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PubMed2006

Laterality in persons with intellectual disability. I--do patients with trisomy 21 and Williams-Beuren syndrome differ from typically developing persons?

Persons with trisomy 21 (T21) and Williams-Beuren syndrome (WBS) have different brain abnormalities which may affect manual laterality. We assessed 45 persons with T21 and 34 with WBS (mean age 13) and 81 typically developing children (TD). Manual laterality was assessed with a fifteen-item task administered two times, and Bishop's card-reaching task. We found more left-handers in the T21 group compared to the other two groups. Inconsistent laterality was higher in the two groups with genetic diseases than in the TD group. For Bishop's test, both T21 and WBS participants were less right-oriented than the TD group. They displayed different response patterns in midline crossing when reaching for the cards, but did not display more midline crossing inhibition than the TD group. Is atypical handedness linked to specific genetic syndromes and, more specifically for persons with T21, to the trisomy of some of the genes?

Aging↗
PubMed1987

Survival of black persons compared with white persons in the Coronary Artery Surgery Study (CASS).

From July 1974 to May 1979, 573 black persons in the Coronary Artery Surgery Study (CASS) underwent coronary angiography. Compared with 23,008 white persons, larger percentages of black men and women were current smokers and reported a history of systemic hypertension. Despite the presence of chest pain, larger percentages of blacks had normal coronary arteries by angiography than did whites. The 5-year age- and sex-adjusted survival rate was 88% for whites and 82% for blacks (p less than 0.0001). Cox analysis indicated that black race was related to poorer survival in the medical group (p = 0.0006) but not in the surgical group (p = 0.28). For blacks, surgical therapy was related to a better survival rate (p = 0.009). These results raise questions concerning the effects of excess cigarette smoking and systemic hypertension and the role of coronary artery bypass surgery on survival of black persons.

Black People↗
PubMed1984

Estimation of personal exposure to tobacco smoke with a newly developed nicotine personal monitor.

To evaluate the actual level of exposure of nonsmokers to tobacco smoke in their living environments, a convenient personal monitor of nicotine specific for tobacco smoke has been developed. The nicotine personal monitor consists of a sampler tube containing 450 mg of Uniport-S coated with silicon OV-17 and a portable sampling pump with a mechanical counter for obtaining total sampling volume. Using the personal monitor attached to a nonsmoker, ambient nicotine was collected in the sampler tube by drawing environmental air at a constant flow rate for a maximum period of 8 hr. The collected nicotine was desorbed by heating and directly transferred onto a GC column with a carrier gas. The amounts of nicotine inhaled by passive smoking in various living environments were estimated to be in the range of 0.9-40 micrograms/hr. These levels are equivalent to those from the active smoking of about 0.001-0.044 ordinary cigarettes in 1 hr.

Equipment and Supplies↗
PubMed2007

A person-centered workplace: the foundation for person-centered caregiving in long-term care.

OBJECTIVE: This study seeks to understand what role managers and the work setting they create play in a nursing facility that seeks to make a transition to person-centered care. DESIGN: The study uses a human-relations framework to test 3 propositions: Managers play a critical role in the satisfaction, loyalty and commitment (ie, the engagement) of their staff; managers construct a person-centered workplace that deepens staff engagement; and engaged staff promote the well-being of the residents. SETTING AND PARTICIPANTS: The study draws on responses of Certified Nurse Assistants (CNAs) and families of residents collected in 2 satisfaction surveys conducted in 156 nursing facilities. It also uses state inspection survey data from the same facilities. MEASUREMENTS: The analysis uses measures of satisfaction, loyalty, and commitment as well as 6 scales of quality; 3 as they pertain to staff and 3 as they pertain to families. Data reduction, correlational, and risk analyses assess how managers and the work environment affect CNA engagement and the quality of caregiving. RESULTS: Management approach and the work environment are powerful predictors of CNA satisfaction, loyalty, and commitment. The work environment also correlates with how families and state surveyors evaluate quality in a nursing facility. CONCLUSION: The managers and the work setting they create hold primacy in the work life of the CNAs. Caring managers fashion a person-centered workplace conducive to turn workers into devoted caregivers. When the workplace adds quality to the life of caregivers, the caregivers add quality to the life of the resident.

Analysis of Variance↗
PubMed2003

Sensitivity to gender, person, and tense inflection by persons with Alzheimer's disease.

This paper investigates sensitivity to gender, person, and tense inflection in individuals with Alzheimer's disease (AD) in on-line and off-line tasks. Fourteen persons with AD and 14 matched controls participated in two studies: sensitivity to gender incongruity was tested in an on-line reading task and sensitivity to violation of tense and person was tested with an off-line grammaticality judgement test. Group performance was comparable on both tasks. It is argued that patients' preserved sensitivity to these features is primarily a function of the simplicity of the required operations. The notion of simplicity in this context is discussed and various parameters are offered for future investigation.

