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Biomedical subjects

B Wright

Publications and source records attributed to B Wright.

At least 55 records · Page 3Linked to original sources
PubMed1998

A cross-national study of self-evaluations and attributions in parenting: Argentina, Belgium, France, Israel, Italy, Japan, and the United States.

This study investigated and compared ideas about parenting in Argentine, Belgian, French, Israeli, Italian, Japanese, and U.S. mothers of 20-month-olds. Mothers evaluated their competence, satisfaction, investment, and role balance in parenting and rated attributions of successes and failures in 7 parenting tasks to their own ability, effort, or mood, to difficulty of the task, or to child behavior. Few cross-cultural similarities emerged; rather, systematic culture effects for both self-evaluations and attributions were common, such as varying degrees of competence and satisfaction in parenting, and these effects are interpreted in terms of specific cultural proclivities and emphases. Child gender was not an influential factor. Parents' self-evaluations and attributions help to explain how and why parents parent and provide further insight into the broader cultural contexts of children's development.

Adult↗
PubMed1998

The effects of hyperoxia on the biosynthesis of cyclooxygenase products and haemodynamic response to nitric oxide synthase inhibition with L-NAME in endotoxaemic pigs.

The interaction between constitutive nitric oxide and oxygen may depend on the degree of tissue oxygenation and may play a critical role in the pathophysiological response to endotoxaemia. We investigated if hyperoxia (100% O2) attenuated the systemic and pulmonary vasoconstriction and increased biosynthesis of thromboxane B2 (TXB2) and 6-keto-prostaglandin (PG) F1alpha induced by inhibition of nitric oxide synthase with NG-nitro-L-arginine-methyl-ester (L-NAME) in a porcine model of endotoxaemia. Twenty-two domestic, random source pigs, weighing 15.4 +/- 2.7 kg (mean +/- standard deviation) were the subjects of this study. Pigs were anaesthetized with isoflurane in 100% O2, orotracheally intubated and ventilated to maintain normocapnia, and then instrumented for haemodynamic monitoring. Following instrumentation, pigs were maintained at an end-tidal isoflurane concentration of 2%. Pigs were randomly assigned to treatment groups: saline + 30% O2 (Control, n = 6); Escherichia coli lipopolysaccharide (5 microg/kg/h from 1 to 2 h followed by 2 microg/kg/h from 2 to 5 h) + 30% O2 (LPS, n = 4); L-NAME (0.5 mg/kg/h, from 0 to 5 h) + LPS + 100% O2 (n = 6); and L-NAME + LPS + 30% O2 (n = 6). L-NAME and endotoxin significantly (P < 0.05) increased mean arterial pressure, mean pulmonary arterial pressure, and systemic and pulmonary vascular resistance index beginning at 90 min. When results were pooled across all time periods, mean arterial pressure and mean pulmonary arterial pressure were significantly higher in the L-NAME + LPS + 30% O2 group than all other groups, reflecting pulmonary and systemic vasoconstriction. Hyperoxia attenuated the L-NAME + LPS-induced increases in TXB2 and 6-keto-PGF1alpha concentrations at 90 and 120 min and 120 min, respectively, although the differences were not statistically significant. These results support the observation that nitric oxide synthase inhibition with L-NAME has deleterious haemodynamic effects in this model of endotoxaemia. The temporal attenuation of L-NAME-induced pulmonary and systemic vasoconstriction by hyperoxia suggested that the haemodynamic effects of acute endotoxaemia were in part influenced by the relative amounts of nitric oxide and oxygen present.

6-Ketoprostaglandin F1 alpha↗
PubMed1998

Effect of diet on the urinary excretion of hippuric acid and other dietary-derived aromatics in rat. A complex interaction between diet, gut microflora and substrate specificity.

