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Biomedical subjects

John E Byrd

Publications and source records attributed to John E Byrd.

6 recordsLinked to original sources

Patient-reported behavior and problems in using glaucoma medications.

OBJECTIVE: The objectives of the current study were to describe the different types of problems patients receiving adjunctive therapy reported having when taking their glaucoma medications and to examine the relationship between patient-reported problems in taking their glaucoma medications and patient adherence. DESIGN: Cross-sectional survey. PARTICIPANTS: A survey was distributed to glaucoma patients in 4 geographically distinct ophthalmology practices. We excluded patients using only 1 glaucoma medication. The survey was completed by 324 patients. METHODS: For each patient, average percent adherence to his or her glaucoma medication regimen was calculated. Logistic regression was used to examine how patient characteristics and problems in using glaucoma medications were related to reported adherence. MAIN OUTCOME MEASURE: Whether patients were less than 100% adherent in the previous week. RESULTS: We found that 60% of patients reported 1 or more problems with taking their glaucoma medications. Fourteen percent of patients reported being less than 100% adherent to their glaucoma regimen medications during the previous week. Patients who had difficulty remembering to take their glaucoma medications and those who reported that they had other problems or concerns with their glaucoma medications were significantly less likely to be 100% adherent. CONCLUSIONS: Patient adherence to a glaucoma medication regimen could be improved among patients receiving adjunctive therapy. Ophthalmologists and their clinical colleagues should make sure to discuss the problems and concerns that patients may have in taking their glaucoma medications in an effort to improve adherence.

Adult↗

Resolution of small-scale commingling: a case report from the Vietnam War.

A case is reported that involves the commingled skeletal remains of two individuals who died in a helicopter crash in 1969 during the Vietnam War. The incomplete portions of two bodies were initially recovered soon after the crash. These portions were identified by personnel at a U.S. Army Mortuary in Saigon and were returned to the next-of-kin. While searching for scrap metal in 2002, a Vietnamese citizen unexpectedly discovered human remains and personal effects interspersed with buried aircraft wreckage. The personal effects correlated with the individuals who died in the 1969 incident. These newly discovered remains and artifacts were subsequently received at the U.S. Army Central Identification Laboratory, Hawaii (CILHI) for analysis. As part of the CILHI analysis it was necessary to segregate the commingled remains into specific individuals for identification purposes. Details regarding various sorting techniques are described that provide a solid framework for systematically dealing with small-scale commingling. The sorting techniques used in the resolution of this case consist of visual pair-matching, articulation, process of elimination, osteometric comparison, and taphonomy. These techniques, when used in conjunction with each other, provided a solid basis for the individualization of most skeletal elements.

Accidents, Aviation↗

Factors associated with potentially inappropriate drug utilization in a sample of rural community-dwelling older adults.

BACKGROUND: Many medications present special risks when used by older adults (ie, those aged > or = 65 years) and are considered potentially inappropriate for this population. The Beers criteria are often used to identify such medications. Past research has documented that use of Beers drugs is common among older adults. OBJECTIVE: The aim of this work was to examine factors associated with potentially inappropriate drug use among rural community-dwelling older adults using a conceptual framework adapted from the Andersen-Newman behavioral model of health service use. METHODS: This was a population-based, cross-sectional survey. Data were collected via face-to-face home interviews between 2002 and 2004. Rural community-dwelling older adults residing in a single county in North Carolina were eligible. Potentially inappropriate drug use was operationalized using the Beers criteria. Data concerning predisposing (ie, age, sex, race, education, and marital status), enabling (ie, social support and insurance status), need (ie, disability and history of major depression, hypertension, osteoarthritis, back problems, or other comorbidities), and utilization factors (ie, number of medications used) were collected. RESULTS: Data were gathered from 892 people, with information on medication use available for 800. Two hundred thirteen of these 800 participants (26.6%) used > or = 1 Beers drug. Compared with individuals who used no Beers drugs, those who used > or = 1 Beers drug reported lower levels of social support (odds ratio [OR], 0.94; 95% CI, 0.90-0.99) and higher levels of disability (OR, 1.48; 95% CI, 1.11-1.97), used more medications (OR, 1.07; 95% CI, 1.01-1.13), and were more likely to have a history of major depression (OR, 1.67; 95% CI, 1.05-2.66), hypertension (OR, 1.58; 95% CI, 1.07-2.33), osteoarthritis (OR, 1.58; 95% CI, 1.09-2.29), and back problems (OR, 1.72; 95% CI, 1.19-2.47). CONCLUSION: As suggested by the Andersen-Newman model, the risk of potentially inappropriate drug use is highest among those with the greatest medication needs, as evidenced by poorer health status in this sample of rural community-dwelling older patients.

Adult↗

Osteometric sorting of commingled human remains.

This paper describes the method of osteometric sorting. Osteometric sorting is the formal use of size and shape to sort bones from one another. The method relies heavily on measurement data and statistical models and is designed to maximize objectivity. The goal of this paper is to validate the use of osteometric sorting and to provide case examples of its utility. Selected regression models are also presented for use with osteometric sorting. We advocate this technique as one tool among many in the anthropologist's toolkit for sorting commingled skeletal remains.

Adolescent↗

Interobserver variation of selected postcranial skeletal measurements.

Osteometric data are of great importance for analytical purposes in the field of forensic anthropology, and it is critical that interobserver concordance is high in order for the results of these analyses to be reliable. Significant interobserver variation of skeletal measurements is cause for concern since it may result in conflicting conclusions. The range of interobserver variation of selected postcranial measurements is addressed. Thirteen standard measurements familiar to most forensic anthropologists were examined, as well as nine nonstandard measurements that were unfamiliar to most participants in the study. Sixty-eight individuals participated in the study, the majority of whom considered themselves to be forensic anthropologists with various levels of experience. In general, interobserver variation of the tested standard postcranial measurements was found to be minimal, with the exception of pubis length and subtrochanteric femur measurements. The difficulties that can lead to measurement error are discussed and possible solutions are recommended.

Anthropometry↗