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H Bryant

Publications and source records attributed to H Bryant.

36 records · Page 2Linked to original sources
PubMed1992

Age as a factor in breast cancer knowledge, attitudes and screening behaviour.

OBJECTIVE: To determine whether there are age-related differences in knowledge, attitudes and behaviour with respect to breast cancer and whether the differences reflect the age-specific Canadian recommendations on breast cancer screening. DESIGN: Telephone survey. SETTING: Two cities and five towns and their surrounding areas in Alberta. PARTICIPANTS: The age-specific, randomly selected sample comprised 1284 women aged 40 to 75 years who did not have breast cancer. Of the 1741 eligible women who were contacted, 1350 (78%) agreed to participate; 66 were excluded because of age ineligibility or a history of breast cancer. MAIN OUTCOME MEASURE: Frequency of knowledge, attitudes and behaviour with respect to breast cancer, by age group. RESULTS: Knowledge of breast cancer risk factors was generally low and decreased with age. Few women were aware of the Canadian recommendations on breast self-examination, physical examination of the breasts by a health care practitioner and mammographic screening. Older women believed they were less susceptible to breast cancer than younger women and were less likely to have positive attitudes toward screening. Self-examination was performed 9 to 15 times per year by 424 women (33%), and 810 (63%) had been examined by a health care professional in the past year. Although 664 (52%) had undergone mammography, the proportion decreased with age after age 59. The main barriers to mammography were lack of physician referral and the woman's belief that the procedure is unnecessary if she is healthy. CONCLUSIONS: Education is needed to increase breast cancer knowledge, promote the Canadian recommendations for early detection of breast cancer and decrease negative beliefs about the disease. Changes in the behaviour of women and physicians are needed to increase the use of breast self-examination, clinical breast examination by a health care professional and mammographic screening. Reaching women in the upper range (60 to 69 years) of the target group for mammographic screening should be a focus in promoting early detection of breast cancer.

Adult↗
PubMed1992

Effect of oral contraceptive use on reoperation following surgery for Crohn's disease.

The influence of oral contraceptive (OCP) use as a risk factor for the development of Crohn's disease is disputed. We wished to determine if OCP use affected the risk of recurrence (defined as need for a second surgery) in women who had already undergone a resection for Crohn's disease. We hypothesized that if contraceptive use was a risk factor for disease development, it could influence recurrence. Using a mail questionnaire, we surveyed 138 women regarding their OCP use following surgery for Crohn's disease. All participants were between ages 16 and 35 at the time of their initial surgery which occurred between 1966 and 1984. Ninety-seven women (70%) responded. Mean follow-up was 9.9 years (range 4-27). Forty-six women required a second surgery. The recurrence rate as determined by actuarial analysis, was 27.2% (95% confidence intervals (CI95 16.5-38.1) and 58.0% (CI95 37.8-78.2) at 5 and 10 years, respectively. Thirty-two women took OCP in the first year following surgery. Eleven OCP users (34.4%) required additional surgery compared to 34 (53.1%) of nonusers. Using life table analysis, the percentage requiring a second surgery was 25.0% (CI95 6.9-43.1) and 40.7% (CI95 1.5-80%) at 5 and 10 years, respectively, for users compared to 28.4% (CI95 6.9-43.1) and 64.0% (CI95 40.5-87.5) for nonusers (Lee Desu, P greater than 0.05). When surveyed about their reasons for using OCP, most women stated that their disease did not affect their decision to use contraceptives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Breast cancer screening attitudes and behaviors of rural and urban women.

This study was carried out to assess the breast cancer knowledge, attitudes, and awareness of women age 40 to 74 in Alberta, a Canadian province of 2.4 million people. This analysis compares the attributes of 538 rural women, defined as those living between 1 and 3 hr drive from the major cities in Alberta, and 735 urban women who lived in one of these two cities. Rural women were found to have the same basic knowledge of breast cancer or perceptions of barriers to mammography, but had more negative attitudes about breast cancer itself. Despite their similar access to physician care, they were less likely to have had a recent clinical breast examination or mammogram (P less than 0.001). These differences remained when adjustment was made for demographic background variables; the adjusted prevalence rate ratio for a screening mammogram in the past 2 years was 0.52 (95% C.I., 0.43, 0.64), and for intention to have a mammogram in the next 2 years, 0.75 (0.63, 0.90). The results suggest particular program delivery strategies when planning for provision of breast screening information and service to the large subgroup of rural women.