1. A combined in vivo and in vitro study has been devised to investigate an observation, obtained by 1H NMR of urine, that Alp:AprSD (Wistar derived) rats kept under standard husbandry conditions did not excrete urinary hippuric acid (HA). meta-(hydroxyphenyl)-propionic acid ¿m-HPPA¿ was identified as the major aromatic component in urine samples lacking HA. 2. Examination of urine from Alp:APrSD and Zücker (obese negative) rats fed various diets showed that the lack of HA/presence of m-HPPA was due to diet and not to the strain of animal. This observation was reinforced by the demonstration that the administration of benzoic acid (BA) to rats not previously excreting urinary HA resulted in the return of this component to the urinary excretion profile. Thus rats receiving the standard diet were still capable of glycine conjugation. 3. Changing the diet of rats excreting m-HPPA led to the cessation of m-HPPA excretion and the return of HA urine excretion. Interestingly, switching back to the original diet did not cause the loss of HA and the re-emergence of m-HPPA. 4. In vitro studies on the two enzyme systems responsible for glycine conjugation (benzoyl CoA:synthetase and benzoyl CoA:glycine N-acyltransferase) in isolated liver mitochondria showed that m-HPPA did not inhibit either enzyme. However, m-HPPA was not found to be a substrate for the first reaction step explaining why it was found in the urine as the free acid and not as a glycine conjugate. 5. The absence and presence of m-HPPA and hippuric acid is suggested to be due to a combination of differences in dietary precursors of substrates for glycine conjugation and a dietary dependent redistribution of the intestinal microflora responsible for breakdown of plant phenolics and aromatic amino acids. Taken collectively this study emphasises how a simple diet change can cause a profound change in metabolism.

Acyltransferases↗
PubMed1998

19F-NMR and directly coupled HPLC-NMR-MS investigations into the metabolism of 2-bromo-4-trifluoromethylaniline in rat: a urinary excretion balance study without the use of radiolabelling.

1. The metabolic fate and urinary excretion of 2-bromo-4-trifluoromethylaniline has been studied in rat using 19F-NMR spectroscopic and directly coupled HPLC-NMR-MS methods. The compound was dosed to Sprague-Dawley rats (50 mg kg-1, i.p.) and urine collected over 0-8, 8-24 and 24-48 h post-dosing. 2. A total urinary recovery of 53.5 +/- 7.0% of the dose was achieved up to 48 h after dosing. The major metabolite in the urine was identified as 2-amino-3-bromo-5-trifluoromethylphenylsulphate accounting for a total of 35.7 +/- 6.2% of the dose. 3. Further metabolites detected were 2-bromo-4-trifluoromethylphenylhydroxylamine-1V-glucuronide (9.7 +/- 0.2% of the dose), 2-bromo-4-trifluoromethylaniline-N-glucuronide (3.0 +/- 0.3%) and 2-amino-3-bromo-5-trifluoromethylphenylglucuronide (2-St 0-4). Minor metabolites, including 2-bromo-4-trifluoromethylphenylhydroxylamine-O-glucuronide, 2-amino-3-bromo-5-trifluoromethylphenol and 2-bromo-4-trifluoromethylphenylsulphamate, in total accounted for 2.3 +/- 0.9% of the dose. 4. Directly coupled HPLC-NMR-MS and 19F-NMR spectroscopy proved to be efficient techniques for the unequivocal and rapid determination of the urinary metabolic fate and excretion balance of fluorinated xenobiotics without the need for radiolabelling.

Aniline Compounds↗
PubMed1998

Dependence and perceived difficulty in daily activities in community-living stroke survivors 2 years after stroke: a study of instrumental structures.

BACKGROUND AND PURPOSE: There is a need for better understanding of the structure of instruments for functional outcome assessment after discharge from rehabilitation. One purpose of the study was to contribute to the analysis of instrumental dimensionality. Another purpose was to compare disability in stroke patients within the younger age range 2 years after onset of stroke with that at discharge with respect to both dependence and patients' perceived difficulty and to extend the assessments with instrumental activities. METHODS: We studied 68 stroke survivors aged 18 to 71 years at onset (59% aged <55 years) by means of interviews in their home, using activities from the Functional Independence Measure (FIM) and Instrumental Activity Measure (IAM) for ratings of dependence and perceived difficulty. Rasch analysis was used to construct calibrated linear measures and to evaluate the level of fit. RESULTS: Acceptable models for comparison of dependence between discharge and follow-up were found for the physical and the social-cognitive items in FIM. However, personal care and social-cognitive items showed an increased level of dependence at follow-up compared with at discharge. A combination of physical activities from FIM and IAM also gave acceptable models for both dependence and perceived difficulty, and the hierarchical orders of activities are presented. In general, there was agreement between the ratings of dependence and perceived difficulty, but with some discrepancies. Men found it harder to be independent in such instrumental activities as cooking and cleaning than women; the opposite was true for small-scale shopping and locomotion outdoors. Subjects aged > or =55 years had slightly higher level of dependence and perceived difficulty in IAM activities than those below that age. CONCLUSIONS: Changes in the hierarchical order of activities should be taken into account in follow-up studies. Differences in the environment between hospital and home, as well as differences in support and motivation, might explain the relatively larger degree of dependence at follow-up compared with at discharge and indicate the need for further rehabilitation efforts. Instrumental activities could be combined with FIM activities in a model. For individual items, ratings of both dependence and perceived difficulty may provide further insight into the disablement process.

