-07-01

    Poor sleep is often associated with a series of health problems in patients with chronic obstructive pulmonary disease (COPD), but the relationship between sleep quality and functional exercise capacity has not been previously investigated. To evaluate the relationship between quality of sleep and functional exercise capacity in clinically stable COPD. One hundred three consecutive subjects with stable COPD were recruited. The subjects were assessed with the Pittsburgh Sleep Quality Index (PSQI) and divided into poor sleep group (PSQI >5) and good sleep group (PSQI ≤5). Subjects were also assessed with spirometry, 6-min walk distance (6MWD), oxygen saturation (SP O2 ), the Epworth Sleepiness Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, COPD Assessment Test (CAT), Modified Medical Research Council dyspnea scale and quadriceps muscle function. Poor sleep was present in 43.69% of the patients with COPD. Subjects with poor sleep had shorter 6MWD (t = -3.588, P quality of life (t = 5.487, P sleep quality and functional exercise capacity in patients with COPD. © 2014 John Wiley & Sons Ltd.

  12. Measuring New Product Portfolio Innovativeness: How Differences in Scale Width and Evaluator Perspectives Affect its Relationship with Performance

    DEFF Research Database (Denmark)

    Schultz, Carsten; Salomo, Søren; Talke, Katrin

    2013-01-01

    Portfolio innovativeness is a central variable in innovation management. However, the impact of portfolio innovativeness on new product development (NPD) performance is unclear, which may partly be due to the construct’s multifaceted nature. Different facets may reflect different degrees of innov......Portfolio innovativeness is a central variable in innovation management. However, the impact of portfolio innovativeness on new product development (NPD) performance is unclear, which may partly be due to the construct’s multifaceted nature. Different facets may reflect different degrees...... is dependent on the facets included in the scale, and on the specialization of the professional assessing the facets. Inverted U-shaped performance effects are found when the scale covers the entire spectrum of innovativeness, and linear positive or zero effects with different types of more narrowly modeled...... scales. Inverted U-shaped performance effects are also found when technology professionals assess the facets, while the assessments by marketing professionals lead to linear positive effects....

  13. Large-scale downy brome treatments alter plant-soil relationships and promote perennial grasses in salt desert shrublands

    Science.gov (United States)

    The interrelationship between invasive annual grass abundance and soil resource availability varies spatially and temporally within ecosystems and may be altered by land treatments. We evaluated these relationships in two salt desert landscapes where the local abundance of Bromus tectorum L. (downy...

  14. A multi-scale cardiovascular system model can account for the load-dependence of the end-systolic pressure-volume relationship

    Science.gov (United States)

    2013-01-01

    Background The end-systolic pressure-volume relationship is often considered as a load-independent property of the heart and, for this reason, is widely used as an index of ventricular contractility. However, many criticisms have been expressed against this index and the underlying time-varying elastance theory: first, it does not consider the phenomena underlying contraction and second, the end-systolic pressure volume relationship has been experimentally shown to be load-dependent. Methods In place of the time-varying elastance theory, a microscopic model of sarcomere contraction is used to infer the pressure generated by the contraction of the left ventricle, considered as a spherical assembling of sarcomere units. The left ventricle model is inserted into a closed-loop model of the cardiovascular system. Finally, parameters of the modified cardiovascular system model are identified to reproduce the hemodynamics of a normal dog. Results Experiments that have proven the limitations of the time-varying elastance theory are reproduced with our model: (1) preload reductions, (2) afterload increases, (3) the same experiments with increased ventricular contractility, (4) isovolumic contractions and (5) flow-clamps. All experiments simulated with the model generate different end-systolic pressure-volume relationships, showing that this relationship is actually load-dependent. Furthermore, we show that the results of our simulations are in good agreement with experiments. Conclusions We implemented a multi-scale model of the cardiovascular system, in which ventricular contraction is described by a detailed sarcomere model. Using this model, we successfully reproduced a number of experiments that have shown the failing points of the time-varying elastance theory. In particular, the developed multi-scale model of the cardiovascular system can capture the load-dependence of the end-systolic pressure-volume relationship. PMID:23363818

  15. Relationship Between the DSM-5 Anxious Distress Specifier and the Hamilton Depression Rating Scale Anxiety/Somatization Factor.

    Science.gov (United States)

    Zimmerman, Mark; Clark, Heather; McGonigal, Patrick; Harris, Lauren; Guzman Holst, Carolina; Martin, Jacob

    2018-02-01

    We examined the association between the Hamilton Depression Scale (HAMD) approach to classifying depressed patients into anxious and nonanxious subgroups and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) anxious distress specifier subtyping. Two hundred two depressed patients were interviewed with semistructured diagnostic interviews. Patients were rated on the 17-item HAMD and the Hamilton Anxiety Rating Scale and completed the Clinically Useful Anxiety Outcome Scale. Both approaches toward identifying anxiety in depressed patients resulted in most of the patients meeting the anxiety subtype. Both subtyping methods were significantly correlated with clinician-rated and self-report measures of anxiety, and scores on the anxiety scales were higher in the patients who met the anxious subtype. However, DSM-5 anxious distress subtyping was only marginally associated with the HAMD anxiety/somatization factor subtyping approach (k = 0.21), and dimensional scores were only moderately correlated (r = 0.50). These findings indicate that the DSM-5 and HAMD approaches toward identifying an anxious subtype of depression are not interchangeable.

  16. Relationship of Different Perceived Exertion Scales in Walking or Running with Self-Selected and Imposed Intensity

    Directory of Open Access Journals (Sweden)

    Dias Marcelo Ricardo Cabral

    2014-12-01

    Full Text Available The aims of this study were to: (1 compare the Heart Rate (HR and Rating Perceived Exertion (RPE in training with self-selected and imposed loads, and (2 associate the OMNI-Walk/Run and Borg scales with self-selected and imposed loads, both on a treadmill. Ten trained men (20.3 ± 2.0 years, 75.6 ± 9.8 kg, 175.1 ± 5.1 cm participated in a training program with self-selected load (time and speed individually preferred and another with imposed load (even self-selected time and speed 10% higher. The HR and RPE were measured, every minute of training, by the OMNIWalk/ Run and Borg scales. No significant differences were found in the HR and RPE between training sessions. The correlation between the OMNI-Walk/Run and Borg scales showed a moderate association (r = 0.55 in training with self-selected load and a strong association in imposed load (r = 0.79. In this study, self-selected load induced a suboptimal stimulus to elicit favorable organic adaptations. Moreover, high correlation of OMNI Walk/Run and Borg scales with the imposed load showed that the greater the load of training the best were answers of RPE.

