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Biomedical subjects

M Williams

Publications and source records attributed to M Williams.

At least 829 records · Page 46Linked to original sources
PubMedDate not supplied

Psychological support to an autologous bone marrow transplant unit in a community hospital: a pilot experience.

Autologous Bone Marrow Transplantation (AuBMT) has emerged as an efficacious treatment for certain hematological and solid tumors. Some of the complications of allogeneic transplants are avoided with an autologous transplant. Due to the decreased toxicity of this procedure, AuBMT can be administered at a community hospital where the setting is less burdensome for patients and families. The latter can continue to provide support for the patient as relocation is not necessary and visiting is easier. This report is a case analysis of the first 30 patients to undergo an autologous transplant as a pilot study in such an environment. This pilot project--done in a community hospital in Connecticut--may provide cost effective, high quality care in a more personal environment in the patient's own community. The different neoplastic diagnoses are listed as well as the types of psychological interventions available for these patients. Two case studies are described for clinical illustration. A discussion presents how psycho-oncology can assist the multidisciplinary team.

Adult↗
PubMedDate not supplied

The protective performance of bicyclists' helmets in accidents.

A study of the injuries sustained by 1,892 bicycle riders during accidents indicated that 432 of the bicyclists had been wearing a helmet and 64 of the latter group had sustained an impact to the helmet. The 64 helmets were evaluated in this project to relate the nature and severity of the impact they had sustained to the head injury experienced by the wearer. The protective performance of the helmet shells, impact absorbing liners, and retention systems were evaluated, and the severity of the impacts sustained by the helmets was simulated in the test laboratory. The simulation was performed by dropping sample helmets from progressively greater heights in a test apparatus until the damage observed on a sample helmet matched that observed on an accident damaged helmet. The severity observed in the simulated impacts was compared with the severity of test impacts prescribed in established helmet performance standards (ANSI 1984; Snell 1984; AS 1986). It was found that all of the impacts occurred against flat objects; a high proportion of helmets sustained more than one impact; most impacts occurred on areas of a helmet which were not tested during certification to a standard; and many impacts were more severe than those stipulated in performance standards. The predominant form of head injury recorded was low severity concussion--AIS-1, AIS-2, AIS-3. All serious head injuries occurred when the helmet came off the rider's head and collapsed due to a material defect or was struck predominantly below the rim. A high proportion of helmets worn by young riders had been misused, and many helmets displayed defects in the impact-absorbing liners. Recommendations have been made for improving helmet construction and altering current standards to reflect the conditions encountered in the field.

Accident Prevention↗
PubMedDate not supplied

Stages of change and self-efficacy for controlling drinking and driving: a psychometric analysis.

Indicators of self-efficacy and motivation to change (stage of change) with regard to drinking and to drinking and driving were examined in a sample of Driving Under the Influence (DUI) offenders in a court-mandated intervention program. Self-administered questionnaires that contained pertinent measures were completed by 210 consenting offenders (34 of whom were female) during the intervention program. A factor analysis of efficacy and stages of change items showed distinct factors for the respective constructs; however, drinking and drinking-and-driving items of the same type (e.g., efficacy or stages of change) tended to codefine common factors, and the factor pattern suggested that motivations and efficacy for changing drinking behavior are critical for avoiding the drinking-and-driving sequence. Most participants were classified into the action stage in both drinking and drinking-and-driving domains. In regression analysis, contemplation of action and self-efficacy measures pertaining to drinking and driving predicted prior crashes and arrests; however, after accounting for recent alcohol problems, action items pertaining to drinking and driving were the best predictors of recent drinking-and-driving incidents.

Adult↗
PubMedDate not supplied

Within-program factors as predictors of drinking outcome following cognitive-behavioral treatment.

