An Innovative Solution to Assessing Staff Learning Needs

Traditional needs assessments for continuing education reflect personal interests and perceptions of learning needs rather than actual knowledge deficits. With an influx of new staff in a rapidly expanding neonatal ICU, time constraints made it imperative to accurately assess the learning needs of the novice practitioner. A needs assessment tool, developed by the unit-based education committee, identified gaps in knowledge among NICU staff. The questionnaire consisted of direct questions covering aspects of clinical and professional issues in neonatal care. The respondents were asked to indicate their ability to answer the questions completely, partially, or not at all. The questions were categorized according to patient populations and professional issues, thereby providing curriculum for continuing education specific to identified learning needs.

Predicting normal age-related changes with intelligence, projective, and perceptual-motor test variables

From four tests, the WAIS, Rorschach, Hand Test, and Bender-Gestalt, 67 variables were derived and used to predict age for 240 individuals. Ages ranged from 15 to 65 yr., divided into five age intervals, with 48 subjects per group. 36 variables correlating with age were further reduced to 12 by means of a stepwise multiple R. A final R of .73 was obtained, accounting for 53% of the variance. While variables from all four of these tests correlated with the criterion, most of the significant variance could be attributed to intellectual factors.

Chiropractic adjustive manipulation on subjects with acute low back pain: visual analog pain scores and plasma beta-endorphin levels

The purpose of this study was to evaluate pain scores and plasma beta-endorphin levels following a single spinal adjustive manipulation in subjects with acute low back pain. Eighteen subjects were randomly assigned to either a control group, which received no treatment; a sham group, which received only light physical contact (touch); or an experimental group, which received an adjustive manipulation at a specific lumbar segment. Following a standard protocol, all subjects were administered visual analog pain scales and venous blood was drawn 5 min prior to, 5 min after, and 30 min after intervention. Analysis of the pain scores indicated that there was a slight, but significant, reduction of pain in the experimental group, but no similar reduction in the control or sham groups. Furthermore, this reduction of pain in the experimental group was not accompanied any significant change in the plasma beta-endorphin concentration.

Recurrent aneurysmal subarachnoid haemorrhage: incidence, timing and effects. A re-appraisal in a surgical series

A series of 510 patients with proven aneurysmal subarachnoid haemorrhage (SAH) is reported. The incidence of recurrent haemorrhage during the period awaiting surgery was 13.7%. There was no significant difference in incidence between good and poor grade patients. Following rebleeding there was an immediate mortality of 34% in good grade patients and 52% in poor grade patients. In the long term only 44.4% of good grade and 8% of poor grade patients made a good recovery following a second bleed as compared to 70.6% and 52.8% respectively for those who did not rehaemorrhage.

Post-ictal blood pressure in aneurysmal subarachnoid haemorrhage

A prospective study in which the effect of the post-ictal systemic blood pressure levels on the outcome following surgically treated aneurysmal subarachnoid haemorrhage (SAH) in 325 patients is reported. No differentiation was made between pre-existing essential and prolonged reactive hypertension. A significant association was found between the trend for rising diastolic blood pressure levels and the tendency towards a poor outcome. There was a similar trend for rising systolic blood pressure levels which did not reach statistical significance. Patients with definite hypertension (blood pressure of 160/95 mmHg or greater) were 1.6 times as likely to have a poor outcome than were those with lower blood pressures.

Dipyridamole and postoperative ischemic deficits in aneurysmal subarachnoid hemorrhage

Recent evidence has suggested that the delayed cerebral ischemic deficits that often follow surgery for aneurysmal subarachnoid hemorrhage (SAH) may be due to a proliferative vasculopathy. This vascular pathology may result from an interaction between the platelets and the vessel wall. A single-blind controlled trial of dipyridamole administration in 677 patients presenting with SAH (of whom 348 came to surgery) was undertaken to test the hypothesis that the modification of platelet behavior might reduce the incidence of ischemic deficits. Blind independent assessment of the outcome in the surgical group based on the Glasgow Outcome Scale and the specific neurological deficits revealed no significant differences between the control and treatment groups.

Possible disease-modifying effects of naproxen in the adjuvant-arthritic rat

Naproxen was evaluated for possible disease modifying effects in the Freund's adjuvant injected rat (AIR). Oral administration of the clinical dose, 7 mg/kg/day, lead to an almost complete inhibition of hindpaw swelling and cartilage and bone erosion. This was noted in animals maintained on drug as well as those in which therapy was discontinued. AIR, comparable to arthritic patients, demonstrate a reduced lymphocytic response to T cell mitogens. This response was normalized in naproxen-treated rats. These results suggest that naproxen has a disease modifying effect in the AIR.

Divergent effects of suramin on in vitro and in vivo assays of cartilage degradation

Proteinases are thought to be responsible for cartilage and bone erosion noted in chronic inflammatory conditions. Suramin [8-(3-benzamindo-4-meta-1-benzamindo)naphthalene-1,3,5-trisulfonic acid], 10(-5) and 10(-4) M, inhibited the release of a mouse macrophage-derived cartilage proteoglycan-degrading enzyme. At 10(-5) M it antagonized the activity of beta-glucuronidase and cathepsin D derived from the mouse macrophage, as well as similar enzymes secreted by rat macrophages in vivo. When cultured at 10(-4) M with rabbit knee cartilage, it antagonized the autolytic release of proteoglycan, indicating an inhibitory activity against a chondrocyte-derived neutral proteinase. After in vivo treatment at 10 mg/kg/day s.c., it was ineffective in preventing the cartilage and bone erosion noted in the adjuvant arthritic rat.

