Patient activation measures in a government homeopathic hospital in India.

The American Patient Activation Measure-22 questionnaire (PAM-22) quantifies the knowledge, skills, and confidence essential to manage own health and health care. It is a central concept in chronic illness care models, but studied sparsely in homeopathic hospitals. PAM-22 was translated into Bengali and a cross-sectional study was undertaken in chronically ill 417 patients visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, India. Response rate was 90.41%. Data were analyzed using Rasch rating scale model with Winsteps. Activation score was 54.7 ± 8.04 or 62.13% of maximum score. PAM scores differed significantly by age, education, income, and health status (P < .05). The items had good data quality fit statistics and good range of difficulty. The construct unidimensionality was confirmed by good model fits for Rasch model and principal component analysis of residuals found no meaning structure. The questionnaire showed acceptable psychometrics. Patient activation was moderate and needs to be improved.

Attention deficit/hyperactivity disorder (ADHD) symptoms and digit ratios in a college sample.

Diagnosticians recognize three subtypes of attention deficit/hyperactivity disorder (ADHD) if there are developmentally inappropriate levels (six or more symptoms) of Hyperactive-Impulsive behavior, or Inattentive behavior, or both (Combined), respectively. ADHD may partly reflect androgen dysfunction, and an arguable proxy for prenatal androgen exposure is the 2D:4D finger ratio set at least as early as week 9 in the fetus; this is lower in men than in women. We examined the relationship between digit ratios and ADHD symptoms representing the three phenotypes: ADHD/Combined as measured by "summarized" (Rasched) scales, i.e., 1) the short version of the Wender Utah Rating Scale (WURS) and a total symptom list derived from the DSM IV, and the subdivided DSM IV into 2) ADHD/Inattentive and 3) ADHD/Hyperactive-Impulsive inventories, in a sample of European-descent college students (135 female, 52 male) not selected for ADHD. All digit ratios were calculated excluding the thumb. There were significant sex differences for the 2D:4D digit ratios of both hands (RH and LH), and between the RH 3D:4D and between the LH 2D:3D ratio. In females, the more masculine the LH 2D:4D ratio, the more the ADHD/Combined symptoms (both WURS and DSM) and the more the ADHD/Inattentive symptoms and ADHD/Hyperactive-Impulsive symptoms. More masculine ratios also correlated between the total WURS and RH 2D:3D, RH 2D:4D, and LH 2D:3D; and between the inattentive DSM symptoms and LH 2D:5D, and between the ADHD/Hyperactive and Impulsive symptoms and RH 3D:4D.

Attention-deficit hyperactivity disorder and fluctuating asymmetry in another college sample.

Attention deficit/hyperactivity disorder (AD/HD) represents a developmental lag that may be reflected in fluctuating asymmetry (FA), i.e., differences from perfect symmetry in traits that display bilateral symmetry. Burton et al. (2003 Am. J. Hum. Biol. 15:601-619) found a statistical trend for FA to increase (as dermatoglyphic index or as total index) as the behavioral measure for AD/HDness (Rasch logit values derived from the Wender Utah Rating Scale, or WURS) increased in males but not in females. The objective here was to do a similar study in an independently collected sample of college students (n = 222; 61 male, 161 female) not selected for AD/HD, looking at FA vs. symptoms for AD/HD based on Rasch versions of responses to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) (Barkley and Murphy 1998 Attention-Deficit Hyperactivity Disorder, New York: Guilford Press, p. 95-96) and the more comparable shortened WURS. FAs were lowest for body and ear height, and highest for eye width and nose width, and ranged from 0.01 +/- 0.001 (mean +/- SE) for foot and ankle widths to 0.13 +/- 0.01 in eye and nose widths for both sexes; the sexes did not differ significantly. Males displayed higher AD/HD symptom rates overall. There was a significant correlation between body FA and the WURS measure in females after Bonferroni correction (P = 0.002, r(2) = 0.058). Thus, AD/HD symptoms levels increased with an increase in body FA in female college students not selected for AD/HD.

Attention-deficit hyperactivity disorder (AD/HD) and fluctuating asymmetry (FA) in a college sample: an exploratory study.

Departures from normal development can be partly assessed by measuring fluctuating asymmetry (FA), that is, differences from perfect symmetry in traits that display bilateral symmetry. Attention-deficit hyperactivity disorder (AD/HD), one of the most common psychiatric conditions, is diagnosed if there are developmentally inappropriate levels of inattention, hyperactivity, and impulsivity. The objective here is to measure whether AD/HD behaviors positively correlate with FA in head, hands, and fingerprints of a sample of college students (n = 176, 57 male, 119 female) not selected for AD/HD. FA was measured as the absolute value of the difference between right and left sides divided by group mean trait size. Average FAs (mean, SE) were lowest for finger lengths (e.g., male, 3rd, 0.011 +/- 0.001; female, 3rd, 0.012 +/- 0.001) and highest for digit ridge counts (e.g., male, 5th, 0.075 +/- 0.007; female, 2nd, 0.069 +/- 0.005). Average FAs were similar between the sexes and only one facial measure and the facial index (summed FAs) differed significantly between the sexes (F > M). The scores for measures of the adult AD/HD behavioral assessment instrument, the Wender Utah Rating Scale (WURS) were high overall in this sample and males exhibited higher rates of symptoms than females. A Rasch measurement model analysis of individual responses to the WURS produced a true interval score for each person that is a measure of individual "AD/HDness." FA indices were then regressed on Rasch scores. A univariate analysis of all the variables demonstrated a significant interaction of sex. Hand, Dermatoglyphic, Face, and Total Indices were then regressed by sex on the Rasch values of "AD/HDness." Only in males was there a trend for the Dermatoglyphic Index (F(1,55) = 3.627, P = 0.062) and Total Index (F(1,55) = 3.811, P = 0.056) to increase as AD/HDness increases.

