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Powers of inspectors (1) An inspector may, at all reasonable times- (a) enter upon- (i) any place or premises from which- (aa) a person authorized under this (Act to compound or dispense medicines or scheduled substances; (bb) the holder of a licence as contemplated in section 22C(1)(b): (cc) the holder of a certificate of registration of a medicine, conducts business. Offences Any person who - (a) obstructs or hinders any inspector in the exercise of his or her powers or the performance of his or her duties under this Act; or [Para. Penalties (1) Any person who is convicted of an offence referred to in section 29 shall be liable to a fine, or to imprisonment for a period not exceeding 10 years. Funds of council (1) The funds of the council shall consist of- (a) State funds received through the Department of Health; (b) fees raised and interest on overdue fees; (c) money accruing to the council from any other source. Delegation of powers (1) The Minister may in writing authorise the Director-General or any officer of the Department of Health to exercise any of the powers conferred upon the Minister by this Act other than the powers referred to in sections 3, 24(1) and 35, or to exercise or perform any of the duties or functions conferred or imposed on the Minister in terms of this Act. Operation of Act in relation to other laws The provisions of this Act shall be in addition to and not in substitution for any other law which is not in conflict with or inconsistent with this Act. Short title This Act shall be called the Medicines and Related Substances Act, 1965. Milano scientifc landscape, and therefore confrmed the need Via Celoria 16 20133 Milano Italy for their continuation. Below: (left) Advanced approaches to high intensity laser-driven ion acceleration, see page 123. Examples and specifc topics 128 Annexes 145 Foreword l l l Nuclear physics is a coin that has two sides: basic research and applications. Without basic 3 research there would be little to be applied; applications resulting from basic research contribute to the wealth and health of society. Modern medicine benefts tremendously from nuclear physics, both for diagnosis and for therapy. The input received from the community was incorporated, resulting in the report now at hand. In particular it was stated ing the mission of this expert committee of the that further development of the nuclear physics European Science Foundation. One important question in this con- ety of related techniques and applications such nection is: how can nuclear physics techniques as those in medicine which have considerable improve medical diagnostics and contribute to impact on society. It is on this specifc question The development of nuclear physics since that we have decided to focus and thus to issue the first discovery of the atomic nucleus by this report prepared by a group of distinguished Rutherford in the early 20th century has been expert researchers, who have contributed a great intimately tied to the development of new detec- deal and at a high level, to answer to these key tion techniques, accelerators and to theoretical questions. Comprehensive be used to image and trace these agents inside the surveys on the impact of nuclear physics were body to study human health and diseases. Since then nuclear antee early detection of disease and to select the physics has progressed and new ideas have most appropriate therapeutic strategies. Life sciences projects in nuclear physics labo- driven by the use of hadrons (particles subject ratories are literally saving lives every day. This to the strong force) such as protons and atomic is commonly the case in European laboratories, nuclei (ions). This frontier in radiation therapy, which also contribute by providing consider- recognised and pursued worldwide, is illustrated able expertise and advice to other centres which together with new on-going developments. One can see that the contribution new developments from which nuclear medicine of nuclear physics to hadrontherapy has been enor- will beneft. In this regard, exploitation of new In applying nuclear physics in medicine, con- technologies in the nuclear physics research will structive interaction with physicians is central. The main point of The answers to these questions are various and this chapter is to emphasise how nuclear phys- require some consideration and are addressed to ics research has always been involved in medical some extent in this booklet. Developments in medical imaging parallel advances in instrumentation for nuclear physics experiments, sharing methods, In the footsteps of the alchemists techniques, and manufacturers. Emphasis is given Paracelsus, a famous alchemist and medicus of to the interplay of detector design and simulation the early 