Showing papers by "University of Pittsburgh published in 1983"

Assessment of patient satisfaction in activities of daily living using a modified stanford health assessment questionnaire

Abstract: Patient satisfaction in performing activities of daily living (ADL) was assessed by using a self-administered questionnaire modified from the Stanford Health Assessment Questionnaire (HAQ). The HAQ includes questions to determine a patient's degree of difficulty and need for help and assistive devices in ADL. A modification of the HAQ (MHAQ) was developed to include questions concerning perceived patient satisfaction regarding the same ADL, along with perceived change in degree of difficulty. In order to add additional questions while maintaining the length of the questionnaire in a format suitable in routine care, the number of ADL included in the MHAQ was reduced from 20 to 8. Information regarding degree of difficulty derived from 8 questions in the MHAQ is comparable with that derived from 20 questions in the HAQ. The response of a patient that a specific activity is associated with difficulty in functional capacity was not inevitably associated with the absence of patient satisfaction; 43.7% of patients responding "with some difficulty" and 19.1% of patients responding "with much difficulty" expressed satisfaction with their functional capacity. A major determinant of expression of patient satisfaction was perceived change in difficulty: 81.4% of patients noting that their function was "less difficult now," in contrast to 16.9% of patients responding "more difficult now," expressed satisfaction. These studies suggest that data regarding patient satisfaction and perceived change in difficulty can be assessed to more completely characterize patients' functional status in ADL.

A Theoretical Perspective for Understanding Reactions to Victimization

Abstract: Although specific victimizations may differ, there appear to be common psychological responses across a wide variety of victims. It is proposed that victims' psychological distress is largely due to the shattering of basic assumptions held about themselves and their world. Three assumptions that change as a result of victimization are: 1) the belief in personal invulnerability; 2) the perception of the world as meaningful; and 3) the view of the self as positive. Coping with victimization is presented as a process that involves rebuilding one's assumptive world. Introductions to the papers that follow in this issue are incorporated into a discussion of specific coping strategies adopted by victims.

Mathematics and science learning: a new conception.

Abstract: Findings in cognitive science suggest new approaches to teaching in science and mathematics.

The Effects of Long-Term Vocabulary Instruction on Reading Comprehension: A Replication:

Abstract: A study that investigated the relationship between vocabulary instruction and reading comprehension was replicated and extended. The original study showed substantial gains in accuracy of word know...

Problem-Solving Skill in the Social Sciences

Abstract: Publisher Summary This chapter presents a model of problem-solving skill in the social sciences. Many social-science problems involve the existence of an undesirable state of affairs that requires improvement ( solutions). In general, problem solving consists of isolating the cause(s) of a problem and eliminating or at least reducing the effects. In social sciences, however, problem solving is often made quite difficult by two factors: the lack of agreed-upon solutions and delay in implementing solutions. The chapter discusses the processes involved in learning the skill of social-science problem solving and emphasizes the importance of experience in providing ways of organizing information so that it may subsequently be utilized in further processing. Ideas regarding the way a social-science problem-solving skill is acquired and the way it is related to a more general problem-solving research are discussed in the chapter. Testing hypotheses in social sciences tends to be a much more protracted process. Thus, the relatively large amount of argumentation found in social sciences may be attributed to the fact that problems do not have agreed-upon solutions, whereas the problems studied so far in natural sciences have well-formulated solutions.

Major and minor life events as predictors of psychological distress: further issues and findings.

Abstract: Current trends in research on stressful life events and disease have been to focus upon other psychosocial factors that may be associated with stress and illness relationships. Recently, the study of relatively minor life events or situations (e.g., daily hassles) has provided a promising alternative avenue of inquiry into basic stress measurement and the relationship of stress to disorder. While initial findings in this area of research appear encouraging, several methodological and procedural issues currently preclude definitive conclusions. The present paper outlines several of the most important limitations of existing research on this topic and provides further data taking these limitations into account for the role of minor life events as predictors of psychological distress. The results of the present prospective study indicate that undesirable minor events (e.g., hassles) significantly predict psychological symptoms, even once initial symptom status is controlled for statistically. Additionally, hassles were uniformly better predictors of subsequent psychological symptoms than were major life event categories; potentially important interactive effects (e.g., hassles x prior symptoms; hassles x prior major events) were also tested and their implications are discussed. Finally, basic associations between major and minor events were examined. The findings are discussed specifically in the context of recent advances in this area and more generally in relation to clarifying our understanding of psychosocial predictors of disorder.