  17. RELATIONSHIPS BETWEEN FLUID VORTICITY, KINETIC HELICITY, AND MAGNETIC FIELD ON SMALL-SCALES (QUIET-NETWORK) ON THE SUN

    Energy Technology Data Exchange (ETDEWEB)

    Sangeetha, C. R.; Rajaguru, S. P., E-mail: crsangeetha@iiap.res.in [Indian Institute of Astrophysics, Bangalore-34 (India)

    2016-06-20

    We derive horizontal fluid motions on the solar surface over large areas covering the quiet-Sun magnetic network from local correlation tracking of convective granules imaged in continuum intensity and Doppler velocity by the Helioseismic and Magnetic Imager (HMI) on board the Solar Dynamics Observatory . From these we calculate the horizontal divergence, the vertical component of vorticity, and the kinetic helicity of fluid motions. We study the correlations between fluid divergence and vorticity, and between vorticity (kinetic helicity) and the magnetic field. We find that the vorticity (kinetic helicity) around small-scale fields exhibits a hemispherical pattern (in sign) similar to that followed by the magnetic helicity of large-scale active regions (containing sunspots). We identify this pattern to be a result of the Coriolis force acting on supergranular-scale flows (both the outflows and inflows), consistent with earlier studies using local helioseismology. Furthermore, we show that the magnetic fields cause transfer of vorticity from supergranular inflow regions to outflow regions, and that they tend to suppress the vortical motions around them when magnetic flux densities exceed about 300 G (from HMI). We also show that such an action of the magnetic fields leads to marked changes in the correlations between fluid divergence and vorticity. These results are speculated to be of importance to local dynamo action (if present) and to the dynamical evolution of magnetic helicity at the small-scale.

  18. Teaching Quality in Math Class: The Development of a Scale and the Analysis of Its Relationship with Engagement and Achievement.

    Science.gov (United States)

    Leon, Jaime; Medina-Garrido, Elena; Núñez, Juan L

    2017-01-01

    Math achievement and engagement declines in secondary education; therefore, educators are faced with the challenge of engaging students to avoid school failure. Within self-determination theory, we address the need to assess comprehensively student perceptions of teaching quality that predict engagement and achievement. In study one we tested, in a sample of 548 high school students, a preliminary version of a scale to assess nine factors: teaching for relevance, acknowledge negative feelings, participation encouragement, controlling language, optimal challenge, focus on the process, class structure, positive feedback, and caring. In the second study, we analyzed the scale's reliability and validity in a sample of 1555 high school students. The scale showed evidence of reliability, and with regard to criterion validity, at the classroom level, teaching quality was a predictor of behavioral engagement, and higher grades were observed in classes where students, as a whole, displayed more behavioral engagement. At the within level, behavioral engagement was associated with achievement. We not only provide a reliable and valid method to assess teaching quality, but also a method to design interventions, these could be designed based on the scale items to encourage students to persist and display more engagement on school duties, which in turn bolsters student achievement.

  19. No relationship found between mercury and lead concentrations in muscle and scales of chub Squalius cephalus L

    Czech Academy of Sciences Publication Activity Database

    Valová, Zdenka; Hudcová, H.; Roche, Kevin Francis; Svobodová, J.; Bernardová, I.; Jurajda, Pavel

    2013-01-01

    Roč. 185, č. 4 (2013), s. 3359-3368 ISSN 0167-6369 R&D Projects: GA ČR GBP505/12/G112 Institutional support: RVO:68081766 Keywords : Mercury * Lead * Chub * Nonlethal methods * Scales Subject RIV: EG - Zoology Impact factor: 1.679, year: 2013

  20. On the relationship between large-scale climate modes and regional synoptic patterns that drive Victorian rainfall

    Directory of Open Access Journals (Sweden)

    D. C. Verdon-Kidd

    2009-04-01

    Full Text Available In this paper regional (synoptic and large-scale climate drivers of rainfall are investigated for Victoria, Australia. A non-linear classification methodology known as self-organizing maps (SOM is used to identify 20 key regional synoptic patterns, which are shown to capture a range of significant synoptic features known to influence the climate of the region. Rainfall distributions are assigned to each of the 20 patterns for nine rainfall stations located across Victoria, resulting in a clear distinction between wet and dry synoptic types at each station. The influence of large-scale climate modes on the frequency and timing of the regional synoptic patterns is also investigated. This analysis revealed that phase changes in the El Niño Southern Oscillation (ENSO, the Indian Ocean Dipole (IOD and/or the Southern Annular Mode (SAM are associated with a shift in the relative frequency of wet and dry synoptic types on an annual to inter-annual timescale. In addition, the relative frequency of synoptic types is shown to vary on a multi-decadal timescale, associated with changes in the Inter-decadal Pacific Oscillation (IPO. Importantly, these results highlight the potential to utilise the link between the regional synoptic patterns derived in this study and large-scale climate modes to improve rainfall forecasting for Victoria, both in the short- (i.e. seasonal and long-term (i.e. decadal/multi-decadal scale. In addition, the regional and large-scale climate drivers identified in this study provide a benchmark by which the performance of Global Climate Models (GCMs may be assessed.

  1. Developing a Social Enterprise Performance Scale and Examining the Relationship Between Entrepreneurs’ Personality Traits and Their Perceived Enterprise Performance

    OpenAIRE

    Liang, Chao-Tung; Peng, Li-Pei; Yao, Shu-Nung; Liang, Chaoyun

    2015-01-01

    On the basis of the lack of measurement tools and the research gap regarding social entrepreneurship, three studies were conducted to develop a new measure of social enterprise (SE) performance that is empirically valid and easy to administer. The purpose of this measure was to examine the relationship between entrepreneurs’ personality traits and their perceived SE performance. The results indicated that SE performance can be assessed using four dimensions: personal issues, so...

  2. Mindfulness meditation and countertransference in the therapeutic relationship: A small-scale exploration of therapists' experiences using grounded theory methods

    OpenAIRE

    Millon, G.; Halewood, A.

    2015-01-01

    Background: Difficulties with containing or processing emotions brought up in the countertransference response have long been understood as having the potential to cause a rupture in the therapeutic relationship, often with damaging results for the client. As increasing numbers of psychotherapists are becoming interested in mindfulness meditation, and as evidence is building to suggest that mindfulness meditation is an effective way of relating to one's thoughts and emotions in a non-judgemen...

  3. Scaling analysis of heart beat fluctuations data and its relationship with cyclic alternating pattern data during sleep

    Science.gov (United States)

    de León-Lomelí, R.; Murguía, J. S.; Chouvarda, I.; Méndez, M. O.; González-Galván, E.; Alba, A.

    2016-01-01

    During sleep there exists a nonlinear dynamic phenomenon, which is called cyclic alternating pattern. This phenomenon is generated in the brain and is composed of a series of events of short duration known as A-phases. It has been shown that A-phases can be found in other physiological systems such as the cardiovascular. However, there is no evidence that shows the temporal influence of the A-phases with the cardiovascular system. For this purpose, we consider the scaling method known as detrended fluctuation analysis (DFA). The analysis was carried out in well sleepers and insomnia people, and the numerical results show an increment in the scaling parameter for the insomnia subjects compared with the normal ones. In addition, the results of the heart dynamics suggests a persistent behavior toward the 1/f-noise.

  4. Modeling and measuring the relationships between sediment transport processes, alluvial bedforms and channel-scale morphodynamics in sandy braided rivers.

    Science.gov (United States)

    Nicholas, A. P.; Ashworth, P. J.; Best, J.; Lane, S. N.; Parsons, D. R.; Sambrook Smith, G.; Simpson, C.; Strick, R. J. P.; Unsworth, C. A.

