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Biomedical subjects

D McNeil

Publications and source records attributed to D McNeil.

51 records · Page 3Linked to original sources

Effectiveness of alcoholism treatment in partial versus inpatient settings: twenty-four month outcomes.

The authors examined the effectiveness of the partial hospital setting, in contrast to the inpatient setting, for the rehabilitation of alcohol abusers and alcoholics. Outcomes after 24 months in five life health areas indicated marked improvement from baseline for the entire follow-up period on almost all measures. There also was a strong relationship between drinking outcomes and outcomes in the other health areas. Although there were few between group differences on the clinical outcome measures, differences which were found favored the partial hospital setting. Furthermore, cost of treatment over two years clearly favored the partial hospital.

Activities of Daily Living↗

Diet and drinking habits in relation to the development of alcoholic pancreatitis.

To determine whether increased intakes of fat and protein or particular drinking habits are associated with the development of alcoholic pancreatitis, a dietary study has been conducted. Patients with clinically evident alcoholic pancreatitis were compared with individuals with clinically evident alcoholic cirrhosis with respect to dietary and drinking habits before the onset of clinical illness. There was no significant difference between the two groups regarding intake of nutrients, drinking habits or type of alcoholic beverage consumed.

Adult↗

IgE Fc receptor positive T, B and NK cells in patients with the hyper-IgE syndrome.

Patients with the hyper-IgE syndrome have greatly elevated percentages of IgE Fc receptor (Fc epsilon R)-positive B cells, but they have less than 0.1% Fc epsilon R+ T cells (T epsilon cells) and few, if any, Fc epsilon R+ natural killer cells. They also have markedly decreased numbers of IgG receptor positive (Fc gamma R+) T cells (T gamma cells). Patients with the hyper-IgE syndrome resemble in this respect patients with severe atopic dermatitis. Since a portion of T epsilon and T gamma cells of mildly atopic patients react with monoclonal antibody OKT8, they may have a suppressor function. However, whether the low number of T epsilon cells is responsible for the high IgE serum level in hyper-IgE syndrome and atopic dermatitis patients remains to be demonstrated. Attempts to obtain a reliable assay for human IgE synthesis in vitro to investigate the function of Fc epsilon R-positive lymphocytes proved to be difficult. Even isolated B cells from atopic donors seldom produced more than twice the quantity of IgE released from cells incubated in the presence of the protein synthesis inhibitor cycloheximide.

B-Lymphocytes↗

Perception of life event stress in patients with chronic duodenal ulcer. A comparison of the rating of life events by duodenal ulcer patients and community controls.

Stress is often claimed by doctors and patients to be an aetiological factor in peptic ulcer disease. The aim of the present study was to investigate whether ulcer patients perceive that they would react more strongly than normal to life event stress. Seventy-three patients with duodenal ulcer and their sex- and age-matched controls rated 81 events for the amount of distress and life change they considered the events would cause them personally. With regard to individual events, only one difference emerged: female patients rated promotion at work significantly lower for distress than did controls, when event experience was taken into account. There was a systematic tendency for ratings of male patients to be lower than those of controls. These observations suggest that duodenal ulcer patients do not perceive that their reaction to life events would be in excess of normal.

Adolescent↗

The location of chronic gastric ulcer: a study of the relevance of ulcer size, age, sex, alcohol, analgesic intake and smoking.

Ulcer size, age, sex, alcohol and analgesic intake and cigarette consumption were studied in relation to the site of the ulcer in 215 patients with chronic gastric ulcer, of whom 96 were initial and 115 recurrent ulcers. Ulcer site was classified into upper (U), middle (M) and lower (L) thirds of the stomach, on X-ray films of air-contrast barium studies. The ulcers were situated in the upper third in 37 patients (17%), middle third in 90 patients (42%) and lower third in 88 patients (41%), i.e., significantly more in M and L compared to U (p less than 0.001). 135 ulcers were on the lesser curve (63%) with more in L and M compared to U (p less than 0.0005). Posterior wall ulcers accounted for 29.3%. Ulcers were smallest in L (mean 28.8 mm2) compared to those in M (mean 66.1 mm2) and U (mean 64.4 mm2) (p less than 0.001). Mean size overall was 49.0 mm. The mean age of the patients was 58.8 years with no significant differences in age between U, M and L (p greater than 0.9). The M/F ratio in the whole series was 0.6 which varied with ulcer site, being 0.3 in U (differing significantly from the whole series, p less than 0.05), 0.4 in M and 1.2 in L (significantly different from the whole series, p less than 0.01) and from U (p less than 0.01). Initial ulcers did not differ from recurrent ulcers except in women where initial ulcers were more common in M and L, whereas recurrent ulcers were more commin in U. The independent variables, namely, alcohol and analgesics (with the exception of smoking), were not determinants of ulcer site, size or position once the patients were segregated by sex. In men only, there were interactions between L and lesser curve site (p less than 0.004) and L and smoking (p less than 0.03).

Age Factors↗

Wide range of causes found for hospital closures.

Survey conducted by the American Hospital Association has determined where hospitals have closed, what types of hospitals close, and the reasons for closing. Comparative data for a three-year period are used to show trends in a variety of factors affecting hospital closings.

Bed Occupancy↗

A death at home.

Explore the source record for details and available documents.

Adult↗

Predictors for the risk of hookworm infection: experience from endemic villages in southern Thailand.

To assess the role of defaecation pattern in predicting the level of risk for hookworm infection in southern Thailand, 4 villages in different geographical settings in endemic areas were studied. Close observation and stool examinations for hookworm were carried out. The first village was used for exploring the risk factors for hookworm infection. The resultant statistical model was then tested using the other 3 villages. Only 23-40% of the sample regularly defaecated in a latrine. The pattern of defaecation did not differ between the sexes, but was associated with age and site of residence. In the first village, the following variables were not statistically significant: sex, age, level of past education, household income, having neighbouring houses within 20 m, latrine availability, site of defaecation. The only statistically significant protective factor was shoe wearing, which showed an exposure-outcome severity relationship. Similar results were obtained in the other 3 villages. These results refute the protective effect of latrine use on the individual user, who may still get infection from the faeces of other community members. Promotion of shoe-wearing, which provides individual protection, should be an important supplementary strategy for hookworm control programmes in such areas.

Adolescent↗

Maternal work in the NICU: a case study of an "NICU-experienced" mother.

This study explored one woman's experience in becoming a mother to her premature son during his prolonged hospitalization. This paradigm case is an exemplar selected from a larger phenomenological study that examined the high-risk perinatal experience. Hermeneutic analysis led to the discovery of the phenomenon of maternal work embedded in the experience of this mother. Dimensions of her maternal work included working for love, working for meaningful moments, working amid uncertainty, working against the odds, and working overtime. Understanding the experience of maternal work can assist nurses to acknowledge and support the work inherent in becoming a mother within the neonatal intensive care unit.

Female↗

Maternal tasks of uncertain motherhood.

A longitudinal, phenomenological study was carried out to gain understanding of what it was like for women to be in a high-risk perinatal situation. Twenty-seven women participated in the study during which focused, unstructured interviews were conducted throughout their experience. Hermeneutic methods were applied to the 174 interviews and 13 diaries collected. A serendipitous finding revealed that women in high-risk situations work on the same developmental tasks as described by Rubin in 1975. However, these tasks are altered by the uncertainty of attaining motherhood inherent in the high-risk situation. The alterations in the tasks are described in this paper. The importance of Rubin's work as basic clinical research for maternity nursing is underlined by this finding.

Adaptation, Psychological↗