In vivo and in vitro effects of dexamethasone on leukocyte migration in the rat adjuvant arthritis model

When polymorphonuclear leukocytes (PMNs) and mononuclear cells were isolated from the blood of dexamethasone-treated normal rats, in vitro mononuclear cell migration was inhibited and PMN migration was stimulated in comparison to controls. Inflammogen-induced PMNs showed inhibited cell migration due to dexamethasone treatment. Gamma camera imaging was then used to detect cells in vivo after labeling with indium-111. When the dexamethasone-treated blood cells were injected into adjuvant arthritis diseased rats, mononuclear cells showed depressed migration into the inflamed paws, while PMNs showed stimulated migration into the inflamed paws in comparison to controls. When the recipient adjuvant arthritic animals were treated with dexamethasone, both normal mononuclear cell and normal PMN migration to the inflamed paws were inhibited.

Consistency of some personality measures as a function of stage of menstruation

Two groups of college women were administered the Hand Test and selected scales from the Guilford-Zimmerman Temperament Survey. One group was tested in the premenstrual phase of the menstrual cycle (days 20-25); the other group at the beginning of the cycle (days 5-9). Significant differences were obtained, but the results did not corroborate earlier findings that negative personality characteristics are associated with the premenstrual phase of the cycle. The implications of the results and relevant methodological considerations are discussed.

Small-cell carcinocythaemia

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Split-half and test-retest Hand Test reliabilities for pathological samples

Computed split-half and test-retest reliabilities for some major Hand Test scoring categories for a group of 100 Ss of mixed psychopathology. All correlations were significant; the rs ranged from "modest" to "high.' Withdrawal, the most serious of all indices of psychopathology, showed the most consistency across both split-half and test-retest formats. Results were interpreted as lending credence to Hand Test rationale. Reliabilities appear high enough to justify the clinical use of the technique.

Efficacy of three projective techniques in differentiating brain damage among subjects with normal IQs

Obtained substantial differentiation between brain-damaged (N = 25) and non-brain-damaged (N = 25) groups of average intelligence with the WAIS, Rorschach and Hand Test. The use of projective tests in diagnosing neurological impairment was encouraged, but it was cautioned that brain damage and IQ are heavily interrleated, sometimes in complex ways, and that reliable signs of organicity may vary with the Ss level of intelligence.

Effects of naproxen on connective tissue changes in the adjuvant arthritic rat

The Freund's adjuvant-injected rat shares a number of features with the arthritis patient, viz the presence of a proliferative synovitis, joint swelling, and cartilage and bone erosion. Naproxen, a prostaglandin synthetase inhibitor which is an effective antiinflammatory agent in laboratory animals and humans, was evaluated as an inhibitor of connective tissue destruction in this model by use of radiologic and histopathologic analyses. Sixteen days after rats were injected with Freund's complete adjuvant, marked joint swelling was noted. On day 17, vehicle or naproxen, 7 mg/kg/day, was administered orally. Twenty-eight days later vehicle-treated animals demonstrated the following pathologic changes in their hindpaws; swelling, cartilage loss, large amounts of pannus within the joint spaces, osteoporosis, bone erosions, periosteal new bone formation, heterotopic ossification, and bony ankylosis. Rats treated 28 days with naproxen had significantly milder disease than the vehicle controls. The incidence of severe juxtaarticular bone destruction was 10/10 in the vehicle controls versus 2/10 of the drug-treated group (P less than 0.01). A comparable reduction in cartilage erosion, incidence of pannus, and new bone formation was noted in the drug-treated group. These effects may relate to an inhibition of prostaglandin biosynthesis; prostaglandins have been shown to: 1) stimulate collagenase secretion from macrophages, 2) stimulate bone resorption in vivo and in vitro, and 3) diminish proteoglycan synthesis in cartilage.

Factors affecting perceptual functioning and activity in albino rats

The effects of crowding and estrus cycling upon visual observing behavior and general activity level in the albino rat were investigated. Experimental groups were composed of non-estrus or estrus females and were subjected to one of three different crowding conditions. Measures of the frequency and duration of observing of photographic slides were taken as well as a measure of general activity. Slides were composed of either geometric patterns or color photographs depicting rats in various social postures. Contrary to previous reports, observing measures did not vary with levels of crowding or stage of estrus. There were, however, differences among the various crowded conditions on a measure of general activity. Relatively short-term crowding was shown to affect estrus based cyclical variation in activity and observing.

Structural Representation of Social Behavior in Rodents

The value of using multivariate techniques in categorization of behaviors derived from naturalistic observations was examined. It is suggested that these techniques are superior to the traditional methods of forming categories based on a priori conceptualizations, simply correlating the measures, or leaving the categorization of a multitude of behaviors to the reader. The present study used factor analytic techniques to identify both the number and nature of dimensions of rodents' social behaviors observed in the open field. Predictions as to the relationship between these derived categories and visual behaviors were then made. It was shown that rodents' social behavior is not unidimensional and is related to visual experience. Also, the utility of using multivariate statistics for both analyzing and categorizing a large number of behaviors was shown.

Visual observing behavior in the albino rat: effects of nature and complexity of visual stimuli and stage of estrus

The effect of varying levels of complexity within two types of visual stimuli on observing behavior of albino rats (60 females, 30 males, CD Strain, Charles River) was examined. Measures of frequency and duration of looking, as well as measures of general activity, were recorded. Differences in duration of observing as a function of group membership and type of stimuli were obtained. Activity was affected by the level of complexity. A re-examination of the concept of complexity is suggested. Further delineation of variables affecting observing behavior is also needed.