    2017-12-01

    Recent years have seen significant advances in the development and application of morphodynamic models to simulate river evolution. Despite this progress, significant challenges remain to be overcome before such models can provide realistic simulations of river response to environmental change, or be used to determine the controls on alluvial channel patterns and deposits with confidence. This impasse reflects a wide range of factors, not least the fact that many of the processes that control river behaviour operate at spatial scales that cannot be resolved by such models. For example, sand-bed rivers are characterised by multiple scales of topography (e.g., dunes, bars, channels), the finest of which must often by parameterized, rather than represented explicitly in morphodynamic models. We examine these issues using a combination of numerical modeling and field observations. High-resolution aerial imagery and Digital Elevation Models obtained for the sandy braided South Saskatchewan River in Canada are used to quantify dune, bar and channel morphology and their response to changing flow discharge. Numerical simulations are carried out using an existing morphodynamic model based on the 2D shallow water equations, coupled with new parameterisations of the evolution and influence of alluvial bedforms. We quantify the spatial patterns of sediment flux using repeat images of dune migration and bar evolution. These data are used to evaluate model predictions of sediment transport and morphological change, and to assess the degree to which model performance is controlled by the parametrization of roughness and sediment transport phenomena linked to subgrid-scale bedforms (dunes). The capacity of such models to replicate the characteristic multi-scale morphology of bars in sand-bed rivers, and the contrasting morphodynamic signatures of braiding during low and high flow conditions, is also assessed.

  5. Brief Multidimensional Students’ Life Satisfaction Scale – PTPB Version (BMSLSS-PTPB): Psychometric Properties and Relationship with Mental Health Symptom Severity Over Time

    Science.gov (United States)

    Athay, M. Michele; Kelley, Susan Douglas; Dew-Reeves, Sarah E.

    2012-01-01

    Youth life satisfaction is a component of subjective well-being, an important part of a strengths-based approach to treatment. This study establishes the psychometric properties of the Brief Multidimensional Students’ Life Satisfaction Scale – PTPB version (BMSLSS-PTPB). The BMSLSS-PTPB shows evidence of construct validity with significant correlations as expected to measures of youth hope and youth symptom severity, and no relationship as expected to youth treatment outcome expectations. A longitudinal analysis was conducted examining the relationship between youth-reported life satisfaction and mental health symptom severity (youth, caregiver-, and clinician-report) for 334 youth (aged 11–18 years) receiving in-home treatment. Results indicate that life satisfaction consistently increases over the course of treatment but increases faster in youth whose symptom severity, as rated by all reporters, decreases. Implications, future directions, and limitations of the study are discussed. PMID:22407553

  6. Brief Multidimensional Students' Life Satisfaction Scale-PTPB Version (BMSLSS-PTPB): psychometric properties and relationship with mental health symptom severity over time.

    Science.gov (United States)

    Athay, M Michele; Kelley, Susan Douglas; Dew-Reeves, Sarah E

    2012-03-01

    Youth life satisfaction is a component of subjective well-being, an important part of a strengths-based approach to treatment. This study establishes the psychometric properties of the Brief Multidimensional Students' Life Satisfaction Scale-PTPB Version (BMSLSS-PTPB). The BMSLSS-PTPB showed evidence of construct validity with significant correlations as expected to measures of youth hope and youth symptom severity, and no relationship as expected to youth treatment outcome expectations. A longitudinal analysis was conducted examining the relationship between youth-reported life satisfaction and mental health symptom severity (youth-, caregiver-, and clinician-report) for 334 youth (aged 11-18 years) receiving in-home treatment. Results indicated that life satisfaction consistently increased over the course of treatment but increased faster in youth whose symptom severity, as rated by all reporters, decreased over the course of treatment. Implications, future directions, and limitations of the study are discussed.

  7. Scaling relationship between corner frequencies and seismic moments of ultra micro earthquakes estimated with coda-wave spectral ratio -the Mponeng mine in South Africa

    Science.gov (United States)

    Wada, N.; Kawakata, H.; Murakami, O.; Doi, I.; Yoshimitsu, N.; Nakatani, M.; Yabe, Y.; Naoi, M. M.; Miyakawa, K.; Miyake, H.; Ide, S.; Igarashi, T.; Morema, G.; Pinder, E.; Ogasawara, H.

    2011-12-01

    Scaling relationship between corner frequencies, fc, and seismic moments, Mo is an important clue to understand the seismic source characteristics. Aki (1967) showed that Mo is proportional to fc-3 for large earthquakes (cubic law). Iio (1986) claimed breakdown of the cubic law between fc and Mo for smaller earthquakes (Mw law holds even for micro earthquakes (-1 4) by using high quality data observed at a deep borehole (Abercrombie, 1995; Ogasawara et al., 2001; Hiramatsu et al., 2002; Yamada et al., 2007). In order to clarify the scaling relationship for smaller earthquakes (Mw Africa. We used 4 tri-axial accelerometers of three-component that have a flat response up to 25 kHz. They were installed to be 10 to 30 meters apart from each other at 3,300 meters deep. During the period from 2008/10/14 to 2008/10/30 (17 days), 8,927 events were recorded. We estimated fc and Mo for 60 events (-3 Common practice is using direct waves from adjacent events. However, there were only 5 event pairs with the distance between them less than 20 meters and Mw difference over one. In addition, the observation array is very small (radius less than 30 m), which means that effects of directivity and radiation pattern on direct waves are similar at all stations. Hence, we used spectral ratio of coda waves, since these effects are averaged and will be effectively reduced (Mayeda et al., 2007; Somei et al., 2010). Coda analysis was attempted only for relatively large 20 events (we call "coda events" hereafter) that have coda energy large enough for analysis. The results agree with those of the direct S-wave analysis for the same events, though the latter showed more scattering in fc-Mo trend. So, we combine the results from the both analyses to examine the fc-Mo trend down to very small events. Therefore, we adopted fc and (relative) Mo estimated from coda spectral ratios for coda events, while we adopted them from direct spectra for other events despite of their lower reliability. We

  8. The relationship between the Rating Scale and Partial Credit Models and the implication of disordered thresholds of the Rasch models for polytomous responses.

    Science.gov (United States)

    Luo, Guanzhong

    2005-01-01

    There is a perception in the literature that the Rating Scale Model (RSM) and Partial Credit Model (PCM) are two different types of Rasch models. This paper clarifies the relationship between the RSM and PCM from the perspectives of literature history and mathematical logic. It is shown that not only are the RSM and the PCM identical, but the two approaches used to introduce them are statistically equivalent. Then the implication of disordered thresholds is discussed. In addition, the difference between the structural thresholds and the Thurstone thresholds are clarified.

  9. An observational search for large-scale organization of five-minute oscillations on the sun. [coronal holes or sector structure relationships

    Science.gov (United States)

    Dittmer, P. H.; Scherrer, P. H.; Wilcox, J. M.

    1978-01-01

    The large-scale solar velocity field has been measured over an aperture of radius 0.8 solar radii on 121 days between April and September, 1976. Measurements are made in the line Fe I 5123.730 A, employing a velocity subtraction technique similar to that of Severny et al. (1976). Comparisons of the amplitude and frequency of the five-minute resonant oscillation with the geomagnetic C9 index and magnetic sector boundaries show no evidence of any relationship between the oscillations and coronal holes or sector structure.

  10. Towards an objective assessment of motor function in sub-acute stroke patients: Relationship between clinical rating scales and instrumental gait stability indexes.

