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Biomedical subjects

W C Hunt

Publications and source records attributed to W C Hunt.

At least 73 records · Page 4Linked to original sources
PubMed1992

Work stress, burnout, and sense of coherence among dialysis nurses.

The overall goal of this study was to examine the relationship among work stressors, burnout, and sense of coherence (SOC) in dialysis nurses. Two hundred thirty-eight registered nurses from 56 dialysis units completed a demographic data form, the Nursing Stress Scale, the Maslach Burnout Inventory, and Antonovsky's Sense of Coherence Scale. The results indicated that work load was the major contributing factor to both overall stress and burnout. Understanding the stressors that affect responses to the work environment will allow for successful interventions to alter the risk of exhaustion and burnout.

Adult↗
PubMed1992

Meat, poultry, and fish consumption and nutrient intake in the healthy elderly.

Food selection of the healthy elderly may be influenced by life-styles, the food supply, and recommendations related to diet and disease. This study used food group analysis of 3-day diet records to examine red meat, poultry, and fish consumption by free-living, healthy elderly individuals. Dietary data were from 122 women and 97 men (median age = 75 years) who were participants in the New Mexico Aging Process Study in 1984. Mean dietary intake was 1,494 kcal/day for women and 2,079 kcal/day for men--82% and 94% of the Recommended Dietary Allowance (RDA), respectively. Protein, iron, and selected B vitamins were above 100% of the RDA. Women's mean daily intake of meat/poultry/fish was 87.7 g (52.1 g meat, 23.6 g poultry, 12.0 g fish); men's intake of meat/poultry/fish was 121.2 g (78.4 g meat, 21.2 g poultry, 21.6 g fish). Of the total red meat, more than 50% was beef, 20% was pork/ham, and more than 10% was processed meat. For women, meat/poultry/fish provided 14% of total dietary energy, 37% of protein, 13% to 32% of selected B vitamins and iron, 20% of fat, and 34% of cholesterol. Percentages were similar for men. There was no significant association between age and total dietary intake, but food group consumption had distinct associations with age for women and men. Our findings indicate that a moderate but not excessive intake of meat/poultry/fish made a substantial contribution to nutrient intake. The fat contribution of these food groups could be decreased by emphasizing lower-fat selections of meat, poultry, and fish.

Age Factors↗
PubMed1991

Survival of children and adolescents with acute lymphoid leukemia. A study of American Indians and Hispanic and non-Hispanic whites treated in New Mexico (1969 to 1986).

During the period 1969 to 1986, 196 American Indian and Hispanic and non-Hispanic white children and adolescents (ages, 0 to 19 years) were treated for acute lymphoid leukemia (ALL) at the University of New Mexico affiliated institutions. There were 28 American Indians (14%), 91 Hispanic whites (46%), and 77 non-Hispanic whites (39%). Median survivals for patients undergoing antileukemic therapy ranged from 8 months for American Indian boys to 140 months for non-Hispanic white girls. American Indian boys had the highest initial median leukocyte count (WBC) at 23.8 X 10(9)/l. Compliance problems occurred most commonly among American Indian children of both genders. Other clinical and pathologic features evaluated in this study were distributed similarly among the ethnic gender groups. Multi-variate analysis revealed that independent prognostic variables for survival included initial WBC, age, and gender. Ethnicity and compliance problems were possible, but confounded, prognostic variables. To the authors' knowledge this represents the most comprehensive study to date of ALL in American Indian patients.

Adolescent↗
PubMed1991

Thyroid function in a healthy elderly population: implications for clinical evaluation.

Evaluation of thyroid function in elderly people is complex and has generated some controversy about what is normal. This study analyzed thyroid function assays in an identified healthy elderly population of 216 subjects. Thyroxine, free thyroxine, triiodothyronine, T3 uptake, "supersensitive" thyrotropin, and thyroid antibody titers were performed. Histories of treatment for thyroid conditions were present in 13.9% (n = 30) of the population, and test results for an additional 4.3% (n = 8) revealed some hypothyroidism. These subjects were excluded from statistical analysis. Test results revealed significant differences from younger controls as well as skewed distributions for T4, FT4, and TSH. There were no significant correlations with increasing age or gender within the elderly population. 11.8% (n = 21) of the population exhibited elevated TSF levels with normal T4 values, and 23.0% (n = 41) exhibited a titer of one or both thyroid antibodies. Current reference ranges for thyroid tests are broad enough to include the range of values seen in the healthy elderly, but some cautions are discussed.

Adult↗
PubMed1991

A population-based study of functional status and social support networks of elderly patients newly diagnosed with cancer.

We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment.

Activities of Daily Living↗
PubMed1990

Determinants of cancer stage. A population-based study of elderly New Mexicans.

