Biomedical subjects

J M Holden

Publications and source records attributed to J M Holden.

At least 19 recordsLinked to original sources

PubMed2001

Enhancing personal wellness in counselor trainees using biofeedback: an exploratory study.

The purpose of this study was to explore whether biofeedback-assisted relaxation training could reduce stress-related symptoms and enhance personal well-being in a group of counselor trainees enrolled in a basic counseling skills course. Treatment participants received ten sessions of weekly biofeedback-assisted relaxation training, whereas the control participants received no intervention. The treatment group showed, significant improvements in several symptom areas measured by the Symptom Checklist 90-Revised: physical complaints (Somatization), personal inadequacy (Interpersonal Sensitivity), confused thinking or alienation or both (Psychoticism), and the overall number and severity of symptoms (Global Severity Index and Positive Symptom Total). The control participants showed no significant improvements in any symptom areas. Biofeedback-assisted relaxation was shown to be an effective stress-reducing intervention for counselor trainees, which resulted in a greater sense of personal well-being.

Adult↗

PubMed1996

Isolation of presumptive Streptobacillus moniliformis from abscesses associated with the female genital tract.

We report three cases in which Streptobacillus moniliformis was isolated from abscesses. Abscess material in each case contained small, pleomorphic, gram-negative to gram-variable bacilli. Anaerobic blood agar cultures yielded pinpoint colonies adjacent to small gray-white colonies. The pinpoint colonies did not gram stain, and the gray-white colonies varied from gram-variable coccobacilli to long, curly, gram-variable rods. The pinpoint colonies microscopically resembled L-forms on Dienes-stained agar preparation. Subculture to serum-supplemented thioglycolate broth demonstrated "puff ball" colonies. Fatty acid profiles obtained with use of gas chromatography coupled with mass spectrometry showed major peaks for C16:0, C18:2, C18:1, and C18:0 fatty acids, a profile characteristic of S. moniliformis. Results of biochemical testing of each isolate were equivocal. S. moniliformis, bacterial L-forms, and common isolates from genital tract abscesses are discussed.

Abscess↗

PubMed1996

Expert systems for the evaluation of data quality for establishing the Recommended Dietary Allowances.

In view of the important role that nutrient intake assessments play in establishing the Recommended Dietary Allowances (RDAs), the quality of food composition data must be assured for accuracy and representativeness. Assurance of data quality requires the definition of critical parameters in the data generation process and the evaluation of specific data for foods and components according to these parameters. An expert systems approach for evaluating the quality of analytical data has been developed by scientists at the Beltsville Human Nutrition Research Center to determine the quality of food composition data for five parameters: sampling plan, sample handling, number of samples, analytical method and analytical quality control. A rating scale for each parameter was developed with 0 representing poor or inadequately documented data and 3 representing optimal data. Specific criteria for each parameter and rating have been developed and incorporated into expert systems software to facilitate the objective assignment of ratings for each data source by the reviewer. After all ratings for a specific food-nutrient combination are assigned, the system calculates a composite score called the "confidence code" which indicates to the user the relative level of confidence in the data. By identifying and rating the important steps in the data generation process, one can begin to partition the possible sources of error or variability in the process. Limitation of the data set relative to specific purposes (e.g., setting the RDAs) can be identified. The evaluation process can provide the basis for focussed research to improve the most critical areas of the data generation process. A similar process could be established to evaluate the quality of analytical data for clinical measurements used to establish the RDAs.

Documentation↗

PubMed1996

Use of selenium concentration in whole blood, serum, toenails, or urine as a surrogate measure of selenium intake.