    Science.gov (United States)

    Tamburini, P; Mazzoli, D; Stagni, R

    2018-01-01

    The assessment of walking function alterations is a key issue to design effective rehabilitative interventions in sub-acute stroke patients. Nevertheless, the objective quantification of these alterations remains a challenge. Clinical rating scales are commonly used in clinical practice, but have been proven prone to errors associated to the evaluator subjective perception. On the other hand, instrumental measurement of trunk acceleration can be exploited for an objective quantitative characterization of gait function, but it is not applied in routine clinical practice, because the resulting quantitative indexes have not been related to the clinically information, conventionally provided by the rating scales. To overcome this limitation, the relationship between the indexes, in specific clinical conditions, and rating scale must be better investigated, to support their exploitability in the clinical practice as a fast and reliable screening tool. Thirty-one sub-acute stroke patients (17 with and 14 without cane) participated in the study. All were assessed with 6 rating scales (MI, TCT, MRI, FAC, WHS, CIRS) and 2 functional tests (2MWT and TUG). Sample Entropy (SEN) and Recurrence Quantification Analysis (RQA) in AP, ML and V directions were calculated over 2MWT and walking section of TUG. The influence of assessment task and cane was analysed, as well as correlation of SEN and RQA indexes with clinical rating scales. SEN and RQA on the medio-lateral plane resulted influenced by the use of the cane, while the correlations between indexes and clinical scales showed that SEN and RQA for antero-posterior direction correlate positively with WHS. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Using the Kannada version of the Connor Davidson Resilience Scale to assess resilience and its relationship with psychological distress among adolescent girls in Bangalore, India.

    Science.gov (United States)

    Sidheek, K P Fasli; Satyanarayana, Veena A; Sowmya, H R; Chandra, Prabha S

    2017-12-01

    A widely used and accepted scale for assessing resilience is the Connor-Davidson Resilience Scale (CD-RISC). The aim of the present study was to establish the psychometric properties of the Kannada version of the scale and assess the relationship between resilience and psychological distress in a sample of adolescent girls living in low-income settings. Data was obtained from a sample of 606 adolescent girls studying in a college meant for women from a socio-economically disadvantaged setting. The CD- RISC (25 item) was used to assess resilience and Kessler Psychological Distress Scale (K10) was used to assess psychological distress. Exploratory factor analysis yielded four stable factors instead of the original five factors. Similar results have been obtained in other factor-analytic studies. A significant negative correlation was found between psychological distress and resilience. Our study shows that the CD-RISC is a valuable measure to assess resilience among adolescents in low-income settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. The Diagnostic Apathia Scale predicts a dose-remission relationship of T-PEMF in treatment-resistant depression.

    Science.gov (United States)

    Bech, Per; Lunde, Marianne; Lauritzen, Lise; Straasø, Birgit; Lindberg, Lone; Vinberg, Maj; Undén, Mogens; Hellström, Lone Christina; Dissing, Steen; Larsen, Erik Roj

    2015-02-01

    The aim of this study was to evaluate the predictive validity of the apathy subsyndrome in patients with therapy-resistant depression in the dose-remission study with transcranial pulsating electromagnetic fields (T-PEMF). The apathy subsyndrome consists of the symptoms of fatigue, concentration and memory problems, lack of interests, difficulties in making decisions, and sleep problems. We evaluated 65 patients with therapy-resistant depression. In total, 34 of these patients received placebo T-PEMF in the afternoon and active T-PEMF in the morning, that is, one daily dose. The remaining 31 patients received active T-PEMF twice daily. Duration of treatment was 8 weeks in both groups. The Hamilton Depression Scale (HAM-D17) and the Bech-Rafaelsen Melancholia Scale (MES) were used to measure remission. We also focused on the Diagnostic Apathia Scale, which is based on a mixture of items from the MINI and the HAM-D17/MES. In patients without apathy, the remission rate after T-PEMF was 83.9% versus 58.8% in patients with apathy (p≤0.05). In patients without apathy receiving one active dose daily 94.4% remitted versus 50% for patients with apathy (p≤0.05). In patients without apathy who received two active doses 69.9% remitted versus 66.7% for patients with apathy (p≤0.05). Taking the baseline diagnosis of the apathy syndrome into consideration, we found that in patients without apathy one daily dose of T-PEMF is sufficient, but in patients with apathy two daily doses are necessary. Including the apathy syndrome as predictor in future studies would seem to be clinically relevant.

  13. Large Scale Variability of Phytoplankton Blooms in the Arctic and Peripheral Seas: Relationships with Sea Ice, Temperature, Clouds, and Wind

    Science.gov (United States)

    Comiso, Josefino C.; Cota, Glenn F.

    2004-01-01

    Spatially detailed satellite data of mean color, sea ice concentration, surface temperature, clouds, and wind have been analyzed to quantify and study the large scale regional and temporal variability of phytoplankton blooms in the Arctic and peripheral seas from 1998 to 2002. In the Arctic basin, phytoplankton chlorophyll displays a large symmetry with the Eastern Arctic having about fivefold higher concentrations than those of the Western Arctic. Large monthly and yearly variability is also observed in the peripheral seas with the largest blooms occurring in the Bering Sea, Sea of Okhotsk, and the Barents Sea during spring. There is large interannual and seasonal variability in biomass with average chlorophyll concentrations in 2002 and 2001 being higher than earlier years in spring and summer. The seasonality in the latitudinal distribution of blooms is also very different such that the North Atlantic is usually most expansive in spring while the North Pacific is more extensive in autumn. Environmental factors that influence phytoplankton growth were examined, and results show relatively high negative correlation with sea ice retreat and strong positive correlation with temperature in early spring. Plankton growth, as indicated by biomass accumulation, in the Arctic and subarctic increases up to a threshold surface temperature of about 276-277 degree K (3-4 degree C) beyond which the concentrations start to decrease suggesting an optimal temperature or nutrient depletion. The correlation with clouds is significant in some areas but negligible in other areas, while the correlations with wind speed and its components are generally weak. The effects of clouds and winds are less predictable with weekly climatologies because of unknown effects of averaging variable and intermittent physical forcing (e.g. over storm event scales with mixing and upwelling of nutrients) and the time scales of acclimation by the phytoplankton.

  14. Parent-child relationship disorders. Part I. Parental overprotection and the development of the Parent Protection Scale.

    Science.gov (United States)

    Thomasgard, M; Metz, W P; Edelbrock, C; Shonkoff, J P

    1995-08-01

    There is a spectrum of parental protective behaviors promoting child safety and security, ranging from neglect to overprotection. This paper describes the development and psychometric properties of a new measure of parental protective behaviors toward children age 2 to 10 years, the Parent Protection Scale (PPS). Items were selected to represent key dimensions of protective behaviors. Factor analyses suggested four subscales: Supervision, Separation Problems, Dependence, and Control. The PPS has acceptable internal consistency, test-retest reliability, and clinical validity. Norms by child age in the form of cutoff points corresponding to +1 SD were determined. Clinical and research uses for the PPS are noted.

