Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

International adoption: Symptoms of attachment disorders and their associations with the child’s background and developmental outcome

Many internationally adopted children have lived their first years of life in an environment with limited opportunities for primary caregiving. The lack of consistent care increases the prevalence of attachment disorders among them. Less is known about the influences of attachment disorders on a child’s later course of life. This study is part of the Finnish Adoption Study. Parents of all Finnish children who had been internationally adopted by legal adoption organisations between 1985 and 2007 were sent questionnaires (N=1450). Parental evaluations of the children’s symptoms of reactive attachment disorder (RAD) at the time of adoption, their later learning or language problems using a screening scale, and children’s self-reported school bullying experiences were evaluated. Each child’s attachment-related behavioural problems were requested in a follow-up survey 1.9 and 3.8 years after adoption and compared with a Finnish reference group. This study indicated that Finnish internationally adopted children have at least three-fold prevalence of learning and language problems compared with their age-mates. A child’s symptoms of attachment disorders were associated with learning or language problems at school age as well as with his/her school bullying experiences. The adopted children had more attachment-related behavioural problems two years after adoption than their age-mates, but the difference was no longer evident four years after adoption. In conclusion, this study showed that the symptoms of attachment disorder indicate a risk for an adopted child’s later developmental outcome. The findings demonstrate the need for comprehensive clinical examinations and planning of treatment strategies for children with symptoms of RAD.

Life-related negative customer emotions in real estate agent encounters

The goal of this study was to explore how do customers’ life-related negative emotions affect real estate business. This was divided into two research questions: 1. What life-related negative emotions can be recognised in real estate customer encounters? 2. How do the recognised emotions affect customer encounters and the realtor’s work? 3. How can the realtor take the emotions into account in customer service? The theoretical background consists of two main lines of study: emotions and customer encounters. A wide literary review on emotions research was conducted from a cognitive psychology point of view, focusing on negative emotions. Emotions research was then combined into the field of customer encounters. Qualitative study was chosen as the methodological basis of the study. Empirical material of this study was collected through in-depth interviews with 13 successful Finnish real estate agents. Narrative research was used as a method for the study. Four life-related emotion categories were recognized in real estate customer encounters: sadness, anger, anxiety and shame. These emotions rose from issues varying from death of a close one to divorce and from major changes in life stages to deep emotional attachment to an old home. The study also found that these incidental negative emotions do affect customer encounters and realtors’ work. The emotions affected the decision making of customers and sometimes overshadowed reason. Some emotions made the customer passive and slow to make any decisions, while others made their decision making fast and hasty. Even though the incidental emotions might not have had anything to do with the real estate deal, they could affect the outcome of the customer encounter and the whole real estate deal. Interestingly enough, the study found that not all successful real estate agents knowingly serve customers in an emotional level. The study does, however, suggest that in fact it may be an ethical decision of the customer server to take into account the emotional state of the customer. Attending to the emotional side of customers does not only increase pleasantness of the customer encounter, but may improve and balance customer decision making and prevent hasty decisions possibly leading to improved customer satisfaction. This study also gave practical managerial implications to customer service providers on how negative incidental emotions can be attended to in a customer encounter. This study could be useful not only to real estate agents, but also in other types of customer service, especially with vulnerable populations or other types of home-related business.

Perceived modifiability of self-blame attributions for negative life events : implications for well-being /

