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Biomedical subjects

D Nelson

Publications and source records attributed to D Nelson.

At least 343 records · Page 19Linked to original sources
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Menopausal changes in body composition and energy expenditure.

Adult American women as a group tend to gain weight with age, and many women report that their weight gain started around the time of their menopause. Moreover, as women age, there are changes in body composition that include losses in bone mineral and body cell mass, and increases in total body fat, visceral fat, and extracellular fluid. It appears as if these body composition changes begin or accelerate during the menopausal years. The importance of weight gain and changes in body composition are their associations with an increased risk of developing some malignancies, cardiovascular disease, osteoporosis, and several other clinical conditions. This overview describes selected studies of menopause and aging-associated weight gain, changes in body composition, and alterations of energy expenditure in women. Gaps in the present understanding of these changes are highlighted, and an emphasis is placed on new research methodologies for investigating body composition and energy expenditure in vivo. A concluding section of the report summarizes areas in need of future investigation.

Body Composition↗
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Evaluation of a mini-cascade impactor for sampling exposure chamber atmospheres.

Andersen 4-stage mini-cascade impactors, designed primarily for personnel dosimetry, were tested for suitability of characterizing solid-particle aerosols within inhalation exposure chambers. Performances were assessed by comparing their particle-size separating capabilities against cyclone separators and Andersen 8-stage ambient cascade impactors. Data reveal excellent agreement between respirable (ACGIH) mass fractions, and mass median aerodynamic diameters, measured with the mini-samplers and the larger laboratory cascade impactors. Cyclone data did not correlate as well. Findings indicate that where accurate particle characterization at low sampling flow rates is desired, compact mini-cascade impactors are appropriate instruments.

Aerosols↗
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The feasibility of dobutamine stress echocardiography in the emergency department with telemedicine interpretation.

Dobutamine stress echocardiography (DSE) was performed on 26 patients admitted for chest pain deemed at low risk for myocardial infarction. Pharmacologic stress in the emergency department on a 24-hour basis was administered by nurses and echocardiographic ultrasonographers with electrocardiograms and echocardiograms being interpreted through telemedicine relay by an off-site cardiologist. Target heart rate was achieved in 84% of patients with an average peak dobutamine dose of 48 microg/kg/min. Echocardiographic transmission to the cardiologist over standard telephone lines took 9 minutes per quad-screen cine-loop display. The entire protocol added 2.2 hours to the emergency room evaluation. The one patient out of 26 who had incipient myocardial infarction was diagnosed by resting echocardiography. The remaining 25 patients were found clinically to have no infarction or ischemia. Of these, 22 out of 25 had normal DSE in the emergency department; three had wall motion abnormalities on peak stress images. Another three patients had other cardiac diseases documented by echocardiography. Evaluation of chest pain on a 24-hour basis with DSE with telemedicine interpretation appears to be a rapid and safe means of screening patients at low risk in the emergency department. Further experience with this modality is needed before all patients should be enrolled or early discharge of patients on the basis of DSE can be advised.

Adult↗
PubMedDate not supplied

Distress and growth outcomes in mothers of medically fragile infants.

BACKGROUND: With recent advances in medical and nursing care, many high-risk infants are surviving the neonatal period with severe, life-threatening chronic illnesses, resulting in extended hospitalizations and/or frequent rehospitalizations and long periods of dependence on technology for survival. OBJECTIVE: To describe the factors predicting maternal adjustment in mothers caring for medically fragile infants. METHOD: Subjects were mothers (n = 67) whose infants had a serious life-threatening illness requiring hospitalization and technology for survival. Data for this longitudinal study were collected at enrollment and hospital discharge, and at 6, 12, and 16 months after birth. Distress was measured as depressive symptoms using the Center for Epidemiologic Studies Depression Scale, and growth was assessed using a personal developmental impact rating scale. Data about personal characteristics, parental role attainment, infant-illness characteristics, and maternal illness distress were collected. RESULTS: Mothers of medically fragile infants experience distress and growth as a result of their child's illness. Mean scores on the depression scale at both time points were moderately high and a high percentage of mothers scored at risk for depressive symptoms. Maternal developmental impact ratings at 6 months were neutral to slightly negative and at 16 months were between neutral and positive. While the mean depressive symptom scores and maternal developmental ratings were lower at the later time points, these differences were not significant. Maternal depressive symptoms and developmental impact ratings were moderately but negatively correlated at 6 and 16 months, indicating that higher depressive symptoms were related to more negative developmental impact ratings. Distress was influenced by maternal characteristics, hospital environmental stress, and worry about the child's health. Growth was influenced by characteristics of the child's illness, hospital environmental stress, concern about the child's health, and level of maternal role attainment. CONCLUSIONS: Nurses should consider personal characteristics and level of parental role attainment as well as characteristics of the child and illness-related distress in their approaches to intervention with mothers of critically ill infants.

Adaptation, Psychological↗
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Effects of tactile stimulation on premature infant weight gain.