Aged↗
PubMed1993

Characterizing the neuropsychological functioning of persons with human immunodeficiency virus (HIV) infection, Part II. Neuropsychological functioning of persons at different stages of HIV infection.

Neuropsychological impairment has been reported to occur in persons at all stages of infection with the human immunodeficiency virus (HIV). However, the findings of studies to characterize the incidence and pattern of impairment have been limited by inconsistent definitions of impairment and the failure to control for confounding variables, such as hematological abnormalities, history of head injury, or substance abuse. In the present study, neuropsychological tests were administered to 141 persons at four stages of HIV infection. Significant differences were found in the percentage of persons who showed impairment at each stage of infection. Further, participants' performance on the tests tended to decline across progressive stages of infection. These findings may help psychiatric nurses identify and manage the changes associated with HIV infection.

AIDS Dementia Complex↗
PubMed2001

Subject in first person--subject in third person: subject, subjectivity, and intersubjectivity.

In this article, the author traces the history of the concepts of subject, subjectivity, and intersubjectivity in different psychoanalytic theories in the last decades. She argues that the uniqueness of these concepts and their different implications were not emphasized enough. The author discusses the various implications and contexts of the concept of subject in psychoanalytic theory proper and to relate as to: (1). The need to distinguish between the concepts of subject and subjectivity; (2). The mutual interdependence of the subject and his subjectivity and the intersubjective domain (both in the development of the individual and in theoretical thought pertaining to it). Her point of departure is from the position of the subject as a free creature, the centrality of the experiencing individual, from his/her perspective--the subject in the first person. She tries to explain the paradox implicit in the experiential dimension, the place of the other as participant, as both negating and recognizing--the subject in the third person. She suggests the interdependency of the first-person experience of subjectivity on the intersubjective dimension.

Cognition↗
PubMed2002

Managing pain in older persons who receive home-help for their daily living. Perceptions by older persons and care providers.

Pain is a common problem for older persons who need professional help for their daily living. In this study 94 older persons (75+) in persistent pain were compared with 52 care providers concerning the pain management methods they had used/administered during the previous week and how helpful they perceived these methods to be. Interviews were based on 16 items from the original version of the pain management inventory (PMI). Both groups perceived prescribed medication, rest and distraction as the most frequently utilized methods. Specific methods such as transcutaneous electrical nerve stimulation (TENS) or bracing/splinting or bandaging the affected body part were seldom employed, although most users perceived these methods as helpful. Care providers perceived most methods for managing pain as more effective than older persons did. The results imply that care providers need skills in a variety of pharmacological and nonpharmacological methods to manage pain and a need to evaluate effectiveness of the methods in a systematic way.

Activities of Daily Living↗
PubMedDate not supplied

[Sample survey of persons insured in statutory health insurance institutions in Hessen--concept and realisation of person-related data base].

Statutory health insurance data are being increasingly used for secondary data research. Longitudinal data can be prepared for research in health care, epidemiology or demand planning, in particular through the person-related nature of the data which is a precondition for the creation of inter-sector and inter-period data sets. This application possibility was introduced in a method study "person-related sampling of statutory health insurance data" and is now translated into practice on a larger scale for the first time in the regional sample "Versichertenstichprobe AOK Hessen/KV Hessen". For the collection and use of these data, model procedures were designed which take account of organisational (data access, contractual agreement, advisory board), technical (sampling, collection and storage of data) and confidentiality (data protection concept, pseudonymisation) aspects. The insured person-related sample may thus serve as a basis for the data pool planned for the national health system (Social Security Regulation 303 a-SGB V).

Community Participation↗
PubMed1998

A viral gastroenteritis outbreak associated with person-to-person spread among hospital staff.

OBJECTIVE: To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis. SETTING: A regional referral hospital in upstate South Carolina. METHODS: We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996. RESULTS: The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples. CONCLUSION: This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings.

Adult↗
PubMed2001

Caring for the older person: an exploration of perceptions using personal construct theory.

BACKGROUND: There is a reluctance among nurses to enter elderly care. OBJECTIVE: To discover nurses' perceptions of the elderly patients in their care. METHOD: After a period of participant observation, we selected 26 nurses from among those working in two elderly-care rehabilitation hospitals. Interpersonal perceptions were investigated using personal construct theory. We elicited personal constructs, produced repertory grids and rated patients according to popularity. RESULTS AND CONCLUSIONS: The most common way of perceiving patients was in terms of mental or physical dependence. Health-care assistants were more likely than staff nurses to perceive patients in terms of their personality. Nurses tended to have simplified ways of perceiving their patients. Popular patients were always mentally intact.