Research suggests that self-blame attributions are important in the process of adjustment to negative life events. Much of the research originates from JanofTBulman's (1979) theory regarding behavioural and characterological self-blame. She argued that attributing negative events to one's behaviour is adaptive because behavioural self-blame involves attributions to a modifiable source, which implies that a similar event can be avoided in the future. In contrast, attributing negative events to one's character is believed to be maladaptive because character is seen as relatively stable and unmodifiable. Unfortunately, the empirical literature does not show consistent relations between these two types of self-blame attributions and well-being as predicted by Janoff-Bulman. For this thesis, I proposed that one reason for this inconsistency is that Janoff-Bulman's assumption about the perceived modifiability of behavioural versus characterological causes is incorrect — people often dlo perceive character (as well as behaviour) to be modifiable. Sixty-two participants completed a questionnaire regarding a recent negative life event and its impact on their well-being. Consistent with my argument, I found that both behavioural and characterological self-blame attributions following a negative life event were seen as modifiable. As hypothesized, perceived modifiability of causes v^as related to well-being. For example, overall modifiability was related to greater coping efficacy, less social dysfunction, less severe depression, and greater positive affect; however. contrary to predictions, the relation between perceived modifiability of causes and wellbeing was not mediated by the perception that similar events could be avoided in the future. Individual differences in attributional style were also assessed in this study. An attributional style that tended to be more internal, stable, and specific was related to wellbeing as expected; however, neither the perceived modifiability of blame attributions nor the perceived avoidability of similar future events mediated this relation. Implications for professionals dealing with trauma victims and potential directions for future research are discussed.

Cues to action : do they result in belief and behavioural change in women?

With incidence rates of osteoporosis increasing (Osteoporosis Canada, 2007), preventative efforts to minimize costs associated with condition diagnosis are a public health priority. Cues to action are specific internal (e.g., physical symptoms, family member with a condition) or external stimuli (e.g., public service announcements, health education campaigns) that are necessary to trigger appropriate health behaviours and serve to create an awareness of the health threat (Mattson, 1999). To date, limited understanding of the scope of influence cues to action have on health beliefs and behaviour associated with osteoporosis is known. The present investigation was designed to address this gap in the literature. More specifically, the influence of cues to action, a public service announcement (PSA) developed by Osteoporosis Canada and a bone screening by way of Quantitative Ultrasound, on health beliefs and health-enhancing physical activity (HEPA) across a four week period was investigated. Peri-and postmenopausal women (N= 174) were randomly assigned to one of three conditions 1) an osteoporosis public service announcement (PSA) condition; 2) a bone screening condition via quantitative ultrasound techniques, and 3) a PSA attention control condition. Health beliefs associated with osteoporosis were taken at three time points: prior to the cue to action intervention, immediately following the intervention, and four weeks post intervention. Knowledge of osteorporosis risk factors and HEP A were assessed pre and post-intervention only. Results of a regression analysis suggested that baseline health beliefs predicted baseline HEPA (R2 adj = .24; F (9, 161) = 6.49,p = .000; 95% CI = .12 - .35) with exercise barriers (p = -.33) being a negative predictor and health motivation (p = .21) being a positive predictor of HEP A. Baseline health beliefs predicted With incidence rates of osteoporosis increasing (Osteoporosis Canada, 2007), preventative efforts to minimize costs associated with condition diagnosis are a public health priority. Cues to action are specific internal (e.g., physical symptoms, family member with a condition) or external stimuli (e.g., public service announcements, health education campaigns) that are necessary to trigger appropriate health behaviours and serve to create an awareness of the health threat (Mattson, 1999). To date, limited understanding of the scope of influence cues to action have on health beliefs and behaviour associated with osteoporosis is known. The present investigation was designed to address this gap in the literature. More specifically, the influence of cues to action, a public service announcement (PSA) developed by Osteoporosis Canada and a bone screening by way of Quantitative Ultrasound, on health beliefs and health-enhancing physical activity (HEPA) across a four week period was investigated. Peri-and postmenopausal women (N= 174) were randomly assigned to one of three conditions 1) an osteoporosis public service announcement (PSA) condition; 2) a bone screening condition via quantitative ultrasound techniques, and 3) a PSA attention control condition. Health beliefs associated with osteoporosis were taken at three time points: prior to the cue to action intervention, immediately following the intervention, and four weeks post intervention. Knowledge of osteorporosis risk factors and HEP A were assessed pre and post-intervention only. Results of a regression analysis suggested that baseline health beliefs predicted baseline HEPA (R2 adj = .24; F (9, 161) = 6.49,p = .000; 95% CI = .12 - .35) with exercise barriers (p = -.33) being a negative predictor and health motivation (p = .21) being a positive predictor of HEP A. Baseline health beliefs predicted

Does altering brachial artery tone with lower-body negative pressure and flow-mediated dilation affect arterial stiffness?

