Richard L. Einsporn

Breast volume measurement of 598 women using biostereometric analysis.

A study of the volumes of the right and left breasts of 598 subjects was undertaken using biostereometric analysis. This measurement uses close-range stereophotogrammetry to characterize the shape of the breast, and is noncontact, noninvasive, accurate, and rapid with respect to the subject involvement time. Using chi-square tests, volumes and volumetric differences between breast pairs were compared with handedness, perception of breast size by each subject, age, and menstrual status. No significant relationship was found between the handedness, age, or menstrual status of the subject and the breast volume. Several groups of subjects were accurate in their perception of breast size difference. Analysis did confirm the generally accepted clinical impression of left-breast volume dominance. These results are shown to be consistent with those of a previous study using 248 women.

Level of cancer pain knowledge among baccalaureate student nurses

Inadequate nursing education is a major impediment to effective pain relief for cancer patients throughout the world. This study was conducted to identify the level of cancer pain knowledge among baccalaureate student nurses and to determine whether specific activities affect this level of knowledge. Two questionnaires were administered to 82 baccalaureate student nurses in the final course of their program. Although the students displayed a realistic perspective about the severity and prevalence of cancer pain and psychological dependence, specific knowledge deficits and negative attitudes suggest the possibility of inadequate pain management. Specifically, the students believed that (a) maximal analgesic therapy should be delayed until the patients prognosis was less than 12 months; (b) the proportion of patients whose pain can be controlled by appropriate therapy is less than is possible; (c) increasing pain is related to tolerance rather than to progression of the disease; (d) the preferred route of administration is intravenous rather than oral; and (e) the degree of respiratory depression, rather than constipation, does not decrease with repeated administration. Significant positive correlations (P < or = 0.05) were found between age and cancer pain knowledge and between attendance at seminars/workshops and time spent reading professional journal articles. Of the 30% of the participants who perceived a particular person to be a source for obtaining information about cancer pain management, 52% specified a practicing registered nurse. Seminars and workshops were chosen by 59% of the students as the most effective way for nurses to increase their knowledge.(ABSTRACT TRUNCATED AT 250 WORDS)

Social support: gender differences in multiple sclerosis spousal caregivers.

&NA; The purpose of this study was to investigate gender differences in social support of spousal caregivers, of persons with multiple sclerosis (MS). The sample consisted of 37 male and 28 female caregivers of individuals with MS. It was found that female caregivers scored significantly higher than males on the total number of resources available, perceived social support and the perceived availability of friends and self‐help groups. There was a positive relationship between caregiver‐perceived social support and the ability of the mate to perform intimate functions. Caregiver‐perceived social support was also found to be positively correlated with the caregivers level of commitment to the spousal relationship.

An overview of model-robust regression

The proper combination of parametric and nonparametric regression procedures can improve upon the shortcomings of each when used individually. Considered is the situation where the researcher has an idea of which parametric model should explain the behavior of the data, but this model is not adequate throughout the entire range of the data. An extension of partial linear regression and two other methods of model-robust regression are developed and compared in this context. The model-robust procedures each involve the proportional mixing of a parametric fit to the data and a nonparametric fit to either the data or residuals. The emphasis of this work is on fitting in the small-sample situation, where nonparametric regression alone has well-known inadequacies. Performance is based on bias and variance considerations, and theoretical mean squared error formulas are developed for each procedure. An example is given that uses generated data from an underlying model with defined misspecification to provide graphical comparisons of the fits and to show the theoretical benefits of the model-robust procedures. Simulation results are presented which establish the accuracy of the theoretical formulas and illustrate the potential benefits of the model-robust procedures. Simulations are also used to illustrate the advantageous properties of a data-driven selector developed in this work for choosing the smoothing and mixing parameters. It is seen that the model-robust procedures (the final proposed method, in particular) give much improved fits over the individual parametric and nonparametric fits.

Group Therapy for Survivors of Childhood Sexual Abuse Who Are Severely and Persistently Mentally Ill

Background: Few researchers have investigated the effectiveness of long-term group psychotherapy with women who have a core issue of childhood sexual abuse, particularly those who are designated as being severely and persistently mentally ill (SPMI). Women so labeled are usually treated within a biological framework. Medications and supportive care are often the preferred therapies, denying the necessity of dealing with past traumatic issues. Objectives: The objective of this pilot study was to determine the outcome of long-term, time-limited group therapy with women designated as SPMI. The study addressed rate of improvement in symptomatology and self-esteem scores in women who are SPMI and those not designated SPMI. Study Design: A quasi-experimental design was used. The sample (N = 72) consisted of women older than 18 years who were sexually abused as children. The experimental group was made up of women labeled SPMI (n = 13), and the control group was composed of those who had not been designated SPMI (n = 59). The intervention consisted of 50 weeks of group therapy using a family systems model. The instruments, which included the Beck Depression Inventory, the Symptom Check List-90-Revised, and the Rosenberg Self-Esteem Scale, were administered at sessions 1 and 50. Results: Results indicated that women labeled SPMI had lower self-esteem and higher symptomatology scores before receiving the group therapy, but both groups achieved comparable improvement in scores at the end of 50 weeks of group therapy. Conclusion: The results indicated that women labeled as SPMI could benefit from group therapy that addressed the core issue of childhood sexual trauma.

Functional principal component analysis in age–period–cohort analysis of body mass index data by gender and ethnicity

ABSTRACT In this paper, we propose a two-stage functional principal component analysis method in age–period–cohort (APC) analysis. The first stage of the method considers the age–period effect with the fitted values treated as an offset; and the second stage of the method considers the residual age–cohort effect conditional on the already estimated age-period effect. An APC version of the model in functional data analysis provides an improved fit to the data, especially when the data are sparse and irregularly spaced. We demonstrate the effectiveness of the proposed method using body mass index data stratified by gender and ethnicity.

A Note regarding Problems with Interaction and Varying Block Sizes in a Comparison of Endotracheal Tubes

A randomized clinical experiment to compare two types of endotracheal tubes utilized a block design where each of the six participating anesthesiologists performed tube insertions for an equal number of patients for each type of tube. Five anesthesiologists intubated at least three patients with each tube type, but one anesthesiologist intubated only one patient per tube type. Overall, one type of tube outperformed the other on all three effectiveness measures. However, analysis of the data using an interaction model gave conflicting and misleading results, making the tube with the better performance appear to perform worse. This surprising result was caused by the undue influence of the data for the anesthesiologist who intubated only two patients. We therefore urge caution in interpreting results from interaction models with designs containing small blocks.

USE OF BIOSTEREOMETRIC ANALYSIS AS A SCREEN FOR BREAST CANCER

Biostereometric analysis, a photographic surface imaging technology that is noninvasive, was tested for its effectiveness in selecting breast pathology in a sample of 1000 female subjects, including 80 with cancers, 635 normals, and 285 with benign breast conditions. These individuals were recruited from the population of women undergoing routine mammographic examination. The project was designed specifically to determine whether biostereometric analysis could identify the individuals in the sample with malignant breast disease in the hope of providing information to aid in future development of a breast cancer screening protocol. The overall sensitivity of the method for cancers of all sizes was 76%. Biostereometric analysis was 85% sensitive for selection of cancers in the subjects over 50 years of age, and identified 80% (4 of 5) of the subjects with clinically confirmed breast cancers less than 1 cm in size. The method was 69% specific, but identified benign breast disease in only 51% of cases.