Distribution by Scientific Domains
Distribution within Medical Sciences

Terms modified by Subjective

  • subjective alertness
  • subjective appraisal
  • subjective arousal
  • subjective aspect
  • subjective assessment
  • subjective benefit
  • subjective career success
  • subjective change
  • subjective craving
  • subjective criterioN
  • subjective cure rate
  • subjective data
  • subjective day
  • subjective effects
  • subjective estimate
  • subjective evaluation
  • subjective experience
  • subjective factor
  • subjective feeling
  • subjective global assessment
  • subjective health
  • subjective health status
  • subjective image quality
  • subjective improvement
  • subjective index
  • subjective interpretation
  • subjective intoxication
  • subjective judgment
  • subjective knowledge
  • subjective measure
  • subjective measurement
  • subjective memory complaints
  • subjective nature
  • subjective need
  • subjective night
  • subjective norm
  • subjective opinion
  • subjective oral health
  • subjective outcome
  • subjective pain
  • subjective parameter
  • subjective perception
  • subjective probability
  • subjective qol
  • subjective quality
  • subjective rating
  • subjective report
  • subjective response
  • subjective scale
  • subjective severity
  • subjective sexual arousal
  • subjective sleep quality
  • subjective sleepiness
  • subjective stress
  • subjective symptom
  • subjective synonym
  • subjective test
  • subjective well-being

  • Selected Abstracts

    Objective measurement of motor activity during cognitive performance in adults with attention-deficit/hyperactivity disorder

    S. Lis
    Lis S, Baer N, Stein-en-Nosse C, Gallhofer B, Sammer G, Kirsch P. Objective measurement of motor activity during cognitive performance in adults with attention-deficit/hyperactivity disorder. Objective:, This study investigates whether hyperactivity, i.e. an increased level of motor activity, can be observed in adults with attention-deficit/hyperactivity disorder (ADHD). Method:, An infrared motion-tracking system was used to measure motor activity in 20 unmedicated adults with ADHD and 20 matched healthy controls (HC) during a 1-back working memory task. Results:, Motor activity was higher in ADHD. It increased with the duration of testing and co-varied with cognitive performance in ADHD only. Subjective and objective measurements of motor activity were related in HC, but not in ADHD. Conclusion:, Higher levels of motor activity in ADHD are objectively measurable not only in children, but in adults as well. It is linked to cognitive performance arguing against distinguishable diagnostic subtypes. The objective measurement of motor activity seems to extend the description of ADHD symptoms derived from rating scales and might thus help to bridge the gap between psychopathological symptom description and neurobiological alterations. [source]

    Subjective and objective sleep among depressed and non-depressed postnatal women

    S. K. Dørheim
    Objective:, Women sleep less in the postnatal period and it has been suggested that mothers diagnosed with depression alternatively could be suffering from the effects of chronic sleep deprivation. Method:, From a population-based study, we recruited 42 women, of whom 21 scored ,10 on the Edinburgh Postnatal Depression Scale. Sleep was registered by the Pittsburgh Sleep Quality Index (PSQI), sleep diaries and actigraphy 2 months after delivery. Results:, There were significant differences in subjective sleep measured retrospectively by the PSQI between depressed and non-depressed women. In contrast, there were no significant differences in sleep measured prospectively by sleep diaries and actigraphy. Both depressed and non-depressed women had impaired sleep efficiency (82%) and were awake for about 1.5 h during the night. Primipara had worse sleep, measured by actigraphy, compared with multipara. Conclusion:, Measured objectively and prospectively, women with depression did not have worse sleep than non-depressed women. [source]

    Does Neuroticism Influence Cognitive Self-Assessment After Epilepsy Surgery?

    EPILEPSIA, Issue 10 2000
    S. Cañizares
    Summary Purpose: To examine how cognitive, personality, and seizure outcome variables influence the subjective cognitive functioning of patients with refractory temporal lobe seizures after epilepsy surgery. Methods: Thirty-three consecutive patients with drug-resistant partial epilepsy who underwent surgical treatment at a tertiary referral university epilepsy center were tested before surgery and 1 year after surgery. Objective cognitive and subjective cognitive functioning tests were used, and personality was assessed. Seizure control was operationalized as a dichoto-mous variable. Results: A significant inverse relationship was found between neuroticism and subjective cognitive functioning. None of the other pre- and postoperative cognitive and surgery outcome variables were significant predictors of subjective cognitive functioning, even after controlling for the effect of neuroticism. Conclusions: Subjective and objective memory functioning are independent in patients with epilepsy after surgical treatment. Subjective memory functioning appears to be related not to seizure relief but to neuroticism. These data suggest that psychological factors such as personality traits predisposing to emotional distress should be taken into consideration in the clinical management and counseling of patients undergoing epilepsy surgery. [source]