Although medium sized, muscular vessels normally respond to sympathetic stimulation by reducing compliance, it is unclear whether the large brachial artery is similarly affected by sympathetic stimulation induced via lower-body negative pressure (LBNP). Similarly, the impact of flow-mediated dilation (FMD) on brachial artery compliance and distensibility remains unresolved, hi addition, before such measures can be used as prognostic tools, it is important to investigate the reliability and repeatability of both techniques. Using a randomized order design, the effects of LBNP and FMD on the mechanical properties of the brachial artery were examined in nine healthy male subjects (mean age 24y). Non-invasive Doppler ultrasound and a Finometer were used to measure simultaneously the variation in systolic and diastolic diameter, and brachial blood pressure, respectively. These values were used to calculate compliance and distensibility values at baseline, and during both LBNP and FMD. The within-day and between-day repeatability of arterial diameter, compliance, distensibility, and FMD measures were assessed using the error coefficient and intra-class correlation coefficient (ICC). While heart rate (P<0.01) and peripheral resistance increased during LBNP (P<0.05), forearm blood flow and pulse pressure decreased (P<0.01). hi terms of mechanical properties, vessel diameters decreased (P<0.05), but both compliance and distensibility were not changed. On the other hand, FMD resulted in a significant increase in diameter (P<0.001), with no change in compliance or distensibility. hi summary, LBNP and FMD do not appear to alter brachial artery compliance or distensibility in young, healthy males. Whereas measures ofFMD were not found to be repeatable between days, the ICC indicated that compliance and distensibility were repeatable only within-day.

Secretory immunity in overweight and obese versus normal-weight early-and late-pubertal females

Obesity is a condition associated with a wide variety of health problems including hypertension, dyslipidemia, diabetes mellitus, certain forms of cancer, cardiovascular disease, and gallstones (157). TTiere is growing evidence that obesity may also be related to compromised immune function due to altered metabolic, psychological, and physical attributes (93). The aim of this study was to compare: a) immunity-related variables such as frequency of upper respiratory tract infections (URTI) and salivary secretory immunoglobulin A (sIgA) levels between overweight/obese (OB) and normal weight (NW) early-pubertal and late-pubertal girls, and b) stress-related variables such as Cortisol, melatonin, the melatonin/cortisol ratio, testosterone and the testosterone/cortisol ratio. Physical activity levels, stress indicators, and fatigue were used to explain potential differences in the dependent variables. It was hypothesized that the OB females would have lower melatonin (M) and higher Cortisol (C) and testosterone (T) levels compared with NW girls, regardless of maturity status. The altered levels of melatonin, Cortisol, and testosterone, would result in decreased M/C and T/C ratios, despite the increase in testosterone in OB females. It was hypothesized that this altered hormonal status results in a compromised immunity marked by higher frequency of upper respiratory tract infections (URTI) and decreased levels of secretory immunoglobulin A (sIgA). It was also hypothesized that OB girls would participate in less hours of physical activity than their NW counterparts and that this would relate to their stress and immunity levels. Forty (16 early- and 24 late-pubertal) overweight and obese females were compared to fifty-three (27 eariy- and 26 late-pubertal) age-matched normal-weight control subjects. Participants were categorized as early-pubertal (EP) or late-pubertal (LP) using Tanner self-staging of secondary sex characteristics. Subjects were classified into the two adiposity groups according to relative body fat (%BF), where normal weight (NW) subjects had a %BF less than 25%, and overweight and obese (OB) subjects had a %BF greater than 27.5%. Participants completed a number of questionnaires and information was collected on menstrual history, smoking history, alcohol and caffeine consumption, and medical history. Following the determination of maturity status, a complete anthropometric assessment was made including height, body mass, and body composition. All questionnaires and measurements were completed during a one-hour visit between 1 500 and 1900 hours Relative body fat was assessed using bioelectrical impedance analysis. Resting saliva samples were obtained and assayed (ELISA) for testosterone, Cortisol, melatonin and secretory immunoglobulin A. Physical activity was self-reported using the Godin- Shephard Leisure time questionnaire, and quantified using Actigraph GTIM accelerometers, which participants wore for seven consecutive days from the time they woke up in the morning, until the time they went to bed. Late-pubertal girls also completed questionnaires on their perceived stress and fatigue. Finally, all participants also filled out a one-month health log to record frequency of symptoms of upper respiratory tract infections (URTI). Significant age effects were found for testosterone, Cortisol, incidence of sickness, and sIgA when controlling for physical activity, however there were no significant effects of adiposity on any of the variables. There was a trend which neared-significance for an effect of adiposity on sIgA (p=0.01). There were no significant differences between the groups on the total selfreported leisure-time physical activity in METs per week, however EP girls recorded significantly greater levels of moderate, hard, and very hard physical activity from accelerometers. Results of the perceived stress and fatigue questionnaires in late-pubertal girls demonstrated that contrary to what was hypothesized, NW girls reported more stress and more fatigue than OB girls. Results of the present study suggest that excess adiposity in early- and latepubescent girls may not have a negative impact on immunity as hypothesized.

