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Biomedical subjects

C Byrne

Publications and source records attributed to C Byrne.

156 records · Page 9Linked to original sources

Wellness education for individuals with chronic mental illness living in the community.

The article reports a wellness education program developed to enhance and promote healthy life-style behaviors for individuals with chronic mental illness living in the community. Theoretical concepts from health promotion, wellness, and social learning were used in the development of this program. The program comprised three components: wellness education sessions, exercise/activity sessions, and a smoking reduction course.

Adult↗

Factors influencing staff hopefulness in working with people with schizophrenia.

This qualitative study identifies factors that influence staff hopefulness in their work with individuals with schizophrenia. Fifteen mental health professionals from both inpatient and community settings were interviewed via a semi-structured questionnaire. Subjects described the following as important to their hopefulness: knowing clients as people, sharing client successes, and receiving recognition for their accomplishments. Several educational, research, and system issues were also identified as influencing hopefulness. Respondents also described barriers to hopefulness arising from clients, coworkers and public attitudes. The relevance of these findings to promoting hopeful working environments is discussed.

Attitude of Health Personnel↗

Twenty-year follow-up of the breast cancers diagnosed during the Breast Cancer Detection Demonstration Project.

This study reports on the 20-year follow-up of the women diagnosed with breast cancer in the Breast Cancer Detection Demonstration Project (BCDDP) between 1973 and 1980. This project provided 5 years of screening with physical examination and two-view mammography for 280,000 volunteer women across the United States. Based on a 96% follow-up from 1993 to 1995 of the 4,051 women with breast cancer available for analysis, 2,658 (66%) were alive and 1,393 (34%) were dead. A high proportion of the cancers were detected by mammography alone, and 28.6% of all the cancers were smaller than 1.0 cm. Survival rates were calculated by life table method with deaths from breast cancer as the outcome. The adjusted survival rate for the entire group was 80.5%, and the observed survival rate was 61.7%. Adjusted and observed survival rates were 97.2% and 78.5%, respectively, for women with non-invasive cancers and 78.2% and 59.3%, respectively, for those with invasive cancers. Lymph node status and the size of the cancer at diagnosis were prognostic indicators of survival in the BCDDP Women with invasive cancers and negative lymph nodes had an 85.5% breast cancer survival rate and a 65.6% observed survival rate. Adjusted survival rates for women with invasive breast cancers were 90.2% for cancers smaller than 1 cm, 80.5%, for cancers 1.0 to 1.9 cm, 70.5% for cancers 2.0 to 4.9 cm, and 60.6% for cancers larger than 5 cm. Women 40 to 49 years of age demonstrated a greater survival with noninvasive or invasive cancers smaller than 5.0 cm compared with women 50 to 59 and 60 to 69 years of age at diagnosis. These results from the BCDDP are discussed in the context of the recent decline in breast cancer incidence and mortality in the United States.

Adult↗

Trends in periconceptional folic acid use by relatives in Irish families with neural tube defects.

Close relatives in families who have a child with a neural tube defect (NTD) are at greatly increased risk of having an affected child. Periconceptional folic acid reduces the risk of both occurrence and recurrence of NTDs substantially. Public health authorities currently recommend that the diets of all women between the ages of 15 and 44 who are capable of becoming pregnant be supplemented with folic acid tablets daily. We wondered if relatives in NTD families were more likely to use folic acid. From data obtained by interview with uncles and aunts in Irish NTD families we evaluated folic acid use in 144 of their pregnancies occurring between 1990 and 2000. There was a significant trend towards increasing use of folic acid both before and during pregnancy over the 10 years covered by the study. During the most recent years, 1998-2000, 57.9% of pregnancies reported by aunts were supplemented beforehand and 89.5% during the pregnancy. Pregnancies to smokers were significantly less likely to be supplemented with folic acid. In this study close relatives of an NTD child were more likely to report periconceptional folic acid use than the general public. While these results are encouraging, more remains to be done to ensure in this high risk group to ensure that the full prevention potential of folic acid is realised.