    Feminist Pleasure and Feminine Beautification

    HYPATIA, Issue 4 2003
    Ann J. Cahill
    This paper explores the conditions under which feminine beautification constitutes a feminist practice. Distinguishing between the process and product of beautification allows us to isolate those aesthetic, interapos;Subjective, and embodied elements that empower rather than disempower women. The empowering characteristics of beautification, however, are difficult and perhaps impossible to represent in a sexist context; therefore, while beautifying may be a positive experience for women, being viewed as a beautified object in current Western society is almost always opposed to women's equality and autonomy. [source]

    "Chips with Everything": A Laboratory Exercise for Comparing Subjective and Objective Measurements of Potato Chips

    Cathy Davies
    ABSTRACT: The following laboratory exercise was designed to aid student understanding of the differences between subjective and objective measurements. Students assess the color and texture of different varieties of potato chip (crisps) by means of an intensity rating scale and a rank test and objectively with a colorimeter and texture analyzer. For data analysis, student are instructed to critically determine, using basic statistics, any differences between the subjective and objective measurement techniques. This laboratory exercise is very versatile, and although it is designed as a hands-on exercise in an undergraduate Food Analysis course, it has also been a demonstration for High School students. [source]

    Tension-free vaginal tape-obturator procedure for treatment of severe urodynamic stress incontinence: Subjective and objective outcomes during 2 years of follow-up

    Tsung-Hsien Su
    Abstract Aim:, To report our experience of the tension-free vaginal tape-obturator (TVT-O) procedure for the treatment of severe female urodymanic stress incontinence (USI) during 2 years of follow-up. Methods:, Between January 2005 and June 2007, 67 women with severe USI who underwent the TVT-O procedure were enrolled in the study. Pelvic examination, pad test, urodynamic study, and quality of life (QoL) assessment were performed pre- and post-operatively. Regular follow-up was arranged for analysis. Results:, The median duration of follow-up was 24 months. The objective cure rate was 76.2%. The postoperative pad test revealed significant reduction of leakage. The subjective cure rate was 83.5%, and improvement occurred in 14.9%. The postoperative QoL showed significant improvement. One (1.5%) extrusion of tape occurred and three cases of de novo detrusor overactivity were detected. Three patients (4.4%) had immediate postoperative urine retention. No major complications occurred. Conclusion:, Our results show that the TVT-O procedure is an effective and safe surgical procedure for severe female USI with satisfactory outcomes, significant improvement in quality of life, and few complications during 2 years of follow-up. [source]

    Subjective and objective perception of upper incisors

    summary, The purpose of this study was to evaluate the subjective judgment (SJ) of patients on their own dental appearance and to correlate the results with objective measurements (OM) of their dentition concerning the appearance of the upper incisors. Seventy-five participants (30 men and 45 women) with normal well-being were included in the study. In a questionnaire they judged the appearance of their upper incisors. Furthermore, OM were evaluated by the investigator with regard to the following points: (i) absolute length of the upper central incisors, (ii) their length exposed during laughing, (iii) width-to-length ratio of central incisors and (iv) the proportion between the width of the lateral and central incisors. The subjective results were registered on visual-analogue scales. For the objective results standardized photographs were taken. No gender dependent differences could be found for the objectively measured parameters (median): OM1, 10·7 mm; OM2, 8·1 mm; OM3, 0·81; OM4, 0·79. However, significant correlations between subjective and objective results (SJ1/OM1, SJ2/OM2, SJ3/OM3) could be shown for men, but not for women. The maximum of the calculated regression-curves for men reflect ,golden standard values' well known from the literature. The degree of satisfaction concerning appearance of anterior incisors in accordance with golden standard values is higher for men than for women. [source]

    Interpersonal Orientation in Context: Correlates and Effects of Interpersonal Complementarity on Subjective and Cardiovascular Experiences

    Jessi L. Smith
    ABSTRACT Interpersonal orientation (IO) generally refers to individual differences in preference for social interaction. The influence of IO, however, likely depends on the nature of complementarity within the interpersonal context. Using the interpersonal circumplex and Five-Factor Model, we first selected a measure of IO characterized by affiliation and neuroticism. Second, we examined the influence of IO on subjective, physiological, and nonverbal experiences as a function of experimentally manipulated complementarity or noncomplementarity. We hypothesized that women in noncomplementarity conditions (i.e., women low in IO working with a friendly confederate, women high in IO working with an unfriendly confederate) would experience the interpersonal situation more negatively compared to women in complementarity conditions. Study results confirmed this prediction, with noncomplementarity in IO resulting in greater physiological reactivity, greater likelihood to attempt nonverbally to restore complementarity, more partner-related thoughts, and a reduced desire to seek out attention compared to women working in complementarity conditions. Implications for research on IO as a person variable are discussed. [source]

    Objective, Subjective, and Self-Assessment of Preadolescent Orthodontic Treatment Need , A Function of Age, Gender, and Ethnic/Racial Background?

