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Biomedical subjects

Nancy Edwards

Publications and source records attributed to Nancy Edwards.

35 records · Page 2Linked to original sources
PubMed2002

Brain maturation may be arrested in chronic cocaine addicts.

BACKGROUND: Animal and human newborn studies suggest that exposure to cocaine in utero delays glial maturation and white matter myelination. Postmortem data show that in the frontal and temporal lobes, white matter myelination continues into middle age. Recent magnetic resonance imaging (MRI) data have confirmed continued white matter volume increase in these regions, reaching a maximum at age 47. METHODS: Thirty-seven male cocaine dependent (CD) and 52 normal control subjects between ages 19 and 47 were evaluated with MRI. Coronal images focused on the frontal and temporal lobes were acquired using pulse sequences that maximized gray/white matter contrast. RESULTS: Highly significant positive correlations between white matter volume and age were observed in both the frontal and temporal lobes of the control group (r =.52, p =.0001 and r =.54, p =.0001, respectively); however, CD subjects did not demonstrate any age-related increase in white matter volume of the frontal (r = -.001; p =.99) and temporal (r = -.07; p =.67) lobes in this age range. CONCLUSIONS: The age-related expansion in white matter volume occurring in normal control subjects was absent in CD subjects. The findings suggest that in adults, cocaine dependence may arrest normal white matter maturation in the frontal and temporal lobes of addicts who continue using cocaine.

Adult↗
PubMed2002

One-year rehospitalization rates of patients discharged on atypical versus conventional antipsychotics.

This study examined one-year rehospitalization rates for patients who were discharged from Austin State Hospital between August 1, 1997, and July 31, 1998, while taking olanzapine, risperidone, or a conventional antipsychotic. Time to readmission was measured by the product-limit formula. Although conventional antipsychotics were associated with a lower rehospitalization rate, no significant difference in the one-year rehospitalization rate was observed between the groups. At 180 days after initial discharge, the patients who received olanzapine had a higher rate of rehospitalization than patients who were taking conventional antipsychotics. Conventional antipsychotics were associated with a lower one-year rehospitalization rate than risperidone or olanzapine.

Adolescent↗
PubMedDate not supplied

Developing management systems with cross-cultural fit: assessing international differences in operational systems.

Experiences in the Yunnan Maternal and Child Health Project, a 6-year CAN 6 million dollars bilateral initiative implemented in 10 counties (population 2.4 million) in Yunnan, China, are used to illustrate management approaches that successfully bridge cross-cultural differences in operational systems between donor and recipient countries. Donor institutions, local implementing agencies, and partner executing organizations each operate within specific assumptions about how governance structures, financial and administrative systems, human resource infrastructure, communications systems, and monitoring and reporting mechanisms function. These 'system domains' vary across cultures and countries, and become more evident as projects deal with capacity constraints, concerns about accountability, and rapid socioeconomic and political change during implementation. Management teams must be able to identify areas of poor fit among operational systems and respond appropriately. An assessment tool is offered, which management partners can use, as a basis for joint reflections on potential risks, identification of mitigation strategies, and establishing operational systems that are a fit for the funder as well as for partner agencies responsible for executing the project.

Canada↗
PubMedDate not supplied

Development and evaluation of an instrument to measure seniors' attitudes toward the use of bathroom grab bars.

Bath grab bars can minimize the effects of many age-related deficits that may contribute to bath-related falls. Despite their potential value, bathroom safety devices remain largely underutilized by many community-living older adults and knowledge concerning attitudinal factors that influence the use of grab bars is sparse. This void of knowledge is due, at least in part, to the lack of instruments to measure the psychosocial constructs influencing bathroom safety device use. This study examined the psychometric properties of a newly developed Grab Bar Use Attitude scale (GUAS). Instrument formation, including item generation, evaluation by a panel of experts, and pilot testing of the draft instrument to establish its face and content validity, was followed by instrument validation using 546 community-living seniors. Results of principal components analysis of the GUAS revealed a two-factor solution, explaining 56% of the variance. The two constructs may best be described as functional/safety and psychosocial consequences of using grab bars. Psychometric analyses of the 9-item scale provided empirical evidence of the internal consistency of the total scale and each subscale. Finally, the GUAS distinguished between regular grab bar users and nonregular users. Implications for use are discussed.