We examined the validity of using the selenium level in a single biological specimen as a surrogate measure of usual intake. We used data from 77 free-living adults from South Dakota and Wyoming. Subjects provided multiple 1-day duplicate-plate food composites, repeated specimens of blood and toenails, and 24-hour urine collections. We developed a statistical calibration method that incorporated measurement error correction to analyze the data. The Pearson correlation coefficients between selenium intake and a single selenium status measure, after deattenuation to adjust for the effect of within-person variation in intake, were: 0.78 for whole blood, 0.74 for serum, 0.67 for toenails, and 0.86 for urine. We present formulas to estimate the intake of individuals, based on selenium levels in a single specimen of blood, toenails, or urine. In these data, the concentration of selenium in a single specimen of whole blood, serum, or toenails served reasonably well as a measure for ranking subjects according to long-term selenium intake but provided only a rough estimate of intake for each subject.

Adult↗

PubMed1995

Food sampling strategies for energy intake estimates.

Current interest in the relation of diet to the maintenance of good health has stimulated the demand for food composition data. Values for energy, nutrients, and other food-based components are required to calculate intake, to provide an adequate food supply, to formulate and label new products, and to facilitate trade. The US Department of Agriculture National Nutrient Databank serves as the foundation for food composition databases used by the food industry, government agencies, and academia for these activities. To be accurate, a specific estimate in a database must be statistically representative of the universe of all values for a component in a food. Statistically based sampling strategies must be developed to identify and select appropriate units of specific foods for analysis. The determination of energy values for foods is a unique challenge for food sampling because energy values are calculated from values for total fat, protein, and carbohydrate fractions. To establish priorities for sampling, food consumption data can be used to rank the primary contributors of energy for the population of interest. Demographic and marketing data for foods can be used to identify specific products and locations for sampling. Users of food composition data should question the quality and representativeness of estimates for energy, including estimates for total fat, protein, and carbohydrate to be used for their applications.

Databases, Factual↗

PubMed1994

Relationship between dietary intake and plasma concentrations of carotenoids in premenopausal women: application of the USDA-NCI carotenoid food-composition database.

The diet-plasma relationships for carotenoids were examined in a group of 98 nonsmoking premenopausal women who participated in the cross-sectional phase of the National Cancer Institute (NCI)-US Department of Agriculture (USDA) diet study on alcohol-hormone metabolism, 1988-90. With use of the newly developed USDA-NCI carotenoid food-composition database, the mean daily intakes of carotenoids were significantly higher when estimated from the food-frequency questionnaire (FFQ) than from the 7-d diet records. Lycopene (mean = 0.58 mmol/L), lutein plus zeaxanthin (mean = 0.46 mmol/L), and beta-carotene (mean = 0.34 mmol/L) were the major plasma carotenoids. After adjustment for body mass index, energy and alcohol intakes, and total plasma cholesterol concentration, the following significant correlation (P < 0.05) were observed between the diet record and the FFQ-estimated carotenoid intakes and their respective plasma concentrations: alpha-carotene (r = 0.58 vs 0.49), beta-carotene (r = 0.51 vs 0.49), beta-cryptoxanthin (r = 0.49 vs 0.36), lutein plus zeaxanthin (r = 0.31 vs 0.37), lycopene (r = 0.50 vs 0.26), and total carotenoids (r = 0.57 vs 0.49). These data indicate that plasma carotenoid concentrations are reflective of dietary intake, but the magnitude of the correlation varies depending on the specific carotenoid and on the dietary assessment tool.

Adult↗

PubMed1993

Carotenoid content of fruits and vegetables: an evaluation of analytic data.

The test of the association between dietary intake of specific carotenoids and disease incidence requires the availability of accurate and current food composition data for individual carotenoids. To generate a carotenoid database, an artificial intelligence system was developed to evaluate data for carotenoid content of food in five general categories, namely, number of samples, analytic method, sample handling, sampling plan, and analytic quality control. Within these categories, criteria have been created to rate analytic data for beta-carotene, alpha-carotene, lutein, lycopene, and beta-cryptoxanthin in fruits and vegetables. These carotenoids are also found in human blood. Following the evaluation of data, acceptable values for each carotenoid in the foods were combined to generate a database of 120 foods. The database includes the food description; median, minimum, and maximum values for the specific carotenoids in each food; the number of acceptable values and their references; and a confidence code, which is an indicator of the reliability of a specific carotenoid value for a food. The carotenoid database can be used to estimate the intake of specific carotenoids in order to examine the association between dietary carotenoids and disease incidence.

