Search PubMed⌕ Search

Biomedical subjects

E S Mitchell

Publications and source records attributed to E S Mitchell.

36 records · Page 2Linked to original sources
PubMed1989

Changes in survival after transient ischemic attacks: observations comparing the 1970s and 1980s.

We compared survival following transient ischemic attack (TIA) in 2 prospective cohorts of TIA patients admitted to Wake Forest University Medical Center. The 1st consisted of 177 patients admitted between 1961 and 1973, and the 2nd of 185 patients admitted between 1980 and 1983. Patients in the 2nd cohort had significantly greater longevity than patients in the 1st cohort, both univariately and after adjustment for cerebrovascular risk factors. The adjusted 1-year survival estimate increased from 91% in the 1st cohort to 98% in the 2nd, and the adjusted 3-year survival estimate increased from 83% in the 1st to 94% in the 2nd. The underlying causes for this dramatic improvement in survival may include early identification and aggressive management of TIAs or coexisting diseases, improved management of subsequent completed strokes or myocardial infarctions, or unadjusted differences in these cohorts. The data imply that reports of TIA survival from different periods may not be comparable.

Cohort Studies↗
PubMed1988

A biopsychosocial model of medical student distress.

Medical student distress was examined in two consecutive first-year classes (N = 312) in September, before they interacted with the school regimen, and again in May before exams. Anxiety means were one SD above the normative mean for nonpatients at both times. The number of students reporting a significant level of depression doubled from September (N = 36) to May (N = 78). The correlation of distress in September and May was .40, indicating that for many students distress was enduring. A biopsychosocial model of initial distress explained more variance (36%) in the cross-validation sample than did any one variable alone. Distressed students had higher Type A scores. Also, anger held in was a risk factor for distress in students with a family history of cardiovascular disease (CVD). Students who hold anger in may experience prolonged stress which, coupled with a family history of CVD, could make them psychobiologically vulnerable to distress.

Adaptation, Psychological↗
PubMed1988

Being healthy: women's images.

Although the concept of health is central to nursing practice and science, measurement of the concept has lagged far behind theory development. The study presented extends Laffrey's earlier work by describing the meaning of health for a population of women representing multiple ethnic groups residing in the Pacific Northwest. A sample of 528 women from a cross-section of a community who had participated in a study of women's health was asked to respond to the question, "What does being healthy mean to you?" In addition to evidence of the clinical, role performance, and adaptive models of health, the women's responses yielded nine dimensions consistent with the eudaemonistic model. Each dimension included multiple descriptors identified through content analysis of the women's verbatim responses. The women's images of health were consistent with Smith's and Laffrey's four conceptions, but the eudaemonistic category included multiple dimensions. The women reported images of health consistent with contemporary nursing theorists' views. Moreover, their emphasis on eudaemonistic images crossed all categories of age, education, income, ethnicity, and employment status.

Adolescent↗
PubMed1988

Efficacy of ivermectin against Cooperia curticei infection in sheep.

Lambs were inoculated with a single dose of Cooperia curticei. Subcutaneous administration of ivermectin at a dosage of 200 micrograms/kg of body weight resulted in 61.1% and 90.4% anthelmintic efficacy, when measured at 7 and 14 days after treatment, respectively. In the treatment groups, parasites that remained were located more distally in the small intestine than those in the lambs in the control groups.

Animals↗
PubMed1986

Multiple triangulation: a methodology for nursing science.

The discipline of nursing needs methodological strategies that promote the study of complex and dynamic phenomena like human health behavior. Triangulation is an approach conductive to studying such complex behavior. The purpose of this article is to discuss the four basic types of triangulation and to examine several issues and problems related to the use of a more complex form, multiple triangulation. Solutions are proposed for dealing with each of the problems involved in the research application of triangulation.

Humans↗
PubMed1985

Detection and partial characterization of human B cell colony stimulating activity in synovial fluids of patients with rheumatoid arthritis.

