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Biomedical subjects

K Hanson

Publications and source records attributed to K Hanson.

At least 55 records · Page 3Linked to original sources
PubMed1993

Community financing of health care in Africa: an evaluation of the Bamako initiative.

The Bamako Initiative, a controversial attempt to strengthen Primary Health Care using community financing and community participation and management was launched at a meeting of African Ministers of Health in 1987. This evaluation focuses particularly on the community financing aspects of the Initiative. Previous experiences of community financing highlight particular lessons for the development of the Initiative and issues likely to be encountered in implementation attempts. Four country case studies of the Initiative at its early stages of implementation (in June, July and August 1991) were conducted in Burundi, Guinea, Kenya, and Nigeria. Similar activities in Uganda were also studied. These were short studies of one month each and utilised methods of rapid evaluation. The studies aimed to direct implementers quickly to issues requiring attention rather than to reach overall conclusions regarding the success of the Initiative which would be premature at this stage. Price structures used by the Initiative need to consider the access of marginalised groups more than is the case at present. In addition, there is a need to ensure against over-prescription and commercialisation and to ensure that incentives for utilising most appropriate levels of care are maintained. The evidence suggests that most people do find amounts of money to pay for health services which are large in relation to their income. This is probably a tribute to extensive community support mechanisms. Nevertheless, it highlights the plight of those who fall through this safety net for whom even charges for very basic care may be prohibitive. On the other hand, it appears that in most cases, the Initiative's activities provide a service which is cheaper when all costs to the household are taken into account, than was available before. The quality of services included in the Initiative's activities in the five countries was highly variable. Success in raising substantial revenues has also been mixed. In some countries however, substantial funds have been generated and used to achieve real improvements in health services. Overall, the experiences of the five countries appear to have been highly dependent on a number of 'environmental' characteristics: a tradition or not of 'free' services; the adequacy of current resource availability and that immediately preceding the introduction of the Initiative; the existing stage and nature of decentralisation within the country; and the competition the Initiative's activities face with alternatives.

Burundi↗
PubMed1992

Esophageal pseudodiverticulosis: two new cases in children.

Esophageal intramural pseudodiverticulosis (EIPD) is an uncommon entity in which distended esophageal mucous glands form flask-like outpouchings from the esophagus. Its relationship with esophagitis, gastroesophageal reflux, and benign stricture suggests that it is a consequence of inflammation.

Child↗
PubMed1992

Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting.

In a sample of 177 clinic-referred children aged 7-13, an association was found between a diagnosis of conduct disorder (CD) and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parental adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant disorder (ODD) were intermediate to families of children with CD and clinic control children on all variables, but differed from control children only in having a higher rate of paternal substance abuse and paternal antisocial personality disorder (APD). When both parental APD and deviant maternal parenting were entered into 2 x 2 logit-model analyses predicting CD, only parental APD was significantly associated with CD, and no interactions between parental adjustment and maternal parenting were found. The importance of these findings for understanding the etiology of CD and for disentangling correlated risk factors in future studies is discussed.

Antisocial Personality Disorder↗
PubMed1992

AIDS: what does economics have to offer?

AIDS is rapidly becoming a major health problem in developing countries. Limited empirical information is available about the impact of AIDS on the household, the community, the health sector and the broader economy. Special problems exist in estimating the direct economic costs of AIDS in developing countries, including large out-of-pocket expenditures on health care and shortages of drugs and supplies; the difficulties of valuing resources used in caring for people with AIDS; and the lack of treatment alternatives. The calculation of indirect costs is complicated by difficulties in calculating the value of non-market production and international comparisons of the value of healthy life years lost may be erroneous, due to the higher level of average wages in developed countries. Existing evidence on the impact of AIDS at the household, community, sectoral and macroeconomic level is reviewed. Special attention is given to the impact of AIDS on the health sector and the resource allocation decisions which are made at this level. A policy-relevant research strategy would include addressing the particular information needs of the health sector, as well as studies which can help to inform government policy to mitigate the impact of AIDS at the household, community, sectoral and macroeconomic levels.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Second-line treatment of advanced measurable ovarian cancer with iproplatin: a Southwest Oncology Group study.

105 patients with advanced ovarian cancer previously treated with cisplatin or carboplatin were entered into a study of iproplatin as second-line therapy. Patients were either clinically resistant to cisplatin or carboplatin, or had relapsed after complete response to these agents. Patients were treated intravenously at an initial dosage of 270 mg/m2 with dosage adjustments to 340, 200 or 135 based on observed toxicity. Of 101 eligible patients, 7 responses (3 complete, 4 partial; 12%) were observed in 60 patients resistant to cisplatin. 2 partial responses (11%) occurred in 18 patients resistant to carboplatin. 2 complete and 3 partial responses were observed in 19 patients (26%) previously treated with but not resistant to cisplatin. Response durations were 2-20 months. Toxicities of iproplatin included thrombocytopenia in 93% of patients, leukopenia in 76% of patients, anaemia in 68% of patients, and diarrhoea in 40% of patients. Thus iproplatin shares cross-resistance with cisplatin and carboplatin in the treatment of ovarian cancer and is not recommended as an effective second-line agent for platinum-resistant ovarian cancer.

Adult↗
PubMed1990

EMG biofeedback and discriminative muscle control.