The role of molecular, clinical and socioeconomic factors in the long-term survival of axillary node negative breast cancer patients

The overall objective of this study was to investigate factors associated with long-term survival in axillary node negative (ANN) breast cancer patients. Clinical and biological factors included stage, histopathologic grade, p53 mutation, Her-2/neu amplification, estrogen receptor status (ER), progesterone receptor status (PR) and vascular invasion. Census derived socioeconomic (SES) indicators included median individual and household income, proportions of university educated individuals, housing type, "incidence" of low income and an indicator of living in an affluent neighbourhood. The effects of these measures on breast cancer-specific survival and competing cause survival were investigated. A cohort study examining survival among axillary node negative (ANN) breast cancer patients in the greater Toronto area commenced in 1 989. Patients were followed up until death, lost-to-follow up or study termination in 2004. Data were collected from several sources measuring patient demographics, clinical factors, treatment, recurrence of disease and survival. Census level SES data were collected using census geo-coding of patient addresses' at the time of diagnosis. Additional survival data were acquired from the Ontario Cancer Registry to enhance and extend the observation period of the study. Survival patterns were examined using KaplanMeier and life table procedures. Associations were examined using log-rank and Wilcoxon tests of univariate significance. Multivariate survival analyses were perfonned using Cox proportional hazards models. Analyses were stratified into less than and greater than 5 year survival periods to observe whether known markers of short-tenn survival were also associated with reductions in long-tenn survival among breast cancer patients. The 15 year survival probabilities in this cohort were: for breast cancerspecific survival 0.88, competing causes survival 0.89 and for overall survival 0.78. Estrogen receptor (ER) and progesterone receptor (PR) status (Hazard Ratio (HR) ERIPR- versus ER+/PR+, 8.15,95% CI, 4.74, 14.00), p53 mutation (HR, 3.88, 95% CI, 2.00, 7.53) and Her-2 amplification (HR, 2.66, 95% CI, 1.36, 5.19) were associated with significant reductions in short-tenn breast cancer-specific survival «5 years following diagnosis), however, not with long-term survival in univariate analyses. Stage, histopathologic grade and ERiPR status were the clinicallbiologieal factors that were associated with short-term breast cancer specific survival in multivariate results. Living in an affluent neighbourhood (top quintile of median household income compared to the rest of the population) was associated with the largest significant increase in long-tenn breast cancer-specific survival after adjustment for stage, histopathologic grade and treatment (HR, 0.36, 95% CI, 0.12, 0.89).

