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Biomedical subjects

D Edwards

Publications and source records attributed to D Edwards.

At least 109 records · Page 6Linked to original sources

The effects of race and social class on clinical judgment.

Asked 61 male clinical psychologists (21 blacks and 40 whites) to assess case histories that were presented to them to determine whether racial or social class biases could be detected. In order to avoid the apparent artificial results or weak interpretations of past research, only cases with concurrently validated diagnoses and 4-year follow-up were used. An equal number of positive and negative clinical outcomes were included. Diagnosis, disposition, and rated severity were studied. The following results were found: (1) diagnosis for all psychologists was guided by case characteristics, not bias; (2) severity was related strongly to diagnosis; (3) disposition followed judgments of severity and diagnosis, not bias. The question was raised whether clinical investigators may not have overdramatized bias in psychodiagnosis and clinical judgment.

Alcoholism

Urinary MHPG and clinical response to amitriptyline in depressed patients.

The authors treated 18 rigorously diagnosed depressed patients with amitriptyline after baseline urine samples were collected for the measurement of 3-methoxy-4-hydroxphenylglycol (MHPG). Neither age nor severity of depression before treatment correlated with MHPG excretion. There was also no significant correlation between baseline MHPG excretion and clinical response at the end of at least 25 days' treatment with amitriptyline. The authors discuss the relevance of amitriptyline and nortriptyline plasma levels to MHPG and the noradrenergic/serotonergic theories of depression.

Adolescent

Positive results from outpatient mental health intervention.

Collected data on 3,342 outpatients over 2 years. A 4-year follow-up of successful outcomes was conducted on each of the cases. Hospitalized patients showed a 30% success rate. The success rate for the group that was recommended for no treatment was 60%. The success rate for patients who completed outpatient treatment increased to 78%. A patient's expectation of outcome, the clinician's assessment of reason for referral, the diagnosis, and age were the most powerful predictors of success. These findings demonstrate the following: (a) procedures for assessment and intervention can be successful; and (b) a significant portion of the population can be served by intervention with proper selection.

Adolescent

Effects of midterm integration on state and trait anxiety in black and white elementary school children.

This study investigated the effects of stress associated with school integration on state and trait anxiety for 637 Black and White fourth- fifth- and sixth-grade children. A court-ordered integration plan resulted in the transfer of children from all-White and all-Black schools into integrated schools 2 months before the end of the school year. The State-Trait Anxiety Inventory for Children (STAIC) was administered 1 week prior to the transfer and 6 weeks following transfer. Females who were transferred had higher state anxiety scores than nontransferred females, but there were no differences for males. Transferred Black and White children did not differ in state anxiety, but transferred Blacks were higher in trait anxiety than transferred Whites.

Black or African American

Patent ductus arteriosus treated with ligation or indomethacin: a follow-up study.

The course and complications of fifty-two infants with patent ductus arteriosus requiring closure were assessed prospectively. Twenty-six infants with a PDA received indomethacin for pharmacologic closure of the PDA, and 26 underwent ligation. The current study analyzes and compares the longitudinal follow-up with respect to somatic growth, neurologic function, psychomotor and mental development, and renal, ophthalmologic, and audiologic function in 21 infants in each group who entered the follow-up. No selective morbidity was attributable to PDA closure with indomethacin when compared to surgically treated infants.

Child Development

Disappearance of vesicoureteric reflux during long-term prophylaxis of urinary tract infection in children.

Seventy-five children aged 3 weeks to 12 years and found on investigation of symptomatic urinary infection to have vesicoureteric reflux were managed conservatively with continuous low-dose prophylaxis. Serial cystographic and renal growth studies were performed during seven to 15 years' follow-up. Reflux disappeared spontaneously in 53 children (71%) and from 79% of the affected ureters. This occurred at any age and not only in infancy or at puberty. The initial severity or reflux was the most important factor affecting the outcome. Reflux disappeared from 85% of ureters of normal calibre but from only 41% of dilated ureters. Gross reflux associated with existing severe renal scarring was least likely to disappear. Nevertheless, reflux stopped in 12 of the 19 initially scarred renal units (63%). Reflux was as likely to disappear in children who had a recurrence of urinary infection as in those who had no further infection. Renal growth appeared to be normal in 93% of kidneys and fresh or extending scarring was seen in only two children. Management programmes for children with vesicoureteric reflux should take into account the self-limiting nature of three-quarters of the reflux found on investigating uncomplicated urinary tract infection.