Aged↗
PubMedDate not supplied

Cortical gray matter volumes are associated with subjective responses to cocaine infusion.

We analyzed the relationship between cocaine-induced euphoria and measures of frontal and temporal gray matter volumes in eleven cocaine-dependent (CD) patients who underwent magnetic resonance imaging (MRI). Self-reported ratings of the intensity of euphoric response to cocaine infusion were obtained from the CD subjects at 3, 10, and 30 minutes after cocaine infusion. Significant positive correlation between frontal and temporal cortical gray matter volume and the intensity of euphoria was observed at 10 minutes after IV cocaine. The data suggest that frontal and temporal lobe gray matter volume is associated with some of the reinforcing effects of cocaine. Given the well-established negative linear relationship between cortical gray matter volume and age, cortical gray matter volume may be a marker for the neurobiological substrate of the age-related reduction in addiction rates.

Adult↗
PubMedDate not supplied

Bringing safety and responsiveness into the forefront of care for pregnant and parenting aboriginal people.

Poor access to prenatal care for Aboriginal people is well documented, and is explicated as an unethical barrier to care resulting from colonial and neocolonial values, attitudes, and practices. A postcolonial standpoint, participatory research principles, and a case study design were used to investigate 2 Aboriginal organizations' experiences improving care for pregnant and parenting Aboriginal people. Data were collected through exploratory interviews and small-group discussions with purposefully selected community leaders, providers, and community members. The study found that safety in healthcare relationships and settings, and responsiveness to individuals' and families' unique experiences and capacities must be brought into the forefront of care. Results suggest that the intention of care must be situated within a broader view of colonizing relations to improve early access to, and relevance of, care during pregnancy and parenting for Aboriginal people.

Attitude of Health Personnel↗
PubMedDate not supplied

Integrating Web-based technology into distance education for nurses in China: computer and Internet access and attitudes.

To increase continuing education accessibility, nurses around the world are turning to Web-based instruction. However, for Internet education to be successful, particularly in developing countries, nurses must have access to computers and the Internet as well as positive attitudes toward this form of learning. As part of a distance education project for nurses of the Tianjin Municipality in China, a survey of nurses was conducted to examine their sources of professional knowledge as well as their computer and Internet access and attitudes. The attitudes of the nurses were generally positive, and there was evidence of rapidly increasing use of and access to computers and the Internet. This article reports the results of that survey and their implications for Web-based teaching of Chinese nurses.

Adolescent↗
PubMedDate not supplied

The relationship between vulnerability factors and breastfeeding outcome.

OBJECTIVE: To determine whether vulnerability factors (confidence with breastfeeding, postpartum depression, supplementation, and perceived adequacy of support) are associated with breastfeeding outcome at 6 weeks postpartum after controlling for age and education. DESIGN: Secondary analysis of a cross-sectional telephone survey at 6 weeks postpartum. SETTING: Ottawa-Carleton, Ontario, Canada. PARTICIPANTS: A proportionate, consecutive sample of breastfeeding women from each of four hospitals in the region (526/554, 95% response rate). METHODS: Stratified bivariate analyses were used to examine the relationship between each factor and breastfeeding outcome. Multivariate logistic regression analyses examined relationships between all factors and breastfeeding outcome. RESULTS: In the logistic regression analyses, confidence with breastfeeding (odds ratio: 1.85, 95% confidence interval: 1.50-2.27, p < .001) and postpartum depression (odds ratio: 0.28, 95% confidence interval: 0.11-0.71, p= .007) were related to breastfeeding after controlling for age and education. CONCLUSIONS: Support for breastfeeding should include assessment of maternal confidence with breastfeeding and postpartum depression. Evaluation of intervention strategies to address these vulnerability factors is a priority.

Adult↗
PubMedDate not supplied

The prohibitive costs of accessing evidence online.

Delivering continuing education online involves making published materials available to learners. As part of a study that examined the use of the Internet for dissemination of information, permission to provide resources online was sought from 43 publishers, of whom 36 responded. Four (11.1%) denied permission to copy their materials. Seven (19.4%) granted permission to copy articles at no cost. The remaining 25 (69.4%) granted permission for a fee, ranging from dollar 2 to dollar 410 per article. These findings highlight a need for more accessible and cost-effective online resources to meet the challenges of evidence-based programs and practice in public health.

Computer-Assisted Instruction↗