Perceived Threat of Disaster, Efficacy, and Psychological Distress Among Individuals with a Physical Disability: A Longitudinal Model

OBJECTIVE

Individuals with physical disabilities experience distress when faced with the threat of human-made and natural disasters, yet little is known about how to reduce that distress. This study used Protection Motivation Theory to longitudinally test the relationships between psychological distress and disaster-related cognitive appraisals, including perceived threat, emergency preparedness self-efficacy, and response efficacy, in a sample of individuals with physical disabilities.

METHODS

A nationwide convenience sample of 106 adults completed 2 surveys approximately 5 years apart. Structural equation modeling was used to assess effects of perceived threat, self-efficacy, and response efficacy on psychological distress across the 2 waves.

RESULTS

Our results suggest that the associations of proximal perceived threat and self-efficacy with psychological distress remain stable across time, while the effect of response efficacy is variable and may be more context-specific. Importantly, individuals who reported an increase in self-efficacy over time also reported (on average) a decrease in psychological distress.

CONCLUSIONS

In addition to broadening our understanding of factors related to psychological distress, these results have potentially important intervention implications; for example, to the extent that self-efficacy is a malleable construct, one way of reducing disaster-related psychological distress may be to increase an individual's self-efficacy.

Optimizing Provider Preexposure Prophylaxis (PrEP) Training: A Cross-Sectional Analysis of Recommendations from Providers Across the PrEP Implementation Cascade

Expanding PrEP access necessitates training that supports healthcare providers’ progression along the PrEP implementation cascade, moving from PrEP awareness to prescription. We surveyed 359 USA providers about PrEP training content and format recommendations. We examined the association between cascade location and training recommendations. Most providers were aware of PrEP (100%), willing to prescribe PrEP (97.2%), had discussed PrEP with patients (92.2%), and had prescribed PrEP (79.9%). Latent class regression analysis revealed that cascade location was associated with training recommendations. Although all providers recommended PrEP-specific content (e.g., patient eligibility), providers who were located further along the cascade also recommended more comprehensive content, including sexual history-taking and sexual and gender minority competence training. Providers further along the cascade were also more likely to recommend interactive training formats (e.g., role-playing). These insights from providers furthest along the cascade indicate the importance of including comprehensive content and interactive formats in future PrEP training initiatives.

Adolescent version of the questionnaire of eating and weight patterns: reliability and gender differences

OBJECTIVE

The present study determined the test-retest reliability of the adolescent version of the Questionnaire of Eating and Weight Patterns (QEWP-A) and examined gender differences in QEWP-A responses.

METHOD

The QEWP-A was administered to 106 male and female adolescents between the ages of 12 and 18 in a classroom setting and readministered 3 weeks later under the same conditions. Adolescent responses were classified into no diagnosis (ND), nonclinical binge (NCB), and binge eating disorder (BED) diagnostic categories.

RESULTS

BED diagnoses were rare, but nonclinical levels were observed. Significant levels of stability for males and females were observed over a 3-week time period (phi = 0.42). Male and female differences were examined. Female responses changed significantly at the second testing.

DISCUSSION

The implications for these results regarding the utility for the QEWP-A are reviewed.

Pharmacokinetics of the acyl coenzyme A:cholesterol acyl transferase inhibitor CP-105,191 in dogs--the effect of food and sesame oil on systemic exposure following oral dosing

Inhibition of acyl coenzyme A:cholesterol acyl transferase (ACAT) decreases total plasma cholesterol in animals and may be an effective therapy for atherosclerosis in man. The pharmacokinetics of CP-105,191, a potent inhibitor of ACAT, were explored in fed and fasted dogs. Following oral administration of drug, mean apparent plasma half-life ranged from 9 to 16 h. Systemic availability of CP-105,191, as determined by AUC(0-infinity), was approximately 3-4-fold higher in fed dogs than in fasted dogs when 50 mg doses were administered as aqueous suspensions. Tmax was achieved more rapidly and Cmax was lower in fasted dogs. When 50 mg doses, partially dissolved in 20 mL sesame oil, were administered to fed dogs, the availability of CP-105,191 increased by another factor of 2. A 12.5 mg dose of CP-105,191, completely dissolved in sesame oil, was administered to fed and fasted dogs. Plasma AUC's were similar for fed and fasted dogs following the 12.5 mg dose, indicating that the increased availability of drug when administered with food is related to the presence of lipid.