Gas chromatographic electron capture negative ionization mass spectrometric (GC/ECNI/MS) determination of unique fluorinated compounds in the sediments of Lake Ontario and the effect of high-boiling alcohols (as injection solvents) on chromatographic behaviour of polycyclic aromatic hydrocarbons in gas chromatography

Part I - Fluorinated Compounds A method has been developed for the extraction, concentration, and determination of two unique fluorinated compounds from the sediments of Lake Ontario. These compounds originated from a common industrial landfill, and have been carried to Lake Ontario by the Niagara River. Sediment samples from the Mississauga basin of Lake Ontario have been evaluated for these compounds and a depositional trend was established. The sediments were extracted by accelerated solvent extraction (ASE) and then underwent clean-up, fractionation, solvent exchange, and were concentrated by reduction under nitrogen gas. The concentrated extracts were analyzed by gas chromatography - electron capture negative ionization - mass spectrometry. The depositional profile determined here is reflective of the operation of the landfill and shows that these compounds are still found at concentrations well above background levels. These increased levels have been attributed to physical disturbances of previously deposited contaminated sediments, and probable continued leaching from the dumpsite. Part II - Polycyclic Aromatic Hydrocarbons Gas chromatography/mass spectrometry is the most common method for the determination of polycyclic aromatic hydrocarbons (PAHs) from various matrices. Mass discrimination of high-boiling compounds in gas chromatographic methods is well known. The use of high-boiling injection solvents shows substantial increase in the response of late-eluting peaks. These solvents have an increased efficiently in the transfer of solutes from the injector to the analytical column. The effect of I-butanol, I-pentanol, cyclopentanol, I-hexanol, toluene and n-octane, as injection solvents, was studied. Higher-boiling solvents yield increased response for all PAHs. I -Hexanol is the best solvent, in terms of P AH response, but in this solvent P AHs were more susceptible to chromatographic problems such as peak splitting and tailing. Toluene was found to be the most forgiving solvent in terms of peak symmetry and response. It offered the smallest discrepancies in response, and symmetry over a wide range of initial column temperatures.

X-ray diffraction of a gram-negative bacterial membrane mimetic

This thesis applies x-ray diffraction to measure he membrane structure of lipopolysaccharides and to develop a better model of a LPS bacterial melilbrane that can be used for biophysical research on antibiotics that attack cell membranes. \iVe ha'e Inodified the Physics department x-ray machine for use 3.'3 a thin film diffractometer, and have lesigned a new temperature and relative humidity controlled sample cell.\Ve tested the sample eel: by measuring the one-dimensional electron density profiles of bilayers of pope with 0%, 1%, 1G :VcJ, and 100% by weight lipo-polysaccharide from Pse'udo'lTwna aeTuginosa. Background VVe now know that traditional p,ntibiotics ,I,re losing their effectiveness against ever-evolving bacteria. This is because traditional antibiotic: work against specific targets within the bacterial cell, and with genetic mutations over time, themtibiotic no longer works. One possible solution are antimicrobial peptides. These are short proteins that are part of the immune systems of many animals, and some of them attack bacteria directly at the membrane of the cell, causing the bacterium to rupture and die. Since the membranes of most bacteria share common structural features, and these featuret, are unlikely to evolve very much, these peptides should effectively kill many types of bacteria wi Lhout much evolved resistance. But why do these peptides kill bacterial cel: '3 , but not the cells of the host animal? For gramnegative bacteria, the most likely reason is that t Ileir outer membrane is made of lipopolysaccharides (LPS), which is very different from an animal :;ell membrane. Up to now, what we knovv about how these peptides work was likely done with r !10spholipid models of animal cell membranes, and not with the more complex lipopolysa,echaricies, If we want to make better pepticies, ones that we can use to fight all types of infection, we need a more accurate molecular picture of how they \vork. This will hopefully be one step forward to the ( esign of better treatments for bacterial infections.