The awareness model of biofeedback suggests that training teaches new skills or enhances performance at old skills, while the cognitive or feed-forward models suggest that biofeedback brings attention to the response of interest but does not actually increase task skill. In a test of the predictions made by these models, subjects were tested on one or more cross-modal matching tasks, provided brief training, and retested on the task(s). Thirty subjects participated in integer-matching tasks in which they were instructed to produce various levels of frontalis activity corresponding to the levels of a ratio scale. Forty-five subjects participated in a tone-matching task in which they tried to match their frontalis tension to the pitch of a tone. The results indicated that the groups receiving biofeedback training improved at the more difficult integer task and at the tone task. Subjects performed better on the integer tasks than at the tone task. Our findings suggest that an awareness model accounts for changes occurring during biofeedback training. However, an awareness model may be applicable only for tasks of moderate difficulty; for relatively easy tasks, a feed-forward model may be more appropriate. The clinical utility of cross-modal matching tasks is also described.

Awareness↗
PubMed1986

Status of pediatric pain control: a comparison of hospital analgesic usage in children and adults.

A chart review was conducted of the records of 90 children and 90 adults, randomly selected and matched for sex and diagnosis, to investigate analgesic usage. Four diagnostic categories (hernias, appendectomies, burns, and fractured femurs) at two hospitals were examined. Results revealed that adults received an average of 2.2 doses of narcotics per day, whereas children received 1.1 (P = .0001). Significant differences in dosing were noted between the diagnostic categories. Diagnoses associated with a longer hospital stay showed a greater discrepancy between narcotic usage in children and adults. Hospital differences were also significant (P = .004) with more doses per day administered at the urban hospital than the rural one. Infants and young children were less likely than older children to have narcotics ordered for them, but, if ordered, frequency of administration was similar for all children. Our study demonstrates that children and adults with the same diagnoses are treated differently as regards narcotic administration. Further research is necessary to determine whether these results represent a difference in pain tolerance in children or a lack of recognition of their discomfort.

Adult↗
PubMed1984

Clonal heterogeneity of cyclic AMP responsiveness: a comparison of malignant murine lymphoid cell lines.

Various murine lymphoid tumor cell lines were examined for their alterations in intracellular levels of cyclic AMP following exposure to several pharmacologic agents. The agents tested in the present study included 3-isobutyl-1-methylxanthine (MIX), isoproterenol (ISO), prostaglandin E2 (PGE), histamine, and cholera toxin (CT). B cell tumors were generally found to be less responsive to beta-adrenergic and PGE-induced increases in cyclic AMP than were T cell tumors. An exception to this general finding was the murine B lymphoma cell line WEHI-231, which demonstrated marked sensitivity to ISO and PGE. Macrophage tumors were generally found to be even less responsive to PGE than were the B cell tumors, again with some notable exceptions (P388.D1). Cholera toxin produced differential effects in B, T, and macrophage tumors, both in terms of the absolute magnitude of the cyclic AMP response and the kinetics of this response. A T lymphoma cell line (EL-4) was identified that seems to be totally unresponsive to cell surface receptor-mediated increases in intracellular levels of cyclic AMP. The results of this study are discussed in terms of the usefulness of murine lymphoid tumors for the study of pharmacologic modulation of the immune response by cyclic AMP-elevating agents. These results demonstrate the high degree of cellular heterogeneity that can exist within normal lymphoid populations of cells, and suggest that cloned cell lines may be useful in the biochemical characterization of subsets of lymphoid cells.

1-Methyl-3-isobutylxanthine↗
PubMed1976

Effect of flurazepam on sleep spindles and K-complexes.

In this research, a quantitative study of the EEG from 5 subjects permitted a detailed analysis of the effect of 30 mg of flurazepam administered over 7 nights. Four placebo baseline nights and 3 placebo withdrawal nights were also recorded. For 4 of the subjects, a nondrug and nonplacebo follow-up record was obtained 4 to 6 weeks later. The subjects were 4 females, 1 male, age range 23-42. All complained of either sleep onset greater than 45 min, sleep length of less than 6 h, or two or more sleep awakenings. Compressed spectral analysis yielded a computer-generated somnogram on each of the 15 nights of sleep, and an automated spindle detector was used to count and measure the duration of spindle bursts with frequencies of 12.25-15.5 c/sec on baseline nights 3 and 4, drug nights 1, 2, 3 and 7, on the 3rd withdrawal night, and on the 4-6 week followup record. K-complexes were scored visually on the 4th baseline and 7th drug nights. There were no significant differences in spindle rate per minute among baseline nights and the follow-up record. By the 2nd drug night, spindle rate had significantly increased over the baseline rate. Linear contrast analysis indicated there was a significant increase of spindle rate over drug nights. All 5 subjects showed this pattern of increase. In contrast to the increase in spindle activity, the rate per minute of K-complexes significantly decreased during drug administration.

Adult↗
PubMed1976

Congenital complete atrioventricular block and prolapsing mitral valve.

Congenital complete atrioventricular block and prolapsing mitral valve are described in a 41-year-old woman who exhibited ventricular arrhythmias and symptoms initially attributed to her atrioventricular block. The importance of physical examination to elicit clues in the diagnosis of prolapsing mitral valve is emphasized.

Adult↗
PubMedDate not supplied

Smoking topography in tobacco chippers and dependent smokers.

Although most cigarette smokers exhibit signs of tobacco dependence, a subset of this population, referred to as tobacco chippers, does not show characteristic signs of dependence. Few studies have attempted to characterize differences between these groups of smokers. The purpose of the present study was to examine smoking topography in chippers (CH) and dependent smokers (DS). Topographical variables including puff number and duration, and intercigarette interval were examined in seven CH and seven DS under both laboratory and naturalistic conditions. Saliva nicotine, cotinine, and thiocyanate, as well as expired air carbon monoxide (CO) levels were also measured. The results indicate that there were no differences in smoking topography between CH and DS, except those that would be expected based on selection criteria. Although there were differences between groups on pre- and postsmoking CO and saliva cotinine levels, there were no differences in change scores from pre- to postsmoking on these measures. Additional studies will need to be done in order to completely characterize differences between CH and DS.

Adult↗