Adult↗
PubMed1992

Prolactin and prolactin secretagogues reverse immunosuppression in mice treated with cysteamine, glucocorticoids, or cyclosporin-A.

Suppression of prolactin (PRL) secretion with the dopamine agonist, bromocriptine, has been shown in rodents to diminish a variety of immunologic responses, including delayed type hypersensitivity, primary antibody response, T-cell dependent macrophage activation, and ex vivo T- and B-lymphocyte proliferation in response to mitogens. These same responses can be suppressed by endogenous or exogenous glucocorticosteroids and, in large measure, the immunosuppressant peptide cyclosporin A. The sulfhydryl reducing agent cysteamine (2-aminoethanethiol) is known to reduce pituitary and plasma prolactin levels. Treatment of mice with cysteamine at doses which suppressed circulating PRL levels resulted in suppression of ex vivo blastogenic responses of lymphocytes from treated mice. The T-cell-dependent primary IgM response to immunization with sheep red blood cells was also suppressed by cysteamine treatment. Treatment of mice with drugs stimulating the release of endogenous PRL, or with exogenous ovine PRL, was found to antagonize the suppression of lymphocyte proliferative responses to mitogens induced in mice by glucocorticoid or cyclosporin treatment. These data suggest that many drugs in common clinical use could have potential immunomodulatory actions due to suppression or stimulation of pituitary PRL secretion. Furthermore, lactogenic hormones appear to exert counterregulatory actions which may modify glucocorticosteroid actions on immune and other target issues.

Adrenocorticotropic Hormone↗
PubMed1992

Restoration of juvenile baseline growth hormone secretion with preservation of the ultradian growth hormone rhythm by continuous delivery of growth hormone-releasing factor.

The ability of continuously delivered GH-releasing factor (GRF) to enhance GH secretion while maintaining the normal ultradian GH rhythm was investigated. Synthetic human GH-releasing factor (hGRF(1-44)NH2) was continuously infused for 4 days by means of i.v. catheters to 11-week-old broiler chickens. At this age, overall endogenous GH secretion is low, and baseline GH is barely detectable. Six birds per treatment received vehicle (control), 0.324 mg hGRF(1-44)NH2/kg body weight per day (low dose) or 3.24 mg hGRF(1-44)NH2/kg body weight per day (high dose). After 4 days of GRF conditioning, concurrent with continued GRF infusion, serial blood samples were removed via atrial catheters at 15-min intervals for 6 h and GH plasma profiles determined. High dose GRF significantly increased GH plasma concentrations over tenfold compared with controls; however, most of this increase reflected an increase in basal GH, which was reinstated to juvenile baseline levels. Augmentation of pulse amplitude above this increased baseline was not proportionately as high, and failed to reach juvenile levels. The ultradian rhythm of GH was not altered by continuous GRF administration. Both low and high dose GRF treatments resulted in significant enlargement of the anterior pituitary gland. Total pituitary GH mRNA levels, although elevated over twofold by GRF treatment, were not significantly different from controls. Measures of plasma GH magnitude (overall and baseline mean, and peak amplitude) were significantly correlated with pituitary GH mRNA for control birds, but were not correlated for GRF treatments. Feed intake was markedly depressed (33%) on the high dose GRF treatment, in conjunction with total inhibition of body weight gain over the 4-day period of administration. Longitudinal bone growth and width of the epiphyseal growth plate were also significantly reduced by high dose GRF treatment, probably reflecting the reduced level of nutrient intake, despite high circulating concentrations of GH.

Animals↗
PubMed1990

Effect of cigarette smoking on recurrence of Crohn's disease.

