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Biomedical subjects

B Given

Publications and source records attributed to B Given.

36 records · Page 2Linked to original sources
PubMed1979

A structurally abnormal insulin causing human diabetes.

Insulin isolated from the pancreas of a diabetic patient with fasting hyperinsulinaemia showed decreased activity in binding to cell membrane insulin receptors and in stimulating cellular 2-deoxyglucose transport and glucose oxidation. Chemical studies suggest that the isolated hormone is a mixture of normal insulin and an abnormal variant which contains a leucine for phenylalanine substitution at position 24 or 25 of the insulin B-chain.

Amino Acid Sequence↗
PubMedDate not supplied

Promotion of breast cancer screening in a work site population.

We investigated whether attitudes, intentions, and practices regarding breast cancer screening by mammography and clinical breast examination could be positively influenced through a brief educational intervention administered to women employees at diverse work sites. The educational intervention involved the mailing of American Cancer Society brochures that discussed breast cancer screening and contained guidelines on the recommended frequency for each screening modality according to age. Effects of the intervention were measured through pre/post questionnaires. The results were positive for the entire group of women who participated, as evidenced by their increased perception of the importance of mammography and clinical breast examination and of the priority of getting a mammogram regularly, their decreased perception of mammography as an uncomfortable procedure, and the increased frequency of discussions of breast cancer screening at work. Employers, particularly large corporations and agencies, must realize that by introducing effective work site cancer screening programs they not only fulfill their social responsibility to contribute to their employees' health, but also achieve reductions in health care costs.

Adult↗
PubMedDate not supplied

Longitudinal studies as intervention.

The results of this descriptive study support the premise that through the research process researchers actively influenced the experiences of many of the family caregivers in the study. Caregivers seem to have been stimulated to evaluate and change their appraisals of their care-giving situation and, at times, their use of external resources and patient management strategies. We speculate that the predominant way subjects were influenced was through the opportunity to examine their experience relative to that of other caregivers as they completed the study instruments. Although it is possible that the effect was related to the specific behavior of the data collectors, we are reasonably confident that the structured interviewer training methods minimized this effect. Direct comments about interviewers were rare in responses to open-ended questions, and requests for information or help from interviewers were relatively infrequent, lending further support to the idea that interviewer effects were not a major influence on subjects. Although Rubin and Mitchell (1978) aptly described the unintended effect of study participation on their respondents, which was akin to counseling, little attention has been paid to this phenomenon in recent years. What family caregivers experienced as participants in our study, but failed to experience in their social network or formal contacts with the health care system, was an opportunity to: (a) examine their experience as a caregiver in depth, (b) anticipate what the future might hold for them, and (c) compare their personal experience to the experience of other families providing care to elderly members.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMedDate not supplied

The design and implementation of a community breast cancer screening project.

A breast cancer screening program offers a community the opportunity to highlight and address an important health issue. This article has described the important elements of any such screening effort. To be successful, the program will require a multidisciplinary cadre of health care professionals working collaboratively throughout all phases of the planning, screening, and follow-up process. An agency should be identified to lead these professionals and monitor the progress of the screening effort. These screening programs can have direct and indirect benefits in the community. The direct benefits include improved access and delivery of health services, particularly those that meet state-of-the-art quality standards. The indirect benefits involve the promotion of breast cancer screening through education of women and providers about good breast health practices. As our experience in Michigan has shown, efforts featuring a broad coalition of forces can foster debate and discussion throughout the community and ultimately lead to improvements in the delivery of breast cancer screening services.

Breast Neoplasms↗
PubMedDate not supplied

Patient and family caregiver reaction to new and recurrent breast cancer.

Exploratory data on the mental health (depression), symptoms, and functional status of breast cancer patients and the mental health (depression) and reaction to care of their caregivers are examined in this paper. How both are influenced by new and recurrent disease is also reported. Patients and family caregivers were followed over a six-month period to determine whether new or recurrent disease status altered their reaction to the cancer experience. The data suggest that psychological distress may be more marked in the family member than in the patient. Differences in caregiver reaction were not due to new or recurrent disease status, health status of the patient, or the care process of the caregiver. Future research is needed to isolate the cause of variations in mental health of women and their family caregivers experiencing new or recurrent breast cancer.

