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Biomedical subjects

S R Harris

Publications and source records attributed to S R Harris.

101 records · Page 6Linked to original sources
PubMedDate not supplied

Who's listening? Experiences of women with breast cancer in communicating with physicians.

The purpose of this qualitative study was to describe communication behaviors and attitudes of physicians that were most important to women living with breast cancer. Two focus group sessions were conducted, 1 month apart, involving 15 women who were members of a community-based breast cancer support group in Vancouver, British Columbia, Canada. Group dialogue was audiotaped, and notes were taken at each session by the coinvestigators, also members of the support group. Audiotapes, coinvestigators' written notes from the two focus group sessions, and the written homework assignments were used in the qualitative data analysis. Conceptual themes were identified and grouped to discern patterns within the data. The women were asked the following: (a) What were the most helpful things your doctor said or did at the time of your diagnosis? (b) What does a good intervention feel or look like? They were then asked to describe behaviors and attitudes they would like to influence in medical students who might later be communicating with women facing a diagnosis of breast cancer and to indicate which behaviors and attitudes they felt were most important. Women's positive experiences with physicians were characterized by communication based on active listening, awareness of the women's knowledge of their illness, honesty, and partnership. Physicians who showed interest in their patients as persons and who used touch to communicate caring were perceived as supportive communicators. Not surprisingly, there were similarities between the participants' positive experiences with their own physicians and the behaviors and attitudes desired in future physicians. Once again, "listening" was ranked as most important, followed by willingness to discern the individual patient's knowledge level.

Breast Neoplasms↗
PubMedDate not supplied

Case studies, single-subject research, and N of 1 randomized trials: comparisons and contrasts.

Case studies, single-subject research designs, and N of 1 randomized clinical trials are methods of scientific inquiry applied to an individual or small group of individuals. A case study is a form of descriptive research that seeks to identify explanatory patterns for phenomena and generates hypotheses for future research. Single-subject research designs provide a quasi-experimental approach to investigating causal relationships between independent and dependent variables. They are characterized by repeated measures of an observable and clinically relevant target behavior throughout at least one pretreatment (baseline) and intervention phase. The N of 1 clinical trial is similar to the single-subject research design through its use of repeated measures over time but also borrows principles from the conduct of large, randomized controlled trials. Typically, the N of 1 trial compares a therapeutic procedure with placebo or compares two treatments by administering the two conditions in a predetermined random order. Neither the subject nor the clinician is aware of the treatment condition in any given period of time. All three approaches are relatively easy to integrate into clinical practice and are useful for documenting individualized outcomes and providing evidence in support of rehabilitation interventions.

Bias↗
PubMedDate not supplied

Goniometric reliability for a child with spastic quadriplegia.

Intrarater and interrater reliabilities were assessed for upper-extremity goniometric measurements of a 5-year-old girl with severe spastic quadriplegia. Percentage agreement was the method used to evaluate goniometric reliability of three motions bilaterally: shoulder flexion, shoulder abduction, and elbow extension. Intrarater reliability for each of the two raters was higher than interrater reliability. The mean differences and the range of differences between raters for each of the six motions measured also were recorded. There was wide variability in measurements both within and between raters. These results suggest that a difference of +/- 10-15 degrees in range of motion over time does not justify conclusions of either significant improvement or significant regression in a child with severe spastic cerebral palsy.

Cerebral Palsy↗
PubMedDate not supplied

Oxidative stress contributes to the anti-proliferative effects of flavone acetic acid on endothelial cells.