Pharmacokinetics of zopolrestat, a carboxylic acid aldose reductase inhibitor, in normal and diabetic rats

The pharmacokinetics of zopolrestat, a carboxylic acid aldose reductase inhibitor, were examined in normal male rats dosed intravenously at 2 mg/kg and in normal and streptozotocin-diabetic male rats after oral administration at 50 mg/kg. After oral dosing, Cmax was 127 micrograms/ml for normal rats and 144 micrograms/ml for diabetic rats. AUC(0-infinity), however, was lower for diabetic rats than for normal rats and plasma half-life was longer in normal rats (8.0 vs 6.6 hr). Half-lives of zopolrestat in nerve, kidney, and lens were longer than plasma half-life and were similar for both diabetic and normal rats. Less than 2% of the dose was excreted in the urine as unchanged zopolrestat during the 48-hr period following dosing by diabetic or normal rats. Protein binding of zopolrestat was less extensive in plasma from diabetic rats than in plasma from normal rats. Similar kinetics were observed in diabetic animals receiving five daily doses of zopolrestat at 50 mg/kg/day. There was no plasma or liver accumulation of zopolrestat at steady state, consistent with the observed half-lives. However, zopolrestat did accumulate in nerve, kidney, and lens to varying degrees during multiple dosing, reflecting the longer half-lives of zopolrestat in these tissues.

Cunninghamella bertholletiae and Pneumocystis carinii pneumonia as a fatal complication of chronic lymphocytic leukemia

A unique patient with chronic lymphocytic leukemia died with pneumonia caused by both Cunninghamella bertholletiae and Pneumocystis carinii. In tissue sections, the hyphae of C bertholletiae were twisted and ribbon-like, but were smaller than those typical for zygomycetes, displayed more than occasional septa, and exhibited Y branching, making histologic distinction from Aspergillus sp difficult.

Interference by endogenous glycerol in an enzymatic assay of phosphatidylglycerol in amniotic fluid

We investigated the possibility of interference by endogenous glycerol with the enzymatic measurement of phosphatidylglycerol in amniotic fluid. Phosphatidylglycerol is an important indicator of fetal lung maturity. The concentrations of glycerol and phosphatidylglycerol in amniotic fluid were measured by using a coupled enzymatic assay with and without phospholipase D (EC 3.1.4.4). The precision of the assay was acceptable (within-run CV = 1.2%, between-run CV = 4.8%). Endogenous glycerol content was demonstrated to be approximately 10-20 times that of phosphatidylglycerol. This high proportion of endogenous glycerol in amniotic fluid would preclude the accurate enzymatic determination of amniotic fluid phosphatidylglycerol unless the glycerol is first removed. Nor can the actual phosphatidylglycerol concentration be determined by subtracting the endogenous glycerol concentration from the total glycerol, which includes that glycerol derived from phosphatidylglycerol. With a usual range of 9 +/- 7 mumol/L, the error for a given phosphatidylglycerol measurement of +/- 6.6 mumol/L (+/- 2 SD) clearly is too high for this assay to be clinically useful. There was no correlation between concentration of endogenous glycerol or apparent phosphatidylglycerol in amniotic fluid and the lecithin/sphingomyelin ratio of the sample.

Interference by endogenous glycerol in an enzymatic assay of phosphatidylglycerol in amniotic fluid

We investigated the possibility of interference by endogenous glycerol with the enzymatic measurement of phosphatidylglycerol in amniotic fluid. Phosphatidylglycerol is an important indicator of fetal lung maturity. The concentrations of glycerol and phosphatidylglycerol in amniotic fluid were measured by using a coupled enzymatic assay with and without phospholipase D (EC 3.1.4.4). The precision of the assay was acceptable (within-run CV = 1.2%, between-run CV = 4.8%). Endogenous glycerol content was demonstrated to be approximately 10-20 times that of phosphatidylglycerol. This high proportion of endogenous glycerol in amniotic fluid would preclude the accurate enzymatic determination of amniotic fluid phosphatidylglycerol unless the glycerol is first removed. Nor can the actual phosphatidylglycerol concentration be determined by subtracting the endogenous glycerol concentration from the total glycerol, which includes that glycerol derived from phosphatidylglycerol. With a usual range of 9 +/- 7 mumol/L, the error for a given phosphatidylglycerol measurement of +/- 6.6 mumol/L (+/- 2 SD) clearly is too high for this assay to be clinically useful. There was no correlation between concentration of endogenous glycerol or apparent phosphatidylglycerol in amniotic fluid and the lecithin/sphingomyelin ratio of the sample.

Employment status of 53 handicapped college graduates

Of 57 students who graduated between November, 1961, and June, 1965, and who were also served by the University's Disabled Student's Office, 53 or 93% responded in a follow-up. Of the 53, 52 or 98% were engaged in various occupations. The 19 handicapped graduates of the 1964–65 class moved directly into employment with no time lapse, but the 33 earlier graduates (one was still unemployed) required a mean of 2.5 mo. to find jobs. Two principal reasons probably accounted for this difference. First, the 1964–65 class graduated at a time when the national and state economies were booming. And second, the 1964–65 graduates had had the full benefit of the university's vocational planning and personal counseling.