Dietary Supplements↗

Septic shock syndrome in the surgical wound care patient.

The occurrence of septic shock in lower extremity surgery is rare. Its early identification and treatment are vital to its outcome. The authors present a case history of septic shock occurring in the surgical wound care patient, discuss the pathophysiology of septic shock, and then consider diagnosis along with treatment options.

Debridement↗

Postoperative cellulitis of the foot and lower leg following coronary bypass.

Greater saphenous vein grafts are standardly used for coronary artery bypass grafting. Recurrent acute cellulitis of the saphenous vein-donor extremity is an infrequently reported complication. The authors present a protocol designed to reduce the incidence of the recurrent cellulitis through proper preoperative assessment and postoperative management.

Cellulitis↗

The meaning of illness questionnaire: reliability and validity.

The reliability and validity of a recently developed Meaning of Illness Questionnaire (MIQ) is described. Questionnaire content was based on the work of Lazarus and Folkman (1984b). Three hundred twenty chronically ill subjects completed the 33-item MIQ and two open-ended questions. Subjects also completed the 45-item Psychosocial Adjustment to Illness--Self-Report Scale (PAIS-SR) described by Derogatis and Lopez (1983). Test-retest reliability for 70 subjects was, on the whole, substantial (kappa = .45 to 1.00) as was the ability of nurse clinicians to reliably categorize the qualitative component of the questionnaire into one of 12 categories (kappa = .64). The factor structure of the questionnaire supported the theoretical assumptions underlying the instrument. Three of the factors of meaning given the illness, R2 = .46, and/or three items, R2 = .60, had more power than coping behavior in explaining a person's adjustment to chronic illness. The questionnaire has accumulated reliability and validity in measuring a variety of concurrent yet divergent meanings that may be given an illness for three chronically ill populations--those with mixed cancer, rheumatological, and gastroenterological disorders.

Adaptation, Psychological↗

Analyses of coping responses and adjustment: stability of conclusions.

This study was conducted to determine the stability of conclusions derived from analyses of different ways of scoring coping responses in relation to the adjustment of subjects who had survived a burn injury. As part of a larger study of adjustment to burn injury, 260 adults who had sustained a burn injury over a 12-year period consented to complete the Billings and Moos Coping Responses Scale (CRS; Moos, Cronkite, Billings, & Finney, 1984) and the Psychosocial Adjustment to Illness Scale (PAIS; Deragotis & Lopez, 1983). A clinician made a global assessment of each subject's adjustment. Three ways of scoring the CRS were used for analyses: Method and Foci of coping (Indices of Coping Responses), as suggested by Moos et al. (1984), new factor analysis, and separate responses. Stepwise multiple regression analysis of each of these with three different outcomes of adjustment (PAIS, global clinical judgment scores, and the PAIS psychological distress component) gave consistent results. The more adjusted burn survivors used more problem-solving coping responses and fewer avoidance responses. The two responses in the individual multiple regression analysis gave a higher correlation than the factor or index descriptors. These two responses correlated well with all three adjustment outcomes, r = .49, .37, and .47. The relationship between coping behavior and adjustment to illness was not sensitive to the different ways of scoring the CRS.

Adaptation, Psychological↗

Public health nursing clientele shared with social assistance: proportions, characteristics and policy implications.

This study was designed to determine (1) the extent to which public health nursing visits and social services income programs serve the same population (shared clientele), (2) whether shared and unshared clientele differ in their characteristics, and (3) whether those who use both these services are high users of other health and social services. A computerized record linkage showed that 17% of individual public health nursing clients were shared with social services. Shared clientele had more social, perinatal, emotional and mental health problems. It is these characteristics, rather than the simultaneous use of both services, that were associated with more public health nursing visits, days in care, and use of all other health providers. The trend away from in-home nursing visits may create a situation of unmet need. While health and social resources are expended on persons with children with greater risk circumstances, the question remains about the efficacy and efficiency of this mix of service for parents and children receiving social assistance.

Adolescent↗