Priority setting in complex problems

Abstract: There are three principles which one can recognize in problem solving. They are the principles of decomposition, comparative judgments, and synthesis of priorities. The Analytic Hierarchy Process (AHP) provides a comprehensive framework to cope with the intuitive, the rational, and the irrational in us all at the same time when we make decisions. It is a method we can use to integrate our perceptions and purposes into an overall synthesis. The AHP does not require that judgments be consistent or even transitive. The degree of consistency (or inconsistency) of the judgments is revealed at the end of the AHP process.

The evolution of Middle America and the Gulf of Mexico–Caribbean Sea region during Mesozoic time

Abstract: A plate-tectonic model for the evolution of Middle America and the Gulf of Mexico-Caribbean Sea region is presented. The model, which is based upon the existence of the Mojave-Sonora megashear, incorporates into the Triassic Pangea reconstruction three microplates between North and South America, thus avoiding the overlap of the Bullard fit. These plates are the Yaqui, bounded on the north by the Mojave-Sonora megashear; the east and west Maya plates, bounded on the north by the Mexican volcanic zone and on the south by a predecessor of the Motagua fault zone; and the Chortis plate (parts of Guatemala and Honduras). During Late Jurassic time, as North America split away from Europe, Africa, and South America, shear, with left-lateral sense of displacement, occurred along the transform faults that bounded the micro-plates. If ∼800 km of left-lateral displacement along the Mojave-Sonora megashear, ∼300 km along the Mexican volcanic belt, and ∼1,300 km along a proto-Motagua megashear are restored, and if Yucatan and Cuba are rotated to fit against northern South America, then (1) a curvilinear belt of late Paleozoic rocks that show lithologic as well as paleontologic similarities extends across the reconstruction and links outcrops in Texas, eastern Mexico, nuclear Central America, and Colombia; (2) a Mediterranean-like sea is delineated that was a precursor of most of the present Gulf of Mexico; (3) correlation is implied between the distinctive quartzose San Cayetano Formation of Cuba and the Caracas and Juan Griego Groups of Venezuela. Geometric constraints suggest that probably shear initially occurred along the Mexican volcanic zone near the end of the Middle Jurassic. Subsequently, probably about 160 m.y. ago, displacements that total ∼800 km began along the Mojave-Sonora megashear. Contemporaneously, Yucatan and fragments of pre-Cretaceous rocks that compose parts of central and western Cuba migrated northward toward their present positions. Rotation of Yucatan was facilitated by considerable displacement along the proto-Motagua zone and along a zone that is probably coincident with the modern Salina Cruz fault. Accumulation of widespread major salt units of Late Jurassic (Callovian to early Oxfordian) age in the Gulf Basin probably occurred contemporaneously with the arrival of these blocks at their present positions. Clastic units that interfinger with some of the youngest salt units and rim the Gulf of Mexico have not recorded major recognized translations since their accumulation. Clockwise rotation of South America and the Chortis plate occurred during Early Cretaceous time. This movement, which was manifested by subduction of Jurassic ocean floor against the previously rifted precursor of the island of Cuba and under parts of Hispaniola and Puerto Rico, is recorded by circum-Caribbean orogeny. Abrupt changes in the relative motions between North and South America during Late Cretaceous time may have resulted in extension and outpourings of basalt upon the Jurassic rocks of the ocean floor of the Venezuelan Basin. West of Beata Ridge, sea-floor spreading formed the Colombian Basin. Related subduction occurred as the Chortis plate (including part of Central America, the Nicaraguan Rise, and southeastern Cuba) was sutured against the Maya East plate along the present Motagua fault and Cayman Trench. Our model is constrained by published geologic data, the relative positions of North and South America from Atlantic sea-floor magnetic anomalies, and the requirement that the major transform faults be compatible with the poles of rotation for the appropriate relative motions between North and South America. Paleomagnetic data from Middle America are sparse but do not conflict with the predicted motions of some of the microplates, especially Chortis.