16th century stated: Many have said and reconstruction models. A point of major focus of alchemy, that it is for the making of gold is quality control in hadrontherapy. For me such is not the aim, but to also briefy describes some applications in medical consider only what virtue and power may lie imaging of mass spectrometry, which is playing an in medicines. Today, 500 years afer Paracelsus, we may diferent strategies for producing isotopes for med- therefore conclude: Many have said of nuclear ical use. Indeed radionuclides are the essential fuel physics, that it is for the making of new gold that is driving all nuclear medicine applications. For With few exceptions the required radionuclides us such is not the only aim, but also to con- are not present in natural decay chains, so have to sider what virtue and power may lie in these be produced by artifcial transmutation driven by for medicine. It is important to stress that advances in This report is organised into three chapters: the production of new radioactive isotopes come the frst on hadrontherapy, the second on medical out of accelerator and research reactor centres that imaging and the third on radioisotope production. On the other hand the infuence of new In general, accelerator and research reactor techniques and of particular improvements in centres play a key role in education and training each of these topics on the others is well stressed of scientists and technical personnel for nuclear in the three chapters. As a fnal remark it is worth noting that the booklet is not intended to be a position paper. Rather, it gives an updated overview of how fun- damental nuclear physics research (in its broadest sense) has had and will continue to have an impact on developments in medicine. As with previous Framework Programmes, it is important to be engaged in and committed to nuclear physics pro- jects within Horizon 2020 that will enhance the mutual roles of fundamental and applied nuclear research. Tese reports have shown has grown into an advanced, cutting-edge clini- the very strong interface between physics, biol- cal modality. More than 10,000 instruments, which have had a large impact on our have been treated with heavier ions, generally car- healthcare systems. Various companies are now ofering turn-key on hadrontherapy gives an updated view on the solutions for medical centres. The benefts of hadrontherapy are based both In 1946, accelerator pioneer Robert Wilson laid on physical (better ballistic accuracy) as well as the foundation for hadrontherapy with his article in biological reasons (especially for heavy ions), result- Radiology about the therapeutic interest of protons ing in more accurate and efcient irradiation of for treating cancer . Today, cancer is the second the tumour, thereby reducing the dose to the sur- highest cause of death in developed countries. Its rounding healthy tissue and thus leading to a lower treatment still presents a real challenge. Clinical interest in hadron therapy Pion therapy worldwide resides in the fact that it delivers precision treatment Vancouver 1979 1994: 367 patients of tumours, exploiting the characteristic shape of Villigen 1980 1993: 503 patients the Bragg curve for hadrons, i. While Proton therapy Villigen X-rays lose energy slowly and mainly exponentially 1974: Ocular treatments 72 MeV as they penetrate tissue, charged particles release passive beam spread more energy at the end of their range in matter 1996: deep seated tumours 230 MeV ring the Bragg peak. The Bragg peak makes it possible cyclotron to target a well-defned region at a depth in the Active beam delivery: horizontal magnetic body that can be tuned by adjusting the energy of defection the incident particle beam, with reduced damage to Vertical: patient shif the surrounding healthy tissue.
Gilead s relevant pipeline is smaller than ister half (50%) of its newest products in a few strong compliance system rogaine 5 60 ml low price prostate cancer causes, including guidance the industry average order rogaine 5 visa prostate cancer 7 out of 10, and it falls below indus- priority countries (disease-specifc sub-sets and contractual obligations to contractors generic rogaine 5 60 ml with visa prostate cancer uptodate. In an try standards for clinical trial conduct and clinical of countries with a particular need for access innovative move, the company has developed a data transparency. Gilead has an ethical marketing ted to conducting R&D for resource-limited set- Monitors prices and provides pricing guidelines code that also applies to third parties, but it has tings. For its hepatitis C prod- marketing activities and payments in countries ucts, the company sets pricing guidance for its within scope. The company is not a signatory to Poor measures to ensure clinical trials are con- sales