A study was conducted to determine the effect of continuous tactile stimulation on weight gain in premature infants. Thirty infants made up the sample. The experimental group received continuous tactile stimulation by being placed on a pile decubitus pad for a five-day period. Infants in the control group received routine nursery care. Both groups were weighed daily on the same scale. Analysis of covariance was used to analyze the data, which resulted in a failure to reject the hypotheses of no difference.

Arousal↗
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Surveying managed care members on chronic disease.

We compare prevalence estimates of self-perceived health status and chronic disease risk factors from a managed care member survey with estimates from the Behavioral Risk Factor Surveillance System (BRFSS) survey. Unadjusted prevalence estimates for diabetes, high blood pressure, and current smoking status were similar in the two surveys. In contrast, 5.1 percent of respondents to the managed care member survey reported fair-to-poor health status, compared with 12.4 percent of respondents to the BRFSS survey. Standardization of demographic characteristics reduced the prevalence of reported fair-to-poor health status among BRFSS respondents to 9 percent. We conclude that standardized survey questions added to annual member surveys in managed care organizations are a feasible and potentially useful method of chronic disease surveillance.

Adult↗
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Mental health day units: users' views.

This article describes clients' perspectives on psychiatric day care units in an area in the South of England. The results of a small-scale research project show that clients from different localities have similar perspectives and feelings about the units. It is demonstrated that, in the clients' view, the units achieve many of their aims and fulfil needs that supersede the initial purpose.

Clinical Nursing Research↗
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16alpha-bromoepiandrosterone, a dehydroepiandrosterone (DHEA) analogue, inhibits Plasmodium falciparum and Plasmodium berghei growth.

Dehydroepiandrosterone (DHEA) and its analogue, 16alpha-bromoepiandrosterone (alpha-epi-Br), may have activity against viral and parasitic infections, including human immunodeficiency virus (HIV) and Cryptosporidium parvum. Therefore, we evaluated its antimalarial effects on Plasmodium falciparum and Plasmodium berghei. In vitro, chloroquine (CQ)-sensitive and resistant strains of P. falciparum parasitized red blood cells were incubated with escalating doses of alpha-epi-Br or CQ. In vivo, 62 rats were infected with P. berghei and treated with CQ or alpha-epi-Br. At the highest doses tested against a CQ-sensitive strain, parasitemias decreased from 25.4% in the saline control group to 4.3% and 4.8% in the alpha-epi-Br and CQ groups, respectively (P < 0.05). Against two CQ-resistant strains, parasitemias decreased from 22.3-28.8% and 24.8-30% in the CQ and saline groups, respectively, to 2.5-2.7% in the alpha-epi-Br groups (P = 0.003). In vivo, on Day 4, parasitemias decreased from 23% in the saline group to 9-12% and 12% in the in alpha-epi-Br and CQ groups, respectively (P < 0.05). These data demonstrate that alpha-epi-Br shows activity against CQ-sensitive and resistant strains of P. falciparum in vitro. At the doses tested against P. berghei in vivo in rats, alpha-epi-Br is comparable to CQ.

Androsterone↗
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Educating men about prostate cancer screening. A randomized trial of a mailed pamphlet.

CONTEXT: Although evidence-based guidelines recommend that physicians inform men about prostate cancer screening, the most efficient way to do this is not known. OBJECTIVE: To evaluate whether a mailed educational pamphlet affected men's knowledge about early detection of prostate cancer. DESIGN: Randomized, controlled trial. SETTING: Primary care clinic of the Minneapolis VA Medical Center. PATIENTS: 342 men at least 50 years of age who responded to a mailed survey (overall response rate, 68%) and did not report a history of prostate cancer. INTERVENTION: "Early Prostate Cancer" pamphlet mailed to patients in the intervention group 1 week before their scheduled clinic appointments. OUTCOME MEASURES: Patients' responses to a survey mailed 1 week after their clinic appointments; prostate-specific antigen (PSA) testing determined from electronic medical records. RESULTS: Respondents were predominantly elderly white men (mean age, 71 years; 90% white) with chronic illnesses (48% described their health as "fair" or "poor"). Men who received the educational pamphlet were better informed than men in the usual care group, as measured by correct responses to the following three questions about prostate cancer screening: the natural history of prostate cancer (32% vs. 24%; P = 0.10), whether treatment lengthens lives of men with early prostate cancer (56% vs. 44%; P = 0.04), and accuracy of PSA testing (46% vs. 27%; P < 0.008). The overall proportion of correctly answered questions was greater in the intervention group (45% vs. 32%; P < 0.001). Testing for PSA in the year after the index clinic appointments did not differ significantly between the intervention group and the usual care group (31% vs. 37%; P > 0.2). CONCLUSIONS: Male veterans are poorly informed about the potential benefits and risks of prostate cancer screening. Although our mailed educational pamphlet enhanced knowledge only modestly, it was an inexpensive and easily implemented intervention.

Aged↗
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Mitigating disasters: power to the community.

The average Japanese disaster, according to the British environmental agency Earthscan, kills 63 people. In Peru, however, the average death toll is 2,900 persons. This is because poor countries, and the poorest people within poor countries, are the most vulnerable--and it is vulnerability that kills.

Community Participation↗