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Biomedical subjects

M Lyons

Publications and source records attributed to M Lyons.

At least 37 records · Page 2Linked to original sources

Understanding professional behavior: experiences of occupational therapy students in mental health settings.

A phenomenological study explored occupational therapy students' experiences in psychiatric fieldwork. Of particular interest was students' understanding of professional behavior toward persons who use mental health services. Data were gathered from 16 informants via in-depth interviews and participant observation on multiple occasions during fieldwork affiliations. Emerging from informants' views of professional behavior were difficulties in their reconciling conflicting expectations with regard to emotional and social distance from persons who use mental health services. Additionally, the informants experienced a need to assume authority and maintain control in their dealings with service users. Students' encounters with such issues during fieldwork are indicative of challenges they may face as health professionals in a changing climate of mental health services. These data are stimuli for reflection on features of professional relationships with service users, particularly in response to expectations of persons with disabilities regarding control over their lives.

Adult↗

Influence of nicotine on myocardial stiffness and fibrosis during chronic ethanol use.

Cardiomyopathy related to ethanol abuse is often accompanied by cigarette use. To examine if the major cardioactive component may intensify the abnormal function and composition induced by chronic ethanol, nicotine was administered orally, 2.5 mg bid, to a canine model receiving 36% of calories as ethanol for 6 months (group III). These animals were compared with group II receiving ethanol alone, group IV on nicotine alone, and controls (group I). In the intact, ventilated, anesthetized dog, left ventricular pressures and volumes were measured before and after dextran infusion and related to left ventricular collagen alterations. Basal heart rate, aortic pressure, and ejection fraction were comparable with controls. End-diastolic pressure and diastolic chamber stiffness (KPV) were significantly higher in the basal state and during dextran infusion in the three experimental groups, compared with group I. The increment was largest in the ethanol-nicotine group. Analysis of left ventricular myocardium revealed a rise of collagen concentrations in all three experimental groups, with an interstitial distribution on histochemical examination. Moreover, determination of advanced glycosylation endproducts, as a measure of alterations in collagen cross-links, revealed higher concentrations versus controls. The greater increase of diastolic stiffness in the nicotine-ethanol group occurred despite a similar concentration of fluorescent products as group II. Because the former had a larger increase of collage concentration, total cross-linked collagen content was presumably greater after the combined use of nicotine-ethanol. Thus, nicotine in relatively high dose when combined with ethanol, elicited a modest further increase in the left ventricular chamber stiffness and collagen concentration.

Administration, Oral↗

Familial vulnerability factors to post-traumatic stress disorder in male military veterans.

The question has been frequently raised about whether there are emotional disorders that predispose to post-traumatic stress disorder (PTSD). We do know that those with PTSD do have many comorbid disorders, but due to the difficulty in performing prospective studies it is hard to tell what is cause and what is effect. This study bypassed the problem caused by comorbidity by examining family history of four proband groups: PTSD, mixed anxiety disorders, coexisting anxiety and depressive disorders, and screened normal controls. Two questions were examined. First, whether family history predicted who experienced combat situations and second, whether the proband groups could be distinguished by family history. Logistic regression identified two variables that predicted the experience of combat: major depression (odds ratio 2.17) and the DSM-III dramatic personality disorder cluster (odds ratio 1.36). Although there was considerable overlap, family history variables distinguished PTSD from other proband groups. Overall, the pattern of psychopathology in the families of the PTSD probands most closely resembled that in the families of the coexisting anxiety and depressive disorders probands. We conclude that family history methods may be an addition to possible variables that predict who will be exposed to combat and also that family history variables may be able to distinguish a PTSD population from some other types of emotional disorders.

Adult↗

Process over person?: occupational therapy students' fieldwork experiences of people in psychiatric settings.

This paper explores influences of psychiatric service system processes on occupational therapy students' understanding of people with psychiatric disorders. The fieldwork experiences of 16 occupational therapy undergraduates in clinical settings were studied via in-depth interviews and participant observation. An important part of the students' understanding of people with psychiatric disorders arose from the manner in which the psychiatric service system and occupational therapists have structured their dealings with people as patients or clients. Students were influenced by system practices such as the classification of people as acute/chronic, and a heavy emphasis on quantitative performance indicators of services rendered; along with an occupational therapy process that may be excessively problem-oriented, at the expense of attending to other significant personal and environmental factors within patients'/clients' lives. Such circumstances are likely to undermine students' appreciation of the humanity and individuality of people using the psychiatric service system.

Attitude↗

Interrater reliability of the Glasgow Coma Scale.

The purpose of this study was to test the interrater reliability of the Glasgow Coma Scale (GCS) when used in assessing neurologically impaired patients. In order to control variables, a videotape was developed of seven patients with different neurological impairments. A total of 57 nurses and physicians with varying degrees of education and experience used the GCS to score the patient responses. These responses were then compared for consensus and against a criterion standard. The comparison showed a low disagreement rating and a moderate to high agreement rating demonstrating that this tool has good interrater reliability (p = 0.000). Nurses may use this tool with confidence as one measure of assessment in evaluating neurologically impaired patients.

Adult↗

Changes in pathological narcissism.