To assess the role of delay and other factors in determining stage of cancer at diagnosis, the authors interviewed a population-based sample of 800 elderly persons with newly diagnosed cancer at selected sites. Lengthening delay interval was associated with a declining proportion of local stage cases for breast cancer but not other sites. Of the other determinants of stage examined, older age, having a family physician, receiving medical checkups, having greater knowledge of cancer, and having no functional loss were most strongly predictive of local stage. For breast cancer, performance of breast self-examination also predicted local stage.

Activities of Daily Living↗
PubMed1990

Changes in surgical treatments: the example of hysterectomy versus conization for cervical carcinoma in situ.

From 1969 through 1985, 4584 women in the state of New Mexico were diagnosed with carcinoma in situ of the cervix. Of these women, 65.5% underwent hysterectomy while 31.1% had a conservative therapy (primarily conization). Over the 17-year period, there was a steady increase in the percentage of women receiving conservative therapies, from 11.8% in 1969 to 50.3% in 1985. Younger women, unmarried women and American Indian women were more likely to receive conservative therapy. This marked shift in therapeutic approach occurred during a time of apparent controversy as to the optimal treatment for cervical carcinoma in situ, and illustrates a rapid change in surgical practice in the absence of any controlled trials comparing the two major treatment modalities.

Adolescent↗
PubMed1990

Histologic correlations with the clinical diagnosis of dysplastic nevus.

In melanoma kindreds the presence of dysplastic nevi correlates with greatly increased melanoma risk. The relative importance of sporadic, nonfamilial dysplastic nevi as a risk factor for melanoma is less certain. Although the clinical features of dysplastic nevi have been well described, the histologic basis for the diagnosis is not as firmly established. This study examines the degree of correspondence between the clinical and histopathologic diagnosis of dysplastic nevus. Histologic review of nevi with clinical features of dysplasia from 1,000 individuals demonstrated classic histologic features of dysplasia (as previously demonstrated in melanoma kindreds) in 54.7%. In 20.4% of patients, nevi displayed less convincing or only partially developed features of dysplasia. The remaining patients (24.9%) had nevi of other types. Correspondence between the clinical and histologic diagnosis of dysplasia was best for lesions from the trunk and in individuals beyond the age of 20 years. This study supports the validity of the dysplastic nevus as a clinical and pathologic entity.

Adolescent↗
PubMed1990

Alcohol intake in the healthy elderly. Changes with age in a cross-sectional and longitudinal study.

Several cross-sectional studies have shown a decline in alcohol intake with increasing age. Longitudinal studies have failed to confirm this trend, which suggests that cohort effects may account for the reported decline. To address this, both cross-sectional and longitudinal analyses of alcohol use in 270 healthy elderly persons over a seven-year period (1980-1987) were performed. Alcohol consumption was assessed by three-day diet records. One hundred sixty-five subjects (61.1%) remained in the study until 1987; 143 (53%) completed diet records for every year. Longitudinal analysis showed a statistically significant decline in the percent of subjects consuming any alcohol over time (slope = -2% per year; 95% confidence interval -2.8, -1.1%). A cross-sectional analysis of the 1980 data revealed a similar decline in percent drinkers with increasing age (slope = -2.7% per year; 95% confidence interval -4.4, -1.1%). Mean alcohol intake for those who continued to drink did not change over time except among heavy drinkers (consumption of greater than 30 g per day in 1980), who did show a significant decline in mean alcohol intake (P = .02). Thus, in our population the decline in percent of drinkers with age found by a cross-sectional analysis was confirmed in longitudinal analyses, suggesting that this represents a true age-related decline rather than a cohort effect.

Age Factors↗
PubMed1989

Clinical chemistry reference intervals for healthy elderly subjects.

In 1979, 304 healthy elderly individuals in New Mexico were recruited for a longitudinal study of nutrition and aging. Repeat measurements on a yearly basis of commonly requested clinical chemistry analytes allowed the calculation of reference intervals, between and within-subject variance components, and percentiles for change in concentration between two yearly measurements. The latter was further divided into analytical and biological variance components. The upper 95th percentile for the difference between two yearly measurements, expressed as a percent of the population mean, ranged from 4% for Na+ to approximately 20% for total cholesterol and to greater than 90% for ferritin. Year-to-year differences attributable to the biological component ranged from a low of 2% of the population mean for Na+ to 70% for gamma-glutamyltransferase.

Adult↗
PubMed1989

Carbon dioxide laser vaporization: relationship of scar formation to power density.

A direct relationship exists between the power density of a carbon dioxide laser and the thickness of scars it produces in rat skin. Statistically significant positive relationships were noted between laser power and scar thickness at days 14, 21, and 32. The slope of the curve increased as the number of days elapsed. At day 32, the ratio of scar thickness to CO2 laser power density delivered was 0.3 microns/W-cm2. Scar formation took longer for completion at higher wattages of irradiation.