agents via transfer prices. Despite having policies in place to ensure ethical clinical trial conduct, Gilead Consistent recall guidelines. Gilead has glob- Publicly discloses policy positions and con- does not provide evidence that it monitors clin- ally consistent guidelines for issuing drug recalls fict of interest policy. Gilead publishes its policy ical trial conduct or takes disciplinary action in all countries relevant to the Index where its positions related to access, in particular those when ethical violations occur. Gilead has not recalled 110 Access to Medicine Index 2016 a product for a relevant disease in a country in all of its hepatitis C portfolio. Notably, it did so Monitoring mainly the responsibility of part- scope during the period of analysis. Gilead contractually requires that donation it does make recall information publicly available. The com- fovir disoproxil fumarate and efavirenz/emtric- environmental conditions, demographic or cul- pany builds manufacturing capacity in coun- itabine/tenofovir disoproxil fumarate each year tural needs. In April 2015, Gilead launched an with equitable pricing strategies that target the capacity. Gilead makes a general commitment innovative donation programme with the goal of majority of priority countries (disease-specifc to building manufacturing capacity in relevant eliminating hepatitis C virus in Georgia. In the period of analysis, the com- gramme includes universal screening and treat- to relevant products). Together, these strategies pany undertook a number of technology trans- ment, prevention and surveillance. Gilead now has more products with equitable will provide 20,000 free courses of sofosbuvir/ pricing strategies than in 2014. Gilead routinely updates safety Best practice: high transparency of products labels for its products in countries in scope. The company discloses one relevant initiative HiV- Maintains top rank in Patents & Licensing. Gilead did not dis- close any relevant activities to build R&D capac- Continuing engagement in voluntary licens- ity or strengthen supply chains in countries in ing. It main- Best practice: licensing all on-patent prod- tains its long-term donation programmes for vis- ucts in scope for high-burden diseases. Once again, it was not found to have breached to more products than in 2014, only half target high-burden laws or regulations. It is building pharmacovigilance capacity, mainly in Latin management, and its approach to transparency in market- America. A structured approach would AbbVie can further develop its access AbbVie can strengthen its identifcation and tar- entail setting clear registration targets within a approaches into a strategy and clearly align it geting of local skills gaps in low- and middle-in- fxed timeframe, tied to decision-making crite- with its corporate strategy. This can help AbbVie ensure new products wider availability of high-need products for pop- ing (for example, to increase local R&D capac- are brought to markets in low- and middle-in- ulations in need. The company can also demonstrate that it come countries as soon as possible upon leav- cally using more equitable pricing and reponsible has a clear process in place for mitigating con- ing the pipeline. AbbVie can expand more high-need countries such as China and the geographic scope of licences agreed for for- Indonesia: combination ombitasvir/paritaprevir/ mulations of ritonavir (Kaletra ) in its licens- ritonavir (Technivie ) and dasabuvir/ombitas- ing activities. Rest of world Japan Europe North America *AbbVie Inc became an independent company on 1 January 2013. The company has gained fve market AbbVie s R&D projects have progressed along Communicable Multiple categories approvals since 2014: including, in Q4 2014, the pipeline. It has several features intended to development, plus atrasentan for diabetic nephropathy. Commitment to R&D partnerships, but no Drops two places due to a lack of improvement policy. AbbVie discloses a list of trade associa- compounds for screening and technical exper- all areas of measurement. It is not transparent tions from around the world in which one of its tise to outside partners. However, it does not regarding its access targets, the performance of employees is a board member. Nevertheless, it report an ofcial policy of ensuring access-ori- its access activities and its stakeholder engage- does not publish its policy positions on topics ented measures are systematically included in its ment selection process. Takes strategic approaches to access but these Takes measures to ensure ethical clinical trial do not align with business strategy. However, AbbVie has not specifed how marketing or corruption anywhere in the world High transparency around clinical trials. AbbVie these components are connected, nor how they during the