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Biomedical subjects

J K Austin

Publications and source records attributed to J K Austin.

At least 37 records · Page 2Linked to original sources
PubMed1996

Adolescents with active or inactive epilepsy or asthma: a comparison of quality of life.

PURPOSE: We compared quality of life (QOL) in youth with inactive or active epilepsy with that of a similar sample of youth with asthma. We explored 19 different dimensions in three domains (psychological, social, and school) and also determined differences related to illness severity and gender. METHODS: Subjects were 228 adolescents (117 with epilepsy and 111 with asthma). Data were collected from clinic records and from the adolescents, their mothers, and their teachers through questionnaires and structured interviews. Data were analyzed by analysis of covariance. RESULTS: The analysis with all 19 QOL variables indicated a significant difference between the total asthma and the total epilepsy samples (multivariate F = 3.36, p = 0.0001). Further evaluation reflected differences between the epilepsy group and the asthma group on 13 of the 19 QOL variables. When active and inactive epilepsy and asthma groups were compared, youth with active epilepsy were faring worse than all other groups in 10 areas. Moreover, youth with inactive epilepsy were faring worse than those with inactive asthma in four areas. Illness severity and sex differences were more strongly related to QOL in the epilepsy sample than in the asthma sample. Sex-severity interactions suggested that girls with high seizure severity were most at risk for QOL problems. CONCLUSIONS: Youth with active epilepsy generally had the poorest QOL. Severe seizures and female sex were associated with more problems. Sex-severity interactions should be explored in future research.

Adolescent↗
PubMed1996

Adolescent psychosocial issues in epilepsy.

Adolescence is a period of profound biological, emotional, intellectual, and social transformation unmatched, perhaps, by any other period of life. Ideally, the individual emerges from this period with a positive self-image, a strong sense of identity, and the capacity for intimacy with peers and independence from the family (McAnarney, 1985). The adolescent with epilepsy is confronted with the additional task of adjusting to a chronic seizure condition. Epilepsy leads to problems when it interferes with the completion of developmental tasks at the proper time.

Activities of Daily Living↗
PubMed1995

Vascular outcome in men with asymptomatic retinal cholesterol emboli. A cohort study.

OBJECTIVE: To determine whether asymptomatic retinal cholesterol embolism is a risk factor for vascular events. DESIGN: Cohort study with retrospectively selected controls. SETTING: A Veterans Affairs medical center. PATIENTS: 70 consecutive patients with asymptomatic retinal cholesterol emboli on dilated ocular examination in an eye clinic and 70 controls without retinal emboli. Controls were matched to patients for sex; age; prevalence of hypertension, diabetes mellitus, and ischemic heart disease; serum cholesterol level; and smoking history. MEASUREMENTS: Stroke, myocardial infarction, and death. RESULTS: During a mean follow-up of 3.4 years, stroke occurred at an annual rate of 8.5% among patients and 0.8% among controls (adjusted relative risk, 9.9; 95% CI, 2.3 to 43.1; P = 0.002). Nineteen strokes occurred, 17 in patients and 2 in controls; all were nonfatal cerebral infarctions. Twelve of the 17 that occurred in patients were in a carotid artery territory ipsilateral to the qualifying retinal cholesterol embolus and 5 were in another vascular territory. Ocular infarction or hemorrhagic stroke did not occur. Nonfatal myocardial infarction or vascular death occurred at an annual rate of 7.7% among patients and 4.9% among controls (adjusted relative risk, 1.4; 95% CI, 0.7 to 2.9; P = 0.39). CONCLUSION: Asymptomatic retinal cholesterol embolism is an important risk factor for cerebral infarction independent of commonly recognized vascular risk factors.

Aged↗
PubMed1995

Impact of polyamine analogues on the NMDA receptor.

