Biomedical subjects

L Cushman

Publications and source records attributed to L Cushman.

7 recordsLinked to original sources

PubMed1998

Depressive symptoms and Norplant contraceptive implants.

Women enrolled in a multicenter prospective study were evaluated to identify any possible relationship between depressive symptoms and the use of contraceptive implants. Women choosing Norplant implants (n = 910) were evaluated before starting this contraceptive and were reinterviewed at 6 months and 2 years. Women who continued the method had lower depressive symptom scores before initiating Norplant implants than did the women who discontinued the method or who were lost to follow up. Among the continuing Norplant implant users, the mean scores were similar before starting Norplant and at 6 months (7.9 vs 7.7). The strongest overall predictor of the depressive symptom score was relationship satisfaction. At 24 months, the subgroup of continuing users with decreased relationship satisfaction had an increase in depressive symptom score, but those with stable or improved relationships had stable depressive symptom scores. The subjects with the highest (i.e., worst) scores at enrollment demonstrated improved scores during follow-up. These results are reassuring for women who are concerned that Norplant use may adversely affect their mood.

Adolescent↗

PubMed1998

Depressive symptoms and Depo-Provera.

Women enrolled in a multicenter prospective study were evaluated to identify any possible relationship between depressive symptoms and the use of contraceptives. Women choosing Depo-Provera (n = 495) were evaluated before starting these contraceptives and were reinterviewed 1 year later. Women who continued the method had lower depressive symptom scores at baseline than did the women who discontinued the method or who were lost to follow-up. Among the continuing Depo-Provera users, the depressive symptom scores improved slightly at 1 year (7.4 vs 6.7). Those subjects with the highest (i.e., worst) scores at enrollment demonstrated improved scores at follow-up.

Adolescent↗

PubMed1998

Potential barriers to the removal of Norplant among family planning clinic patients.

OBJECTIVES: This study examined the prevalence and effects of potential barriers to removal of levonorgestrel implants (Norplant) among low-income women. METHODS: A sample of 687 women who received Norplant at hospital-based family planning clinics were interviewed before Norplant insertion and 6 months after Norplant insertion (or at Norplant removal if removal occurred earlier). Those who continued to use Norplant were reinterviewed at 2 years or at removal. RESULTS: In a multivariate analysis, only 1 of the 4 potential barriers--cost--significantly impeded Norplant discontinuation. CONCLUSIONS: Family planning clinics need to make clear that they follow a policy of Norplant removal on demand, regardless of the patient's ability to pay.

Adolescent↗

PubMed1997

Interventional recovery outside the walls of an intensive care environment.

St. Luke's Episcopal Hospital in Houston, Texas, created a cardiology collaborative practice team to review patient flow, to develop and implement process redesign, and to evaluate the effectiveness of the redesign project. The team focused on the recovery of interventional patients outside the critical care or intensive care unit environment. In December 1993, the team opened an interventional cardiology recovery unit on a cardiovascular telemetry floor. One thousand forty-five patients were recovered in this unit in the first year. Complication rates did not change significantly for low-risk patients; patient and family satisfaction scores improved, and the cost per case was reduced by $1,746. The success of the pilot project has become the standard for implementing new programs within the cardiology services.

Case Management↗

PubMed1990

A time comparison study of the New York State Safety Belt Use Law utilizing hospital admission and police accident report information.

New York state enacted the first safety belt use law in the United States in 1984. We evaluated the effects of the law by reviewing all hospital admissions from motor vehicle crashes in Monroe County, New York. We compared admissions for the 18 months prior to the effective date of the law with those for the 18 months after the law became effective. Police accident reports and hospital records were coupled and intensively reviewed. Motorcyclists, pedestrians, and bicyclists (bicycle collisions with motor vehicles) became controls for the study. Seat belt usage was determined from police and hospital record information. Analysis of the data revealed that safety belt use among patients hospitalized because of motor vehicle accidents increased from 11.2% before the law became effective to 53% after the law became effective. Hospital admissions decreased 11.9% among motor vehicle occupants and increased 2.6% among controls. The ISS decreased from 16.01 to 14.55 for motor vehicle occupants and increased from 14.77 to 15.11 among controls. Among subjects all injuries decreased except injuries of the spine and abdomen, which increased in the postlaw period.

Abdominal Injuries↗

PubMed1987

Multiple memory systems: evidence from stroke.

In this report, we describe the "fractionation of memory systems" in a 62-yr.-old woman following a left anterior stroke. Despite the presence of a significant, persistent declarative memory (verbal learning) deficit, this patient exhibited relatively intact procedural learning. The latter was manifested over a 4-day period by improved performance on a maze task executed under "mirror-tracing" conditions. By the final set of trials, the patient's performance approximated that of a normal control subject with respect to speed, although not errors. The selective preservation of particular learning abilities in brain-damaged patients has implications for rehabilitative interventions.

Brain Damage, Chronic↗

PubMed1984

Neuropsychological impairment after carotid endarterectomy correlates with intraoperative ischemia.

Detailed neuropsychological assessments were performed before and shortly after carotid endarterectomy in thirty-four patients. The degree of intraoperative ischemia was assessed by monitoring the somatosensory evoked cortical potential change upon carotid clamping. Changed neuropsychological performance was found to be related to intraoperative ischemia most clearly in patients with a history of previous stroke and in those with more severe vascular disease. In such patients greater SSEP change was correlated with greater neuropsychological change postoperatively.

Aged↗