period of analysis. Has a centralised performance management AbbVie has strong procedures for holding all AbbVie manages requests for data in-house. AbbVie has assigned board- employees and business partners accountable Rejections based on scientifc merit are for- level responsibility for access issues and has for their behaviour. It does not disclose specifc access-related to and including termination of employment. The company has an Has stakeholder engagement strategy, but auditing system, but does not provide details Drops 8 places due to relatively poor pric- is not transparent. AbbVie has a stakeholder about its processes and whether these include ing and registration performance. However, AbbVie does ers when it comes to rapidly registering new not publish details of the stakeholder groups it Drops two places but maintains strong perfor- products in high-burden countries, or to adapt- engages with, nor its process for selecting who mance. AbbVie s drop in rank is explained by the ing its brochures and packaging to facilitate the to engage with. However, pliance system, but its transparency around its only 20% of its products have equitable pric- marketing and lobbying activities is limited. The company Together, they cover 50% of all corresponding ited marketing code and its sales staf are incen- has processes for goal-setting and monitoring priority countries. For its inter-country equitable tivised using sales targets only, which may not and for evaluating progress toward its relevant pricing strategies, AbbVie considers either dis- be sufcient to curb unethical behaviour. It contributes to meeting ease burden or prevalence, as well as the state company is not a signatory of the United Nations the London Declaration targets by 2020, includ- of public fnancing systems. This makes it the newest pharma- ceutical company to engage in non-exclusive vol- Rises four places. With four donation programmes, AbbVie does not have disease-specifc registra- Abbvie has the second largest number of struc- tion targets and does not publish products reg- Does not publish its policy positions on trade tured donation programmes.
High phosphates cause pruritus (itching) purchase rogaine 5 60 ml with visa prostate gland location, chronic r In prerenal failure cheap rogaine 5 60 ml on line prostate x supplement, the kidney is not damaged but renal failure leads to renal osteodystrophy cheap rogaine 5 60 ml visa mens health 15 minute workout dvd. Recovery may be possible, though if the disease is severe and scarring results, full Acute renal failure functional recovery is unlikely. The rate at which these rise depends on a number of factors, including how Clinical features catabolic the patient is, i. Complete anuria is only seen with bladder out- Oliguria (urine output <15 mL/hour or <400 mL/ ow obstruction, bilateral (or unilateral in a single 24hour) is common, but does not occur with all causes functioning kidney) ureteric obstruction. Water retention can lead to r Hyperventilationmaybeduetohypoxiaorrespiratory hyponatraemia. Acute glomeru- Primary and secondary causes r Bloods lonephritis of glomerular disease Acute interstitial Pyelonephritis, drugs 1 Anaemia (normochromic, normocytic if underly- nephritis ing disease or in chronic renal failure). Management Acute renal failure is an emergency, with possible life- threatening complications. Complications Reversiblecausesshouldbetreatedassoonaspossible; Hyperkalaemia may cause cardiac arrhythmias and sud- withdraw any potentially nephrotoxic drugs, treat sepsis, den death. Fluid overload may cause cardiac failure, malignant hypertension, and relieve any obstruction. Central venous r Persistent hyperkalaemia >6 mmol/L despite medical pressure measurement may be helpful, but should therapy not be relied upon over clinical assessment espe- r Severe acidosis cially in the presence of cardiac or pulmonary disease. If blood pressure remains low Prognosis despite lling (such as due to cardiac insufciency, Depends on underlying cause and concomitant medical sepsis), then additional treatment, usually inotropic conditions. Denition r In uid overload, or in oliguric renal failure high doses Necrosis of renal tubular epithelium as caused by hypop- of furosemide may be effective in causing a diuresis. However, there is no good evidence that furosemide speeds the recovery from renal failure, and it should Aetiology be avoided in those thought to have pre-renal failure. In addi- tion, in shock renal blood ow is particularly likely to Hyperkalaemia suffer because of constriction of renal vessels due to r Treatseverehyperkalaemia(K>6. Toxin induced r Endogenous Haemoglobinuria, myoglobinuria, Review all medication for dosages in renal failure. Glomerulonephritis 12% Toxinsmayhaveavarietyofmechanismssuchascaus- Pyelonephritis/reux nephropathy 