Breast Neoplasms↗
PubMedDate not supplied

Relationships of processes of care to patient outcomes.

This study examined relationships between process and outcome components of patient care. Relationships were determined between independent process variables--diagnostic approach, therapeutic approach, and patient compliance--and dependent outcome variables--functional status, clinical health status, perception of health and care, and knowledge and understanding of disease and therapy. Criteria for process and outcome dimensions were developed, based on a literature review. Data on 103 patients, followed for a five-month period, were collected by use of patient record audit and beginning- and end-of-study patient interviews. Cross-tabulations and multiple regression analysis were used to determine relationships between independent and dependent variables. Analysis of variance was used to determine difference in provider and patient process dimensions according to patient severity groups. Significant relationships were found between all independent variables and the dependent variables of clinical health status and knowledge and understanding of disease and therapy. Patient compliance level was found to be the most significant process variable.

Adult↗
PubMedDate not supplied

Loss of physical functioning among patients with cancer: a longitudinal view.

This study investigated, in a convenience sample of 279 patients with cancer, the trajectories of symptoms and loss of physical functioning over time, the relationships of these variables to age and co-morbidity, and differences existing according to cancer site (breast, lung, colorectal/gastrointestinal, urinary/reproductive, lymphoma, and "other"). The patients were surveyed twice; at intake (wave I, n = 279) and 6 months later (wave II, n = 160). Findings indicated, at wave I, that age and co-morbidity were significantly correlated, and loss of physical functioning was associated primarily with symptoms and, to a lesser degree, with age. Loss of function scores varied significantly according to cancer site, with higher levels for patients with lung cancer and lower levels for patients with breast or colorectal/gastrointestinal cancer. The most frequently occurring symptoms were fatigue, insomnia, pain, and nausea. Average levels of symptoms and loss of physical functioning were lower at wave II, indicative of a possible treatment-related effect (at wave II, a smaller percentage of patients had recently undergone treatment). Although co-morbidity was only modestly correlated with symptoms and loss of function for the total sample, it was highly correlated with both symptoms and loss of physical functioning for the younger patients (those younger than 60 years of age). The significant link that was identified between symptoms and loss of physical functioning has important implications for physicians, nurses, and other healthcare providers caring for patients with cancer as they deal with symptom management and quality-of-life issues.

Activities of Daily Living↗
PubMedDate not supplied

Concordance of cancer patient and caregiver symptom reports.

PURPOSE: This study investigated whether family caregiver reports of cancer patients' symptoms (specifically: nausea, pain, poor appetite, insomnia, fatigue, cough, constipation, and diarrhea) were in concordance with patient reports, and whether variables such as patient depression, caregiver depression, caregiver optimism, and perceived impact of caring on caregiver health would explain discrepancies in patients' and caregivers' reports. DESCRIPTION OF STUDY: A sample of 216 patients and their family caregivers was recruited through six community-based cancer treatment centers located in lower Michigan. Data on the study variables were obtained from two separate, multifaceted survey instruments completed by the patients and their family caregivers, respectively. RESULTS: The rate of agreement between patient and caregiver was highest for fatigue and lowest for insomnia, whether the entire sample, male caregivers, or female caregivers were considered. Female caregivers had a higher percentage agreement with their patients, and a higher level of association between patient and caregiver responses than male caregivers, uniformly for all symptoms. The overall accuracy of caregiver reports was approximately 71% and seemed to be relatively independent of the number of symptoms reported by the patient. CLINICAL IMPLICATIONS: Health professionals caring for patients with cancer must recognize that patient and caregiver reports of patient symptoms may not always be in agreement. Awareness of variables that may cloud family caregivers' observations is needed, so that accurate symptom reporting occurs, and appropriate management can be initiated to enhance quality of life for the patient as much as possible. It is also important for health professionals to educate family caregivers about the nuances of symptom distress presentation and to teach caregivers techniques to elicit accurate information so that timely, appropriate palliative management can be initiated.

Aged↗