The Demise of the Demarcation Problem

Abstract: We live in a society which sets great store by science. Scientific ‘experts’ play a privileged role in many of our institutions, ranging from the courts of law to the corridors of power. At a more fundamental level, most of us strive to shape our beliefs about the natural world in the ‘scientific’ image. If scientists say that continents move or that the universe is billions of years old, we generally believe them, however counter-intuitive and implausible their claims might appear to be. Equally, we tend to acquiesce in what scientists tell us not to believe. If, for instance, scientists say that Velikovsky was a crank, that the biblical creation story is hokum, that UFOs do not exist, or that acupuncture is ineffective, then we generally make the scientist’s contempt for these things our own, reserving for them those social sanctions and disapprobations which are the just deserts of quacks, charlatans and con-men. In sum, much of our intellectual life, and increasingly large portions of our social and political life, rest on the assumption that we (or, if not we ourselves, then someone whom we trust in these matters) can tell the difference between science and its counterfeit.

Large and giant paraclinoid aneurysms: surgical techniques, complications, and results.

Abstract: Twenty-five patients with giant (greater than 25 mm in diameter) and 9 patients with large (15 to 25 mm in diameter) aneurysms of the internal carotid artery in the ophthalmic or paraophthalmic region are reviewed. In 23 of these patients the aneurysm was clipped directly. There was 1 death in this group, and none of the survivors had disabling neurological complications outside the visual system. The other 11 patients were treated by a trapping procedure or by either common carotid ligation or internal carotid ligation in the neck. Of the 5 patients treated by internal carotid ligation preceded by an extracranial to intracranial bypass graft, 3 developed embolic complications, which in 1 patient resulted in death. One of the 4 patients treated by ligation of the common carotid artery died 1 year later from a recurrent subarachnoid hemorrhage. Of the total group, 18 patients had visual loss preoperatively as a result of aneurysmal compression; in 10 the vision was improved by operation, in 3 it was made worse, and in 2 it was unchanged. In another patient the vision continued to deteriorate slowly after common carotid occlusion, and the other 2 patients died postoperatively before vision could be assessed. The complications in the patients are described and analyzed in detail. Maneuvers found to be of value in the direct approach to these lesions are described. Of these, exposure of the internal carotid artery in the neck for temporary occlusion during clipping and thorough drilling of the anterior clinoid process and unroofing of the optic canal were particularly helpful. The literature on indirect methods of treatment by carotid occlusion with and without bypass graft is reviewed with special reference to the complications and effectiveness of each alternative. Based on this review of the literature and our experience, a treatment scheme is suggested for these aneurysms depending on their mode of presentation.

Experience with 150 liver resections.

Abstract: One hundred fifty liver resections were performed with an operative mortality rate of 4%. Indications for liver resections were 43 primary liver malignancies, 43 metastatic liver tumors, and 64 benign liver diseases. The 3-year actuarial survival rate after treatment of primary liver malignancy was 56%, and that after treatment of metastatic liver tumors was 66%. All but one of 59 patients with benign disease who survived operation were alive without development of late symptoms or complications.

Social stress and atherosclerosis in normocholesterolemic monkeys

Abstract: Socially stressed adult male cynomolgus monkeys (Macaca fascicularis) fed a low fat, low cholesterol diet developed more extensive coronary artery atherosclerosis than unstressed controls. Groups did not differ in serum lipids, blood pressure, serum glucose, or ponderosity. These results suggest that psychosocial factors may influence atherogenesis in the absence of elevated serum lipids. Psychosocial factors thus may help explain the presence of coronary artery disease (occasionally severe) in people with low or normal serum lipids and normal values for the other "traditional" risk factors.

Assessment of childhood depression: correspondence of child and parent ratings.

