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Biomedical subjects

B Higgins

Publications and source records attributed to B Higgins.

At least 55 records · Page 3Linked to original sources
PubMed1997

Differences between treatment seekers in an obese population: medical intervention vs. dietary restriction.

This study examined two groups of people who were pursuing treatment for obesity: either medical intervention (a hospital group; N = 20) or support for dietary restriction (a community group; N = 18). This study addressed four questions: (1) Were there differences between the two groups in terms of their psychological distress (as measured by the Symptom Checklist)? (2) Does binge eating moderate psychological distress? (3) Do feelings of ineffectiveness moderate psychological distress? and (4) Which variables best accounted for group membership (i.e., type of treatment sought)? Results suggested that the hospital group was significantly more distressed than the community group. However, there were no differences between the two groups with respect to binge eating or feelings of ineffectiveness. These findings suggest that it is the effects of morbid obesity that are most likely to moderate psychological distress.

Adult↗
PubMed1997

The effects of smoking on labour after uncomplicated pregnancy: a comparison between the progress and outcome of labour in 400 smokers and 400 matched non-smokers.

A comparison was made between the progress of labour and its outcome after an uncomplicated pregnancy, in 400 smokers and 400 non-smokers. Strict selection criteria were applied to eliminate, as far as possible, the variables which might have influenced labour in both groups and to ensure that the two groups of women were matched. The duration of labour was longer in smokers, who also had a higher incidence of caesarean sections. Smokers had a higher incidence of retained placenta and postpartum haemorrhage. The neonates of smokers had a higher incidence of problems in the immediate post-delivery period.

Journal Article↗
PubMed1996

An evaluation of the POSSUM surgical scoring system.

POSSUM (Physiological and Operative Severity Score for the enUmeration of Morbidity and mortality) has been studied as a possible surgical audit system for a 9-month interval using a sample of 28 per cent of the general surgical workload. Mortality or survival was analysed as an endpoint. In this sample the published POSSUM predictor equation for mortality overpredicted deaths by a factor of more than two. The bulk of the overprediction occurred in the group at lowest risk (predicted mortality 10 per cent or less), in which death was overpredicted by a factor of six. This is the most important group for audit purposes since it contains the majority of surgical patients and is composed of fit patients undergoing minor surgery. The published predictor equation for mortality returns a minimum predicted mortality of 1.08 per cent, clearly far higher than that expected for a fit patient having minor surgery. Logistic regression was done on a set of 1485 surgical episodes to generate a local predictor equation for mortality. This process gave a predictor equation that fitted well with the observed mortality rate and gave a minimum predicted risk of mortality of 0.20 per cent. The previously published POSSUM predictor equation for mortality performed badly when tested using a standard test of goodness of fit for logistic regression and must be modified.

England↗
PubMed1996

Levels of dissociation in detoxified substance abusers and their relationship to chronicity of alcohol and drug use.

This study compared the frequency and types of dissociative experiences reported by detoxified alcoholics and drug abusers, and examined the relationship between dissociation and recent and lifetime use of alcohol, cannabis, cocaine, and heroin. One hundred thirty-eight self-referred male veterans detoxified from alcohol (N=62) and drugs (N=76) on inpatient units at a Veterans Affairs hospital completed questionnaires including the Dissociative Experiences Scale. Three types of dissociative experiences were examined: amnesia, depersonalization/derealization, and absorption. Ninety-one of the patients were also given the Addiction Severity Index interview to determine their histories of recent (past 30 days) and lifetime drug and alcohol use. High levels of dissociation were found in both groups, with alcoholics reporting higher levels of all three types of dissociative experiences than drug addicts. Chronicity (lifetime years) of both alcohol and cocaine use was significantly correlated with dissociation scores. The amnestic effect of chronic cocaine use persisted even after controlling for the effects of chronic alcohol use. In contrast, no dissociative effects of recent (past month) use of alcohol or drugs were found. These findings suggest that dissociation may be a chronic residual effect of long-term substance abuse, including both alcohol and cocaine. Implications are discussed for the treatment of chronic substance abusers.

Adult↗
PubMed1996

Caring as therapeutic in nursing education.