    Elizabeth A. Christopherson
    Abstract Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. Objectives: To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Methods: Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Results: Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Conclusions: Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES. [source]

    Adult Children's Supportive Behaviors and Older Parents' Subjective Well,Being,A Developmental Perspective on Intergenerational Relationships

    Frieder R. Lang
    Adult children's supportive behaviors were examined with respect to children's autonomy and social motivation towards parents, and with respect to longitudinal changes of parents' subjective well,being. In total, 115 adult children from 83 German families completed a questionnaire on supportive behaviors and social motivation. The children also reported what pleased or irritated their parents most. Findings suggest that filial autonomy was associated with resistance to strain. Older parents' satisfaction improved when children expressed affection or gave emotional support. However, informational support from children was associated with decreased satisfaction among parents. Findings suggest that filial autonomy may facilitate supportive behaviors that correspond to older parents' socioemotional needs. [source]

    Temperature modulated histamine-itch in lesional and nonlesional skin in atopic eczema , a combined psychophysical and neuroimaging study

    ALLERGY, Issue 1 2010
    F. Pfab
    Abstract Background: Itch is the major symptom of many allergic diseases; yet it is still difficult to measure objectively. The aim of this study was to use an evaluated itch stimulus model in lesional (LS) and nonlesional (NLS) atopic eczema (AE) skin and to characterize cerebral responses using functional magnetic resonance imaging (fMRI). Methods: Thermal modulation was performed on a histamine stimulus in randomized order on LS or NLS in rapid alternating order from 32°C (warm) to 25°C (cold). Subjective itch ratings were recorded. Additionally, fMRI measurements were used to analyze the cerebral processing (n = 13). Healthy skin (HS) of age-matched volunteers served as control (n = 9). Results: Mean VAS itch intensity was significantly (P < 0.0001) higher during the relative cold [55.2 ± 8.3% (LS); 48.6 ± 8.2% (NLS)] compared to the relative warm blocks [36.0 ± 7.3% (LS); 33.7 ± 7.6% (NLS)]. Compared to HS, the itch response was delayed in LS and NLS. Itch intensity was perceived highest in LS, followed by NLS and HS. For NLS, fMRI revealed at the beginning of the itch provocation a cerebral deactivation pattern in itch processing structures (thalamus, prefrontal, cingulate, insular, somatosensory and motor cortex). During the course of stimulation, the cerebral deactivation was reduced with time and instead an activation of the basal ganglia occurred. In contrast LS showed an activation instead of deactivation pattern already at the beginning of the stimulation in the above mentioned structures. Conclusions: Moderate short-term temperature modulation led to a reproducible, significant enhancement of histamine-induced itch with the strongest effect in LS. The differences in itch perception and itch kinetics between healthy volunteers and NLS in patients point towards an ongoing central inhibitory activity patients with AE, especially at the beginning of the itch provocation. [source]

    Botulinum toxin for the treatment of lower urinary tract symptoms: A review

    A. Sahai
    Abstract Aims To review the available literature on the application of botulinum toxin in the urinary tract, with particular reference to its use in treating detrusor overactivity (DO). Methods Botulinum toxin, overactive bladder (OAB), detrusor instability, DO, detrusor sphincter dyssynergia (DSD), and lower urinary tract dysfunction were used on Medline Services as a source of articles for the review process. Results DO poses a significant burden on patients and their quality of life. Traditionally patients have been treated with anti-cholinergic drugs if symptomatic, however, a significant number find this treatment either ineffective or intolerable due to side effects. Recent developments in this field have instigated new treatment options, including botulinum toxin, for patients' refractory to first line medication. Botulinum toxin, one of the most poisonous substances known to man, is a neurotoxin produced by the bacterium Clostridium botulinum. Botulinum toxin injections into the external urethral sphincter to treat detrusor sphincter dyssynergia has been successfully used for some years but recently its use has expanded to include voiding dysfunction. Intradetrusal injections of botulinum toxin into patients with detrusor overactivity and symptons of the overactive bladder have resulted in significant increases in mean maximum cystometric capacity and detrusor compliance with a reduction in mean maximum detrusor pressures. Subjective and objective assessments in these patients has shown significant improvements that last for 9,12 months. Repeated injections have had the same sustained benefits. Conclusions Application of botulinum toxin in the lower urinary tract has produced promising results in treating lower urinary tract dysfunction, which needs further evaluation with randomised, placebo-controlled trials. © 2004 Wiley-Liss, Inc. [source]

