A novel blood-based biomarker for detection of autism spectrum disorders.

Autism spectrum disorders (ASD) are classified as neurological developmental disorders. Several studies have been carried out to find a candidate biomarker linked to the development of these disorders, but up to date no reliable biomarker is available. Mass spectrometry techniques have been used for protein profiling of blood plasma of children with such disorders in order to identify proteins/peptides that may be used as biomarkers for detection of the disorders. Three differentially expressed peptides with mass-charge (m/z) values of 2020 ± 1, 1864 ± 1 and 1978 ± 1 Da in the heparin plasma of children with ASD that were significantly changed as compared with the peptide pattern of the non-ASD control group are reported here. This novel set of biomarkers allows for a reliable blood-based diagnostic tool that may be used in diagnosis and potentially, in prognosis of ASD.

Time in care for older people living in nursing homes.

In order to measure actual care needs in relation to resources required to fulfill these needs, an instrument (Time in Care) with which to evaluate care needs and determine the time needed for various care activities has been developed with the aim of assessing nursing intensity in municipal care for older people. Interreliability (ICC = 0.854) of time measurements (n = 10'546) of 32 nursing activities in relation to evaluated care levels in two nursing homes (staff n = 81) has been determined. Nursing intensity for both periods at the two nursing homes comprised on average a direct care time of 75 (45%) and 101 (42%) minutes, respectively. Work time was measured according to actual schedule (462 hours per nursing home during two weeks). Given that the need for care was high, one must further investigate if the quality of care the recipients received was sufficiently addressed.

Are digital images good enough? A comparative study of conventional film-screen vs digital radiographs on printed images of total hip replacement.

The aim of this study was to evaluate the inter- and intra-observer variability and to find differences in diagnostic safety between digital and analog technique in diagnostic zones around hip prostheses. In 80 patients who had had a total hip replacement (THR) for more than 2 years, a conventional image and a digital image were taken. Gruen's model of seven distinct regions of interest was used for evaluations. Five experienced radiologists observed the seven regions and noted in a protocol the following distances: stem-cement; cement-bone; and stem-bone. All images were printed on hard copies and were read twice. Weighted kappa, kappa(w), analyses were used. The two most frequently loosening regions, stem-cement region 1 and cement-bone region 7, were closely analyzed. In region 1 the five observers had an agreement of 86.75-97.92% between analog and digital images in stem-cement, which is a varied kappa(w) 0.29-0.71. For cement-bone region 7 an agreement of 87.21-90.45% was found, which is a varied kappa(w) of 0.48-0.58. All the kappa values differ significantly from nil. The result shows that digital technique is as good as analog radiographs for diagnosing possible loosening of hip prostheses.

First-time mothers' satisfaction with early encounters with the nurse in child healthcare: home visit or visit to the clinic?

UNLABELLED: The aim of this study was to describe first-time mothers' views of satisfaction with their first encounter with the nurse, in order to investigate differences between home visits and clinic visits and between high/middle and low socioeconomic classification (SEC). A nation-wide postal questionnaire sent to 800 first-time mothers yielded the data for statistical analysis. Data were collected using a modified version of the questionnaire "Quality of Care from the Patient's Perspective", the part concerning child healthcare. The results showed that mothers who had received home visits were more content with the encounter than were mothers who had to visit the clinic. This particularly concerned advice on breastfeeding, being able to talk to the nurse in peace and quiet, and the fact that the nurse took time and was personal. In contrast, the mothers who had received a home visit were less content with the competence of the nurse when she examined the child. Mothers of low SEC were less satisfied with the first encounter than were mothers of high/middle SEC with regard to several points. CONCLUSION: Home visits were shown to have advantages over visits to the clinic. Mothers of low SEC were less satisfied with the first encounter with the nurse than were mothers in the high/middle SEC.

Self-perception and value system as possible predictors of stress.

This study was directed towards personality-related, value system and sociodemographic variables of nursing students in a situation of change, using a longitudinal perspective to measure their improvement in principle-based moral judgement (Kohlberg; Rest) as possible predictors of stress. Three subgroups of students were included from the commencement of the first three-year academic nursing programme in 1993. The students came from the colleges of health at Jönköping, Växjö and Kristianstad in the south of Sweden. A principal component factor analysis (varimax) was performed using data obtained from the students in the spring of 1994 (n = 122) and in the spring of 1996 (n = 112). There were 23 variables, of which two were sociodemographic, eight represented self-image, six were self-values, six were interpersonal values, and one was principle-based moral judgement. The analysis of data from students in the first year of a three-year programme demonstrated eight factors that explained 68.8% of the variance. The most important factors were: (1) ascendant decisive disorderly sociability and nonpractical mindedness (18.1% of the variance); (2) original vigour person-related trust (13.3%) of the variance); (3) orderly nonvigour achievement (8.9% of the variance) and (4) independent leadership (7.9% of the variance). (The term 'ascendancy' refers to self-confidence, and 'vigour' denotes responding well to challenges and coping with stress.) The analysis in 1996 demonstrated nine factors, of which the most important were: (1) ascendant original sociability with decisive nonconformist leadership (18.2% of the variance); (2) cautious person-related responsibility (12.6% of the variance); (3) orderly nonvariety achievement (8.4% of the variance); and (4) nonsupportive benevolent conformity (7.2% of the variance). A comparison of the two most prominent factors in 1994 and 1996 showed the process of change to be stronger for 18.2% and weaker for 30% of the variance. Principle-based moral judgement was measured in March 1994 and in May 1996, using the Swedish version of the Defining Issues Test and Index P. The result was that Index P for the students at Jönköping changed significantly (paired samples t-test) between 1994 and 1996 (p = 0.028), but that for the Växjö and Kristianstad students did not. The mean of Index P was 44.3% at Växjö, which was greater than the international average for college students (42.3%) it differed significantly in the spring of 1996 (independent samples t-test), but not in 1994, from the students at Jönköping (p = 0.032) and Kristianstad (p = 0.025). Index P was very heterogeneous for the group of students at Växjö, with the result that the paired samples t-test reached a value close to significance only. The conclusion of this study was that, if self-perception and value system are predictors of stress, only one-third of the students had improved their ability to cope with stress at the end of the programme. This article contains the author's application to the teaching process of reflecting on the structure of expectations in professional ethical relationships.

Self-image, self-values and interpersonal values among newly graduated nurses.

This longitudinal study (1994-1996) used the Gordon Personality Inventory to measure nursing students' self-image (Gordon A), self-values (Gordon B) and interpersonal values (Gordon C). It was performed with students from three colleges of health in the south of Sweden: Jönköping (n = 54), Växjö (n = 24) and Kristianstad (n = 38). The null hypothesis of the study was that the new academic three-year programme did not have the power to change significantly the students' self-image and professional values. The hypothesis was tested by paired sample Student's t-test. The result was that, at Jönköping, self-image changed and increased significantly in the dimensions of 'cautiousness' and 'personal relations', and decreased in 'sociability', and increased in the self-value 'order'. At Växjö the self-image dimensions of 'original thinking' and 'personal relations' increased, and, at Kristianstad, the students increased their self-image scores in 'responsibility'.