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Biomedical subjects

C Arfken

Publications and source records attributed to C Arfken.

8 recordsLinked to original sources
PubMed2006

Psychosocial factors and treatment adherence in paediatric HIV/AIDS.

A social ecological model provides a promising framework for understanding the individual, family, and societal factors contributing to non-adherence to treatment of paediatric HIV. This study explored which factors relevant to this model are associated with caregivers' adherence and child health outcomes. A cross-sectional design was utilized to assess relationships among current individual, familial, extra-familial factors, caregiver adherence, and viral load. Data were collected from 43 caregivers, and viral load data were obtained from the medical records of their HIV+ children. Caregiver drug and alcohol use and HIV+ status were associated with non-adherence and elevated viral load. Negative outcome expectancy was associated with lower adherence but was not significant in the multivariate analyses. Family factors were not significant, but these measures had low reliability in this sample. Extra-familial factors such as dissatisfaction with medical specialty care and more stressful life events were not directly associated with adherence but were related to increased caregiver substance use. Results of this first study to explore multiple predictors of adherence and health outcomes in paediatric HIV require replication with larger samples, but findings suggest caregiver characteristics that place children at risk for disease progression due to poor adherence to treatment.

Adolescent↗
PubMed2005

Measuring adherence to treatment of paediatric HIV/AIDS.

Parent, child, physician report and pill counts were used to measure adherence in paediatric HIV. Relationships to viral load were assessed. Pill counts were considered invalid. Adherence measures did not correlate with one another. Physicians reported lower adherence than parents, but parent and physician report correlated with viral load. The clinical and research utility of the various measures are discussed.

Adolescent↗
PubMed1997

Directive and nondirective social support in diabetes management.

Directive and Nondirective Support were distinguished (interrater agreement = 88.2%) through open-ended interviews completed by 60 adults with Insulin Dependent Diabetes Mellitus. Supporting validity, the sum of both Directive and Nondirective Support was correlated with scores on the Interpersonal Support Evaluation List (ISEL; r = .36). Supporting their distinction, Directive and Nondirective Support were inversely correlated (r = -.26), and Directive but not Nondirective Support decreased with age. Partial/correlations controlled for general support as measured by the ISEL, to examine the unique associations of Directive and Nondirective Support. For those less than 30 years old, Nondirective Support was associated with better metabolic control (p = .004). For those 30 or older, Directive Support appeared counterproductive, being associated with greater negative mood (p = .02). Different types of support may play different roles in different areas of disease management (e.g., metabolic control versus mood) and as a function of individual characteristics such as age.

Journal Article↗
PubMed1996

Acceptability and feasibility of a community approach to asthma management: the Neighborhood Asthma Coalition (NAC).

Understanding of asthma and co-management between patient and physician improves outcome. Feasibility of programs to achieve these goals in underserved settings is not documented. We used the Precede-Proceed model to document (a) community acceptance of a program to engage peer support of asthma management and care; (b) program revision to emphasize greater attention to availability of care and promotional events as channels for education; (c) engagement of intended audiences in planning and implementation; (d) participation of parents in program activities; and (e) peer-based education/support to reach parents, including socially isolated parents whose children experience heightened morbidity.

Adult↗
PubMed1995

Detecting cumulative trauma disorders in workers performing repetitive tasks.

On-site testing of 157 poultry processors disclosed that 50% had three or more abnormal upper extremity findings out of a total of 22 possibles. The average worker had five to six abnormal findings. Impaired pinch strength, decreased vibration sensitivity in the fingertips, and reports of current numbness were the most prevalent. Of workers with signs, 25% reported no symptoms, whereas only 8% of workers reported symptoms but had no signs. The investigators concluded that this measurement method has utility for assessments of worker populations to determine prevalence of CTDs and, potentially, for preclinical detection of these disorders to permit early intervention, reduce medical costs, and minimize disability. The need for accurate measurement to enhance early detection and prevention is discussed.

Adult↗
PubMed1990

Stenosing flexor tenosynovitis.

A review of 253 consecutive digits with stenosing flexor tenosynovitis was done to clarify the respective role of steroid injection and surgical release in the management of stenosing flexor tenosynovitis. Treatment selection was based on the patient's age and severity of presenting complaints. In patients aged 10 years or more, analysis showed no statistically significant difference between results with steroid injection and surgical release. Surgical treatment was associated with higher cost and more complications. Based on this review, we recommend up to three injections of 20 mg of triamcinolone into the digital flexor sheath as the initial management of nonlocking, stenosing flexor tenosynovitis in adults. Initial management by surgical release is reserved for children and patients with digits locked in flexion.

Adolescent↗