Anti-Infective Agents

Primary and secondary benefits from treatment for alcoholism.

The authors recorded diagnoses and total number of sick days for 148 men before and after treatment for alcoholism in a Navy alcoholic rehabilitation center. Over a 4-year period (2 years before and 2 years after treatment), there was a reduction of sick days for each man and a reduction of alcohol-and nonalcohol-related complaints. The authors stress the importance of valid evaluation criteria for alcohol rehabilitation programs.

Alcoholism

Metronidazole in prevention and treatment of bacteroides infections after appendicectomy.

The frequency of non-clostridial anaerobic infection was studied in 95 patients who had undergone acute appendicectomy: 49 received prophylactic metronidazole and 46 received placebo. Anaerobic infection did not develop in any of the metronidazole-treated patients, but infections did develop in nine (19%) of the 46 controls. Metronidazole is conveniently administered by suppository to patients who cannot take oral drugs. Five patients with intra-abdominal infections caused by non-clostridial anaerobes were successfully treated with metronidazole.

Adolescent

Encoding and decoding of connected discourse during altered states of consciousness.

The following hypotheses were investigated in a study of memory recall and an altered state of consciousness: (a) A direct relationship was expected between the magnitude of correct responses and task complexity. (b) Semantic context variation was expected to cause greater impairment in verbal processing than variation in syntactic constraints. (c) Under N2O fewer correct responses in verbal processing were expected to be made. Forty-four volunteers, male corpsmen in the U. S. Navy between the ages of 20 and 29, were randomly divided into two equal groups: a nitrous oxide group and an air group. After breathing either N2O or air for 10 minutes, Ss were required to repeat pairs of taped sentences of high syntax/high semantic context to low syntax/low semantic context. Responses were scored for errors. All three hypotheses were accepted. Task complexity caused the greatest magnitude of errors. Ss were able to compensate for variations in syntax and in the gas state, but low semantic quality strongly affected performance. The factors interacted in powerful ways to produce differential response errors from a low error rate for air/high syntax/high context to a high error rate for N2O/low syntax/low context.

Adult

Empirical validation of diagnostic similarities from a structural perspective.

In an effort to establish definitive patterns of patient variables for the diagnostic categories used by psychiatry, this study investigated the similarity between diagnostic classes as perceived by psychiatrists when evaluating patients from their own caseloads. A grid method was used to evaluate the diagnostic process. Thirteen psychiatrists rated their own patients on the constructs generated from their own personal dimensions. An overall analysis of the data demonstrated that patients within a diagnostic category were seen as more similar to one another than were patients from different diagnostic categories. Similarities between diagnostic classes showed that neurotic/situational maladjustment, personality disorder/alcoholic, and psychotic/alcoholic were the most similar pairs of unlike diagnoses. Examination of the process of diagnosis showed the functional similarity between some diagnostic classes. Specific areas of diagnostic similarity were present in a system that produced overall diagnostic clarity. Implications for the use of the grid method in psychiatric training were discussed.

Alcoholism

Psychological considerations in maxillofacial prosthetics.

An attempt has been made to integrate information from psychological principles and clinical research which is relevant to maxillofacial prosthetics. Attention was given to the role of body parts in the human experience, with particular consideration of facial aspects. The importance of the maxillofacial region in early development, personality dynamics, and day-to-day interpersonal relationships was reviewed together with several specific problems which often accompany maxillofacial changes in structure or function. The dentist must be concerned with the patient's expectations, personality characteristics, and ability to accept and integrate the prosthesis. Several implications for clinical practice were presented. The dentist's understanding and utilization of psychological considerations should result in increased effectiveness in treatment and rehabilitation of maxillofacial patients.

Attitude