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Biomedical subjects

D Lippman

Publications and source records attributed to D Lippman.

10 recordsLinked to original sources

Role-modeling experience improves nursing students' attitudes toward people living with AIDS.

Two groups of student nurses were given on AIDS Knowledge/Attitudes survey before different clinical experiences. Group One worked with nurses experienced in the care of persons living with AIDS (PLWA) on a high-acuity unit with many AIDS patients. The other group were precepted on a acute-care unit with no AIDS patients. Outcomes measures revealed significantly better student attitude scores for Group One on scales measuring (1) avoidance intentions to working with PLWA and (2) attitude toward homosexuals.

Acquired Immunodeficiency Syndrome↗

Food intake and energy expenditure of male and female farmers from Upper-Volta.

1. The energy balance of eleven male and fourteen female adult farmers was measured for 6 d after the harvest, in December-January. Their energy intake was recorded by weighing their food consumption and their energy expenditure was determined using indirect calorimetry. 2. Body-weight, expressed as percentage of expected weight-for-height was 91 and 86% of the Inter-departmental Committee on Nutrition for National Development (1963) standard for women and men respectively. 3. The staple foods were sorghum (Sorghum vulgare) and millet (Pennisetum typhoïdes); carbohydrates, fat and protein supplied approximately 80, 13 and 12% of the total energy of the diet respectively. 4. In the male group, the mean energy intake (9.0 MJ (2148 kcal)) was in good agreement with the average energy output (8.91 MJ (2130 kcal)). By contrast, in the female group, the mean energy expenditure (8.11 MJ (1941 kcal)) exceeded the mean energy intake (6.3 MJ (1515 kcal)) and the deficit was statistically significant. 5. This study allows an evaluation of the adequacy of food intake for subjects living in a particular hostile environment, by using their actual energy output instead of current standard values. The energy deficit found for female farmers whose energy intake was similar to that reported in other developing countries emphasizes the need for a better understanding of the regulation of energy balance in such conditions.

Activities of Daily Living↗

Plasma growth hormone: effect of anxiety during flooding in vivo.

The treatment of phobias by rapid in vivo exposure to the feared situation was accompanied by an increase in plasma growth hormone levels on at least one of two occasions in 8 of 11 subjects. The average growth hormone response was greater on the second occasion, even though subjective anxiety was less. Plasma growth hormone was not elevated during the subjects' adaptation to the laboratory. Strong subjective and behavioral anxiety responses failed to elevate plasma growth hormone levels in some subjects. The probability of a growth hormone response was the same whether or not baseline levels were elevated prior to exposure.

Adult↗

Anxiety and plasma cortisol at the crest of the circadian cycle:reappraisal of a classical hypothesis.

Near-maximal anxiety by subjective and behavioral criteria was evoked and terminated in phobic patients by initiation and termination of rapid live confrontation ("flooding in vivo") with the specific stimulus that each avoided, at a time approximating the crest of the circadian cycle of adrenal cortical function. The procedure was associated with moderate, but not marked, elevations of plasma cortisol above control levels in some, but not all, subjects. Differences in anxiety levels as self-rated by the patients did not account for differences in cortisol response. The findings should stimulate further reevaluation of the hypothesis that affective arousal is the key psychological determinant of adrenal cortical function. Dissociation between subjective-behavioral arousal and plasma cortisol during flooding may be a manifestation of what behavior therapists call "desynchrony of fear."

Adult↗

"Flooding in vivo" during the circadian phase of minimal cortisol secretion: anxiety and therapeutic success without adrenal cortical activation.

Seven patients with maximally severe phobias for physical objects were treated by "flooding in vivo", i.e. live confrontation with the feared object. Each reported to the laboratory for 3 hr on five separate occasions, all in the early evening during the circadian phase of minimal adrenal cortical activity. At 20-min intervals during each session, blood was taken for cortisol assay, and anxiety was self-rated on a scale of 0 to 100. Treatment was carried out during the 2nd hr of the third and fourth sessions. The remaining time provided control observations. By behavioral and subjective criteria, the treatment hours produced very intense anxiety. However, they failed to evaluate plasma cortisol levels. The remission of the phobias was 100%. Anxiety, even when intense and dramatic, does not necessarily activate the adrenal cortex, and an adrenal "stress" response is not necessary for the therapeutic effect.

Adrenal Cortex↗