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Biomedical subjects

J Dwyer

Publications and source records attributed to J Dwyer.

At least 91 records · Page 5Linked to original sources
PubMed1991

Explanatory style and cell-mediated immunity in elderly men and women.

Correlated pessimistic explanatory style--the belief that negative events are caused by internal, stable, and global factors--with lowered immunocompetence in a sample of 26 older adults. Two measures of cell-mediated immunity--T-helper cell/T-suppressor cell ratio and T-lymphocyte response to mitogen challenge--were lower in individuals with a pessimistic style, controlling for the influence of current health, depression, medication, recent weight change, sleep, and alcohol use. A relative increase in the percentage of T-suppressor cells seemed to underlie this immunosuppression. Although the mechanism by which explanatory style might influence immune function remains unknown, we speculate that a pessimistic style might be an important psychological risk factor--at least among older people--in the early course of certain immune-mediated diseases.

Aged↗
PubMed1990

A double-blind, placebo-controlled trial of intravenous immunoglobulin therapy in patients with chronic fatigue syndrome.

PURPOSE: The chronic fatigue syndrome (CFS) is characterized by profound fatigue, neuropsychiatric dysfunction, and frequent abnormalities in cell-mediated immunity. No effective therapy is known. PATIENTS AND METHODS: Forty-nine patients (40 with abnormal cell-mediated immunity) participated in a randomized, double-blind, placebo-controlled trial to determine the effectiveness of high-dose intravenously administered immunoglobulin G. The patients received three intravenous infusions of a placebo solution or immunoglobulin at a dose of 2 g/kg/month. Assessment of the severity of symptoms and associated disability, both before and after treatment, was completed at detailed interviews by a physician and psychiatrist, who were unaware of the treatment status. In addition, any change in physical symptoms and functional capacity was recorded using visual analogue scales, while changes in psychologic morbidity were assessed using patient-rated indices of depression. Cell-mediated immunity was evaluated by T-cell subset analysis, delayed-type hypersensitivity skin testing, and lymphocyte transformation with phytohemagglutinin. RESULTS: At the interview conducted by the physician 3 months after the final infusion, 10 of 23 (43%) immunoglobulin recipients and three of the 26 (12%) placebo recipients were assessed as having responded with a substantial reduction in their symptoms and recommencement of work, leisure, and social activities. The patients designated as having responded had improvement in physical, psychologic, and immunologic measures (p less than 0.01 for each). CONCLUSION: Immunomodulatory treatment with immunoglobulin is effective in a significant number of patients with CFS, a finding that supports the concept that an immunologic disturbance may be important in the pathogenesis of this disorder.

Adolescent↗
PubMed1990

Facilitating a match between teaching and learning styles.

As a result of educator/student interactions within a particular course, both parties anticipate that some learning will occur, some change in behaviour will have taken place and some personal growth will be evident. In order to facilitate such change every educator ought to reflect on personal practice and ask 'Is what I am doing helping the student to learn?' The answer to this question firstly should come from the student and secondly should further prompt the educator to ask 'Do I need to change my style of teaching to match the learning needs of these students?' In searching for an answer to these questions it is suggested that the teacher would need to reflect on just what constitutes teaching and learning styles. Then one might need to investigate the possibility of matching teaching style with the students' learning styles. This paper looks at the perceived need to identify different approaches to learning and the potential for matching teaching and learning styles. It is suggested that a facilitative approach to teaching, such as that used at Macarthur Institute of Higher Education in Australia, will accomodate students' learning needs.

Curriculum↗
PubMed1990

Emmert's law in the Ames room.

The Ames distorted room illusion, in which the perceived sizes of objects placed within the room differ from their objective sizes, has been used to support arguments for indirect perception. A study is reported in which Emmert's law of the apparent size of after-images was examined in relation to the Ames room's illusory alteration of apparent and actual distances. Size judgments of afterimages projected into the Ames room were compared with control conditions in which both actual and apparent afterimage projection distances were reproduced. Results indicate that Emmert's law may not provide a simple geometrical relationship between proximal image size and actual viewing distance, and that the processes involved in making afterimage size judgments are similar to those processes involved in making size judgments of 'real world' objects.

Adult↗
PubMed1990

Expert opinions on nutrition issues in clinical dentistry.

Diet assessment and counseling are essential components of comprehensive preventive dental care programs. However, the lack of consensus on what constitutes appropriate nutrition services has resulted in diversity in the level and quality of such services to dental patients. Seventy nine nationally recognized experts in dental nutrition were surveyed using the Delphi method to seek consensus on the appropriate scope of nutrition in clinical dentistry.

Chi-Square Distribution↗
PubMed1989

Changing times changing paradigm (1): From hospital training and college education in Australia.

In 1985, nurse education in New South Wales (NSW), Australia changed from hospital based nursing courses to preparation for comprehensive registration within the tertiary sector. The Nightingale apprenticeship system with an emphasis on the service needs of the institution had persisted for almost a century. The early 1970's however saw the emergence in Australia of a new paradigm in nurse education challenging the traditional training perspective. The student nurse in NSW has now assumed the role of learner and is supernumerary to the health care team when practising in a wide range of health care settings. This article has two parts, the first of which discusses the background to the development of a new paradigm in nurse education and the implications of the change process. In particular, the reaction of the medical profession to the greater degree of autonomy demonstrated by nurses in relation to their preparation for practice, is discussed.

Education, Nursing, Baccalaureate↗
PubMed1989

Changing times, changing paradigm (2): The Macarthur experience.