OBJECTIVE: This study investigated types of change that occur over time in the psychopathology of narcissistic patients. METHOD: Baseline scores on the Diagnostic Interview for Narcissism of 20 patients, clinically diagnosed as having narcissistic personality disorder, were contrasted with their scores 3 years later by means of t tests and chi-square statistics. The authors then compared these changes in narcissism with the patients' accounts of their life events during the interval between the two assessments. RESULTS: A significant decrease in the overall level of pathological narcissism was found, particularly in the areas of interpersonal relations and reactiveness. At follow-up, 60% of the subjects had reached the cutoff score on the diagnostic interview that indicated significant improvement, and 40% remained unchanged, with a high level of pathological narcissism. A high baseline level of narcissism in interpersonal relations was associated with absence of change at follow-up. Examination of life events in the interval between assessments suggests that changes in pathological narcissism are related to three kinds of experiences: achievements, new durable relationships, and disillusionments. CONCLUSIONS: The instability of narcissistic psychopathology found in this study raises questions about the construct validity of narcissistic personality disorder as a diagnostic category and about the core construct of pathological narcissism.

Adult↗

Recruitment order of motoneurons during functional tasks.

The recruitment order of motoneurons of first dorsal interosseous (1DI) muscle has been shown to be the same during either isometric abduction or flexion of the index finger. However, it is not known whether this stereotyped recruitment is the same for all functional tasks. This question was addressed by using the 1DI muscle, which contributes to many functional tasks involving the hand and fingers. Single motor units and surface electromyographic activity were recorded from 1DI in three human subjects. Each subject performed tasks of abduction of the index finger, rotation to unscrew a threaded knob and pincer to close a spring-loaded clip. The same motor units were activated for each of the three tasks, providing no evidence for the existence of task groups. The order of recruitment of pairs of selected motor units was the same for each of the three tasks.

Adult↗

Sexually transmitted diseases in the history of Uganda.

First noticed in Uganda in 1863 by a European explorer, sexually transmitted diseases (STDs) were cited as a major cause of morbidity and mortality throughout this century. In 1908 the venereal diseases campaign was launched marking the real introduction of western medicine. By the mid-1920s, the campaign was combined with the medical service but throughout the colonial period (1901-1962) venereal diseases were considered intractable. A 1991 survey revealed alarming incidence rates and in light of the importance of STDs as a co-factor in the transmission of HIV, it is of paramount importance to implement more effective control measures.

HIV Infections↗

Correlation between red blood cell deformability and changes in hemodynamic function.

BACKGROUND: In sepsis red blood cells (RBCs) have been shown to be less deformable (i.e., more rigid) and have been implicated in decreasing nutrient blood supply and possibly leading to organ dysfunction. However, no studies have demonstrated an association between organ dysfunction and rigid RBCs. This study examined cardiovascular physiologic and histologic changes in two different models to determine whether a relationship may exist between RBC deformability and organ function. METHODS: In the following two experiments, cardiac index (CI) was continuously measured, whereas both deformability index and histology were examined at the end of the experimental periods. The first experiment studied nonanesthetized, hydrated rats after a cecal ligation and puncture (CLP), a slow-developing means of inducing RBC rigidity. In a second experiment animals were anesthetized and received a 20% total blood volume transfusion of either diamide-treated (rigid) RBCs or normal RBCs. RESULTS: CLP-treated animals' CI gradually decreased during 18 hours (232 +/- 60 ml/min/kg to 123 +/- 90 ml/min/kg; p = 0.05), with an increase in systemic vascular resistance (1459 +/- 517 dyne.sec/cm5.m2 to 2337 +/- 1213 dyne.sec/cm5.m2; p = 0.02). Diamide-treated animals had a rapid decrease in CI (86 +/- 7.0 ml/min/kg to 58 +/- 13 ml/min/kg; p = 0.05) and increase in SVR (2269 +/- 373 dyne.sec/cm5.m2 to 3897 +/- 988 dyne.sec/cm5.m2; p = 0.05) from baseline to 120 minutes after treatment respectively. The DI was significantly lower in both CLP and diamide groups (p < 0.03) when compared with control animals. Histologic evidence of subendocardial necrosis was shown in both the CLP- and Diamide-treated animals. CONCLUSIONS: These data suggest an association with RBC deformability and organ function in both septic and nonseptic animal models.

Animals↗

A case report of intracortical hemangioma. A forgotten intracortical lesion.

The differential diagnosis for lytic intracortical lesions consists primarily of osteoid osteoma and Brodie's abscess. A third, less-well-known lesion is the intracortical hemangioma. It has an identical appearance to the two aforementioned lesions on bone scan and radiographs. This case report will describe the magnetic resonance imaging appearance of intracortical hemangioma and how it might be differentiated from osteoid osteoma and Brodie's abscess.

Abscess↗

Student perceptions of persons with psychiatric and other disorders.

Policy shifts toward fostering community inclusion of persons with disabilities have brought community attitudes (including attitudes of professionals) into sharper focus as a cause for concern. Using a social distance scale, this study examined the attitudes of cohorts of occupational therapy and business students toward persons with psychiatric and other disorders. Contrary to expectations, occupational therapy seniors did not demonstrate significantly different attitudes from occupational therapy freshmen. Although freshman occupational therapy students expressed a desire to maintain less social distance from persons with various disabilities than did freshman business students, there was nonetheless a hierarchy of preference for persons with certain disabilities over others. This order of preference had only weak stability between cohorts, with persons with psychiatric disabilities consistently ranking among the least favored. It is proposed that occupational therapy curricula attend to students' attitudes toward persons with psychiatric and other disabilities. To this end, certain strategies to enrich students' education are suggested.

Adult↗

Problem-solving in the fields: an action-oriented approach to farmworker education about pesticides.

This paper describes two educational programs initiated to address the problems of farmworker pesticide poisoning in Nicaragua and in the United States and Puerto Rico. Both programs utilize a participatory and action-oriented educational methodology known as popular education. The methodology is presented using examples to demonstrate its application to the planning, delivery and evaluation of pesticide education programs. Preliminary outcomes of using this methodology are also explored as well as implications for developing future training programs in the field.

Agriculture↗