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Biomedical subjects

Diane King

Publications and source records attributed to Diane King.

9 recordsLinked to original sources
PubMed2006

Body composition and nutritional intake in children with chronic kidney disease.

The aim of this study was to assess body composition in children with chronic renal failure (CRF) and post renal transplantation (Tx), and to compare it to body mass index (BMI) and nutritional intake. Dietary assessment using 3-day diaries, total and regional body composition assessment by dual x-ray energy absorptiometry of 50 CRF children (29M, 21F), median age 8.9 yrs and 50 Tx children (32M, 18F), median age 12.9 yrs. BMI, percentage fat mass (%FM) and lean mass (LM) were corrected for height and expressed as SDS (HSDS). In both groups, BMIHSDS was lower than %FMHSDS and higher than LMHSDS (p<0.05). In the Tx group, there were associations on bivariate analysis between energy & protein intake and BMIHSDS & %FMHSDS (r,0.5, p<0.05), and between LMHSDS and protein intake (r,0.5, p<0.05). On multivariate analysis, there was an association between LMHSDS and time since transplantation (r,-0.4, p<0.05). Children in the CRF and Tx groups had a high percentage predicted trunk:leg FM ratio of 148% and 157%, respectively. Children with CRF and Tx have discordant body composition with a relatively high FM and low LM, which is not reflected by BMI. In addition, they appear to have an increased level of central adiposity that may predispose them to increased morbidity in later life.

Absorptiometry, Photon↗
PubMed2006

The role of rapport: lessons learned from conducting research in a primary care setting.

Conducting research in a primary care setting is difficult because of the competing demands primary care offices have to manage in the current medical environment. Every primary care office has its own relationship and reporting structures, norms, and ways of conducting day-to-day affairs. Regardless of the setting, when carrying out qualitative and/or mixed-methods research, researchers must have rapport with the individuals or group of individuals they will be working with to carry out the research. In this article, the authors describe the different approaches that research staff have used to create rapport with practice staff that were not only participants in the study but were also responsible for the delivery and implementation of this effectiveness study.

Colorado↗
PubMed2005

Variation in perceived competence, glycemic control, and patient satisfaction: relationship to autonomy support from physicians.

There is considerable variation in care provided to patients with diabetes related to metabolic control, preventive services, and degree of patient-centered support. This study evaluates the relation of self-determination theory (SDT) constructs of clinician autonomy support, and patient competence to glycemic control, depressive symptoms, and patient satisfaction from baseline surveys of 634 patients of 31 Colorado primary care physicians participating in a program to improve diabetes care. Spearman correlations of autonomy support from one's clinician with patient competence, HbA1c, depressive symptoms and satisfaction were significant (R = -0.11 to 0.55, P < 0.005). Structural equation modeling demonstrated that autonomy support was significantly related to perceived competence, depressive symptoms, patient satisfaction, and indirectly to glycemic control. Perceived competence was significantly related to depressive symptoms, patient satisfaction and glycemic control. Further, the motivation constructs from SDT accounted for 5% of the variance in glycemic control, 8% of the variance in depression, and 42% of the variance in patient satisfaction. Quality improvement efforts need to pay greater attention to patient competence, satisfaction, and depression, in addition to glycemic control. Clinician autonomy support was found to be reliably measured and moderately correlated with psychosocial and biologic outcomes related to diabetes self-management. These results suggest training clinicians to increase their support of patient autonomy may be one important avenue to improve diabetes outcomes.

Adult↗
PubMed2004

Verbal abuse.

Explore the source record for details and available documents.

Aggression↗
PubMed2004

Pramipexole protects against apoptotic cell death by non-dopaminergic mechanisms.

We have investigated the ability of pramipexole, a dopamine agonist used in the symptomatic treatment of Parkinson's disease (PD), to protect against cell death induced by 1-methyl-4-phenylpyridinium (MPP+) and rotenone in dopaminergic and non-dopaminergic cells. Pre-incubation with either the active (-)- or inactive (+)-enantiomer forms of pramipexole (10 microm) decreased cell death in response to MPP+ and rotenone in dopaminergic SHSY-5Y cells and in non-dopaminergic JK cells. The protective effect was not prevented by dopamine receptor blockade using sulpiride or clozapine. Protection occurred at concentrations at which pramipexole did not demonstrate antioxidant activity, as shown by the failure to maintain aconitase activity. However, pramipexole reduced caspase-3 activation, decreased the release of cytochrome c and prevented the fall in the mitochondrial membrane potential induced by MPP+ and rotenone. This suggests that pramipexole has anti-apoptotic actions. The results extend the evidence for the neuroprotective effects of pramipexole and indicate that this is not dependent on dopamine receptor occupation or antioxidant activity. Further evaluation is required to determine whether the neuroprotective action of pramipexole is translated to a disease-modifying effect in PD patients.