  15. The relationship between exercise capacity and different functional markers in pulmonary rehabilitation for COPD

    Directory of Open Access Journals (Sweden)

    Kerti M

    2018-02-01

    Full Text Available Maria Kerti, Zsuzsanna Balogh, Krisztina Kelemen, Janos T Varga Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, Budapest, Hungary Rationale: The relationship of functional parameters such as lung mechanics, chest kinematics, metabolism and peripheral and respiratory muscle function with the level of exercise tolerance remains a controversial subject. While it has been previously shown that pulmonary rehabilitation is capable of improving exercise tolerance in patients afflicted by COPD, as expressed by values of 6-minute walking test (6MWT, the degree of contribution to this change by each of the aforementioned parameters remains unclear.Aims: To investigate the correlation between changes in exercise capacity and other functional markers following pulmonary rehabilitation in COPD and to determine which parameters are more closely related to improvements of exercise tolerance.Materials and methods: Three hundred and twenty-seven patients with COPD (with average, 95% CI for forced expiratory volume in the first second [FEV1]: 45% [25%–83%] predicted, age: 64 [48–80] years, and BMI: 27 [13.5–40.4] kg/m2 participated in this study. Thirty percent of the patients had pulmonary hypertension as comorbidity. Patients underwent a pulmonary rehabilitation program with 20–30 minutes sessions two to three times per day for 4 weeks. The program was composed of chest wall-stretching, controlled breathing exercises, and a personalized training schedule for cycling and treadmill use. Measurements of 6MWT, lung function, chest wall expansion, grip strength, maximal inspiratory pressure, and breath holding time were taken. The Body mass index, airflow Obstruction, Dyspnea and Exercise capacity (BODE-index, body mass index [BMI], FEV1, 6MWT, modified Medical Research Dyspnea Scale score, and an alternative scale score (for BMI, FEV1, 6MWT, and COPD Assessment Test were calculated.Results: Rehabilitation resulted in a

  16. NOAA's Regional Climate Services Program: Building Relationships with Partners and Customers to Deliver Trusted Climate Information at Usable Scales

    Science.gov (United States)

    Mecray, E. L.; Dissen, J.

    2016-12-01

    Federal agencies across multiple sectors from transportation to health, emergency management and agriculture, are now requiring their key stakeholders to identify and plan for climate-related impacts. Responding to the drumbeat for climate services at the regional and local scale, the National Oceanic and Atmospheric Administration (NOAA) formed its Regional Climate Services (RCS) program to include Regional Climate Services Directors (RCSD), Regional Climate Centers, and state climatologists in a partnership. Since 2010, the RCS program has engaged customers across the country and amongst many of the nation's key economic sectors to compile information requirements, deliver climate-related products and services, and build partnerships among federal agencies and their regional climate entities. The talk will include a sketch from the Eastern Region that may shed light on the interaction of the multiple entities working at the regional scale. Additionally, we will show examples of our interagency work with the Department of Interior, the Department of Agriculture, and others in NOAA to deliver usable and trusted climate information and resources. These include webinars, print material, and face-to-face customer engagements to gather and respond to information requirements. NOAA/National Centers for Environmental Information's RCSDs work on-the-ground to learn from customers about their information needs and their use of existing tools and resources. As regional leads, the RCSDs work within NOAA and with our regional partners to ensure the customer receives a broad picture of the tools and information from across the nation.

  17. Conceptualization and measurement of mental health providers' recovery-promoting competence: the recovery promoting relationships scale (RPRS).

    Science.gov (United States)

    Russinova, Zlatka; Rogers, E Sally; Cook, Karon F; Ellison, Marsha Langer; Lyass, Asya

    2013-03-01

    The purpose of this study was to construct and validate an instrument that measures practitioners' competence to promote the recovery among individuals with psychiatric disabilities from the perspective of the person served. Items were developed based upon input from individuals served and practitioners as well as the extant literature on recovery. "Recovery-promoting competence" was conceptualized as a set of practitioner capabilities that promote the recovery process and enhance the working alliance. A scale was developed using a two-stage process that initially identified specific recovery-promoting competencies and then tested candidate items measuring those competencies. Item Response Theory and Classical Test Theory approaches were used to validate the instrument and assess its psychometric properties with a national sample of 382 individuals with psychiatric disabilities. Analyses revealed two distinct sets of recovery-promoting competencies: (a) competencies that enhance clients' recovery, and (b) competencies that build and maintain a strong therapeutic or working alliance. The first set further differentiated into subcompetencies-enhancing clients' hopefulness, empowerment, and self-acceptance. The instrument had high internal consistency and acceptable stability over time, convergent, criterion, and known groups' validity. This scale is a tool for assessing mental health and rehabilitation practitioners' competencies from the perspective of the individual served which can be used both in research and program evaluation of agencies serving individuals with psychiatric disabilities. PsycINFO Database Record (c) 2013 APA, all rights reserved

  18. Yoga-based pulmonary rehabilitation for the management of dyspnea in coal miners with chronic obstructive pulmonary disease: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rajashree Ranjita

    2016-07-01

    Conclusions: Findings indicate that IAYT benefits coal miners with COPD, reducing dyspnea; fatigue and PR, and improving functional performance and peripheral capillary SpO2%. Yoga can now be included as an adjunct to conventional therapy for pulmonary rehabilitation programs for COPD patients.

  19. Data-driven multi-scale multi-physics models to derive process-structure-property relationships for additive manufacturing

    Science.gov (United States)

    Yan, Wentao; Lin, Stephen; Kafka, Orion L.; Lian, Yanping; Yu, Cheng; Liu, Zeliang; Yan, Jinhui; Wolff, Sarah; Wu, Hao; Ndip-Agbor, Ebot; Mozaffar, Mojtaba; Ehmann, Kornel; Cao, Jian; Wagner, Gregory J.; Liu, Wing Kam

    2018-01-01

    Additive manufacturing (AM) possesses appealing potential for manipulating material compositions, structures and properties in end-use products with arbitrary shapes without the need for specialized tooling. Since the physical process is difficult to experimentally measure, numerical modeling is a powerful tool to understand the underlying physical mechanisms. This paper presents our latest work in this regard based on comprehensive material modeling of process-structure-property relationships for AM materials. The numerous influencing factors that emerge from the AM process motivate the need for novel rapid design and optimization approaches. For this, we propose data-mining as an effective solution. Such methods—used in the process-structure, structure-properties and the design phase that connects them—would allow for a design loop for AM processing and materials. We hope this article will provide a road map to enable AM fundamental understanding for the monitoring and advanced diagnostics of AM processing.

  20. Allometry and size control: what can studies of body size regulation teach us about the evolution of morphological scaling relationships?

    Science.gov (United States)

    Mirth, Christen K; Anthony Frankino, W; Shingleton, Alexander W

    2016-02-01

    The relationship between organ and body size, known as morphological allometry, has fascinated biologists for over a century because changes in allometry generate the vast diversity of organism shapes. Nevertheless, progress has been limited in understanding the genetic mechanisms that regulate allometries and how these mechanisms evolve. This is perhaps because allometry is measured at the population level, however adult organ and body size depends on genetic background and the developmental environment of individuals. Recent findings have enhanced our understanding of how insects regulate their organ and body sizes in response to environmental conditions, particularly nutritional availability. We argue that merging these developmental insights with a population genetics approach will provide a powerful system for understanding the evolution of allometry. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Large-scale determination of sequence, structure, and function relationships in cytosolic glutathione transferases across the biosphere.