The relationship between a variety of within-treatment factors and the outcome of treatment for alcoholism was examined. One hundred and twenty-eight male and 68 female participants (consecutive referrals with an ICD-10 diagnosis of alcohol dependence syndrome) were followed at 12 months following in- and day-patient cognitive behavioral treatment on an addiction unit. Within-treatment factors (of self-efficacy, psychological symptoms, expectations for treatment, treatment satisfaction, treatment climate, therapeutic alliance, and treatment evaluation), were assessed to determine their relationship to global outcome categorization into abstinent, nonproblem drinker, drinking but improved, and unimproved participant groups. A logistic regression analysis identified five variables that were predictive of a more favorable outcome: higher self-efficacy in positive social situations, greater treatment program involvement, a lower perception of staff control, a greater perception of treatment as helpful, and a reduction in psychological symptoms during treatment. Findings confirm previous research that pinpoints the importance of self-efficacy as a treatment variable of significance in treatment planning and delivery. It also highlights the prognostic significance of a reduction in psychological distress and, thus, the value of dynamic predictors of treatment outcome. The failure of the therapeutic alliance to predict outcome is discussed. It is concluded that time-limited alcoholism treatment programs need to give equal emphasis to within-treatment change via the promotion of patient confidence and the perception of helpfulness, as well as to skill-based relapse prevention strategies.

Adult↗
PubMedDate not supplied

The role of neuronal nicotinic acetylcholine receptors in antinociception: effects of ABT-594.

ABT-594, a nicotinic acetylcholine receptor agonist, has antinociceptive effects in rat models of acute thermal, persistent chemical, and neuropathic pain. Direct injection of ABT-594 into the nucleus raphe magnus (NRM) is antinociceptive in a thermal threshold test and destruction of serotonergic neurons in the NRM attenuates the effect of systemic ABT-594. However, lidocaine-inactivation of the NRM prevents the antinociceptive effect of systemic (-)-nicotine but not that of systemic ABT-594.

Analgesics, Non-Narcotic↗
PubMedDate not supplied

Aggressive epithelioid hemangioendothelioma of the lower extremity: a case report and review of the literature.

A case of epithelioid hemangioendothelioma (EHE) of the left lower extremity in a 50-year-old male is discussed. The neoplasm presented as a tan-purple, painful mass involving the fourth digit of the left foot. Following an excisional biopsy and partial amputation of the fourth digit, the lesion recurred with a multifocal distribution. A physical exam following the recurrence demonstrated multiple palpable lymph nodes in the left inguinal region. A complete amputation of the fourth digit was performed in conjunction with local excisions of the remaining lesions. Additionally, an inguinal lymphadenectomy was performed for staging purposes. Histologically, the tumor was predominantly composed of epithelioid endothelial cells forming nests, cords, and sheets and occasionally forming irregular, primitive vascular structures. Less commonly, nests of tumor cells assumed a spindled morphology. Patches of necrosis and hemorrhage were apparent throughout the neoplasm. There was minimal atypia and mitoses were not identified. Immunohistochemical stains for CD34, CD31, and Ulex europaeus antigens were positive in tumor cells. This case illustrates the potential aggressive behavior of this rare neoplasm and argues against the designation "tumor of low-grade malignancy" with which it is commonly attributed.

Foot Diseases↗
PubMedDate not supplied

Prospective payment and baccalaureate nursing education: projections for the future.

The implementation of a prospective payment system has had a profound effect on health care delivery in the United States. Providing realistic nursing experiences for baccalaureate students has become a challenge in the new arena of increased patient acuity, decreased length of patient stay in acute care settings, and increased use of home care services. The purpose of this study was to describe changes in the health care system and projected changes in baccalaureate nursing education associated with prospective payment. The descriptive survey design used a mail questionnaire to which deans or their designees from 186 National League for Nursing (NLN) accredited baccalaureate nursing programs responded. Outcomes of the study indicated specific health care delivery changes in all geographic areas and all types of institutions. Projected changes in nursing education included curriculum, teaching methods, and clinical learning experiences.

Clinical Competence↗