1-Methyl-4-phenylpyridinium↗
PubMedDate not supplied

The Communication Clerk role in the emergency department.

OBJECTIVE: Analyse the clinical hours saved by the introduction of a dedicated Communications Clerk to the ED. METHODS: A Communications Clerk role was introduced at Flinders Medical Centre during 2002. Over a seven-week period the number of telephone calls taken and paging performed was logged. This function had previously been performed purely by clinical staff, and the number of clinical hours saved was evaluated. RESULTS: Over the study period the Communication Clerks worked for 509 h. A total of 7302 telephone calls were answered or made, and 924 pages made. The clinical hours saved was calculated at 243.3. The ratio of hours worked by the Communication Clerk to clinical hours saved overall was 2.1. CONCLUSION: The role of a Communication Clerk in a busy ED is an effective work practice change, particularly in relation to clinical hours saved.

Emergency Medical Service Communication Systems↗
PubMedDate not supplied

Changing demand for mental health services in the emergency department of a public hospital.

OBJECTIVE: Deinstitutionalization and mainstreaming may have contributed to increased attendance in public emergency departments by people with mental health problems. This study describes changing patterns of attendances by patients with mental health problems to the emergency department (ED) of a public teaching hospital in Adelaide, South Australia. METHOD: Records from a 10-year period from the ED were examined to identify changes in the number of, and diagnoses for, patients attending for primarily mental health concerns. Admission rates, detention and length of stay (LOS) were also examined in an attempt to identify trends. RESULTS: A tenfold increase in the number of patients attending the ED with primarily mental health problems has occurred over the 10-year period. This is within the context of relatively stable total ED presentations. The increase has been observed in all diagnostic categories although the greatest increase, by percentage, has been for psychotic disorders. A lesser increase was observed for patients presenting with overdose. People presenting with psychotic disorders are also more likely to be detained and admitted. LOS in the ED has also increased along with increasing demand. CONCLUSIONS: Reasons for the increased demand are likely multifactorial. While deinstitutionalization and mainstreaming have contributed, the closure of the ED at the local psychiatric hospital does not account entirely for the change. Insufficient community-based mental health services may also contribute to the reasons why people present to the ED and lack of inpatient beds contributes to the increasing LOS experienced in the ED.

Cross-Sectional Studies↗
PubMedDate not supplied

The frequency and behavioral outcomes of goal choices in the self-management of diabetes.

PURPOSE: The purpose of this study was to determine the frequency and effectiveness of behavioral goal choices in the self-management of diabetes and to test goal-setting theory hypotheses that self-selection and behavioral specificity of goals are key to enhancing persistence. METHODS: Participants with type 2 diabetes in a randomized controlled trial (n = 422) completed baseline behavioral assessments using a clinic-based, interactive, self-management CD-ROM that allowed them to select a behavioral goal and receive mail and telephone support for the initial 6 months of the trial followed by additional behavioral assessments. Frequency of behavioral goal selection and 6-month behavioral data were collected. RESULTS: Approximately 49%, 27%, and 24% of the participants, respectively, set goals to increase physical activity (PA), reduce fat intake, or increase fruits and vegetables (F&V) consumed. At baseline, participants who selected PA, reduced fat consumption, or F&V were significantly, and respectively, less active, consumed more dietary fat, and ate fewer F&V regardless of demographic characteristics. Participants who selected a reduced-fat goal showed a significantly larger decrease than did those that selected PA or F&V goals. Participants who selected an F&V goal showed significant changes in F&V consumption. Participants who selected a PA goal demonstrated significant changes in days of moderate and vigorous physical activity. CONCLUSIONS: When participants are provided with information on health behavior status and an option of behavioral goals for managing type 2 diabetes, they will select personally appropriate goals, resulting in significant behavioral changes over a 6-month period.

Analysis of Variance↗