Activities of Daily Living↗
PubMed1998

Call of the wild.

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Community Health Nursing↗
PubMed1997

Bioanalysis of p-trifluoromethylmandelic acid and Mosher's acid by chiral gas chromatography and fluorine nuclear magnetic resonance to study chiral inversion: application to rat urine samples.

Methods for the nuclear magnetic resonance and gas chromatographic analysis of the enantiomers of p-trifluoromethylmandelic acid (p-TFM) and Mosher's acid (alpha-methoxy-alpha-(trifluoromethyl)phenylacetic acid) present in rat urine samples are described. Gas chromartography was performed using cyclodextrin capillary columns with both compounds analysed following derivatisation with methanolic HCl. Nuclear magnetic resonance was performed directly on the untreated urine samples following addition of beta-cyclodextrin. The methods were suitable for the determination of the individual enantiomers of the analytes in urine. Analysis of the rat urine samples indicated that the p-TFM had undergone a unidirectional enantiomeric interconversion in vivo, while the enantiomers of Mosher's acid were excreted unchanged.

Animals↗
PubMed1997

Treatment and health outcomes of women and men in a cohort with coronary artery disease.

BACKGROUND: Women with coronary artery disease are treated differently than men. Although mortality has been studied, functional outcomes for women and men have not been prospectively compared. METHODS: The Manitoba Health Reform Impact Study used hospital databases to identify all residents aged 45 years and older in Manitoba who were hospitalized for a myocardial infarction between October 1, 1991, and September 30, 1992. Cohort members were interviewed twice, an average of 16 and 25 months after hospitalization. Baseline and follow-up measures included treatments (eg, physician visits, diagnostic testing, revascularization, and cardiac medications), physical health status (physical component summary [PCS] score derived from the Medical Outcomes Study Short Form 36), reinfarction, and mortality. RESULTS: Of the 820 patients who completed the initial survey, 31 died during the follow-up period, and 734 completed the follow-up survey. Data were complete for the primary outcome (PCS score) and all relevant covariates for the 677 patients who were included in this study Women constituted 34% of this cohort. Although women had more physician visits during follow-up, they were less likely to have undergone treadmill testing or angiography (odds ratio, 0.68; 95% confidence interval, 0.46-0.99). Women were equally likely to report taking beta-adrenergic blocking agents, but were less likely than men to report the use of aspirin (odds ratio, 0.69; 95% confidence interval, 0.48-0.98). After adjusting for baseline differences in PCS scores, age, income, social supports, and the levels of angina and dyspnea, the PCS score for women declined by 1.4 points, while the score for men improved by 0.2 points (P = .03). During the follow-up period, reinfarction and mortality rates were low overall, but were not different in men and women. CONCLUSIONS: In this cohort of patients with known coronary artery disease, we found less aggressive treatment of coronary artery disease and less use of aspirin among women than among men during 1 year of observation. After controlling for baseline differences, women with coronary artery disease experienced a more rapid decline in physical health status than did men during 1 year of follow-up.

Age Factors↗
PubMed1997

Perceived adequacy of tangible social support and health outcomes in patients with coronary artery disease.

OBJECTIVE: Health outcomes of patients with chronic disease might be influenced by assistance from others in performing daily activities. We examined whether perceived adequacy of such tangible support was associated with prognosis in a cohort of patients with coronary artery disease. DESIGN: Longitudinal cohort study. SETTING/PARTICIPANTS: In spring 1993, a cohort of 1,468 patients with chronic artery disease was identified using claims data. The cohort consisted of all surviving residents of Manitoba, Canada, who had been hospitalized for acute myocardial infarction from 1991 to 1992: 820 patients completed the initial survey, and 734 completed a follow-up survey approximately 1 year later. MEASUREMENTS AND MAIN RESULTS: Adequacy of tangible support was assessed by asking if respondents needed help at home because of health problems, and whether these needs were met. We examined the association between perceived adequacy of tangible support and health outcomes at 1 year (mortality, physical function). Of 820 participants, 74% perceived no need for help, 13% had sufficient help, 9% needed more help, and 5% needed much more help; 31 patients died during follow-up. After adjustment for age and initial health status, odds ratios (95% confidence interval) for death were: sufficient help 1.8 (0.61, 5.8); need more help 3.2 (1.1, 9.4); and need much more help 6.5 (2.0, 21.6) compared with respondents with no perceived need. Decline in physical function was also linearly related to perceiving less-adequate tangible support. Sensitivity analyses indicated it is highly improbable that results were due to selection bias. CONCLUSIONS: Perceived lack of needed assistance was related to mortality and to decline in physical functioning. Adequacy of tangible support was an important prognostic factor for these patients with coronary artery disease and may be a determinant of health outcomes.