Abstract: The present investigation evaluated the correspondence of child and parental reports of the children's depression. One-hundred-four children (ages 5–13) hospitalized on a psychiatric intensive care service, 101 mothers, and 47 fathers independently completed several measures to assess severity and duration of the children's depression. To validate the depression instruments, measures of hopelessness and self-esteem (completed by the children) and somatic complaints and internalizing (completed by the parents) were also included. The results indicated that different measures of depression completed by the same rater (child, mother, or father) were highly intercorrelated. However, there was little or no relationship between mother-child and father-child reports of the children's depression for the same or different measures of depression. Children's ratings of depression were positively correlated with hopelessness and parent ratings of somatic complaints and negatively correlated with self-esteem. Children independently diagnosed as depressed (DSM-III) were higher in severity of depression than nondepressed children on child and parent completed measures. The implications of the present results for further evaluation of child self-report and factors that may contribute to correspondence with parental report are highlighted.

Expecting Continued Play in Prisoner's Dilemma Games: A Test of Several Models

Abstract: Several models of prisoner's dilemma interactions were tested in a series of twelve games whose termination point was determined probabilistically. A new model was introduced to discriminate among equilibrium and nonequilibrium situations on the basis of a player's expected benefits or losses for cooperating. The experiment included twelve payoff matrices, three probabilities for continuing, two opponent strategies, and the player's sex as independent variables. Results showed that both the game payoffs and the probability that the game would continue interacted to affect the rates of cooperation observed, and that the equilibrium model predicted this outcome most accurately. While the predictions of each of the models were supported, the equilibrium models appeared to be superior to the others. The discussion highlights the importance of considering the likelihood of a game terminating as a major determinant of the cooperation that can be expected in mixed—motive interactions.

A locally parameterized continuation process

Abstract: The design of a package of continuation procedures called PITCON to handle the following tasks is described' (1) follow numerically any a priori specified curve on an equilibrium manifold; (2) on such a curve determine the exact location of target points where a given variable has a specified value; and (3) on such a curve identify and compute exactly the (simple) limit points where stability may be lost. The process is based on the local parametenzatmn wh]ch uses an estimate of the curvature to control the chome of parameter varmble. Categorms and Subject Descriptors. G 1.5 [Numerical Analysis]Roots of Nonlinear Equations-tteratwe methods, systems of equattons General Terms" Algorithms, Design Addltmnal

Wound healing by secondary intention. A cosmetic appraisal.

Abstract: Secondary intention healing is a simple method of wound management that can provide excellent cosmetic results. Wounds located on concave surfaces of the skin heal with a better cosmetic result than those on convex surfaces. The technic of wound care is reviewed and a set of guidelines is presented that helps one to predict the final appearance of healed cutaneous wounds.

A note on the falkner-skan flows of a non-newtonian fluid

Abstract: Non-similar solutions are established for the boundary layer flow of a homogeneous incompressible fluid of second grade past a wedge placed symmetrically with respect to the flow direction. The variation of the skin-friction with respect to the non-Newtonian parameters is discussed.

The organizational context of accounting

Abstract: It is our contention that accountants have typically sought to reduce uncertain situations into a framework characterized by well structured tasks and highly measureable outputs. We review the literature on budgetary and organizational control in the light of this argument. Furthermore, we describe the many kinds of behaviors that can result from the efforts of subordinates to distort the information system to their desired ends when they find themselves operating outside the structured and measureable framework.

Child, mother, and father evaluations of depression in psychiatric inpatient children.

Abstract: The agreement among children and their parents in evaluating the children's depression was examined in 48 families. Newly admitted inpatient children (ages 6-13) and their mothers and fathers independently completed self-report and interview measures to assess severity and duration of the children's depression. The results indicated that different measures of depression completed by the same rater (child, mother, or father) were highly intercorrelated. Yet there was little or no relationship between child-mother and child-father ratings of the children's depression for the same or related measures of depression. Children independently diagnosed (DSM III) as depressed rated themselves and were rated by their parents as more depressed than nondepressed children. Even so, children consistently rated themselves as less depressed across the measures than did their parents. Parent ratings of the children's depression and the correspondence of child-parent ratings varied as a function of several child and family variables, including child IQ, gender, race, and family welfare status.