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Biomedical subjects

E Boyko

Publications and source records attributed to E Boyko.

6 recordsLinked to original sources
PubMed1987

Binding the elderly: a prospective study of the use of mechanical restraints in an acute care hospital.

Little information exists on the use of mechanical restraints among nonpsychiatric inpatients. This prospective study evaluates their use among consecutive medical and surgical admissions to an acute care hospital. Daily direct observation of patients and hospital record review provided data on potential predictors of restraint, reasons for their application, complications, and outcome. Cox regression analysis was used to calculate relative risk of restraint while adjusting for duration of hospitalization as well as other variables. Restraints were applied to 37 (17%) of the 222 study patients. Restrained patients were eight times more likely to die during hospitalization (24% v 3%; P less than 0.01). Abnormal mental status exam, diagnosis of dementia, surgery, and presence of monitoring and support devices (eg, intravenous lines) were statistically significant independent predictors of restraint. Mechanical restraint is a common occurrence among nonpsychiatric inpatients particularly those with impaired mentation, requirement for surgery, or intensive medical intervention. Identification of medical and surgical patients at risk for restraint may reduce the use of these devices by concentrating surveillance and prevention on this group.

Aged↗
PubMed1986

Health beliefs as predictors of success of alternate modalities of smoking cessation: results of a controlled trial.

The primary objective of this study was to determine whether health beliefs influenced the outcome of the three alternate modalities of reducing cigarette consumption. The study randomized volunteers either to a control group or to one of three cessation programs, using behavior modification, health education, or hypnosis. A questionnaire was used to document health beliefs, demographic characteristics, and smoking history. Blood samples were taken before and after the completion of intervention programs to measure changes in serum thiocyanate. A follow-up questionnaire was used to assess smoking behavior after 6 months. Statistically significant decreases in serum thiocyanate levels followed participation in each of the three programs. Factor analysis and reliability tests were used to identify four scales reflecting major variable dimensions in the health belief model. Significant correlations between change in serum thiocyanate and two of the scales (general health concern and perceived vulnerability) were found only for the group randomly assigned to the health education intervention program.

Adult↗
PubMed1984

A randomized trial comparing smoking cessation programs utilizing behaviour modification, health education or hypnosis.

The purpose of this study was to determine the efficacy of hypnosis, health education, and behaviour modification programs for cigarette smoking cessation. A randomized clinical trial comparing these three programs and a control group was conducted in 168 volunteers. Follow-up data three weeks after completion was available in 140 subjects. Each program showed significant reductions in reported cigarette consumption and serum thiocyanate levels, an indicator of long-term cigarette consumption, compared to entry and to the control group. However, there were no significant differences between the hypnosis, health education, or behaviour modification groups with respect to the proportion who reported quitting smoking, the number cigarettes smoked or change in serum thiocyanate levels. Reported cigarette consumption ascertained six months later again showed no significant differences between these three approaches. Factors such as subject age, age at starting cigarette smoking, educational level, marital status, spouse or partners smoking did not identify subgroups with differences between treatment responses. Thus, hypnosis, health education, and behaviour modification are each effective programs for changing cigarette smoking and each is equally effective in this regard.

Adult↗
PubMedDate not supplied

Changes in high density lipoprotein cholesterol after initiation of insulin therapy in non-insulin dependent diabetes mellitus: relationship to changes in body weight.

To determine the interrelationships of serum lipoproteins and body weight changes with insulin therapy, 55 diabetics (mean age 52.0 +/- 2.2 years), had measurements of body weight, sum of skinfold thickness, fasting serum glucose, serum high density (HDL-C) and low density (LDL-C) lipoprotein cholesterol and serum triglycerides before and 6 weeks after beginning insulin. At entry HDL-C had a significant (p less than 0.05) negative correlation with indices of body weight-body mass index, relative weight and a significant positive correlation with serum triglycerides but no significant association with sum of skinfold thickness, fasting serum glucose or LDL-C. The relationships were seen mainly in patients who previously had not been receiving oral hypoglycemic medications. Insulin significantly increased HDL-C and body weight, and decreased glucose, triglycerides and LDL-C. Changes in HDL-C showed a significant inverse association with changes in triglycerides and direct correlation with changes in body weight, but no significant association with changes in fasting serum glucose or LDL-C. Thus, insulin therapy of diabetes mellitus favorably affects HDL-C concentration perhaps by altering triglyceride metabolism and represents a unique situation where increases in body weight are associated with increases in serum HDL-C concentration.

Body Weight↗
PubMedDate not supplied

A randomized clinical trial comparing behavior modification and individual counseling in the nutritional therapy of non-insulin-dependent diabetes mellitus: comparison of the effect on blood sugar, body weight, and serum lipids.

To determine whether a group behavior modification approach might be preferable to individual counseling in the nutritional therapy of non-insulin-dependent diabetes mellitus, 40 adults younger than 65 yr of age with diabetes mellitus who were not receiving insulin were randomized to either a program of individualized dietary review and recommendations or a program of group meetings aimed at controlling the signals leading to overeating and noncompliance with a diabetic dietary regimen. Statistically significant (P less than 0.05) decreases in body weight, sum skin-fold thickness, fasting serum glucose, and serum triglycerides but not LDL-C or HDL-C were observed. The individual counseling group had a greater amount of weight loss than the behavior modification group. There were no significant (P greater than 0.05) differences between the two groups with respect to the biochemical outcome variables. Patient characteristics assessed at entry--namely anxiety, internal versus external locus of control and perceived disease severity, and compliance with advice--were significantly associated with weight loss in the behavior modification group while only the latter index was of value in the individual counseling group. Thus, our use of these programs does not identify a clear advantage of either approach in the nutritional therapy of non-insulin-dependent diabetic patients.

Adult↗