10% ing vasoconstriction, a direct toxic effect on tubular cells Renovascular disease 7% Hypertension 6% causing their dysfunction, and they may also cause the Adult polycystic kidney disease 6% death of tubular epithelial cells which block the tubules. Blockageoftherenaltubulescauses renal function requiring any form of chronic renal re- asecondary reduction in glomerular blood ow. The ep- Incidence ithelial cells take time to differentiate and develop their The exact number of people with chronic renal failure is concentrating function. This phase renal disease such as amyloid, myeloma, systemic lupus may last many weeks, depending on the initial severity erythematosus and gout. Initially there may be a phase of large Prognosis volumes of dilute urine production due to reduction In acute tubular necrosis the mortality is high but if in tubular reabsorption. The kidneys are usually small and shrivelled, with 3 The hormone functions of the kidney are also affected: scarring of glomeruli, interstitial brosis and tubular at- reduction of vitamin D activation causes hypocal- rophy. The onset of uraemia is insidious, but by the time vious historical urea and creatinine measurements are serum urea is >40 mmol/L, creatinine >1000 mol/L, very useful. Late symptoms include r U&E to assess progress of the renal failure, ensure Na+ pruritis, anorexia, nausea and vomiting very late and K+ are normal. It is important to assess the r Urinalysis is performed to look for proteinuria and uid status by looking at the jugular venous pressure, skin turgor, lying and standing blood pressure, and haematuria (if new or increasing these may need fur- for evidence of pulmonary or peripheral oedema (see ther investigation) and urinary tract infections. Management r Cardiovascular: Treat even mild hypertension and The aim is to delay the onset of end-stage renal failure consider treating hyperlipidaemia. Patients need to follow a low phos- for dialysis, or prefer conservative treatment. This leads to reduced absorption of cal- cium from the diet and therefore lowers serum cal- Glomerular disease cium levels. In addition, phosphate levels rise, due to The glomerulus is an intricate structure, the function of reduced renal excretion. This binds calcium, further which depends on all its constituent parts being intact lowering serum calcium levels and also causes calcium (see Fig. On the vascular side of the bar- glands in the neck are stimulated to produce increased rier between the blood and the ltrate is endothe- amounts of parathyroid hormone (i. This r Metabolic acidosis also promotes demineralisation of ultraltrate is almost an exact mirror of plasma ex- bone. There are three main types of glomerular disease: Clinical features r Glomerulonephritis describes a variety of conditions See Osteomalacia, Osteoporosis, Secondary and Tertiary characterised by inammation of glomeruli in both Hyperparathyroidism for the clinical features and X-ray kidneys, which have an immunological basis. This r Glomerular damage may also occur due to inltration affects the trabecular bone of the spine, to produce a by abnormal material, such as by amyloid (see page rugger-jersey spine appearance on X-ray. The type of damage caused to the structure of the Fibrinoid necrosis, where brin is deposited in the glomerulus determines the pathological appearance, has necrotic vessel walls. Crescents are formed when abroad relationship to the effect on renal function and necrotic vessel walls leak blood and brin, so that hence the clinical presentation. The disease process may macrophages and proliferating epithelial cells invade be diffuse affecting all the glomeruli, or focal affecting the Bowman s space, crushing the glomerulus. Affected glomeruli may be arecrescentsinmostoftheglomeruli,thetermrapidly completelydamaged(global),oronlyapartmaybedam- progressiveglomerulonephritisisused,assevererapid aged (segmental). Almost all forms of glomerulonephritis have a cellular Within the glomerulus itself, there are different or humoral immunological basis: appearances: r Humoral response: Immune deposits (antibodies or r Proliferation of endothelial cells and mesangial cells antibody antigen complexes) in the glomerulus x is common in diseases that cause nephritic syndrome and activate complement and a variety of other in- (see Fig. Endothelial cell proliferation leads to ammatory mediators such as antioxidants, proteases occlusion of the capillary lumen, reduced blood ow, and cytokines. Increased lial deposits are close to the glomerular capillary lu- matrix can lead to reduced blood ow and/or protein- men, so excite marked inammation which can lead uria. Circulating immune complexes ltered by the kid- over-synthesis of basement membrane material and ney tend to cause less injury than complexes formed in-growth of