Part 2 delves more deeply into the program which the Macarthur Institute of Higher Education has implemented; a problem-based learning curriculum with the focus on self directed learning and the transfer of concepts and principles related to the various sciences associated with health care. Through exploration of specific patient problems students are able to integrate the components of the course using a process of enquiry. This new approach has implications for the student, the new graduate, the teacher/facilitator, the workforce and the recipients of nursing care. A broad overview of the impact of the new paradigm on nursing thus far is provided with a suggested model for formal evaluation of the program.

Australia↗
PubMed1987

The effect of a low fat diet on estrogen metabolism.

Women who consume a diet low in fat are at lower risk for breast cancer than women whose diet is relatively high in fat. To investigate the effects of a low fat diet on estrogen metabolism, six normal young women were studied while eating a Western-style high fat diet and again after 2 months of consuming a defined low fat diet. Both studies involved the simultaneous administration of [3H]estradiol [( 3H]E2) orally and [14C]E2 iv and the subsequent collection of multiple blood samples and urine for 96 h. The blood samples were analyzed for radioactivity as estrone (E1), E2, their glucuronides, and E1 sulfate. An aliquot of the pooled 96-h urine was analyzed for radioactivity as the glucuronides and sulfates of E1, E2, estriol, 16 alpha-hydroxyestrone (16 alpha-OHE1), and the catechol estrogens, i.e. 2-hydroxy and 2-methoxy metabolites of E1 and E2. The low fat diet resulted in a consistent and significant (P less than 0.05) decrease in urinary excretion of both 16-hydroxylated metabolites, estriol and 16 alpha-OHE1, expressed as a percentage of administered dose of [3H]E2 and [14C]E2, and an increase in the excretion of the catechol estrogens. These changes in metabolite excretion were not, however, mirrored by changes in the MCRs or conversion ratios of either [3H]E2 or [14C]E2. Thus, while neither the clearance of E2 from the blood nor its absorption from the intestinal tract was altered by a relatively short term decrease in dietary fat, there was a shift in the pattern of urinary metabolites away from the purported carcinogenic estrogen (16 alpha-OHE1) and toward the less active catechol estrogens. This may represent an important mechanism whereby low fat diets decrease the risk of breast cancer.

Adult↗
PubMed1987

Abnormalities in the immune system of children with beta-thalassaemia major.

We have studied both the humoral and cell mediated immune systems of 23 children with beta-thalassaemia major. In children who had not been splenectomized, a 3-fold expansion in the number of circulating B cells and a modest polyclonal gammopathy was present. Of these patients 70% had decreased numbers of circulating T4 cells; 83% were unresponsive to skin testing with Candida albicans, and the majority had decreased lymphocyte proliferative responses in vitro. In children who had been splenectomized, there was a 10-fold increase in the number of circulating B lymphocytes and a 2-fold increase in the number of T4 and T8 cells present in peripheral blood. Additionally, these patients as a group were more responsive to both skin testing and lymphocyte stimulation in vitro with Candida albicans. Seven patients had an inverted T4/T8 ratio. One child has positive serology to HIV by ELISA and Western Blot techniques with a normal T4/T8 ratio. Thus, while children with thalassaemia are at risk for exposure to HIV, the immunological abnormalities associated with the disease and/or its treatment necessitates cautious interpretation of any AIDS-related immunological changes.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Nutrition education of the cancer patient and family. Myths and realities.

Common myths about nutrition education and care of cancer patients are debunked and realities are discussed. First, frequently held misconceptions of nonspecialized health professionals are considered. These include the myths that diet change in the population will be rapid now that dietary guidelines to prevent cancer have been issued; nutrition education is best relegated to the dietitian for cancer patients; patients do not need nutritional advice until treatment is actually in progress, and then only rarely while they are hospitalized; nutrition education needs taper off once consolidation or intermittent therapy begins and cease entirely with survival of 5 or more years; and nutrition education of the family usually can be ignored. Next, common myths which many patients and their families subscribe to are discussed. These myths include the following: by following the cancer prevention dietary guidelines, protection against cancer is guaranteed; if only the victim had eaten differently, the cancer never would have developed; cancer prevention dietary guidelines also should be followed in the nutritional support of cancer patients; cancer patients can rely on their appetites and hidden hungers to stay in good nutritional balance; special diets can cure cancer; all cancer anorexia can now be reversed by following proper diet; children who have cancer should neither be fed nor can they eat diets similar to those fed to other children at that age; special nutritional support measures such as tube feeding and total parenteral nutrition are only useful for those younger than 65 years; and there is no sense in paying attention to the nutrition of cancer patients in hospices because they are going to die anyway. It is concluded that nutrition education can enhance quality of life, for the patient and his family, throughout his illness and after his recovery.

Adult↗
PubMed1986

Depression of cellular immunity after major injury. Its association with posttraumatic complications and its reversal with immunomodulation.

This study examined a group of surgical patients with respect to the ability of their peripheral blood mononuclear cells to respond to phytohemagglutinin (PHA). Depression of the PHA response of more than 30% below baseline five to seven days after injury was found in 11 of 19 patients, and eight of them developed infectious complications. The addition of indomethacin to in vitro cultures resulted in an average enhancement of the PHA response of 37% baseline. Improvement at five to seven days with in vitro indomethacin was from 34% to 74% in infected patients. These data suggest that major injury can lead to depression of the PHA response, which correlates with the subsequent development of infectious complications. Indomethacin in vitro seems to be able to reverse or decrease this immunologic defect and deserves further study.

Adult↗
PubMed1986

Promoting good nutrition for today and the year 2000.

Present evidence and recommendations for promoting health and preventing disease by diet are summarized in this article. Progression studies relating to these issues over the past 6 years and relevant documents dealing with these and other public health measures are reviewed.

Blood Pressure↗