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Biomedical subjects

J Dwyer

Publications and source records attributed to J Dwyer.

At least 55 records · Page 3Linked to original sources
PubMed1996

Transition from tube feedings to feedings by mouth in children: preventing eating dysfunction.

Tube feeding provides a temporary means of improving nutritional status and growth until a child can be nourished by mouth. Children in transition from tube to oral feeding typically display oral-motor, sensory, and developmental feeding problems and behaviors that make weaning difficult. A smooth transition benefits the child's health immediately by ameliorating eating difficulties and prevents dysfunction later in life. The weaning process from tube to oral feeding is best thought of in developmental terms. A four-step process is suggested to ensure a smooth transition: promote a positive feeding relationship between caregiver and child; determine feeding readiness; normalize feeding, including oral stimulation, eating-related behaviors, environment, and regulation; and initiate a behavioral feeding plan. The awareness and anticipatory guidance of nutrition professionals before this transition maximizes oral-feeding success for the formerly tube-fed child.

Child↗
PubMed1996

Policy and healthy weight.

"Policy" is defined as a definite course of action adopted for reasons of expedience, prudence, wisdom, or common sense. What can be said about policy and healthy weights? We must draw conclusions from the evidence offered for the comorbidities associated with overweight. Then we must ask, what is a healthy weight? How much gain or loss will suffice to arrive at a healthy weight? What other issues such as economics and mental health costs affect policy? To facilitate the process, I will review the policy issues for which there is already a consensus and then outline the evidence available from which this group might gain perspective for formulating practical public health recommendations.

Adult↗
PubMed1996

Health effects of salicylates in foods and drugs.

There is much (renewed) interest about the effects of salicylates on food intolerance, attention-deficit disorders, and cardiovascular disease. Current evidence for the efficacy of salicylate-elimination diets in the treatment of attention-deficit disorders and hyperactivity is weak, and further investigation is required on the relationship between salicylates and cardiovascular disease.

Asthma↗
PubMed1996

Chemokines and T lymphocyte recruitment to lymph nodes in HIV infection.

Recruitment of T lymphocytes to lymph nodes in patients with HIV infection is critical to the pathogenesis of disease. Chemokines are a family of cytokines, which are potent regulators of leukocyte migration. We studied the leukocyte populations and expression of chemokines known to be active upon T cells in lymph nodes of four HIV infected patients and seven control subjects using in situ hybridization, immunohistochemistry, and FACS analysis. The HIV lymph nodes showed CD8+ T lymphocyte accumulation and strongly enhanced chemokine expression, notably for the CD8+ T cell chemoattractant, macrophage inflammatory protein (MIP)-1 alpha. Resident macrophages appeared to be a major cellular source of chemokines in the HIV nodes. RANTES expression was present in both HIV and control lymph nodes, suggesting a physiological role for this chemokine in T lymphocyte recirculation. Chemokines may be important determinants of T lymphocyte accumulation in lymphoid tissue of patients with HIV/AIDS.

Adult↗
PubMed1996

The effects of calcium supplementation on ambulatory blood pressure in African-American adolescents.

This longitudinal trial investigated the effects of calcium supplementation on the mean 24-hour blood pressure in African-American adolescents. Subjects were self-identified African-American adolescents from a high school in a suburb of Los Angeles, California. The subjects were randomly placed in a placebo or treatment group (placebo versus 1.5 g of calcium/day x 4 weeks). Follow-up mean 24-hour ambulatory blood pressure (ABP) for both the treatment and control groups was lower than the baseline mean 24-hour ABP. In the treatment group, there was a decrease of 2.2 mm Hg in the mean systolic blood pressure and 0.7 mm Hg in the diastolic blood pressure. Relative to the placebo group, the net change in ABP was -1.7 mm Hg for systolic blood pressure and -0.5 mm Hg for the diastolic blood pressure. There was no statistically significant effect of calcium supplementation on the 24-hour mean ABP. The net effect of supplementation on ABP during waking and sleeping hours also was not significant.

Adolescent↗
PubMed1995

Overview: dietary approaches for reducing cardiovascular disease risks.

Current interest in reducing heart disease risks by diet involves attention to total fat; saturated, monounsaturated, polyunsaturated and trans fatty acids, as well as dietary cholesterol, soluble fiber, salt, alcohol, antioxidants, dietary alterations causing homocysteinemia and other dietary constituents, such as flavonoid compounds in some soy products. Principles to consider in crafting dietary approaches to reducing heart disease risk and some future directions for research are summarized. Public information about dietary approaches for reducing heart disease risk will benefit from the Nutrition Labeling and Education.