Caring outcomes in practice depend on a caring teaching-learning process. A transformation in thinking and practice in nursing education, that is congruent with the values of caring is essential to develop the kind of nurses that are needed in today's health care system. A project to implement caring as a nursing therapeutic with associate degree nursing students was initiated in a community college of Western New York in the fall of 1993. Watson's carative factors (1988) and Carper's ways of knowing (1978) were utilized as a framework to develop caring strategies to awaken a caring-consciousness among the students. The goals of the project were to provide a caring space for students to dialogue and share their stories and to experience themselves as caring and cared for; and to value and practice caring by implementing creative, knowledgeable, intentional actions for the ultimate good of the patient.

Curriculum↗
PubMed1995

Escherichia coli O157:H7 restriction pattern recognition by artificial neural network.

An artificial neural network model for the recognition of Escherichia coli O157:H7 restriction patterns was designed. In the training phase, images of two classes of E. coli isolates (O157:H7 and non-O157:H7) were digitized and transmitted to the neural network. The system was then tested for recognition of images not included in the training set. Promising results were achieved with the designed network configuration, providing a basis for further study. This application of a new generation of computation technology serves as an example of its usefulness in microbiology.

Animals↗
PubMed1993

The use of consumer-satisfaction surveys by an air medical program.

Surveys were distributed to referring and receiving hospitals or to EMS agencies that used the air medical service. The respondents were asked to evaluate the dispatcher's, pilot's and flight crew's professionalism and courteousness on a Likert scale and through written comments. Phase 1 of the survey distribution was discontinued after problems were encountered due to the distribution process. Phase 2 consisted of the air medical program mailing surveys directly to the referring and receiving facilities or to the EMS agencies. In terms of courteousness and professionalism, 90% of the respondents' answers fell within the strongly agree to neutral range. Questions regarding pilots and dispatchers were often left unanswered. Two areas were identified as needing further work on the part of the medical flight crew: follow-up with referring hospitals on patient outcome and identification of flight physicians vs. flight nurses.

Aircraft↗
PubMed1990

Do psychosocial factors predict weight loss following gastric surgery for obesity?

This study was undertaken to determine whether psychosocial factors determined during a pre-operative semi-structured psychiatric interview were associated either with the amount of weight loss following obesity surgery or with dropping out from follow-up after surgery. Multiple regression and discriminant function analysis of weight loss at six, twelve, twenty four and thirty six months showed no correlation between psychosocial variables and the amount of weight lost or with dropping out from follow-up. It is concluded that the type of psychiatric interview performed in this study does not yield information which reliably predicts weight loss after surgery for obesity.

Adaptation, Psychological↗
PubMed1990

Air transport of the trauma patient.

Flight nursing is a rapidly growing field in critical care nursing. An understanding of the types of trauma patients that warrant helicopter transport is important to any well functioning trauma system. The assessments and interventions necessary in transporting trauma patients are addressed. Safety, environmental, and psychosocial issues that surround the use of air transport are discussed.

Adult↗
PubMed1989

The effect of testosterone replacement on plasma lipids and apolipoproteins.

Ten men with Klinefelter's syndrome were studied to assess the effect of testosterone replacement on plasma lipids and apolipoproteins. Measurements taken before the insertion of a testosterone ester implant were compared with those obtained 1 week and 4 weeks later. Mean plasma testosterone, androstenedione, total cholesterol and calculated LDL-cholesterol increased significantly after 1 and 4 weeks. No significant changes were seen in total plasma concentrations of HDL-cholesterol, HDL-cholesterol subfractions 2 and 3 or in apoplipoproteins A-I, A-II or B. A significant correlation was seen between total cholesterol and plasma oestradiol concentrations (Rs = 0.61; P less than 0.001). A significant negative correlation was seen between the concentrations of total testosterone and total triglyceride (Rs = -0.56; P less than 0.005) but not with the other lipid parameters. Testosterone replacement is associated with slight but potentially adverse changes in plasma cholesterol levels.

Adult↗
PubMed1988

The muskrat in biomedical research.