    Subjective and objective incontinence 5 to 10 years after Burch colposuspension

    Sigurd Kulseng-Hanssen
    Abstract The outcome of incontinence surgery was studied using a questionnaire, a 24-hour pad test (24hPT), and a stress test (ST). Five to 10 years after a Burch colposuspension, 111 patients were asked to complete the Bristol Female Urinary Tract Symptom Questionnaire (BFLUTS) and to perform a 24hPT and a ST. Eighty-two patients completed the questionnaire and 71 and 69 patients performed the stress and pad tests, respectively. Seventy-three percent of the patients did not leak during the ST and 75% of the patients were not leaking during the 24hPT. Seventy-three percent of the patients stated that they were at least occasionally stress or urge incontinent and 62% stated that they were both stress and urge incontinent. However, only 24% of the stress incontinent and 28% of the urge incontinent patients found their incontinence to be "quite a problem" or "a serious problem." Patients leaking urine only "occasionally," "once a week," leaking "drops," and finding the leakage to be "a bit of a problem" had median leakage 0g during ST and 24hPT. Patients who reported the leakage to occur "sometimes" "most or all of the time" and who found the leakage to be "a bit, quite, or a serious problem" accounted for 20 to 30% of all patients, as did patients leaking during objective tests. Objective tests revealed leakage to occur less frequently compared with self-reported leakage. The BFLUTS questionnaire revealed leakage to occur with varying frequency, amount, and bother. Leakage occurring seldom, of small amount and bother may be of minor clinical importance. Neurourol. Urodynam. 21:100,105, 2002. © 2002 Wiley-Liss, Inc. [source]

    Occupational science: updating the United Kingdom journey of discovery

    Catherine R. Mounter
    Abstract The metaphor of a journey is used to describe the incremental influence of occupational science in the UK. A historical perspective is taken to identify and discuss key concepts and issues. Subjective bias and methodological flaws are acknowledged. Discussion for future directions is contained within contextual orientation. Ongoing debate is invited and encouraged. Copyright © 2000 Whurr Publishers Ltd. [source]

    Salivary flow and its relationship to oral signs and symptoms in patients with dry eyes

    ORAL DISEASES, Issue 2 2004
    M Koseki
    Objectives:, The aim of this study was to investigate oral symptoms and clinical parameters in dry eye patients. Subjective reports of the sensation of a dry mouth, salivary flow rates, and clinical parameters of oral disease related to three different types of dry eye patients were examined. Subjects and methods:, There were 224 individuals, including dry eye patients and control subjects. The dry eye patients were classified into three types: patients with Sjögren's syndrome (SS-DE), patients without SS-DE (non-SS-DE), and patients with Stevens,Johnson syndrome (SJS-DE). Salivary flow rates were measured using two kinds of sialometry. Subjective and objective oral symptoms and signs were also examined. Results and conclusion:, Over half of the dry eye patients complained of a dry mouth. The flow rates of their stimulated whole saliva and parotid saliva were significantly lower than those of the control groups (P < 0.05, P < 0.01). The sensation of a dry mouth and changes in oral soft tissues, dental caries, and oral Candida frequently occurred in dry eye patients. [source]

    Clomiphene Citrate and Testosterone Gel Replacement Therapy for Male Hypogonadism: Efficacy and Treatment Cost

    Frederick Taylor MD
    ABSTRACT Introduction., The efficacy of oral clomiphene citrate (CC) in the treatment of male hypogonadism and male infertility (MI) with low serum testosterone and normal gonadotropin levels has been reported. Aim., The aim of this article is to evaluate CC and testosterone gel replacement therapy (TGRT) with regard to biochemical and clinical efficacy and cost. Main Outcome Measures., The main outcome measures were change in serum testosterone with CC and TGRT therapy, and change in the androgen deficiency in aging male (ADAM) questionnaire scores with CC therapy. Methods., Men receiving CC or TGRT with either Androgel® 1% or Testim® 1% for hypogonadism (defined as testosterone < 300 ng/mL) or MI were included. Serum values were collected 1,2 months after treatment initiation and semi-annually thereafter. Retrospective data collection was performed via chart review. Subjective follow up of patients receiving CC was performed via telephone interview using the ADAM questionnaire. Results., A hundred and four men (65 CC and 39 TGRT) were identified who began CC (50 mg every other day) or TGRT (5 g). Average age (years) was 42(CC) vs. 57 (TGRT). Average follow up was 23 months (CC, range 8,40 months) vs. 46 months (TGRT, range 6,149 months). Average posttreatment testosterone was 573 ng/dL in the CC group and 553 ng/dL in the TGRT group (P value < 0.001). The monthly cost of Testim® 1% (5 gm daily) is $270, Androgel® 1% (5 gm daily) is $265, and CC (50 mg every other day) is $83. Among CC patients, the average pretreatment ADAM score was 4.9 vs. 2.1 at follow up (P < 0.05). Average pretreatment ADAM sexual function domain score was 0.76 vs. 0.23 at follow up (P < 0.05). There were no adverse events reported. Conclusion., CC represents a treatment option for men with hypogonadism, demonstrating biochemical and clinical efficacy with few side effects and lower cost as compared with TGRT. Taylor F, and Levine L. Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: Efficacy and treatment cost. J Sex Med 2010;7:269,276. [source]