The effect of cigarette smoking on recurrence (defined in this study as the need for repeat surgery) in patients who had previously required surgery for Crohn's disease was assessed in a historical cohort of 174 patients. Mean follow-up was 10.8 yr. The 5- and 10-yr recurrence rates were 28% and 56%, respectively. Five- and 10-yr rates were significantly different for smokers (36%, 70%) and nonsmokers (20%, 41%). When patients were stratified by gender, the increased risk was more apparent in women (odds ratio 4.2, 95% confidence interval 2.0-4.2) than in men (odds ratio 1.5, 95% confidence interval 0.8-6.0). Evidence for a dose-response relationship could be identified in women but not men. Cigarette smoking may not only be a risk factor for development of Crohn's disease but also may influence disease activity following surgery.

Alberta↗
PubMed1990

Major changes in medical careers following medical school graduation: when, how often, and why.

Knowledge of the timing of, reasons for, and frequency of major medical-career changes of medical school graduates is useful in considering physician manpower needs. This study reports aspects of the medical-career changes made by a cohort of Alberta medical school graduates who graduated from 1973-1985. Of the 603 (81%) who participated, 160 (27%) reported major medical career changes. Significantly more specialists (35%) than family physicians (18%) made major changes. Forty-two percent made changes during the first year of residency, 21% later in residency, and 29% after entering practice. Reasons cited included general dissatisfaction (47%), lifestyle compatibility (24%), and training and practice experiences (19%). This study indicates that while personal needs and preferences influence changes during residency, practice experience is also important to career choices.

Canada↗
PubMed1989

Nail disorders due to trauma and other acquired conditions of the nail.

Physical and chemical trauma to nails may lead to damage, which presents as various conditions. At times the deformity will imitate systemic disorders or cutaneous diseases. Nail cosmetics and footwear are examples of exogenous factors that can cause such deformity if improperly used. Direct and self-inflicted trauma cause injuries as minor as temporary bands or as severe as permanent nail loss. Prompt treatment can prevent long-term cosmetic and functional damage.

Humans↗
PubMed1980

An evaluation of the clinical problem-solving process using a simulation technique.

Currently, research does not agree as to the extent to which medical content and problem-solving processes underlie clinical problem-solving. The results of research in this area fall into two categories: (1) clinical problem-solving is primarily dependent upon medical content specific within the case, and (2) clinical problem-solving is a skill, or series of skills, which can be applied to all clinical problems. In the study reported in this paper, seventy-one second-year medical students who had completed a 2-year, body-systems oriented curriculum were given an examination designed to measure clinical problem-solving. The results indicated that gathering data on patient history and hypotheses generation were specific skills common to clinical problem-solving, while hypotheses refinement, identification of relevant physical examinations, ordering laboratory investigations and making a diagnosis were case-related.

Clinical Competence↗
PubMedDate not supplied

Nursing knowledge and use of restraint alternatives: acute and chronic care.

This descriptive study compares the types of restraints and alternatives to restraints used by nurses in the acute and chronic care setting. Significant results showed that chronic care nurses used fewer restraints and more alternatives than nurses in acute care. It is suggested by the findings stated above that the need is significant for additional and continued education in the acute care setting regarding restraints and alternatives to restraints.

Acute Disease↗
PubMedDate not supplied

Breast cancer screening in Canada: climbing the diffusion curve.

Results of breast cancer screening studies, which point to the efficacy of screening mammography in the 50 to 69 year age group, have been available for several years. A number of initiatives are underway in Canada in an attempt to assure that the diffusion for this technology occurs consistently and rapidly. This paper outlines the initiative of the Canadian Workshop Group of Breast Cancer Screening, which convened in 1988, as well as other national initiatives in this area. In addition, it describes the experience of one screening program in assessing and acting upon shortcomings in screening diffusion in its own province. Specifically, the use of letters of invitation, community mobilization, and mobile service delivery are briefly outlined. This illustrates the use of outcome-based research and programmatic service delivery in assisting the diffusion effort.

Aged↗