Psychosocial and demographic correlates of temporomandibular disorders and related symptoms: an assessment of community and clinical findings.

This study investigated the factor structure and relative prevalence of temporomandibular disorder (TMD) symptoms, in relation to demographic and psychosocial variables in a community sample. Two empirically distinct clusters of TMD symptoms were identified. Similar to reports of TMD clinic patients, more symptoms were reported by females than males and the greatest symptom prevalence was found in subjects between the ages of 30 and 49 years. Further, the number of symptoms reported was significantly and linearly related to scores on depression and repression-sensitization scales. These relationships, however, were similar for both sets of symptom composites even though one composite is clearly identifiable as the core TMD symptoms and the second composite consists of peripheral symptoms. Since the two symptom composites share some common variance, the relationship between demographic and psychosocial characteristics and the number of composite I and composite II symptoms was examined while controlling for the presence of symptoms from the other composite. When controlling for the presence of composite II symptoms, the correlations between psychosocial and demographic characteristics and composite I symptoms are small. When the presence of composite I symptoms is controlled there is little change in the magnitude of the correlations between psychosocial and demographic characteristics and composite II symptoms. It is concluded that the psychosocial profile described in clinical research is actually more characteristic of individuals with pain/dysfunction symptoms other than the classic TMD symptoms and that the relationship between core TMD symptoms (composite I) is largely spurious. It is suggested that this psychosocial profile of TMD patients may have developed through associating certain psychosocial characteristics with TMD while such characteristics are actually present in TMD clinic patients because of the covariation of the two symptom composites in individuals seeking treatment in TMD clinics.

Correspondence between subjective report of temporomandibular disorder symptoms and clinical findings.

Correspondence between subjective reports of temporomandibular disorder symptoms and clinical findings was examined in 65 volunteers. Significant relationships showed that the greater the number of reported symptoms, the greater the likelihood that positive signs would be found during examination. The symptom survey questionnaires served as a valid method for screening patients for temporomandibular disorder-related signs.

Trends in attitudes toward abortion: 1972-1976.

Trends in attitudes toward abortion are examined over the 1972-1976 period. While an overall tendency of more liberal attitudes is noted, important differences over time are apparent by gender, education, occupational prestige, and religiosity.

PIP: Analysis of data from the National Opinion Research Center's General Social Survey conducted annually from 1972-76 revealed trends in attitudes toward abortion. The following 6 questions were asked. Should a person obtain an abortion if: 1) there is chance of defect in the baby; 2) a woman doesn't want any more and is married; 3) if the woman's health is jeopardized; 4) if the family has a low income and cannot afford any more children; 5) if she becomes pregnant because of rape; or 6) if she is not married and does not want to marry the father. The overall trend showed an increase in approval for each of the 6 reasons for an abortion. There was an increase by 3 percentage points for each of the traditionally hard line reasons: health, rape, and defect; and an increase of 3, 6, and 6 percentage points respectively for the soft line reasons: poor, single, and no more. In 1972 males were more approving of abortion than females; 1976 saw an increase in approval for men. There was more disparity between the sexes in 1976 than in 1975. Protestants were consistently more liberal than Catholics. Protestant increases in approval exceeded Catholic increases for rape and defect for males, and health for females. The only decrease in approval of abortion for 1972-76 was for male Catholics for rape, -3 percentage points.

Age differences in attitude change toward premarital coitus.

Research on changes in attitudes toward premarital sexual behavior examine either (1) changes in attitudes of college students over a relatively short period of time or (2) changes in attitudes of adult nonstudent populations over long periods of time using noncomparable data sources. The present research examines changes in attitudes toward premarital coitus over a relatively short period of time utilizing national probability samples of the U.S. population. Rather than treating age as a dichotomous variable of the young and the old, age is considered in 10-year age groups, and changes by age group and sex are examined. The results indicate obvious dangers in employing gross breakdowns of the age variable in that considerable differences within young and old age groups are observed. Further, these difference interact with sex, producing sex- and age-specific change patterns. The exact nature of these patterns strongly suggests that the most rapid change is taking place among females in the 30--39 age group and that this change is such to produce intersex convergence in this age group. Rates of change by age and sex are discussed in terms of the possible differential influences of changes in women's roles.

The dimensionality of body-cathexis.

In an exploratory examination of the dimensionality of body perception in terms of satisfaction with body aspects, a principal components analysis was performed on data from 226 male and female college students. Results indicate that the complex of body aspects can be discussed in terms of a relatively small number of dimensions. The variable content of the factors is interpreted as suggesting the perceptual grouping of body aspects, and in this regard the similarities and differences between males and females are discussed and related to previous research on body-cathexis.