Adult↗
PubMed2001

Orthostatic hypotension in elderly persons during passive standing: a comparison with young persons.

BACKGROUND: The present study was aimed at clarifying the mechanism of orthostatic hypotension (OH) that occurs in elderly persons and at investigating assisting methods to prevent OH by evaluating changes in autonomic nervous system (ANS) activity and cerebral circulation of elderly persons when engaged in passive standing. METHODS: Eight elderly volunteers and 9 young volunteers gave informed consent to participate in the study. Two experimental conditions were established: (i) "active standing," in which the subjects stood on their own with guidance from an assistant, and (ii) "passive standing," in which the subjects were placed in a standing position completely by an assistant. ANS was determined before and after standing by measuring the heart rate variability. The reaction of the ANS was evaluated on the basis of low-frequency power (LF: 0.05--0.15 Hz) and high-frequency power (HF: 0.15--0.4 Hz), which were separated from the R-R interval data by power spectral analysis using the fast Fourier transformation. Cerebral perfusion was measured over the right frontal region using a near-infrared spectroscopy cerebral oxygen monitor. RESULTS: The main findings were: (i) Transient decreases in blood pressure occurred immediately after standing in both the young and elderly subjects. (ii) The LF:HF ratio increased significantly ( p <.05) immediately after active standing in the young subjects, whereas this ratio increased in the elderly subjects after some delay. (iii) The LF:HF ratio increased significantly ( p <.01) immediately after passive standing in the young subjects, whereas this ratio decreased significantly ( p <.05) in the elderly subjects. (iv) In the elderly subjects, the total hemoglobin (HbT) and oxyhemoglobin showed the greatest decrease during the 15-second period after standing. The maximum changes in the HbT with passive standing differed significantly ( p <.01) from those observed during active standing. CONCLUSIONS: Our findings emphasize the need to devise bioengineered means that allow elderly persons to exert themselves, to maintain or improve muscle contractility and ANS function, while providing minimum assistance for standing.

Adult↗
PubMed1982

Norwalk gastrointestinal illness: an outbreak associated with swimming in a recreational lake and secondary person-to-person transmission.

An outbreak of gastrointestinal illness in which headache, low grade fever and myalgia were common symptoms occurred among persons who visited a recreational park in Macomb County, Michigan, on July 13-16, 1979. The temporal clustering of onsets of 121 persons who were the first in their households to become ill suggested an incubation period ranging from 4-77 hours. A history of swimming in the park's lake was elicited with significantly greater frequency from these persons than from park visitors who were not ill (age standardized odds ratio = 4.8; 95% confidence interval, 1.8-12.7). One hundred twenty-six park visitors who became ill were household contacts of index patients who had swum in the lake; at least 62 of these 126 cases were probably due to secondary transmission. A secondary attack rate of 19% was observed in household contacts who had not visited the park. Serologic studies identified Norwalk virus as the etiologic agent. The source of the contamination of the lake could not be determined. Although some water samples collected just before and after the epidemic period had high coliform counts, the geometric mean coliform density of all samples collected on those days was within the limits established by the Environmental Protection Agency as acceptable for recreational contact water.

Adolescent↗
PubMed1982

An outbreak of Norwalk gastroenteritis associated with swimming in a pool and secondary person-to-person transmission.

In June 1977 an outbreak of acute gastroenteritis affected 103 students and teachers at an elementary school in Ohio. The illness typically lasted 24 hours or less and was characterized by vomiting (86%) and cramping (70%), but more than half of the persons involved also reported having nausea, diarrhea, and headache. Similar illness frequently followed in household members (29%) of families with primary cases. Investigation revealed that 70% of the children and teachers who swam in a pool at an all day outing June 1 (4 classrooms) and 55% of those who swam during a similar outing June 2 (2 classrooms) had the onset of acute illness from 12--48 hours later. None of the children who attended the outings but did not swim had a similar illness. The evidence suggested that the primary outbreak was caused by contaminated water in the pool and that person-to-person spread of illness followed. Results of a microbiologic study of pool water were negative for bacterial and viral pathogens. Throat washings, stool specimens, and paired blood samples studied for evidence of pathogens were negative initially, but subsequent serologic studies suggested that infection by Norwalk virus was the cause of the outbreak. The pool chlorinator which was inadvertently unconnected at the time of the school visits was reconnected and an underground leak in the water supply pipes was corrected. No more cases were reported after the pool was drained, cleaned, and reopened.

Disease Outbreaks↗
PubMed1985

Person-to-person transmission in an outbreak of enteroinvasive Escherichia coli.