    Response of the Female Vocal Quality and Resonance in Professional Voice Users Taking Oral Contraceptive Pills: A Multiparameter Approach

    THE LARYNGOSCOPE, Issue 10 2006
    Kristiane M. Van Lierde PhD
    Abstract Objective/Hypothesis: The purpose of this study was to analyze the vocal quality and resonance (nasality and nasalance values) during the menstrual cycle in professional voice users using oral contraceptive pills (OCPs). Although professional voice users are more sensitive and aware of their vocal quality, no changes of voice and resonance characteristics were expected because OCPs create a stable hormonal balance throughout the menstrual cycle. Study Design: The authors conducted a comparative study of 24 healthy, young professional voice users using OCPs. One assessment was performed between the 10th and 17th day of pill intake, when hormonal levels reached a steady state. The second assessment was performed during the first 3 days of menses, when no pills were taken and hormonal levels were minimized. Methods: Subjective (perceptual evaluation of voice and nasality) and objective (aerodynamic, voice range, acoustic, Dysphonia Severity Index [DSI], nasometer) assessment techniques were used. Results: The Mann-Whitney U test showed no significant difference between the perceptual evaluation of the voice and the nasality in the two assessments. The paired Student t test showed no significant difference regarding the maximum phonation time, the vocal performance, the acoustic parameters, and the DSI. Conclusions: These findings indicate that OCPs do not have an impact on the objective and subjective voice and resonance parameters in young professional voice users. This information is specifically relevant to professional voice users who are more aware of vocal quality changes and ear, nose and throat specialists/voice therapists who treat professional voice users with voice problems/disorders. Further research regarding the impact of increased vocal load during the premenstrual or menstrual phase in professional voice users using OCPs should be considered. [source]

    Fascia Augmentation of the Vocal Fold: Graft Yield in the Canine and Preliminary Clinical Experience,

    THE LARYNGOSCOPE, Issue 5 2001
    Sanford G. Duke MD
    Abstract Introduction Glottal insufficiency resulting from vocal fold bowing, hypomobility, or scar is frequently treated by injection augmentation. Injection augmentation with fat, collagen, gel foam, polytef, and recently, fascia lata has been previously reported. Variable graft yield and poor host-tissue tolerance have motivated the continued search for an ideal graft substance. Study Design A prospective trial of autologous fascia augmentation of the vocal cord in the human and in an animal model. Methods Autologous fascia injection augmentation (AFIA) was evaluated in 8 canines and 40 patients at our institution between 1998 and 2000. The animal study compared graft yield from AFIA with autologous fat yield. The outcome measure was graft yield calculated from histological examination of larynges 12 weeks after injection augmentation. Clinical trial outcome measures included symptom surveys, acoustical voice analyses, and subjective voice assessments. Mean follow-up was 9 months. Results In the canine larynx, the mean graft yield for AFIA was 33% (range, 5%,84%) compared with autologous lipoinjection (47%; range, 7%,96%;P = .57). Subjective improvement in vocal quality was reported by 95% of patients (38 of 40) after AFIA. Preoperative and postoperative voice analysis data were obtained from 26 patients. Subjective voice rating demonstrated a significant improvement after AFIA (P <.0001). Acoustical parameters of jitter, shimmer, noise-to-harmonic ratio, phonatory range, and degree unvoiced improved significantly (P <.05) in all patients after fascia augmentation. Conclusions Based on the animal study, we concluded that graft yields are excellent but variable for AFIA. The result is similar in variability and overall yield to autologous lipoinjection. Subjective and objective analyses of voice outcomes after AFIA are universally improved. Fascia appears to be an excellent alternative to lipoinjection in properly selected cases of glottic insufficiency. [source]

    The jungle of quality of life: Mapping measures and meanings for elders

    Penny Hambleton
    The literature on quality of life (QOL) can be described as a jungle: vast, dense and difficult to penetrate, especially for those entering the field without a specialist QOL background. While QOL as a term is entwined in an extensive body of work from many disciplines and covering diverse perspectives, it has been most extensively documented and operationalised within the domains of health-related socioeconomic drivers and is largely quantitative in nature. Subjective and qualitative measurement is less fully developed and documented. This review paper provides a map through the QOL literature by constructing a tabular framework to position the measures and meanings of QOL prior to undertaking a phenomenological study with older people. It concludes by arguing for attention to the further development of qualitative experiential measures specific to life-stage QOL for older people, having found these perspectives rarely visible. [source]