Aged↗
PubMed1996

The structure of an instrument for assessing the effects of assistive devices and altered working methods in women with rheumatoid arthritis.

OBJECTIVE: To use Rasch analysis to transform the ordinal score from a newly developed instrument, the Evaluation of Daily Activities Questionnaire (EDAQ), in order to obtain unidimensional linear measures; to analyze whether items change in difficulty with interventions; and to follow changes in subjects' degree of ability. METHODS: Twenty-one women with rheumatoid arthritis rated their perceived difficulty without and with assistive devices or altered working methods using the EDAQ; the EDAQ consists of 102 items of daily activities, divided into 11 dimensions. RESULTS: All items in the EDAQ could be structured into an acceptable model from "hard" to "easy" with the subjects overall measures ranging from "more able" to "less able." Forty-one items showed a significant reduction of difficulty with interventions. For some items results indicated that easier initial difficulty led to greater effect of interventions. In general, difficulty without assistive devices could not predict difficulty with interventions. Twenty women demonstrated a significant increase in activities of daily living (ADL) ability after interventions. CONCLUSION: The EDAQ analyzed with the Rasch model, demonstrated a hierarchical order of difficulty in 102 items showing that it was possible to evaluate the effect of using assistive devices or altered working methods.

Activities of Daily Living↗
PubMed1996

Structure of a combination of Functional Independence Measure and Instrumental Activity Measure items in community-living persons: a study of individuals with cerebral palsy and spina bifida.

OBJECTIVE: To analyze the structure of a combination of physical items from the Functional Independence Measure (FIM) and seven instrumental activity items using ratings of dependence and perceived difficulty. DESIGN: Disability in terms of dependence and subject's perceived difficulty was studied in patients with cerebral palsy (CP) and spina bifida (SB). Rasch analysis was used to construct calibrated linear measure and to identify suitable models with respect to rating steps. SETTING: Interviews were performed at home with patients from an outpatient university rehabilitation unit for young disabled persons. PATIENTS: Fifty-three CP and 20 SB patients (including 5 with other early acquired spinal cord lesions), 20 to 39 years of age, participated and represented 62% and 80%, respectively, of available patients. All had fulfilled an elementary school program. RESULTS: The best scoring model using Rasch analysis was achieved using 5 levels for dependence and 4 levels for perceived difficulty. Hierarchic orders for all items are presented. The FIM items Bowel and Bladder showed different characteristics in the two groups of patients, especially for perceived difficulty, and were excluded in the joint calibrations. There was close overall agreement between the ratings of dependence and perceived difficulty. Person measure values from the Rasch analyses were separated between wheelchair users and walkers. CONCLUSION: The combination of physical items from FIM and instrumental activity measure (IAM) are useful for disability assessment in community-living persons and should be further studied in other impairment groups.

Activities of Daily Living↗
PubMed1996

As others see us.

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Emergency Nursing↗
PubMed1996

Computers, communication and confidentiality: tales of Baron Munchausen.

The aim was to examine the use of computer and paper based systems in accident and emergency (A&E) departments in the management of patients who are frequent attenders. More than half of the A&E consultants in the Thames regions who were sent a questionnaire responded (44 of the 80). 82% of the respondents use such systems predominantly to monitor violent patients, those with Munchausen syndrome, and children on the "at risk" register. Systems currently in use fail to fulfil many of the functions that would be required of an ideal system. When using computers to store and communicate clinical data, several ethical problems were identified but these appeared to be outweighed by the practical need and were also present with paper based systems. Safeguards could also be built into computer based systems to reduce some of the ethical problems. Computer systems should be deliberately chosen and implemented in response to a specific management problem. The potential benefits should be weighed against possible damaging side effects, such as a breach of confidentiality.

Confidentiality↗