In the summer of 1981, an outbreak of diarrhea occurred in students and staff at a school for mentally retarded adults and children in Columbia, Missouri. Forty-one (48%) of 86 students and 38 (28%) of 137 staff members in the two dormitories with the lowest functioning students were ill. Enteroinvasive Escherichia coli 0124:H30 was isolated from 20 persons including six staff members, 13 students, and the ill mother of one of the students. Contact with students was associated with illness. Thirty-eight (33%) of the 115 student-care staff members and none of the 22 nonstudent-care staff members who worked in the two dormitories were ill (p = 0.004, chi-square). In the dormitory with the most dependent students, illness in student-care staff was associated with the number of contacts with ill students and with having taken a student home during the outbreak. Control measures to interrupt transmission included separation of symptomatic or culture-positive students from those who were well, and emphasizing handwashing. The authors present these findings as the first report of person-to-person transmission in an outbreak of enteroinvasive E. coli.

Adolescent↗
PubMed1989

Epidemiologic surveillance for endemic Giardia lamblia infection in Vermont. The roles of waterborne and person-to-person transmission.

The authors studied 1,211 laboratory-confirmed, non-outbreak-related cases of giardiasis in Vermont residents reported through Vermont's laboratory-based active surveillance system between 1983 and 1986. Giardiasis was the most common reportable disease in the state, with an average annual incidence rate of 45.9 cases per 100,000 population per year. This rate is higher than that in other states reporting giardiasis incidence. Morbidity from giardiasis was also significant in that 30% of cases reported symptoms lasting four or more weeks. Waterborne transmission was suggested to be an important cause of non-outbreak-related cases because rates of infection were highest in persons receiving nonfiltered municipal or nonmunicipal residential drinking water. Rates were also higher at higher elevations, where water supplies may be difficult to protect from contamination. In addition, the pattern of age-specific incidence rates and the high estimated incidence of infection in children attending day care suggested that person-to-person transmission also played a role in causing non-outbreak-related cases. Routine surveillance data can serve to indicate likely important routes of transmission of giardiasis in the community.

Adolescent↗
PubMed1996

The Prevention for Elderly Persons (PEP) Program: a model of municipal and academic partnership to meet the needs of older persons for preventive services.

OBJECTIVE: To create a program to identify preventive needs for community-dwelling older persons and incorporate intervention strategies to improve implementation of these services. DESIGN: Program development and case-series. SETTING: Community-based meal sites, academically administered program. PARTICIPANTS: Persons 60 years of age or older attending meal sites and their primary care physicians. MEASUREMENTS: Demographic characteristics, self reported preventive health behaviors and services, blood pressure measurement. RESULTS: During the first 2 years of the program, 927 persons 60 years of age or older were screened. The most common physician-initiated preventive recommendations were: tetanus booster (72%), aspirin prophylaxis (68%), pneumonia vaccination (61%), and colorectal cancer screening (51%). The most common self-care recommendations have been: calcium supplementation (54% of women) and breast self examinations (51% of women). As part of the adherence intervention, we were able to complete health educator calls for 600 (65%) subjects. In addition, the physicians of 599 (65%) subjects were contacted either by telephone (n = 496) or by letter only (n = 97). CONCLUSION: A community based preventive services program can identify large numbers of unmet preventive services needs, and a dual intervention strategy aimed at meeting these needs can be delivered successfully to the majority of participants. Implementation rates of specific recommendations and impacts on health outcomes remain to be determined.

Academic Medical Centers↗
PubMed1994

Relation between infection with Helicobacter pylori and living conditions in childhood: evidence for person to person transmission in early life.

OBJECTIVES: To relate the prevalence of infection with Helicobacter pylori in adults to their living conditions in childhood to identify risk factors for infection. DESIGN: Prevalence study of IgG antibodies to H pylori (> 10 micrograms IgG/ml, determined by enzyme linked immunosorbent assay (ELISA)) and reported living conditions and other socioeconomic factors in childhood. SETTING: Three factories in Stoke on Trent. SUBJECTS: 471 male volunteers aged 18 to 65 years. MAIN OUTCOME MEASURES: Seroprevalence and variables in childhood. RESULTS: Seroprevalence of H pylori increased with age (22/74 (29.7%) at < 30 years v 29/46 (63%) at 55-65 years; P < 0.001 for trend) and was related to manual occupation (14/65 (21.5%) for non-manual v 162/406 (39.9%) for manual; P = 0.003). After data were adjusted for age and occupation subjects from large families, whose childhood homes were crowded or who regularly shared a bed in childhood, were significantly more likely to be seropositive (adjusted odds ratio (95% confidence interval) 2.15 (1.41 to 3.30) for crowding and 2.13 (1.38 to 3.30) for sharing a bed), but there was no relation with possession of a bathroom, inside toilet, refrigerator, or household pets in childhood. CONCLUSIONS: Close person to person contact in childhood is an important determinant of seroprevalence of H pylori in adulthood, suggesting that the infection is transmitted directly from one person to another and may be commonly acquired in early life.

Adolescent↗