Several N,N'-terminal dialkylated homologs of the tetraamine spermine exhibit a pronounced biphasic activity at the N-methyl-D-aspartate (NMDA) receptor-channel complex in rat cerebral cortex membranes in the presence of 100 microM L-glutamate and 100 microM glycine. At low micromolar polyamine concentrations, these analogs enhance binding of [3H]-(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-im ine ([3H]MK-801) similar to spermine (SPM). At higher concentrations (e.g., > or = 10 microM), the analogs are antagonists of [3H]MK-801 binding. The most potent analog, N1,N14-bis(1-adamantyl)homospermine, is almost totally devoid of agonist activity and is a potent antagonist at concentrations > or = 5 microM. Three structural features of the tetraamines studied appear to correlate with potency of inhibition: (1) N-terminally alkylated polyamines > terminal primary amines (e.g., SPM); (2) length of the polyamine backbone, e.g., DMHSPM > DMNSPM; and (3) size of the terminal alkyl groups, i.e., adamantyl > tert-butyl > ethyl > methyl. These findings emphasize the potential of the tetraamine backbone as a pharmacophore to modulate NMDA receptor-channel function.

Animals↗
PubMed1995

Optic disc drusen and associated venous stasis retinopathy.

METHODS: Optic disc drusen is not an uncommon diagnosis in clinical ophthalmic practice. Although associated complications are quite rare, they may be visually devastating. Complications include optic neuropathy and hemorrhagic retinopathy. A case report of extensive optic disc drusen with associated venous stasis retinopathy is presented. RESULTS: Long-term follow up showed increasing venous stasis retinopathy secondary to optic disc drusen. Cystoid macular edema formed that gradually decreased vision from 20/20 to 20/70. CONCLUSIONS: Although infrequent, complications of optic disc drusen can be visually devastating. There is no treatment for disc drusen, but some of the complications may be amenable to treatment.

Aged↗
PubMed1993

An attributional analysis of formal caregivers' perceptions of agitated behavior of a resident with Alzheimer's disease.

This study uses an attributional framework to examine the relationships between attributions, feelings, expectations, and caregiving behaviors of 49 dementia caregivers. Principal components factor analysis was used to reduce attribution, feeling, expectation, and caregiver behavior items to their basic components. A series of multiple regressions was used to analyze the data. Attributions were a significant predictor of preventable/reversible expectations, with specific causation being the strongest predictor. Attributions were also a significant predictor of expectations of limited predictability and controllability, with general causation being the explanatory variable. Findings support the importance of examination of attributions and their impacts.

Activities of Daily Living↗
PubMed1993

Development of the Child Attitude Toward Illness Scale.

Described the development of the Child Attitude Toward Illness Scale (CATIS), a short self-report instrument designed to provide a systematic assessment of how favorably or unfavorably children feel about having a chronic physical condition. Subjects were children (N = 269), ages 8-12 years, who had either epilepsy (n = 136) or asthma (n = 133). Results of confirmatory factor analysis and predicted relationships with scores on the Child Behavior Checklist and the Piers-Harris Children's Self-Concept Scale provided support for construct validity of the scale. Good internal consistency and test-retest reliability were also found.

Adaptation, Psychological↗
PubMed1993

Neurosyphilis with associated retinitis.

A 59-year-old black male presented with an acute unilateral central scotoma and decreased visual acuity in each eye. Ocular examination revealed bilateral vitritis, nerve fiber layer hemorrhages and infarcts, arteritis, serous macular edema and optic nerve head edema with telangiectasia. Vascular work-up was remarkable for a reactive FTA-ABS, VDRL and RPR. Lymphocytes, monocytes, basophils and platelet count were elevated. HIV tests were nonreactive. Ocular, serologic and cerebrospinal fluid findings along with past sexual history were consistent with a diagnosis of early neurosyphilis. Prompt referral to an infectious disease physician and subsequent treatment with parenteral penicillin resulted in complete resolution of the vitreoretinitis.

Eye Infections, Bacterial↗
PubMed1993

Nonrhegmatogenous retinal detachment in Goodpasture's syndrome: a case report and discussion of the clinicopathologic entity.

BACKGROUND: Goodpasture's syndrome is a rare, rapidly fatal disease that consists of glomerulonephritis and pulmonary hemorrhage. Although not common, the ophthalmic manifestations of this disease include hemorrhagic and/or exudative retinopathy and infrequently, nonrhegmatogenous retinal detachment. METHODS: A 25-year-old white male was examined with a complaint of bilateral intermittent blurring of vision. His medical history revealed a diagnosis of Goodpasture's syndrome with subsequent renal failure and associated complications. Ophthalmoscopy and visual field testing demonstrated bilateral, inferior nonrhegmatogenous retinal detachments. RESULTS: Optimum control of both blood pressure and metabolic processes were recommended to increase the chance of resolution of the nonrhegmatogenous retinal detachments. CONCLUSIONS: Although infrequently seen in Goodpasture's syndrome, nonrhegmatogenous retinal detachment may have a good prognosis for recovery when diagnosed early and with treatment of the underlying disease and its metabolic derangements.

