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Biomedical subjects

S Andrews

Publications and source records attributed to S Andrews.

At least 37 records · Page 2Linked to original sources
PubMed2000

Assessing readiness for death in hospice elders and older adults.

BACKGROUND: Readiness for death may affect the quality of the death experience and influence response to treatments. The psychologic vulnerability of the dying person is a major focus of palliative care. Accurate assessment of readiness for death may lead to earlier and more appropriate interventions. OBJECTIVE: The purpose of this study was to assess the psychometric properties of the revised readiness for death instrument. METHODS: Using a known groups technique and a cross-sectional study design, the revised instrument was administered to 52 elders in hospice care with a terminal diagnosis and 91 community dwelling adults without a terminal diagnosis. RESULTS: Instrument content validity (Kappa = 0.96) was supported by three expert panelists who were hospice researchers. Principal components factor analysis explained 43% of the variance and partially supported the proposed four-factor structure of the revised 26-item instrument. Internal consistency was acceptable (.76). Discriminant validity was significant as assessed by an independent t-test between two contrast groups (t = 5.98, p = 0.000). The factor analysis, reliability testing, and qualitative analysis of items supported deletion of 2 items. CONCLUSIONS: Results indicated that the revised instrument has sound psychometric properties but further testing with a larger sample of hospice subjects is needed to confirm the factor structure of the instrument.

Aged↗
PubMed1998

Ineffectiveness of topical benzocaine spray during colposcopy.

BACKGROUND: Colposcopic evaluation can cause patients to experience pain and anxiety. This study investigated the use of benzocaine spray, a topical anesthetic, and its effects on pain and anxiety associated with colposcopy and colposcopic biopsy. METHODS: The study was a double-blind, placebo-controlled trial of the effectiveness of benzocaine spray applied to the cervix immediately before colposcopic examination, cervical biopsy, or endocervical curettage in patients of a family practice center. Prior to the gynecologic procedure the patient's cervix was sprayed with either benzocaine spray or matching placebo spray. After waiting at least 30 seconds the clinician started the procedure. Pain and anxiety, measured on 10-cm visual analog scales, were determined at the following times: (1) before the start of the gynecologic examination; (2) immediately before using the spray; (3) immediately after using the spray; and, (4) after the procedure was completed. RESULTS: Of 58 consecutive patients who underwent colposcopy, 36 patients were eligible for the trial and were evaluated. Participants were similar to patients not participating with regard to race, gravidity, and parity. Statistical analysis found significant differences in both pain and anxiety scores over time (repeated measures multivariate ANOVA, P < .0001), but no difference between the use of active drug and placebo. Pain scores increased significantly after application of either benzocaine or placebo spray before the start of the procedure (average increase 1.3 cm, P < .0001). CONCLUSIONS: Benzocaine, in a spray vehicle, confers no benefit when used to decrease pain and anxiety in women undergoing colposcopic procedures.

Administration, Topical↗
PubMed1998

The effects of theories on children's acquisition of family-resemblance categories.

Two experiments examined whether 4- to 5-year-olds' acquisition of family-resemblance categories (for fictitious animals) was benefited by giving them a theory that explained the behaviors of category members ("fighter" versus "hider") in terms of the relations between functional surface features. As gauged by immediate and 24-hour-delayed categorization tests, children who performed theory-guided learning were more successful at making feature/category associations than those who performed similarity-guided learning. The Theory group categorized individual attributes significantly better than children for whom features of the training examples were identified simply by pointing and naming (Features condition, Experiment 1) or who were taught unrelated functions for features such that they could not be united within any obvious causal schema (Features Description condition, Experiment 2). These results support claims that mere similarity is insufficient to support category acquisition (Murphy & Medin, 1985) and show that theories giving an explanation for the existence of correlated properties can assist children to learn the distribution of perceptual attributes across categories.

Animals↗
PubMed1997

Optimisation of methodology for enumeration of xerophilic yeasts from foods.

Xerophilic yeasts grow in intermediate moisture foods (aw, 0.65-0.85) such as sugar syrups, fruit concentrates, jams and brines. Non-osmophilic yeasts are enumerated by diluting in 0.1% peptone and then plated onto media such as malt extract or glucose yeast extract agar. In the presence of moulds the yeasts are enumerated in dichloran rose bengal chloramphenicol agar (DRBC). These procedures were demonstrated to be unsatisfactory for the enumeration of xerophilic yeasts in low aw foods. Investigations using pure cultures of xerophilic yeasts as well as naturally contaminated apple juice concentrates and glacé cherries have shown that a reduced aw diluent, in particular 30% w/w glycerol in combination with tryptone 10% glucose yeast extract agar (TGY) optimises the recovery of the yeasts, especially sublethally injured cells. The inclusion of sodium chloride in either the diluents or the culture media was not necessary to optimise the recovery of D. hansenii growing in 20% sodium chloride broths.