    Directory of Open Access Journals (Sweden)

    Susan T Mashiyama

    2014-04-01

    Full Text Available The cytosolic glutathione transferase (cytGST superfamily comprises more than 13,000 nonredundant sequences found throughout the biosphere. Their key roles in metabolism and defense against oxidative damage have led to thousands of studies over several decades. Despite this attention, little is known about the physiological reactions they catalyze and most of the substrates used to assay cytGSTs are synthetic compounds. A deeper understanding of relationships across the superfamily could provide new clues about their functions. To establish a foundation for expanded classification of cytGSTs, we generated similarity-based subgroupings for the entire superfamily. Using the resulting sequence similarity networks, we chose targets that broadly covered unknown functions and report here experimental results confirming GST-like activity for 82 of them, along with 37 new 3D structures determined for 27 targets. These new data, along with experimentally known GST reactions and structures reported in the literature, were painted onto the networks to generate a global view of their sequence-structure-function relationships. The results show how proteins of both known and unknown function relate to each other across the entire superfamily and reveal that the great majority of cytGSTs have not been experimentally characterized or annotated by canonical class. A mapping of taxonomic classes across the superfamily indicates that many taxa are represented in each subgroup and highlights challenges for classification of superfamily sequences into functionally relevant classes. Experimental determination of disulfide bond reductase activity in many diverse subgroups illustrate a theme common for many reaction types. Finally, sequence comparison between an enzyme that catalyzes a reductive dechlorination reaction relevant to bioremediation efforts with some of its closest homologs reveals differences among them likely to be associated with evolution of this

  2. Fig extract drying: The relationship between the main operating parameters of a pilot-scale spray dryer and product specifications.

    Science.gov (United States)

    Kalantari, Maryam; Niakousari, Mehrdad; Haghighi-Manesh, Soroush; Rasouli, Mehrdad

    2018-03-01

    This study aims to optimize extraction and drying conditions of fig syrup. Drying was done in a pilot scale two-fluid nozzle spray dryer. A total of 27 experiments were conducted with varying inlet air temperatures, air flow rates, and also a maltodextrin (MD)- low methoxyl pectin (LMP) ratios. While feed rate, feed temperature, and compressed air flow rate of the atomizer were kept constant. The results of differential scanning calorimetry revealed that high levels of glucose and fructose in the extract resulted in a low glass transition temperature of fig syrup. By an increase in the inlet air temperature, the powder bulk density decreased. However, the MD:LMP ratio and the air flow rate were not significantly effective ( p spray-dried particles and particle size distribution analysis showed that particles were largely in a range of 5 to 50 μm. The best powders were obtained at an inlet air temperature of 170°C.

  3. Gauging policy-driven large-scale vegetation restoration programmes under a changing environment: Their effectiveness and socio-economic relationships.

    Science.gov (United States)

    Li, Ting; Lü, Yihe; Fu, Bojie; Comber, Alexis J; Harris, Paul; Wu, Lianhai

    2017-12-31

    Large-scale ecological restoration has been widely accepted globally as an effective strategy for combating environmental crises and to facilitate sustainability. Assessing the effectiveness of ecological restoration is vital for researchers, practitioners, and policy-makers. However, few practical tools are available to perform such tasks, particularly for large-scale restoration programmes in complex socio-ecological systems. By taking a "before and after" design, this paper formulates a composite index (E j ) based on comparing the trends of vegetation cover and vegetation productivity to assess ecological restoration effectiveness. The index reveals the dynamic and spatially heterogenic process of vegetation restoration across different time periods, which can be informative for ecological restoration management at regional scales. Effectiveness together with its relationship to socio-economic factors is explored via structural equation modeling for three time periods. The results indicate that the temporal scale is a crucial factor in representing restoration effectiveness, and that the effects of socio-economic factors can also vary with time providing insight for improving restoration effectiveness. A dual-track strategy, which promotes the development of tertiary industry in absorbing the rural labor force together with improvements in agricultural practices, is proposed as a promising strategy for enhancing restoration effectiveness. In this process, timely and long-term ecological restoration monitoring is advocated, so that the success and sustainability of such programmes is ensured, together with more informative decision making where socio-ecological interactions at differing temporal scales are key concerns. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Climate, river network, and vegetation cover relationships across a climate gradient and their potential for predicting effects of decadal-scale climate change

    Science.gov (United States)

    Smith, Virginia B.; David, Cédric H.; Cardenas, M. Bayani; Yang, Zong-Liang

    2013-04-01

    We determined present-day (1981-2000) relationships between river network drainage density (Dd) and runoff (R), and between vegetation cover (V) and precipitation (P) across a contiguous 470,800 km2 area (the Texas Gulf Coast basin), where P varies from 438 to 1280 mm/yr. Dd(R) follows a saturation-growth model which is similar to process-based equilibrium landscape models. V(P) follows a linear relationship. The models for Dd(R) and V(P) were used to assess how Dd and V might respond to decadal-scale climate changes in R and P anomalies predicted by a regional climate model between 2041-2060 and 1981-2000. The regional climate model, CRCM, was forced following the SRES A2 emissions scenario. Our calculations indicate a tendency of 57,500 km of active river channels to drying up, representing 9.9% of the present-day total of 581,985 km, due to future decrease in R. This will be accompanied by a loss of 8150 km2 in V due to decrease in P. This study extends empirical studies of relationships between climate and landscape properties and explicitly links observations with process-based models. The results provide a simple framework for modeling potential trajectories of the landscape due to climate change.

  5. Do Low-quality Leader-Member Relationships Matter for Subordinates? Evidence from Three Samples on the Validity of the Norwegian LMX Scale

    Directory of Open Access Journals (Sweden)

    Trude Furunes

    2015-06-01

    Full Text Available Theories on the relations between leaders and subordinates have been of interest to researchers for decades; however, these theories have received less attention in the Nordic countries. The aim of this study is twofold: to investigate the validity of the Leader-Member-Exchange Scale, LMX-7, in three Norwegian samples, and to explore potentially negative relationships between leader–member relationships and work-environment quality indicators. Data were collected from teachers (n = 409, industrial workers (n = 406, and bus drivers (n = 1024. All hypotheses were supported. Results supported use of the measure LMX-7 as indicated by factor structure, high construct validity, sufficient criterion-related validity, discriminant validity, and internal reliability as measured by Cronbach’s alpha above 0.90. Poor quality relationships were associated with higher levels of role conflict, stress, bullying, turnover intentions, age discrimination, and negative affectivity, and lower levels of job satisfaction, commitment, skills utilization, autonomy, participation, perceived fairness, and social support. Potential consequences of low-quality relations and implications of findings are discussed.

  6. Microeconomic relationships between and among fishers and traders influence the ability to respond to social-ecological changes in a small-scale fishery

    Directory of Open Access Journals (Sweden)

    Stuart Kininmonth

    2017-06-01

    Full Text Available Understanding the cross-scale nature of how natural resource trading links to local extraction patterns remains a topic of great relevance to stewardship and sustainable use of ecological systems. Microeconomic influences on a society's pattern of small-scale natural resources utilization can exacerbate resource overuse, especially under increased population pressure. In many rural communities that are based on a limited diversity of resource industries, quantifying the response of extractors and traders to market and environmental fluctuations is critical to understanding management constraints. We examine the fishing practices of a small lake in Uganda, East Africa, from the dual perspectives of the traders and the fishers using a Bayesian Belief Network approach based on detailed interview surveys. Fishers in this small lake target Nile perch (Lates niloticus and Nile tilapia (Oreochromis niloticus, two fish species of high commercial and food security significance in East Africa. We combined data on financial, social, and ecological systems to understand how aspects of trading quantitatively relate to fish extraction patterns in Lake Nabugabo Uganda. Importantly, we find that the patron-client type relationships generate incentives to extract specific fish, whereas "freelancer" independent fishers are able to create responsive and flexible extraction practices that match market and environmental fluctuations. Management of fishing administered by local Beach Management Units will likely have a higher probability of success when in synchrony with trading relationships and ecological dynamics. We use this study in Uganda to reflect on methodological challenges and opportunities of combining multiple types of data sets for cross-scale analysis of social-ecological system dynamics.

