Biomedical subjects

J R Walker

Publications and source records attributed to J R Walker.

204 records · Page 12Linked to original sources

PubMedDate not supplied

The role of perceived overprotectiveness in recovery 3 months after myocardial infarction.

PURPOSE: The purpose of this study was to test the hypothesis that overprotectiveness of patients after myocardial infarction (MI) by the spouse has a negative effect on recovery. METHODS: Subjects were 52 male patients who were admitted to one of four area hospitals with a first documented myocardial infarction (MI) and their wives. While in hospital, patients were interviewed by a research nurse who rated the patient's emotional distress on a scale from 1 to 10. Patients completed a Family APGAR and a self-efficacy scale for cardiac patients estimating their level of functioning in 3 months. Wives also completed a Family APGAR, an estimate of their husbands' functioning in 3 months using the self-efficacy scale, and Zung Depression and Anxiety scales. At 3 months post-MI, patients completed the following questionnaires: Family APGAR, self-efficacy scale for cardiac patients regarding current functioning, Zung Anxiety and Depression scales, and the Psychosocial Adaptation to Illness Scale. Perceived overprotectiveness and criticism were measured using the Influential Relationships Questionnaire. The Goldman Specific Activity Scale was used to quantify cardiac recovery. Wives completed the same questionnaires as at the first assessment. RESULTS: Perceived overprotectiveness was positively correlated with patients' anxiety and depression, with perceived criticism from their wives, and correlated negatively with quality-of-life. However, it was not related to the patients' confidence in their functional abilities or to cardiac functional classification at 3 months. Wives who were perceived as overprotective had been less optimistic about their husbands' functional recovery immediately after the MI. Patients who perceived themselves to be overprotected at 3 months had also been less optimistic about their functional recovery when assessed a few days post-MI. CONCLUSIONS: Although perceived overprotectiveness is part of a negative emotional experience for the male patients, it does not appear to be related to perceived functional abilities or cardiac functional classification at 3 months post-MI. Whether the perceived overprotectiveness studied here is a function of the patient's overall emotional state or the wife's actual behavior or a combination of both is an area for future research.

Adaptation, Psychological↗

PubMedDate not supplied

Emerging characteristics of the acoustic reflex in infants.

One hundred ninety-nine infants (birth to 15 weeks) were administered an impedance battery to describe emerging characteristics of the acoustic reflex in this age range. Tympanometry results suggest that the middle ear system changes from a highly flaccid state at birth to a relatively normal compliance by 15 weeks. Acoustic reflexes were observed infrequently in the newborn population and gradually increased as a function of age, but never exceeding 43% of the ears tested. A conservative approach regarding the relevance of the presence of the reflex in young children is warranted.

Acoustic Impedance Tests↗

PubMedDate not supplied

'Rejection or infection' predictive value of T-cell subject ratio, before and after heart transplantation.

Peripheral T-cell subsets were monitored in ten heart and two heart-lung recipients pre- and up to one year post-operatively. Prior to transplantation four patients had T-helper/T-cytotoxic suppressor ratios (TH/TS-C) above the range for normal healthy controls and all required treatment for rejection episodes, as compared with three of eight patients whose pre-transplantation ratios were within the normal range. No patient with high TH/TS-C ratios developed cytomegalovirus infection as compared with all of the eight patients with normal ratios. Post-transplantation cytomegalovirus infection was the major cause of alterations in TH/TS-C ratios. T-cell subset inversion always preceded the diagnostic rise in cytomegalovirus antibody titre in both primary and secondary cytomegalovirus infections. Inversion was also noted with Pneumocystis carinii infection. Reversal of the TH/TS-C ratio was due to a major increase in the absolute numbers of TS-C cells and was usually followed by a rise in the number of cells expressing a natural killer cell phenotypic marker (Leu-7). All patients with primary cytomegalovirus and two of four cases with secondary cytomegalovirus retained inversion throughout follow-up and showed significantly increased numbers of TS-C and Leu-7 bearing cells. However, the absolute numbers of TH fell by 200 days after transplantation in all patients irrespective of their TH/TS-C ratio. Although TH/TS-C ratio inversion was a predictor of cytomegalovirus infection, no association was found between changes in T-cell subsets after transplantation and rejection episodes.

Adult↗

PubMedDate not supplied

Drug screening in newborns and mothers using meconium samples, paired urine samples, and interviews.

We evaluated the prevalence of illicit substance abuse by comparing drug screening results derived from meconium, urine pairs, and maternal interview. Mother/infant pairs (580) were entered into this blinded, prospective study. Prevalence of illicit substance abuse was 3.4%. The lack of prenatal care correlated with the use of cocaine (p < 0.001). Neonates born to cocaine-using mothers were more likely to be premature, to have a lower birth weight, decreased length, and smaller head circumference using unpaired t test (overall p < 0.05 using Bonferroni method for simultaneous inference). For mother/infant pairs who had positive drug screening for cocaine, the interview, maternal urine sample, and meconium sample showed equal sensitivity, although the newborn urine showed poor correlation. We suggest that the newborn urine sample could be deleted from newborn drug screening, and lack of perinatal care may serve as a marker of substance abuse.

Cocaine↗

PubMedDate not supplied

Funding child rearing: child allowance and parental leave.

This article proposes two financing plans to address what the author identifies as the two primary concerns in the child care field: (1) a child allowance for poor and near-poor households to address the child care problems of low-income families, and (2) a program of voluntary parental leave, available to all parents at child birth or adoption, to ensure the adequacy of infant care. The child allowance plan would cover the first three children in families up to 175% of the poverty level (more than 22 million children) at an annual cost of $45 billion. The author suggests that the allowance could be financed by redirecting funds from existing income support (for example, Aid to Families with Dependent Children), tax credit, and tax deduction programs. Financing the parental leave program would require new revenues, generated by an employee-paid increase in payroll tax totaling 3.5%. Each employee's contributions would create a parental leave account (PLA). Families could use the funds in these accounts to cover the cost of a one-year leave from work after the birth or adoption of a child. If families did not have enough dollars in their accounts to cover the cost of the leave, the federal government would extend a low-interest loan to them, which they would have to pay back. The amount individuals receive through Social Security would be adjusted upward or downward according to the balances in their parental leave accounts at retirement. The author suggests that both proposals would help parents balance work and family obligations and protect parental freedom of choice over the care and upbringing of their children.

Child Rearing↗

PubMedDate not supplied

Neurocognitive function in panic disorder and social phobia patients.

A neuropsychological test battery designed to assess verbal learning and memory, visual memory, psychomotor speed, cognitive flexibility and concentration was administered to patients with panic disorder (N = 18) and social phobia (N = 18) and a group of healthy control subjects (N = 16). Overall, the neurocognitive performance of the panic disorder and social phobia patients was lower than that of control subjects. Analyses of the verbal test variables indicated reduced performance in panic disorder and social phobia patients, relative to control subjects, on measures of verbal learning and memory. In addition, panic disorder patients exhibited deficits on short-delay free recall. No group differences were observed on tests of visual memory, psychomotor speed, cognitive flexibility, and concentration. These results, while indicative of diminished neuropsychological test performance in patients with panic disorder and social phobia, do not suggest the presence of syndrome-specific or localized neurocognitive deficits.

Adult↗