Agar↗
PubMed1997

Chlorine inactivation of fungal spores on cereal grains.

Although 0.4% chlorine for 2 min has been recommended for surface disinfection of food samples before direct plating for fungal enumeration, this procedure may not be adequate for highly contaminated products. The effectiveness of a range of chlorine solutions was investigated using barley samples artificially contaminated with four different concentrations of Aspergillus flavus. A. niger, A. ochraceus, Eurotium repens, Penicillium brevicompactum P. chrysogenum and Cladosporium cladosporioides. At initial contamination levels greater than 10(4)/g, 0.4% chlorine did not inactivate sufficient spores to produce less than 20% contamination. Of the test fungi, ascospores of E. repens were the most resistant to chlorine inactivation, whereas the conidia of C. cladosporioides were the most sensitive. Rinsing the samples with 70% ethanol improved the effectiveness of the recommended surface disinfection procedure. However, some ethanol appears to permeate into the grains and may inactivate sensitive internal fungi, although a minimal effect only was observed on wheat infected with Alternaria.

Aspergillus↗
PubMed1997

Environmental injuries.

Environmental injuries and illnesses can happen in home, work, or recreational settings. The variety and severity of these injuries might require the clinician to call on skills from internal medicine, emergency medicine, and toxicology. Diseases of thermoregulation are hypothermia and hyperthermia. In each instance, treatment is based on the need to restore the patient's core temperature to normal and on monitoring for complications. The victim of a fire might suffer inhalation injury in addition to burns, and it is more likely that the inhalation injury will be fatal. Oxygen deprivation and inhalation of irritant or asphyxiant chemicals contribute to injury. Toxic plants can be the source of poisoning emergencies, especially in children. Misinformation and myths that surround common plants can create diagnostic problems (i.e., which plants really are toxic and require emergency measures). Venomous marine organisms can cause a wide range of injury, from cutaneous eruption to fatal envenomation. Most are encountered in a recreational setting, such as water sports, but keepers of home aquariums are subject to stings from venomous fish. Lightning injury can present many diagnostic and treatment dilemmas. An important point in this regard is that lightning injury and high-voltage electrical injury are different in pathology and require different approaches for treatment. A discussion of electrical, chemical, and thermal burns makes such differences apparent.

Burns↗
PubMed1997

The effect of decreased catecholamine transmission on ERP indices of selective attention.

This study examines the effect of decreased catecholamine transmission on event-related potential (ERP) indices of selective attention. Intravenous clonidine (1.5 micrograms/kg Catapres), droperidol (15 micrograms/kg Droleptan), or placebo were administered to healthy adult males prior to performance of a multidimensional auditory selective attention task (SAT) in which dichotically presented sequences of tone pips varied on dimensions of location (left or right ear), pitch (high or low), and duration (short or long). Subjects were required to make a button press response to infrequent "target" stimuli that matched a prespecified stimulus on the three dimensions. ERPs were recorded during the task. Clonidine led to a significant increase of processing negativity (PN) over 200-400 ms at the irrelevant location. Droperidol led to a significant increase in reaction time (RT), a significant decrease in hit rate, and an attenuation of PN over the 200- to 400-ms and 400- to 700-ms epochs. Neither substance led to a significant change in P3 amplitude. The role of catecholamines in the selective attention subprocesses of "tuning" and "switching" is discussed.

Adrenergic alpha-Agonists↗
PubMed1997

High prevalence of gynecologic disease among hospitalized women with human immunodeficiency virus infection.

We offered standardized gynecologic examinations to consecutive women admitted to an AIDS-designated inpatient medical service; 65 (97%) of 67 women consented to the examination. The median CD4+ T lymphocyte count was 54/mm3. Only 9% of the women were admitted for primary gynecologic or genitourinary diagnoses; however, on evaluation, 83% of these women had gynecologic disease. The overall prevalences of vaginitis, cervical dysplasia, genital condylomata, genital herpes, and pelvic inflammatory disease were 51%, 45%, 23%, 20%, and 5%, respectively. Unexpected findings included adenovirus infection and foscarnet-associated genital ulcerations (two cases each). For predicting disease, gynecologic symptoms had a sensitivity of 76% and a positive predictive value of 95% but a negative predictive value of only 41%. Our results document the high prevalence of comorbid gynecologic disease among women infected with human immunodeficiency virus (HIV). Because of the inability to fully predict disease by symptom history, it is imperative that comprehensive gynecologic evaluation be offered routinely to all HIV-infected women hospitalized for acute medical illnesses.