The joint fluids of 37 patients with rheumatoid arthritis, eight patients with traumatic injuries to their joints, two patients with Reiter's syndrome and three patients with psoriatic arthritis were tested for the presence of B cell colony stimulating activity (B cell CSA). B cell CSA was found in all of the joint fluids from the patients with rheumatoid arthritis but in none of the joint fluids from patients with traumatic injuries to their joints or in the joint fluids from the patients with Reiter's syndrome. A trace of B cell CSA was found in the joint fluid of one of the three patients with psoriatic arthritis. There was a positive correlation (r = 0.796) between the amount of rheumatoid factor present in the joint fluids and the titre of B cell CSA. This correlation was highly significant (P less than 0.001). The B cell CSA was localized to component(s) with molecular weight ranges 115-129 kD and 64-72 kD and an isoelectric point of 6.8. Its activity was sensitive to reduction with 2-mercaptoethanol and to the oxidising action of potassium periodate.

Adult↗
PubMedDate not supplied

Women's images of midlife: observations from the Seattle Midlife Women's Health Study.

Our purpose in conducting this study was to determine how a cohort of women born between 1935 and 1955 defined midlife, and what midlife events they viewed as important, distressing, and satisfying. A random sample of women enrolled in the Seattle Midlife Women's Health Study (n = 131) participated in a telephone interview about the meaning of midlife and important events occurring during the past year. They described midlife similarly to women from earlier birth cohorts with one important exception: the centrality of work and personal achievements in their lives. Contemporary midlife women's views of midlife reflect their roles in society.

Adult↗
PubMedDate not supplied

Three stages of the menopausal transition from the Seattle Midlife Women's Health Study: toward a more precise definition.

OBJECTIVES: As more interest centers on the years surrounding menopause, the inconsistent use of nonspecific terminology to define these years becomes a problem. Our objective was to describe the development of specific criteria that define stages within the menopausal transition and to apply these criteria to classify midlife women into a stage of transition. DESIGN: A total of 184 midlife women from the Seattle Midlife Women's Health Study taking no hormones and for whom data were available about initial menstrual cycle changes were studied. Questionnaires about menstrual cycle changes and menstrual calendars were mailed yearly. Intra-individual analyses for type and chronology of menstrual cycle changes during midlife for change in flow amount or duration, cycle length change, cycle irregularity, or skipped periods were conducted. RESULTS: Changes in flow or cycle length most frequently preceded irregularity without skipped periods, which preceded skipped periods. Initial changes began in the early 30s and most frequently between ages 40 and 44. Only 14% had irregularity as the initial change. Three stages of the menopausal transition were identified: early (flow and/or cycle length changes), middle (irregularity without skipping), and late (skipped periods). Age did not differentiate the three stages. CONCLUSIONS: These findings provide evidence for a progression of menstrual cycle events through the menopausal transition, which form the basis for three stages of the transition: early, middle, and late transition. Studies about the entire transition need to include women younger than 45. Both menstrual calendars and questionnaire data are needed to identify these three stages, and precise definitions of irregularity and skipped period are necessary.

Adult↗
PubMedDate not supplied

Premenstrual tension syndrome.

The premenstrual syndrome is discussed in relation to prevalence, symptomatology, severity, and time course. Methodologic problems common to the study of the menstrual cycle are presented. The research on psychologic and physiologic etiologies is reviewed, and results of studies on various treatment modes are discussed. Newer theories suggesting a combined psychophysiologic etiology and concomitant nonpharmaceutical treatment modes encompassing self-care and stress management skills are included.

Anxiety↗
PubMedDate not supplied

Self-confidence as a critical factor in breast self-examination.

This study was conducted to determine predictors of breast self-examination (BSE) frequency. One hundred ninety-one women completed questionnaires about their personal experiences with BSE, their risk factors, and their perceived risks of breast cancer. Satisfaction with BSE ability and explanation of BSE technique significantly predicted frequency of BSE. Perceived risk, history of breast cancer, BSE demonstration, and a BSE handout did not affect BSE frequency. Of the five BSE teaching variables, only explanation of technique significantly predicted BSE satisfaction. Clinicians can promote BSE frequency by helping women feel confident about their abilities to perform BSE.