  7. An Exploration of the Reliability and Validity of the Spanish Version of the 'Voice and You' (VAY): A Scale for Measuring the Relationship with Voices.

    Science.gov (United States)

    Perona-Garcelán, S; Úbeda-Gómez, J; León-Palacios, M G; Barros-Albarrán, M D; Escudero-Pérez, S; López-Jiménez, A M; Vallina-Fernández, O; Jiménez-García-Bóveda, R; Diez-Alegría, C; Rodríguez-Testal, J F; Ruiz-Veguilla, M; García-Montes, J M; Pérez-Álvarez, M; Hayward, M

    2016-01-01

    The purpose of this study was to adapt the 'Voice and You' Scale (VAY) (Hayward, Denney, Vaughan, & Fowler, 2008) to Spanish and explore its psychometric properties for measuring the perceived relationship with voices. A sample of 50 psychiatric patients with verbal auditory hallucinations (48 had a psychotic disorder and two a borderline personality disorder) was used. Its reliability was calculated using the Cronbach's α and test-retest, and concurrent validity by the Pearson correlation coefficient of the VAY with the Beliefs About Voices Questionnaire and the Psychotic Symptom Rating Scales. The results showed that internal consistency of the Spanish version of the VAY ranged from 0.74 to 0.84 on the various subscales, and test-retest reliability varied from 0.74 to 0.83 on three subscales (voice 'dominance', 'intrusiveness' and hearer 'dependence'), and was lower (0.68) on the hearer 'distance' subscale. Concurrent validity was acceptable as significant associations were found with the Beliefs About Voices Questionnaire and the Psychotic Symptom Rating Scales subscales. It is concluded that the Spanish version of the VAY is a reliable and valid instrument that can assist the exploration of voices within relational frameworks across research and clinical domains. The Spanish version of the VAY is a reliable, valid instrument for evaluating the perception a person can have about his or her relationship with the voices and how the person relates to them. Voices that are perceived as relating dominantly and intrusively, and from whom distance is sought, seem to be distressing and cause disturbance. Voices that are related to dependently are perceived as having benevolent intent and are engaged with. Benevolent or neutral voices may be considered as intrusive because of the intensity and frequency with which they are experienced. Copyright © 2015 John Wiley & Sons, Ltd.

  8. Linking eating and weight control attitudes to relationship experiences: A large-scale survey of adolescent females.

    Science.gov (United States)

    Thomas, Rebekah L; Kelly, Adrian B; Chan, Gary C K; Williams, Joanne W

    2017-07-01

    To examine the extent to which family conflict, peer bullying and psychological distress account for eating and weight loss attitudes in adolescent females. This study examined the degree to which psychological distress mediated the association between family conflict and eating and weight loss attitudes, and the association of bullying and eating and weight loss attitudes. Females aged between 11 and 17 years (N = 5125) were recruited from schools in the State of Victoria (Australia). Key measures included psychological distress, family conflict, and bullying victimisation. A structural model showed good fit, and all predictors were significant. Psychological distress mediated the association between eating and weight loss attitudes, and family problems and bullying. Family conflict and peer bullying were associated with eating and weight loss attitudes and this association may occur via psychological distress. Early intervention programs may benefit from a focus on family and peer relationships. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. The relationship between suicide and five climate issues in a large-scale and long-term study in Japan.

    Science.gov (United States)

    Inoue, K; Nishimura, Y; Fujita, Y; Ono, Y; Fukunaga, T

    2012-08-01

    Suicide rates in Japan were high in 1998 and have remained high since then. Many researchers have discussed the current state of suicide in Japan and the world; however, there are various opinions about the relationship between suicide and climate. In the present study, we report on long-term data of suicide and examine five climatic issues in Japan as a whole and in 10 selected prefectures: the five with the highest suicide rates in 2006 (Akita, Iwate, Shimane, Yamagata and Miyazaki Prefectures) and the five with the lowest (Nara, Tokushima, Okayama, Kanagawa and Kyoto Prefectures). Annual age-adjusted suicide rates were found to have a significant inverse correlation with annual mean air temperature in the five prefectures with the highest suicide rates and in the three prefectures with the lowest suicide rates among women. Annual age-adjusted suicide rates were significantly correlated with annual mean relative humidity in the three prefectures with the highest suicide rates among women and with the annual total sunshine duration in the three prefectures with the highest suicide rates among women. It is important that these associations between suicide and climatic factors be discussed further from various viewpoints, including those of many researchers and relevant organizations.

  10. Fast parametric relationships for the large-scale reservoir simulation of mixed CH4-CO2 gas hydrate systems

    Science.gov (United States)

    Reagan, Matthew T.; Moridis, George J.; Seim, Katie S.

    2017-06-01

    A recent Department of Energy field test on the Alaska North Slope has increased interest in the ability to simulate systems of mixed CO2-CH4 hydrates. However, the physically realistic simulation of mixed-hydrate simulation is not yet a fully solved problem. Limited quantitative laboratory data leads to the use of various ab initio, statistical mechanical, or other mathematic representations of mixed-hydrate phase behavior. Few of these methods are suitable for inclusion in reservoir simulations, particularly for systems with large number of grid elements, 3D systems, or systems with complex geometric configurations. In this work, we present a set of fast parametric relationships describing the thermodynamic properties and phase behavior of a mixed methane-carbon dioxide hydrate system. We use well-known, off-the-shelf hydrate physical properties packages to generate a sufficiently large dataset, select the most convenient and efficient mathematical forms, and fit the data to those forms to create a physical properties package suitable for inclusion in the TOUGH+ family of codes. The mapping of the phase and thermodynamic space reveals the complexity of the mixed-hydrate system and allows understanding of the thermodynamics at a level beyond what much of the existing laboratory data and literature currently offer.

  11. Recent insights into genotype-phenotype relationships in patients with Rett syndrome using a fine grain scale.

    Science.gov (United States)

    Fabio, Rosa Angela; Colombo, Barbara; Russo, Silvia; Cogliati, Francesca; Masciadri, Maura; Foglia, Silvia; Antonietti, Alessandro; Tavian, Daniela

    2014-11-01

    Mutations in MECP2 gene cause Rett syndrome (RTT), a neurodevelopmental disorder affecting around 1 in 10,000 female births. The clinical picture of RTT appears quite heterogeneous for each single feature. Mutations in MECP2 gene have been associated with the onset of RTT. The most known gene function consists of transcriptional repression of specific target genes, mainly by the binding of its methyl binding domain (MBD) to methylated CpG nucleotides and recruiting co-repressors and histone deacetylase binding to DNA by its transcription repressor domain (TRD). This study aimed at evaluating a cohort of 114 Rett syndrome (RTT) patients with a detailed scale measuring the different kinds of impairments produced by the syndrome. The sample included relatively large subsets of the most frequent mutations, so that genotype-phenotype correlations could be tested. Results revealed that frequent missense mutations showed a specific profile in different areas of impairment. The R306C mutation, considered as producing mild impairment, was associated to a moderate phenotype in which behavioural characteristics were mainly affected. A notable difference emerged by comparing mutations truncating the protein before and after the nuclear localization signal; such a difference concerned prevalently the motor-functional and autonomy skills of the patients, affecting the management of everyday activities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Evidence-Based Thresholds for the Volume-Value Relationship in Adolescent Idiopathic Scoliosis: Outcomes and Economies of Scale.