Adult↗
PubMed1996

Evaluation of surface disinfection procedures for enumerating fungi in foods: a collaborative study.

An effective technique for assessing fungal infections of particulate foods such as cereals, nuts, fruits and vegetables is surface disinfection with a sodium hypochlorite solution before plating directly onto agar media. The surface disinfection procedure is used to inactivate the surface mycoflora then permitting assessment of the percentage of particles invaded by specific fungi. A previously recommended procedure treating samples with 0.4% chlorine for 2 min has been shown to be ineffective for barley highly contaminated with conidia of either A. flavus or A. parasiticus. An international collaborative study has demonstrated that modifying the procedure by increasing the chlorine concentration to 0.8%, or increasing the contact time to 8 min, or increasing the volume of chlorine solution is not the answer, especially with surface contamination loads of approximately 10(6) conidia/g. The inclusion of a 70% ethanol pre-rinse prior to a 0.8% chlorine treatment for 2 min made a significant improvement to the inactivation of surface conidia of A. flavus on barley. However, pretreatment with ethanol inactivated some of the internal Alternaria infections especially when the ethanol was not rinsed off. Further studies including an ethanol pre-rinse are recommended to optimise the surface disinfection procedure for seeds and nuts which have a high concentration of fungal surface contaminants.

Aspergillus↗
PubMed1996

Promotion of OTC products within a network-model HMO.

The drug benefits of most health plans do not include reimbursement for over-the counter (OTC) drugs. However, one PMB found that significant savings could be obtained if the OTC option was encouraged.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

College health providers' knowledge, attitudes, and management practices of genital HPV infection.

This comparative survey of college health providers explored nurse practitioners' (N = 73) and physicians' (N = 70) knowledge, attitudes, and management practices related to genital human papillomavirus (HPV) infection in females. Both groups had adequate knowledge of basic issues of HPV epidemiology, diagnosis, and treatment. Divergent attitudes and management practices were reported among the providers, with generally low agreement with national STD treatment guidelines published by the Centers for Disease Control and Prevention (CDC). Generally, providers tended to practice a more aggressive management approach on several aspects of HPV infection than recommended by the CDC guidelines. The one major exception reported by the majority of providers was the conservative use of colposcopy for identifying subclinical HPV infection in patients with external genital warts, a finding consistent with CDC guidelines. The availability of colposcopy within a provider's health center was found to be associated with the reported use of colposcopy. Recommendation for future research and implications for college health and advanced nursing practice are addressed.

Adult↗
PubMed1996

Promoting a sense of connectedness among individuals by scientifically demonstrating the existence of a planetary consciousness?

The subjective experience of feeling consciously connected with others and our environment-to that which is larger than ourselves-has been found to promote physical and mental health, or well-being. Various ways of evaluating this sense of connectedness have been studied under controlled scientific conditions. Through these studies, more has been learned about the effect of connectedness, ways of facilitating a sense of connection, and how to approach some objective understanding of its physical basis and human value. Evidently, we do share a interconnected rapport with others and with nature. However, we may have formed the contrary habit of dissociating and repressing a sense of connectedness for reasons strategic to their individual survival. Nevertheless, individual and global health could depend on therapeutically confronting these choices-both personally and socially.

Consciousness↗
PubMed1995

Social support as a stress buffer among human immunodeficiency virus-seropositive urban mothers.

The article presents three examples of how mothers with human immunodeficiency virus (HIV) disease cope with stressors in their lives. These examples were generated through the clinical perspective and interpretation of one clinician-researcher. Knowledge of specific women over time indicates that HIV disease is often experienced within the context of poverty. To survive with hope, the individual woman faced with an HIV diagnosis must find ways to overcome the stigma of the diagnosis and adapt using individual coping responses. Social support and social networks are viewed as resources for women who struggle to survive with the diagnosis of HIV seropositivity.

Adaptation, Psychological↗
PubMed1995

ERP indices of auditory selective attention in aging and Parkinson's disease.

In the present study, we compared the performance of normal subjects in three age groups and of medicated Parkinson's disease patients on auditory selective attention processes. Two tone sequences were dichotically presented. Subjects responded to deviant tones in the attended location. Event-related potentials (ERPs) were recorded from nine scalp electrodes. The old group showed significant decline in hit rate, increase in N1 amplitude, and reduction in P3a, P3b, target negativity, and mismatch negativity amplitude. The amplitude and duration of late Nd increased with age, reflecting modulation of both attended and unattended standard ERPs. Although the middle group showed a similar pattern of ERP changes, the effects were generally nonsignificant. The Parkinson's disease group showed little further disruption of behavioral or ERP measures. However, Parkinson's disease affected late Nd in the direction opposite of that of aging, reflecting differential modulation of unattended standard positivity.

Acoustic Stimulation↗