Animals↗
PubMed1989

Survival after cancer surgery of elderly patients in New Mexico, 1969-1982.

To examine the effects of advancing age, sex, and ethnicity on estimated 30-day survival after surgery for cancer, we reviewed population-based data on 16,130 cancer cases collected by the New Mexico Tumor Registry from 1969-1982. For surgery at most sites, mortality increased with increasing age. The highest mortality was observed for sites requiring laparotomy or thoracotomy. Sex and ethnicity (Hispanic versus non-Hispanic white) had little effect on short-term survival. Comparison of short-term survival for two time periods, 1969-1975 and 1976-1982, showed a strong trend of improving survival for many sites.

Age Factors↗
PubMed1988

Changing treatment of breast cancer in New Mexico from 1969 through 1985.

A review of information from the New Mexico Tumor Registry on women diagnosed as having primary breast cancer from 1969 through 1985 revealed temporal changes in the surgical treatment of this disease. After 1980 the percentage of women receiving breast-conserving surgery for local-stage disease increased from 6% to 25%. Most surgeons performing operations for breast cancer had not performed a breast-conserving operation before 1981 but had used this procedure at least once in the period from 1981 through 1985. Women younger than 50 years or older than 80 years were most likely to undergo this procedure. In that period, radiotherapy after breast-conserving surgery could not be documented for 26% of the women 65 years old or younger or for 56% of the women aged 65 years or older. Thus, there has been a marked shift in New Mexico in the surgical approach to local-stage breast cancer in the 1980s. This shift involved most surgeons treating the disease and included women of all age groups. The apparent lack of adjuvant radiotherapy in some women receiving conservative surgeries may prove to be a deleterious consequence of this change in surgical management.

Age Factors↗
PubMed1988

Delay in seeking care for cancer symptoms: a population-based study of elderly New Mexicans.

To characterize the delay by the elderly in seeking care for cancer symptoms, we interviewed 800 New Mexicans, greater than or equal to 65 years of age, with newly diagnosed cancer. Overall, 29.4% of the subjects were asymptomatic when cancer was detected, and 48.0% presented within 2 months of symptom onset. However, 19.2% of the subjects delayed seeking care for at least 12 weeks and 7.4% delayed at least 1 year. Site of cancer was the strongest determinant of delay. Hispanics tended to report longer delay than non-Hispanics, and age was not associated with delay. Of the numerous other factors considered, only having a regular checkup was significantly associated with delay interval.

Aged↗
PubMed1988

Physician acceptance of the hepatitis B vaccine at a university medical center.

To examine how physicians at different training levels accepted the hepatitis B vaccine (Heptavax), we mailed questionnaires to all medical students, residents, and faculty at our university medical center. Eighty-one per cent responded; 57 per cent of those had been vaccinated. Attitudes of vaccine safety and efficacy and the perception of increased risk of getting hepatitis B were associated with having been vaccinated. The associations were strongest for the faculty and weak or negative for the medical students.

Academic Medical Centers↗
PubMed1988

Cancer treatment protocols. Who gets chosen?

We compared the age distribution of all adults in New Mexico with cancer incident from 1959 through 1982 with that of all adult New Mexican patients enrolled in cancer treatment protocols sponsored by the Southwest Oncology Group (New Mexico). For all cancer sites, elderly patients were substantially underrepresented in the Southwest Oncology Group protocols. While 31% of all adult patients with cancer were over age 70 years, only 7% of patients with cancer enrolled in Southwest Oncology Group protocols were in that age group. The underrepresentation of elderly individuals in cancer treatment protocols will make it difficult to determine optimal therapies for older patients with cancer.

Age Factors↗
PubMed1987

The effect of marital status on stage, treatment, and survival of cancer patients.

The effects of marital status on the diagnosis, treatment, and survival of patients with cancer were examined in population-based data on 27,779 cancer cases. Unmarried persons with cancer had decreased overall survival (relative hazard, 1.23; 95% confidence limits, 1.19 to 1.28). We identified three complementary explanations for the poorer survival of the unmarried persons. First, unmarried persons were more likely to be diagnosed at a regional or distant stage (odds ratio, 1.19; 95% confidence limits, 1.12 to 1.25). After adjustment for stage, unmarried persons were more likely to be untreated for cancer (odds ratio, 1.43; 95% confidence limits, 1.31 to 1.55). Finally, after adjustment for stage and treatment, unmarried persons still had poorer survival. Previous studies have demonstrated that unmarried persons have decreased overall mortality. For cancer, our results suggest that the favorable consequence of being married on overall survival is secondary to the beneficial effects at several steps in the diagnosis, choice of treatment, and response to treatment.

Adult↗