    Randomised comparison of Burch colposuspension versus anterior colporrhaphy in women with stress urinary incontinence and anterior vaginal wall prolapse

    Mario Colombo Senior Registrar
    Objective To compare the Burch colposuspension and the anterior colporrhaphy in women with both stress urinary incontinence and advanced anterior vaginal wall prolapse (cystocele). Design Prospective randomised study. Setting Secondary referral centre, Urogynaecology Unit, San Gerardo Hospital, Monza, Italy. Sample Seventy-one women undergoing surgery for primary genuine stress incontinence and concurrent grade 2 or 3 cystocele (descending at or outside the vaginal introitus). Methods Full urodynamic investigation performed pre-operatively and repeated six months after surgery. Clinical follow up continued for 8 to 17 years. Main outcome measures Subjective (patient history) and objective (negative stress test result) cure of stress incontinence. Assessment of cystocele recurrence. Results Thirty (86%) of the 35 evaluable women who had the Burch colposuspension and 17 (52%) of the 33 evaluable women who had the anterior colporrhaphy were subjectively cured (OR 5.6, 95% CI 1.6 to 21.6; P= 0.005). Objective cure rates were 74% (26 of 35) and 42% (14 of 33), respectively (OR 3.9, 95% CI 1.3 to 12.5; P= 0.02). A recurrent cystocele of grade 2 or 3 with or without prolapse at other vaginal sites was recorded in 34% (12 of 35) and 3% (1 of 33) of women, respectively (OR 16.7, 95% CI 2.0 to 368.1; P= 0.003). Conclusions The Burch colposuspension was better in controlling stress incontinence but it lead to an unacceptable high rate of prolapse recurrence. The anterior colporrhaphy was more effective in restoring vaginal anatomy but it was accompanied by an unacceptable low cure rate of stress incontinence. Neither of the two operations is recommended for women who are suffering from a combination of stress incontinence and advanced cystocele. [source]

    Objective vs. subjective factors in the psychological impact of vitiligo: the experience from a French referral centre

    P. Kostopoulou
    Summary Background, Vitiligo affects around 0·5% of the population. The burden of disease perceived by patients seems to be underestimated by the medical community. Objectives, To analyse the impact of objective and psychological factors on the quality of life (QoL) and self-body image of patients with vitiligo. Methods, Demographic data, medical information and psychological factors (perceived severity, trait anxiety, trait depression, trait self-esteem, body image and QoL) were prospectively collected for all patients. Results, Forty-eight patients with a mean age of 43·9 years were included in the study. Vitiligo caused overall a moderate effect on patients' QoL with a 7·17 Dermatology Life Quality Index (DLQI) mean score (out of 30) without correlation with gender. According to distribution, no or minimal (DLQI 0,1), mild (2,5), moderate (6,11) and severe (12,20) impairment of QoL was found in five (10%), 14 (29%), 18 (38%) and 11 (23%) patients, respectively. The mean perceived severity evaluated by the patients was 4·91 based on visual analogue scale from 0 to 10. The self-body image was influenced by gender, perceived severity and disease characteristics. Perceived severity and patient personality were predictors of QoL impairment. Perceived severity of vitiligo was explained mainly by the patients' personality and less significantly by objective criteria. Conclusions, Subjective as well as objective factors should be included in the assessment of disease severity and follow-up of patients with vitiligo. A simple perceived severity scale is useful in clinical practice. [source]

    Can objective parameters derived from videofluoroscopic assessment of post-laryngectomy valved speech replace current subjective measures?

    An e-tool-based analysis
    Objectives:, The primary purpose of this study was to assess the pharyngoesophageal segment in total laryngectomy patients using a videofluoroscopy e-tool. Study design:, Cross-sectional study. Setting:,, Head and Neck Oncology Unit, Tertiary Referral Centre. Patients:, Forty-two patients following total laryngectomy. Intervention:, Videofluoroscopy using an e-tool (JRuler). Main outcome measures:, Subjective and objective videofluoroscopy parameters correlated with the GRBAS scale and treatment variables. Results:, Of 32 men and 10 women, mean age 63.5 years (10.8) the majority (64.3%) had a reasonable voice (good = 11 and poor = 4 patients). Comparing subjective and objective parameters, significant correlations were only seen with a smaller minimal neoglottic distance at phonation with no regurgitation of barium at phonation (P = 0.05) and a type 1 shape of neoglottis at phonation (P = 0.02). There were also significant correlations between smaller maximum sub-neoglottic distance at phonation and type 1 shape of neoglottis (P = 0.02), smaller maximum sub-neoglottic distance at rest and absence of stasis of barium at phonation (P = 0.05) and the length of neoglottis at phonation and type 1 shape of neoglottis (P = 0.01). For perceptual evaluation, significant correlation was seen only between G1 voice and a smaller minimal neoglottic distance at phonation (P = 0.03) amongst the subjective and objective parameters. There were no correlations between visual parameters and the clinical parameters. Conclusions:, Our observations suggest that this interesting concept has limitations. While objective and quantifiable data can be obtained using videofluoroscopy in laryngectomees, only a few correlate with each other and with voice quality. [source]