Perceived parental monitoring, adolescent disclosure, and adolescent depressive symptoms : a longitudinal examination

Parental monitoring has long been stressed as an important parenting practice in reducing adolescent susceptibility to depression. An extensive review by Stattin and Kerr (2000), however, , revealed that researchers had confounded perceptions of parental monitoring (i.e., parental solicitation and control) with parental knowledge, and neglected to consider the role of adolescent willingness to disclose. In the present study, adolescents (N = 1995; 51.3% female) were surveyed at two time points (grade 10 and 11). To disentangle the role of perceived parenting, three central issues were addressed. First, the present study examined whether parental knowledge, adolescent disclosure, and parental monitoring (i.e., parental solicitation and control) in grade 10 predicted adolescent depression in grade 11. Second, the predictive value of adolescent depression in grade lOon parental knowledge, adolescent disclosure, parental solicitation and parental control in grade 11 was considered. Lastly, associations among parental knowledge, adolescent disclosure, parental solicitation and parental control were examined over time. Findings indicated that higher levels of parental knowledge were associated with subsequent lower levels of depressive symptoms, and that depressive symptoms predicted lower levels of parental knowledge over time. Both adolescent willingness to disclose and parental control predicted higher parental knowledge. These findings underscore the role of adolescent and perceived parent contributions to parental knowledge, and highlight the importance of perceived parental knowledge in predicting reduced adolescent susceptibility to depression.

The Co-occurrence of Depressive Symptoms and Alcohol Use for Adolescent Boys and Girls: An Investigation of the Role of Self-Regulation and Approach Behavior

While many studies have been conducted on adolescent depressive symptoms and alcohol use, much of the research has examined these behaviors separately rather than examining their co-occurrence within individuals. In the present study, adolescents (N = 4412; 49% female) were surveyed at four time points (grade 9, 10, 11, and 12) and growth mixture modeling was used to identify groups of individuals reporting various patterns of depressive symptoms and alcohol use across the high school years. Four groups were identified, including co-occurrence (higher depressive symptoms and higher alcohol use relative to peers, comprising 6.1 % of boys and 7.1 % of the girls in the sample), pure depressive symptoms (higher depressive symptoms and lower alcohol use; 12.7% of boys and 12.5% of girls), pure alcohol use (higher alcohol use and lower depressive symptoms; 20.9% of boys and 19.9% of girls), and low co-occurrence (lower depressive symptoms and alcohol use, 60.3% of boys and 60.5% of girls). Groups were compared on self-regulatory (i.e., delay of gratification) and approach behaviors. For both boys and girls, delay of gratification was the strongest predictor of group membership, with the co-occurrence group scoring the lowest and the low co-occurrence group the highest. This finding emphasizes the importance of assessing delay of gratification in the identification of high risk youth.

Peer Motivational Climate and its Relationship with Positive and Negative Affect in Intramural Sports

The study of peers as an influence on sport participation has received minimal exploration. The purpose of this cross-sectional study was to determine how peer created motivational climates (task-involved and ego-involved) impact positive and negative affective states of intramural sport participants post-participation. Three hundred and fifteen intramural sport participants (N=315) at a Canadian university completed a questionnaire after participating in their intramural sport. Hierarchical regression analyses and MANCOVAs were used to examine the effects of peer motivational climates on positive and negative affect. Results revealed that task-involved peer climates are more conducive of positive affective states post-participation whereas ego-involved climates result in lesser positive affective states and more negative affective states. Teams that promote improvement and effort instead of intra-team competition and conflict will have more positive recreational sport experiences. Future research should explore other psychological outcomes that can result from peer created motivational climates in recreational sport team settings.

Photograph Negative - Donald Ziraldo working wine equipment

A photograph negative of Donald Ziraldo working a machine.