The synthetic flavonoid flavone acetic acid (FAA) has anti-tumor activity against a variety of transplanted tumors in mice through mechanisms which likely involve effects on tumor vasculature and the host immune system. The aims of the present in vitro study were to compare the sensitivity of tumor and endothelial cells to FAA treatment and to assess if nitric oxide and superoxide are involved in the FAA-mediated suppression of cell proliferation. FAA at 1 mM concentration was approximately two times more effective in suppressing proliferation of endothelial than tumor cells. The anti-proliferative effect of 1 mM FAA on endothelial cells was partially blocked by inhibitors to various superoxide-producing enzymes (xanthine oxidase, cyclooxygenase, poly-ADP-ribose polymerase, ribonucleotide reductase) and completely inhibited by the direct scavengers of superoxide lucigenin and Tiron. In contrast, inhibitors of nitric oxide were unable to prevent the effects of FAA on proliferation. FAA induced apoptosis of endothelial cells, which was not affected by inhibitors of nitric oxide or superoxide. Our data imply that FAA inhibits proliferation of endothelial cells by a superoxide-dependent mechanism and induces apoptosis by a nitric oxide and superoxide-independent mechanism.

Animals↗
PubMedDate not supplied

Improving the time to diagnosis after an abnormal screening mammogram.

INTRODUCTION: Five community-specific interventions to reduce the time to diagnosis after an abnormal breast screen have been evaluated. METHODS: Subjects with abnormal screening mammograms in 1998 were assessed through five community pilot projects (N = 1137) and a control random sample assessed elsewhere in BC (N = 1053). The number, types, dates and physician costs of breast-related interventions after an abnormal screen were compared between pilots and control. RESULTS: The median time to diagnosis for women without a biopsy was reduced from 23 days to 7 days (p = 0.001) in the pilot with facilitated referral to diagnosis. The median time to diagnosis for women with a biopsy was reduced from 57 days to 22-43 days in the pilots. Median physician costs per subject were lower (p = 0.02) in pilots that more frequently used core biopsy to obtain a diagnosis. CONCLUSIONS: Process changes can improve the time to diagnosis after an abnormal breast screen, with similar or lower physician costs per subject. Facilitating the referral process had the greatest impact.

Adult↗
PubMedDate not supplied

Predictive value of the Bayley mental scale in the early detection of cognitive delays in high-risk infants.

One of the most elusive developmental disabilities to diagnose during infancy is cognitive delay. Although infant intelligence tests have been identified repeatedly as poor predictors of future IQ, these predictions have typically been based on interage correlations. This retrospective study examined the sensitivity, specificity, and positive and negative predictive values of the Mental Scale of the Bayley Scales of Infant Development in detecting cognitive delay (IQ < 85) among a sample of 196 high-risk, mostly low birth weight, premature infants who were assessed initially at 4 months' corrected age and followed longitudinally to between 3 and 8 years' corrected age. As hypothesized, the Bayley Mental Scale was better at correctly identifying children with future normal IQs (specificity = 91.9%) than it was at identifying infants who would later show cognitive delays (sensitivity = 38.9%). The positive and negative predictive values were 51.9% and 87.0% respectively. Results of this study support recent assertions that cognitive delay, particularly in the mildest forms, is difficult to detect during early infancy.

Cognition Disorders↗
PubMedDate not supplied

Tumor angiogenesis: biology and therapeutic prospects.

Angiogenesis is now recognized as a critical process in tumor progression and is required for solid tumors to grow beyond a few millimeters in size. The transition from a non angiogenic to an angiogenic phenotype and subsequent tumor vascularization is not well understood but is likely to involve angiogenic stimulators and inhibitors. Regulation of vascular growth also involves complex interactions of extracellular matrix molecules, proteolytic enzymes and cell adhesion molecules. Each step in the angiogenic process represents a potential target for therapeutic anticancer strategies. Antiangiogenic compounds have proven very successful as cancer treatments in murine animal models and demonstrated utility in treating humans cancers in clinical trials. These agents exhibit reduced toxicity and a decreased likelihood for the development of drug resistance compared to conventional chemotherapies. This review summarizes current knowledge of tumor angiogenesis and the factors involved, and, in addition, presents an overview of current and future antiangiogenic therapies.

Angiogenesis Inhibitors↗