mesangium. It appears that lymphocytes, in particular T cells The most common causes of nephrotic syndrome in play a role in causing the functional changes. In children, minimal change disease is Immunouorescence and electron microscopy: The di- more common, accounting for up to 90% of cases under agnosis of glomerular disease may not be possible with the age of 10 years. There is no acute inammatory response ei- Denition ther because there are no immune deposits (such as in Nephrotic syndrome is dened as proteinuria (>3 g/24 minimal change nephropathy, focal segmental glomeru- hour), hypoalbuminaemia and oedema. See also pro- losclerosisandinamyloidosis)ortheimmunecomplexes teinuria (page 227). Haematuria and renal failure are therefore usually minor r Bence Jones protein (to look for myeloma). Clinical features Gradual development of swelling of eyelids, peripheral Management oedema, ascites and pleural effusions. This is usually asymp- tomatic, the rst sign may be a pulmonary embolus, or it may present acutely due to venous infarction with Nephritic syndrome ank pain, haematuria and renal impairment. Nephritic syndrome is characterised by hypertension, r Hypercholesterolaemia is thought to occur due to haematuria and acute renal failure.
Call your local health and wellness programs - they can often help you fnd a family physician or other clinical/non-clinical supports generic 60 ml rogaine 5 otc mens health survival of the fittest. Consider options such as taking a health leave or training part-time as part of your recovery generic 60 ml rogaine 5 fast delivery prostate questionnaire. Quick reference index Highlighted here are some of the most common terms used to discuss issues of physician health and the pages where these terms are discussed throughout the text cheap rogaine 5 60 ml free shipping prostate support. Moffitt Duke University Duke University, Duke University Medical Center, and King s College London Daniel W. Hancox and Richie Poulton Duke University Medical Center University of Otago Brent Roberts W. Murray Thomson University of Illinois at Urbana Champaign University of Otago Avshalom Caspi Duke University, Duke University Medical Center, and King s College London The rising number of newly insured young adults brought on by health care reform will soon increase demands on primary care physicians. Physicians will face more young adult patients, which presents an opportunity for more prevention-oriented care. In the present study, we evaluated whether brief observer reports of young adults personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for health care professionals to personalize preventive medicine. Adding personality information to existing health care electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor patient communication, health service use, and patient outcomes. This research Moffitt, Department of Psychology and Neuroscience, Institute for Ge- received support from U. The study protocol was approved by Health and Development Research Unit, University of Otago, Dunedin, the Institutional Ethical Review Boards of the participating universities. Brent Roberts, Department of Psychology, University of Members of the Dunedin Multidisciplinary Health and Development Study Illinois at Urbana Champaign. We thank the Study members as well as their informants, unit Department of Psychology and Neurosciece, Institute for Genome Sciences research staff, and founder Phil Silva. The resulting proliferation of assessment tools and lates across the life course (Weintraub et al. Accord- piecemeal research made it difficult for clinicians to know what ingly, health professionals are placing increased emphasis on personality measures to use, or how to use them. Smith & Williams, 1992) because medical-based tests in young adults do not provide and guiding translation to clinical practice. Consequently, primary care practitio- typical high and low scorers for each personality trait. Less is known about Openness to Experience, Why Use Personality Traits to Predict Health? The rise in the number of newly insured young adults brought on by health care reform will increase demands on the health care Moving From Prediction to Theory, and system (Sommers & Kronick, 2012). Primary care physicians will From Theory to Translation face more patients whose needs are unfamiliar to them. A vision for orienting health care to better meet patients needs has been set Research has begun dissecting the personality processes under- forth in a recent report by the Institute of Medicine (M. The report calls for anisms by which personality gets outside the skin to affect greater patient centeredness in the health care system, stressing the morbidity and mortality (Hampson, 2012). How can health care practitioners get to know their pa- by heightened emotional