Cardiovascular Diseases↗
PubMed1995

Blood pressure and self-concept among African-American adolescents.

Differences in blood pressure among individuals of African ancestry living in the United States compared with those living in Africa suggest that the high prevalence of hypertension among African Americans may be due in part to environmental factors. There are a number of environmental models that attempt to account for the high rate of hypertension among African Americans. One model proposes that a strong African self-concept protects African-American adolescents from the hypertensive effects of social stress. This model was tested during a blood pressure survey of 333 adolescents in three urban Los Angeles high schools. African self-concept was assessed using a three-item scale. The average score for the three items was strongly related to systolic blood pressure among African-American male adolescents. After controlling for age, body mass index, and parent's education in regression analyses, the relation was reduced, but an effect remained. The model suggests that the hypertensive effects of the environment will operate unless the pathway from environmental stress to hypertension is blocked by a strong African-American self-concept.

Adolescent↗
PubMed1995

Preventing cardiopulmonary arrest via enhanced vital signs monitoring.

A physician-nurse collaborative team developed and implemented a research-based protocol and algorithm for improving vital signs monitoring and early intervention for at-risk patients. Project evaluation showed that in general the protocol and algorithm were used appropriately and consistently and prevented negative patient outcomes.

Algorithms↗
PubMed1994

Longitudinal study of outcome of chronic fatigue syndrome.

OBJECTIVE: To examine the predictors of long term outcome for patients with the chronic fatigue syndrome. DESIGN: Cohort study. SUBJECTS: 139 subjects previously enrolled in two treatment trials; 103 (74%) were reassessed a mean of 3.2 years after start of the trials. SETTING: University hospital referral centre. MAIN OUTCOME MEASURES: Age at onset, duration of illness, psychological and immunological status at initial assessment. Ongoing symptom severity, levels of disability, and immunological function at follow up. RESULTS: 65 subjects had improved but only six reported no current symptoms. An alternative medical diagnosis had been made in two and psychiatric illness diagnosed in 20. The assignment of a primary psychiatric diagnosis at follow up and the strength of the belief that a physical disease process explained all symptoms at entry to the trials both predicted poor outcome. Age at onset of illness, duration of illness, neuroticism, premorbid psychiatric diagnoses, and cell mediated immune function did not predict outcome. CONCLUSION: Though most patients with the chronic fatigue syndrome improve, a substantial proportion remain functionally impaired. Psychological factors such as illness attitudes and coping style seem more important predictors of long term outcome than immunological or demographic variables.

Adaptation, Psychological↗
PubMed1994

Client flow analysis: a practical management technique for outpatient clinic settings.

Client flow analysis (CFA) is a practical technique to help address one of the most frequently cited causes of patient disquiet with quality of health services--waiting times. It allows clinic managers and workers to look at the way that clients and patients move through the clinic. It gives information on waiting times, time spent in contact with different service providers, bottle-neck areas in services and staff utilization patterns. It is a technique which is simple, quickly performed, cost effective, easy to learn and easily transferrable. This paper gives two illustrative examples of sites where CFA has been initiated in Africa--a free-standing family planning clinic and a provincial hospital outpatient clinic. Waiting times were reduced by over one-half and by one-third, respectively. By reducing waiting times for clients and patients and addressing some of the problems of staff time allocation, the quality of clinic operations can be improved for both providers and clients.

Ambulatory Care Facilities↗
PubMed1994

Diet, Helicobacter pylori infection, food preservation and gastric cancer risk: are there new roles for preventative factors?

Risks for gastric cancer in relation to diet and other environmental factors are receiving renewed attention. New developments include the emerging relationship between Helicobacter pylori infection and an increased risk for gastric cancer, and positive results of chemoprevention trials in decreasing gastric cancer risk with the use of beta-carotene and vitamin E supplements. Factors that may enhance risk include consumption of nitrites, nitrates, alcohol, and highly salted, pickled, fermented, or smoked foods. Other environmental factors which may promote cancer are H. pylori infection, inappropriate food storage, metal and cement dust exposure, and cigarette smoking. High intakes of fruits and vegetables or of antioxidants, such as beta-carotene, vitamin E, and vitamin C may decrease risk.

Animals↗