    Fuzzy Monte Carlo Simulation and Risk Assessment in Construction

    N. Sadeghi
    However, subjective and linguistically expressed information results in added non-probabilistic uncertainty in construction management. Fuzzy logic has been used successfully for representing such uncertainties in construction projects. In practice, an approach that can handle both random and fuzzy uncertainties in a risk assessment model is necessary. This article discusses the deficiencies of the available methods and proposes a Fuzzy Monte Carlo Simulation (FMCS) framework for risk analysis of construction projects. In this framework, we construct a fuzzy cumulative distribution function as a novel way to represent uncertainty. To verify the feasibility of the FMCS framework and demonstrate its main features, the authors have developed a special purpose simulation template for cost range estimating. This template is employed to estimate the cost of a highway overpass project. [source]

    Persistent Orthopnea and the Prognosis of Patients in the Heart Failure Clinic

    Luís Beck Da Silva MD
    Heart failure (HF) is a public health problem with ever-growing costs. Signs such as jugular venous pressure and third heart sound have been associated with disease prognosis. Symptoms of heart failure are frequently subjective, and their real value is often overlooked. The authors aimed to assess the relationship between orthopnea and left ventricular ejection fraction (LVEF) and hospitalization rate in patients referred to the HF clinic. One hundred fifty-three new consecutive patients referred to the HF clinic from September 2001 to July 2002 were reviewed. Information about orthopnea was available at baseline and at a 6-month to 1-year follow-up. One hundred thirty-one patients had a baseline multigated radionuclide ventriculogram scan, and 68 patients had a follow-up multigated radionuclide ventriculogram scan available. The patients were divided into groups by presence of orthopnea and compared with respect to LVEF and hospitalization rate. Patients with or without orthopnea had similar LVEFs at baseline (32%±17% vs. 33%±15%, respectively; p=NS). However, patients who were orthopnea-free at the follow-up visit had a significant LVEF improvement whereas patients with ongoing orthopnea at follow-up had no LVEF improvement (11%±13% vs. ,1%±6%; p<0.001). Patients who presented with persistent orthopnea had a significantly higher rate of hospitalization (64% vs. 15.3%; p=0.0001). Persistent orthopnea in HF patients is associated with a significantly higher rate of hospitalization and with worsening or no improvement in LVEF. Patients with persistent orthopnea may require a more aggressive approach to improve their outcome. This result may help centers with limited access to LVEF measurements to better stratify HF patients' risk. [source]

    Optimizing Service Attributes: The Seller's Utility Problem,

    DECISION SCIENCES, Issue 2 2001
    Fred F. Easton
    Abstract Service designers predict market share and sales for their new designs by estimating consumer utilities. The service's technical features (for example, overnight parcel delivery), its price, and the nature of consumer interactions with the service delivery system influence those utilities. Price and the service's technical features are usually quite objective and readily ascertained by the consumer. However, consumer perceptions about their interactions with the service delivery system are usually far more subjective. Furthermore, service designers can only hope to influence those perceptions indirectly through their decisions about nonlinear processes such as employee recruiting, training, and scheduling policies. Like the service's technical features, these process choices affect quality perceptions, market share, revenues, costs, and profits. We propose a heuristic for the NP-hard service design problem that integrates realistic service delivery cost models with conjoint analysis. The resulting seller's utility function links expected profits to the intensity of a service's influential attributes and also reveals an ideal setting or level for each service attribute. In tests with simulated service design problems, our proposed configurations compare quite favorably with the designs suggested by other normative service design heuristics. [source]

    Behavioral and cardiovascular effects of 7.5% CO2 in human volunteers

    Jayne E. Bailey M.Sc.
    Abstract The study of carbon dioxide (CO2) inhalation in psychiatry has a long and varied history, with recent interest in using inhaled CO2 as an experimental tool to explore the neurobiology and treatment of panic disorder. As a consequence, many studies have examined the panic-like response to the gas either using the single or double breath 35% CO2 inhalation or 5,7% CO2 inhaled for 15,20 min, or rebreathing 5% CO2 for a shorter time. However, this lower dose regime produces little physiological or psychological effects in normal volunteers. For this reason we have studied the effects of a higher concentration of CO2, 7.5%, given over 20 min. Twenty healthy volunteers were recruited to a double blind, placebo-controlled study where air and 7.5% CO2 were inhaled for 20 min. Cardiovascular measures and subjective ratings were obtained. When compared to air, inhaling 7.5% CO2 for 20 min increases systolic blood pressure and heart rate, indicating increased autonomic arousal. It also increases ratings of anxiety and fear and other subjective symptoms associated with an anxiety state. The inhalation of 7.5% CO2 for 20 min is safe for use in healthy volunteers and produces robust subjective and objective effects. It seems promising as an anxiety provocation test that could be beneficial in the study of the effects of anxiety on sustained performance, the discovery of novel anxiolytic agents, and the study of brain circuits and mechanisms of anxiety. Depression and Anxiety 00:000,000, 2005. © 2005 Wiley-Liss, Inc. [source]