reactivity to environmental stimuli, has tients? Personality traits can be measured cheaply, easily, and been tied to greater activation of neuroendocrine and immune reliably; are stable over many years; and have far-ranging effects systems (Lahey, 2009). Greater levels of Neuroticism could pos- on important life outcomes, including morbidity and early mortal- sibly reflect an underlying hyperresponsiveness to both emotional ity. The magnitude of personality effects are on par with other and physiological negative stimuli. For example, individuals higher in of personality to predict objective measures such as disease and Extraversion may seek out more socially engaging environments mortality has primarily focused on the second half of the life allowing them to call on a richer network of social support when course. This leaves a gap in our understanding of whether dealing with illness (Carver & Connor-Smith, 2010). Third, per- personality predicts health in the first half of the life course, sonality differences are thought to be related to a wide range of before the typical emergence of clinical problems. We evaluated health behaviors are not mutually exclusive and may work to- the predictive utility of personality traits over and above other gether to affect health outcomes. To move forward in applying also tested whether personality could predict whose health personality measurement in clinical settings requires the utmost would deteriorate over time. The most powerful test in an confidence in the robustness of personality health associations. Accordingly, we tracked change in health using cohorts and over 75,000 adults revealed that Conscientiousness repeated measures of our index of physical health at age 26 and was consistently associated with elevated mortality risk (Jokela et again at age 38. Although these results are certainly impressive, robust prediction should apply not only to a finding s consistency across Method studies but also to its consistency across measurement sources. As an analogy, blood pressure readings yield similar prospective Sample utility whether measured at home, by a friend, or at the clinic. How well does personality fare in predicting health when assessed by Participants in our study were members of the Dunedin Multi- different reporters? The overwhelming majority disciplinary Health and Development Study (Moffitt et al. The cohort represents the predict health when personality is assessed by observers who know full range of socioeconomic status in the general population of Study members well? To test this question, we used informant New Zealand s South Island and is primarily White. To test this question, we used Study Study member is brought to the Dunedin research unit for a full member personality assessments completed by Dunedin Study day of interviews and examinations. Personality assessments by the Study nurse and approved each phase of the study and informed consent was receptionist were completed after brief encounters with Study obtained from all Study members. These informants were mailed question- The Present Study naires asking them to describe the Study member using a brief We tested the hypothesis that observer reports of Big Five version of the Big Five Inventory (Benet-Martnez & John, 1998), personality traits predicted health using a prospective- which assesses individual differences on the five-factor model of longitudinal design in a population-representative cohort. Per- We created a composite index of poor physical health at age 38 sonality variables were standardized to the same scale using a by summing the number of clinical indicators on which Study z-score transformation. Data were therefore categorized into Age-32 Personality Trait Assessment: 20-Item five groups: zero clinical indicators-24. Ta- At age 32, personality assessments were conducted by Dunedin ble 4 shows mean values for each clinical indicator as the total Study staff after brief encounters with Study members in the count index rises. This composite index medical history, and monitored their cardiorespiratory fitness dur- of poor physical health was used as the main outcome measure in ing bicycle ergometry. Each item consisted Baseline Age-26 Risk Factors Commonly Ascertained of a 7-point scale assessing a Big Five dimension: Extraversion in Primary Care Settings (e. Staff impression about Study members socioeconomic origins and educational ratings of Study members personalities were made for 935 (97%) attainment; (b) health risk factors were assessed with information of the 960 Study members who participated in the age-32 assess- about smoking and obesity two of the top health risks most likely ment. Personality variables were standardized to the same scale to signal future disease (Lim et al.
E. Kayor. National-Louis University. 2019.