Muskrats are aquatic rodents of moderate size which are plentiful throughout North America, but are not used commonly in the laboratory. Recently, we tested the feasibility of muskrats as experimental models and have found them to be acquired and cared for easily in conventional laboratory animal facilities. Some of their natural characteristics and diseases are described. The husbandry techniques that we used are presented and form a base for the preparation of future guidelines for the maintenance and use of feral animals in research. The results of some initial experiments testing the muskrat's utility for investigations of cardiorespiratory control mechanisms also are presented. Our data show that even anesthetized muskrats possess brisk and dramatic cardiovascular and respiratory reflexes. Our findings that their brains possess the cytoarchitectural and myeloarchitectural features comparable to other mammals, combined with their relative uniformity in size, has allowed us to locate specific neuronal loci stereotaxically. We suggest that the muskrat be considered as an experimental animal model for studies of the neural control of cardiorespiratory systems.

Animals↗
PubMed1987

Recent changes in antibiotic prophylactic measures taken by dentists against infective endocarditis.

In 1985 dentists in the Lothian Region of Scotland were questioned about their use of prophylactic antibiotics for patients at risk of developing infective endocarditis. Replies were compared with those obtained from a similar survey in 1981. The results showed a marked change in practice with widespread adoption of the single-dose oral amoxycillin regimen; this was the regimen of choice for 63% of general dental practitioners. For patients allergic to penicillin 76% of practitioners used erythromycin and there was a decline in the use of tetracycline and clindamycin. The adoption of amoxycillin reflects the ease of compliance with a simple single-dose regimen. This change has produced a striking improvement in the timing of prophylactic antibiotic therapy.

Amoxicillin↗
PubMed1986

Corticosteroids and bone mass in asthma: comparisons with rheumatoid arthritis and polymyalgia rheumatica.

Bone mass has previously been shown to be reduced at peripheral bone sites in patients with bronchial asthma receiving corticosteroids. To assess whether total bone mass is reduced in asthma total body calcium was measured by in vivo neutron activation analysis in patients receiving various treatments for asthma and compared with results from normal controls and patients with rheumatoid arthritis and polymyalgia rheumatica. Compared with controls total body calcium was reduced by 13.6% (p less than 0.001) in patients with asthma receiving daily oral corticosteroids but by only 9.0% (p less than 0.005) in a similar group of patients who had received oral calcium supplements at the start of their corticosteroid treatment. Total body calcium was also reduced in a group of patients receiving only inhaled corticosteroids (8.8%; p less than 0.001) but not significantly reduced in a small group of patients with asthma who had never received these drugs. When compared with controls a group of patients matched for age and for dose of corticosteroids given for rheumatoid arthritis had a similar reduction in total body calcium to the patients with asthma receiving daily oral treatment (17.7%; p less than 0.001), but no such reduction was shown in patients with polymyalgia rheumatica. These findings suggest that the risk of bone loss with low dose oral corticosteroids in similar in asthma and rheumatoid arthritis. Further work is required to assess the clinical relevance of small losses of bone associated with the use of inhaled corticosteroids.

Administration, Oral↗
PubMed1986

Assisted ventilation in severe acute asthma.

During the period 1973-85 assisted ventilation was used for the treatment of severe asthma on 48 occasions in 18 patients (one patient was ventilated 29 times). On each occasion arterial blood gas abnormalities were restored to normal as quickly as possible irrespective of peak inflation pressures. One patient was thought to be brain dead on transfer from another hospital but was ventilated for 48 hours while this diagnosis was confirmed. There was one episode of mediastinal emphysema. There were no other complications apart from transient hypotension (blood pressure less than 100/60 mm Hg), which occurred on 17 occasions but did not have any sequelae. There was no relationship between hypotension and inflation pressure but there was an association between hypotension and rate of fall of arterial carbon dioxide tension. It is concluded that the risks of barotrauma during the ventilation of patients with severe asthma are theoretical or extremely small. Rapid correction of respiratory acidosis abolishes hypercapnic respiratory drive, allowing ventilation without use of muscle relaxants. It may also enable a shorter duration of ventilation, thus decreasing the likelihood of complications.

Acute Disease↗