    Full Scope of Effect of Facial Lipoatrophy: A Framework of Disease Understanding

    BACKGROUND Facial lipoatrophy has been observed to occur in a variety of patient populations, with inherited or acquired disease, or even in aging patients as a natural progression of tissue change over time. There is currently no framework from which physicians of all medical specialties can communally discuss the manifestations, diagnoses, and management of facial lipoatrophy. OBJECTIVE The aim of this assembly was to derive a definition of facial lipoatrophy capable of being applied to all patient populations and develop an accompanying grading system. RESULTS The final consensus of the Facial Lipoatrophy Panel encompasses both aging and disease states: "Loss of facial fat due to aging, trauma or disease, manifested by flattening or indentation of normally convex contours." The proposed grading scale includes five gradations (Grades 1,5; 5 being the most severe), and the face is assessed according to three criteria: contour, bony prominence, and visibility of musculature. CONCLUSION Categorizing the presentation of facial lipoatrophy is subjective and qualitative, and will need to be validated with objective measures. Furthermore, during the assembly, several topics were exposed that warrant further research, including the physiology of volume loss, age and lipoatrophy, and human immunodeficiency virus and lipoatrophy. [source]

    Wire Scalpel for Surgical Correction of Soft Tissue Contour Defects by Subcutaneous Dissection

    Marlen A. Sulamanidze MD
    Background. Increasing demand exists for cosmetic correction of soft tissue contour defects. Treatments include simple tissue augmentation techniques or more complex surgeries with consequent relevant recuperation time for the patient. The search for new simple techniques to correct scars and age-related wrinkles and folds is therefore one of the main goals of cosmetic dermatologic surgery. Objective. To improve the cosmetic outcome of patients suffering from soft tissue contour defects by the use of a novel surgical instrument and technique, subcutaneous dissection by wire scalpel. Methods. Fifty-four patients were treated with the wire scalpel technique with no skin incisions to correct a total of 132 depressed cosmetic defects of the face. Forehead lines, glabellar, nasolabial and oral commissure folds, upper lip wrinkles, and acne scars were treated. A 2-month to 4-year follow-up allowed subjective and photographic evaluation of results. Results. Good or satisfactory results were obtained in 79.7% and 16.6% of the cases, respectively. Minor complications did not change the overall positive outcome of the surgery. Conclusion. Subcutaneous dissection by wire scalpel is a simple, safe, and effective method to improve the contour appearance of patients affected with scars or age-related contour defects. [source]

    Side-effects of antipsychotic medication and health-related quality of life in schizophrenia

    P. E. Bebbington
    Objective:, This analysis used data from the large (n = 1208) European Schizophrenia Cohort to examine the association between subjective side-effects of antipsychotic medication and the Mental and Physical Composite Scores (MCS; PCS) of the SF-36 scale. Method:, Relationships between the subjective evaluation of side-effects identified from the Subjective Side-Effects Scale and the adjusted mean score on the PCS and MCS were examined. Where appropriate, these associations of subjective side-effects were compared with those of the same side-effects measured objectively. Results:, In this study, subjective side-effects of antipsychotic medication were linked either to both the PCS and the MCS or, in a few instances, to neither. Subjective evaluations of sexual side-effects were associated only with the MCS, those of sialorrhoea only with the PCS. Objective ratings of extrapyramidal side-effects were related neither to PCS nor to MCS. Conclusion:, These data suggest that side-effects, whether subjective or objective, may need to be considered individually in relation to their impact on quality of life. [source]

    Executive function and the development of belief,desire psychology

    Hannes Rakoczy
    In two studies children's performance on tasks requiring the ascription of beliefs and desires was investigated in relation to their executive function. Study 1 (n = 80) showed that 3- and 4-year-olds were more proficient at ascribing subjective, mutually incompatible desires and desire-dependent emotions to two persons than they were at ascribing analogous subjective false beliefs. Replicating previous findings, executive function was correlated with false-belief ascription. However, executive function was also correlated with performance on tasks requiring subjective desire understanding. Study 2 (n = 54) replicated these results, and showed that the correlations hold even if age, vocabulary and working memory are controlled for. The results are discussed with regard to the role of executive function and conceptual change in theory of mind development. [source]