Attitude to Health↗
PubMedDate not supplied

Memory functioning among midlife women: observations from the Seattle Midlife Women's Health Study.

OBJECTIVE: As the number of midlife women increases, there is an increased interest in women's experiences of the perimenopause. Because of the evidence linking estrogen with cholinergic and serotonergic activity in the brain and with central nervous system development of dendritic arborization, and mixed evidence of estrogen use with incidence of Alzheimer's disease, the effects of the perimenopause on memory functioning are of interest. The purpose of these analyses, part of the Seattle Midlife Women's Health Study, was to describe changes in women's perceived memory functioning according to their perimenopausal group, age, perceived stress, health status, and mood. DESIGN: Memory functioning was assessed with the Memory Functioning Questionnaire as part of a questionnaire mailed to study participants annually. Perimenopausal group was assessed using Mitchell's rating schema. RESULTS: Age was unrelated to any of the Memory Functioning Questionnaire indicators except for retrospective memory; younger women reported more memory problems than older women. Perimenopausal groups were unrelated to most memory functioning ratings with few exceptions. Memory functioning ratings of current memory compared with the past were worse for women who were in early and middle transition and for those who were using hormone therapy than for those who were in late transition and postmenopause. Women reported more current memory problems compared with 10 and 20 years ago and at age 18. Health ratings were negatively correlated with memory functioning ratings, and depressed mood positively correlated with nearly every indicator of memory functioning (frequency of memory problems, ratings of current memory, past memory, and memory change). Greater perceived stress levels were associated with more memory problems. CONCLUSIONS: Perceived memory functioning seems more closely related to perceived health, depressed mood, and perceived stress than to perimenopausal stage or age. Further work is needed to determine whether these ratings provided by the Seattle cohort will change over time as women age and as they make the transition to menopause and beyond.

Adult↗
PubMedDate not supplied

Gastrointestinal symptoms and bowel patterns across the menstrual cycle in dysmenorrhea.

Gastrointestinal (GI) functional indicators and symptoms across the menstrual cycle were examined in three groups of women: dysmenorrheic (n = 15), non-pill-taking nondysmenorrheic (n = 10), and nondysmenorrheic taking birth control pills (BCPs) (n = 9). Group assignment was based on the reported presence or absence of moderate to severe menstrual cramps in a GI Health Diary which subjects kept for two menstrual cycles. Stool consistencies and frequencies and GI symptoms were also recorded in this diary. Menstrual cycle phase significantly, p = .03, influenced stool consistencies for the sample as a whole with the loosest stools at menses. Reports of stomach pain were higher, p less than .001, at menses than at other cycle phases in all groups, and nausea, p less than .001, and decreased food intake, p less than .01, were more frequently reported by dysmenorrheic women at menses. More dysmenorrheic women had a history of menses-related GI symptoms. Both cycle phase and group differences were significant, p less than .05, for menstrual distress, with negative affect, pain, behavior changes, and autonomic reactions reported more frequently at menses by dysmenorrheic women.

Adult↗
PubMedDate not supplied

Differentiation of women with three perimenstrual symptom patterns.

The purpose of this study was to differentiate women with three perimenstrual symptom severity patterns: premenstrual syndrome (PMS), premenstrual magnification (PMM), and low symptom (LS). Factors entered into the discriminant functions included social demands, personal resources, socialization, parity, age, personal health practices, and psychological distress. A community-based sample of 142 women taking no oral contraceptives was classified into one of the three symptom severity patterns. Three two-way discriminant analyses were performed. Women with PMS had more psychological distress, more education, and a mother with more premenstrual symptoms than those with an LS pattern. Women with PMM had more psychological distress and a mother with more premenstrual symptoms, but they also had more stress and were younger than those with an LS pattern. Finally, the women with PMS, when compared to the PMM subgroup, were older, had more education, engaged in more positive health practices, and had more nontraditional attitudes toward women. In addition, the women with PMM had more stress in their lives than women with PMS.

Adolescent↗