Adult↗
PubMed1992

Concomitants of asymptomatic retinal cholesterol emboli.

BACKGROUND AND PURPOSE: Asymptomatic retinal cholesterol emboli are sometimes encountered on ophthalmoscopic examination. They are associated with decreased survival, but their clinical significance is not fully known. We sought to determine which vascular risk factors are associated with such emboli. METHODS: We studied 70 consecutive men (55-84 years old) with asymptomatic retinal cholesterol emboli diagnosed in an eye clinic. Twenty-one men (57-78 years old) from the same eye clinic without retinal emboli or retinal ischemic events were randomly selected as control subjects. We determined vascular risk factors, presence of ischemic heart disease, and extracranial carotid artery disease. RESULTS: Patients had a higher prevalence of hypertension, smoked more, and had a higher prevalence of heterogeneous or echolucent carotid plaques on either side than did control subjects (p less than 0.001 for all three factors). Patients also had a higher prevalence of carotid artery stenosis greater than or equal to 50% on either side and a higher prevalence of ischemic heart disease than did control subjects, but these did not reach statistical significance (p = 0.06 and p = 0.08, respectively). CONCLUSIONS: Our findings suggest that hypertension and cigarette smoking may be important in the pathogenesis of asymptomatic retinal cholesterol emboli and that these emboli indicate systemic atherosclerosis rather than ipsilateral carotid artery stenosis.

Aged↗
PubMed1991

Public values and beliefs toward nursing as a career.

The purpose of this study was to compare the perceptions of "ideal career" and "nursing as a career." The goal was to provide information for development of innovative recruitment strategies. The sample of 1,116 included college freshmen, students in grades 6 through 12, parents, school nurses, teachers, and counselors. Data were analyzed by t test and analysis of variance to determine differences in attitudes between "ideal career" and "nursing as a career." Similar perceptions for both were opportunities for employment, application of intellectual abilities, caring for people, and an opportunity for academic and scholastic achievement. An "ideal career" was seen as more financially rewarding, more respected, and more powerful than nursing, and as providing more opportunities for leadership, for making decisions, for obtaining and applying knowledge, and for working in a safe environment. Recommendations include strategies to improve recruitment and retention of nurses.

Adolescent↗
PubMed1991

Development of the coping health inventory for children.

This report describes the development of the Coping Health Inventory for Children (CHIC), an instrument designed to provide a systematic assessment of coping behaviors of chronically ill school-aged children. Using a hierarchical approach to the organization of behavior, 45 specific coping behaviors used by chronically ill children were identified and then combined into five conceptually distinct patterns of coping: Develops Competence and Optimism; Feels Different and Withdraws; Is Irritable, Moody, and Acts Out; Complies With Treatment; and Seeks Support. Results of confirmatory factor analysis and predicted relationships with child adaptation measures provide support for construct validity. Good internal consistency and stability reliabilities were also found.

Adaptation, Psychological↗
PubMed1990

Relationship between cross-cultural health attitudes and community health indicators.

Improving health standards both nationally and cross-culturally is a goal for all community health nurses. Previous research has supported links between health attitudes and behavior. The purpose of the present study was to investigate the relationship between attitudes toward health and indexes of community health using a cross-cultural data set. Concepts selected from the data set were I (myself), body, sickness, disease, life, doctor, health, medicine, hospital, nurse, death, and insane. Community health indicators were male and female life expectancy, infant mortality, economic and public health expenditures, and net social progress. The original sample included 1200 high school males within each of 30 language and cultural communities. Data were derived from students' ratings of the dimensions of evaluation, potency, and activity for each concept. The results supported the association between attitudes and objective community health indicators. Unexpected negative correlations were found between attitudes toward medicine and nurse attitudes toward body and life, perhaps indicating that extended contact with health care providers may result in negative attitudes toward them. Positive relationships were found between public health expenditures and nurses, indicating that in countries with more expenditures for community and public health, attitudes toward nurses were more positive.

Adolescent↗