    Science.gov (United States)

    Navarro, Sergio M; Ramkumar, Prem N; Egger, Anthony C; Goodwin, Ryan C

    Increased surgeon and hospital volume has been associated with improved patient outcomes and cost effectiveness for adolescent idiopathic scoliosis (AIS). However, no evidence-based thresholds that clarify the volume at which these strata occur exist. The objective of this study was to establish statistically meaningful thresholds that define high-volume surgeons and hospitals performing spinal fusion for AIS from those that are low volume with respect to length of stay (LOS) and cost. Using 3,224 patients undergoing spinal fusion for AIS from an administrative database, we created and applied four models using stratum-specific likelihood ratio (SSLR) analysis of a receiver operating characteristic (ROC) curve. We generated four sets of thresholds predictive of adverse outcomes, namely, increased cost and LOS, for both surgeon and hospital volume. For both LOS and cost, surgeon volume produced the same strata with low volume identified as 0-5 annual surgeries and high as greater than 5. LOS and cost decreased significantly (p < .05) between volume strata. For hospital volume in terms of LOS, low volume was identified as 0-10 annual surgeries and high as greater than 10; in terms of cost, low volume was identified as 0-15 annual surgeries and high as greater than 15. LOS decreased significantly (p < .05) and cost was $1,500 less but not statistically significant between volume strata for hospital volume. Our study of risk-based volume stratification established a direct volume-value relationship for surgeons and hospitals performing fusion for AIS. A meaningful threshold for low- and high-volume surgeons was established at 5 annual surgeries, but no consensus or clinically meaningful conclusion was reached for hospitals, although the threshold approached 10-15 annual surgeries. This analysis should aid patients, surgeons, and administration reach value-based decisions in the optimal delivery of pediatric spinal fusion for AIS. Copyright © 2017 Scoliosis Research

  13. Concentration-Discharge relationships in a mine-impacted catchment, New River, Tennessee: Comparison across spatial and temporal scales using time-series analysis

    Science.gov (United States)

    Murphy, J.; Hornberger, G. M.

    2009-12-01

    Concentration-discharge (c-Q) relationships are useful in indentifying physical and chemical processes affecting stream water chemistry. Frequently used as a diagnostic tool, c-Q relationships can be used to infer particular mixing patterns that may occur in a catchment. However, much work has shown c-Q relationships are highly variable and often inconclusive, suggesting the catchment behavior they indicate cannot be readily recognized without supporting knowledge of system dynamics. For example, drainage area and location, in addition to changes in land use over time, affect many processes in catchments including flow routing and solute concentrations. The effect of spatial and temporal scales on c-Q relationships are explored using recursive time-series analysis of historic and recent water quality data. The New River encompasses 400 square miles of remote land on the Cumberland Plateau in middle Tennessee and is a major component of the headwaters of the Cumberland River. Current and historic coal mining, oil and gas extraction, and timber harvesting have impaired water quality in the watershed. Historically, the highest magnitude of degradation probably occurred during the mid-1900s with severe acid mine drainage throughout the watershed. In 1975, 56% of all coal mined in Tennessee was derived from the New River watershed. Over the past three decades most of the New River system has rebounded though some small tributaries still experience acid mine drainage and elevated metal loads. Sediment, in terms of quantity and sorption of metals, is currently considered the largest pollutant by many. Water pH is circum-neutral in the system and coal-mining pollution is best identified by elevated specific conductance and sulfate concentration. A combination of historic and recently collected water quality data were obtained for the Indian Fork, a small 4 square mile upland catchment in the New River watershed, and the New River main-stem, approximately 25 miles

  14. Extreme hydrometeorological events in the Peruvian Central Andes during austral summer and their relationship with the large-scale circulation

    Science.gov (United States)

    Sulca, Juan C.

    In this Master's dissertation, atmospheric circulation patterns associated with extreme hydrometeorological events in the Mantaro Basin, Peruvian Central Andes, and their teleconnections during the austral summer (December-January-February-March) are addressed. Extreme rainfall events in the Mantaro basin are related to variations of the large-scale circulation as indicated by the changing strength of the Bolivian High-Nordeste Low (BH-NL) system. Dry (wet) spells are associated with a weakening (strengthening) of the BH-NL system and reduced (enhanced) influx of moist air from the lowlands to the east due to strengthened westerly (easterly) wind anomalies at mid- and upper-tropospheric levels. At the same time extreme rainfall events of the opposite sign occur over northeastern Brazil (NEB) due to enhanced (inhibited) convective activity in conjunction with a strengthened (weakened) Nordeste Low. Cold episodes in the Mantaro Basin are grouped in three types: weak, strong and extraordinary cold episodes. Weak and strong cold episodes in the MB are mainly associated with a weakening of the BH-NL system due to tropical-extratropical interactions. Both types of cold episodes are associated with westerly wind anomalies at mid- and upper-tropospheric levels aloft the Peruvian Central Andes, which inhibit the influx of humid air masses from the lowlands to the east and hence limit the potential for development of convective cloud cover. The resulting clear sky conditions cause nighttime temperatures to drop, leading to cold extremes below the 10-percentile. Extraordinary cold episodes in the MB are associated with cold and dry polar air advection at all tropospheric levels toward the central Peruvian Andes. Therefore, weak and strong cold episodes in the MB appear to be caused by radiative cooling associated with reduced cloudiness, rather than cold air advection, while the latter plays an important role for extraordinary cold episodes only.

  15. Supraceliac and Infrarenal Aortic Flow in Patients with Abdominal Aortic Aneurysms: Mean Flows, Waveforms, and Allometric Scaling Relationships.

    Science.gov (United States)

    Les, Andrea S; Yeung, Janice J; Schultz, Geoffrey M; Herfkens, Robert J; Dalman, Ronald L; Taylor, Charles A

    2010-03-01

    Hemodynamic forces are thought to play a critical role in abdominal aortic aneurysm (AAA) growth. In silico and in vitro simulations can be used to study these forces, but require accurate aortic geometries and boundary conditions. Many AAA simulations use patient-specific geometries, but utilize inlet boundary conditions taken from a single, unrelated, healthy young adult. In this study, we imaged 43 AAA patients using a 1.5 T MR scanner. A 24-frame cardiac-gated one-component phase-contrast magnetic resonance imaging sequence was used to measure volumetric flow at the supraceliac (SC) and infrarenal (IR) aorta, where flow information is typically needed for simulation. For the first 36 patients, individual waveforms were interpolated to a 12-mode Fourier curve, peak-aligned, and averaged. Allometric scaling equations were derived from log-log plots of mean SC and IR flow vs. body mass, height, body surface area (BSA), and fat-free body mass. The data from the last seven patients were used to validate our model. Both the SC and IR averaged waveforms had the biphasic shapes characteristic of older adults, and mean SC and IR flows over the cardiac cycle were 51.2 ± 10.3 and 17.5 ± 5.44 mL/s, respectively. Linear regression of the log-log plots revealed that BSA was most strongly predictive of mean SC ( R 2 = 0.29) and IR flow ( R 2 = 0.19), with the highest combined R 2 . When averaged, the measured and predicted waveforms for the last seven patients agreed well. We present a method to estimate SC and IR mean flows and waveforms for AAA simulation.

  16. A Multi-Scale Approach to Investigating the Red-Crowned Crane