Carotenoids↗

PubMed1993

The development and application of a carotenoid database for fruits, vegetables, and selected multicomponent foods.

A carotenoid database for individual and multicomponent foods has been compiled that contains values for the five most common carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein) in 2,458 fruits, vegetables, and multicomponent foods containing fruits and vegetables. The database was used to estimate intakes of specific carotenoids for 19- to 50-year-old women (n = 1,102), using food consumption data obtained from dietary recalls in the US Department of Agriculture Continuing Survey of Food Intake by Individuals, 1986. The major contributors of alpha-carotene were carrots consumed as a single food or as an ingredient in multicomponent foods. Carrots, cantaloupe, and broccoli were the main sources of beta-carotene. Orange juices and blends, oranges, and tangerines were important contributors of beta-cryptoxanthin. Tomatoes and tomato products consumed as single foods or as ingredients in multicomponent foods provided most of the dietary lycopene. Contributors of lutein + zeaxanthin included collard, mustard, or turnip greens; spinach; and broccoli. The per capita consumption of total carotenoids (the sum of the five specific carotenoids) among these women was approximately 6 mg/day.

Adult↗

PubMed1993

A trainer's perspective of an innovative programme teaching health visitors about the detection, treatment and prevention of postnatal depression.

Health visitors in North Staffordshire, Edinburgh and Lewisham were given the opportunity to participate in a training programme in the detection, treatment and prevention of postnatal depression, based on previously reported successful intervention strategies. They were trained in the use of the Edinburgh Postnatal Depression Scale (EPDS), and given information about the value and practice of non-directive counselling and about preventative strategies. Knowledge acquisition was evaluation by self-report questionnaires given before and after training. The health visitors were encouraged to screen postnatal women at three specified times using the EPDS and to offer non-directive counselling to women who obtained high scores. A baseline measure of the incidence of postnatal depression was obtained by asking health visitors to give an EPDS form to all women in their caseload with a 6-month-old baby before training commenced. A comparison of the number of women with high EPDS scores at 6 months postnatally, before and after training, showed that participation in the programme enabled health visitors to positively influence the emotional well-being of postnatal women. These results have implications for the role of health visitors which is currently being challenged, as well as for components of their training and continuing professional development.

Community Health Nursing↗

PubMed1993

Risk management in hypnotic recall of near-death experiences.

A substantial number of people facing physical and/or psychological crisis report having a near-death experience (NDE) involving a subjectively real experience of an alternate reality. Where NDE content is associated with positive emotions, benefit might be gained by hypnotic recall of the NDE, yet such recall might involve possible risk in the form of reactivation of the original crisis. In this article we describe a study involving hypnotic recall of positive NDEs by one male and five female subjects. We describe in detail some procedures to minimize risk, including a hypnosis protocol.

Adult↗

PubMed1993

The correlation between two dietary assessments of carotenoid intake and plasma carotenoid concentrations: application of a carotenoid food-composition database.

A newly available carotenoid food-composition database providing specific carotenoid values for > 2300 foods was linked to dietary data on 57 male nonsmokers to examine the association between dietary carotenoid intake and plasma carotenoid concentrations over 3 wk when free-living. Carotenoid intake was estimated from a food-frequency questionnaire (FFQ) and 7 d of food diaries with concurrent analysis of plasma carotenoid concentrations. After adjustment for energy intake, percentage of energy from alcohol, and plasma lipid concentrations, significant diet-plasma correlations for the FFQ and the food diaries (FD) included alpha-carotene (r = 0.29 and 0.43), beta-carotene (r = 0.36 FFQ only), beta-cryptoxanthin (r = 0.46 and 0.44), lutein (r = 0.44 FD only), and lycopene (r = 0.53 FD only). Dietary carotenoid intakes were associated with plasma carotenoid concentrations for all the carotenoids except for beta-carotene when food diaries were used whereas the diet-plasma correlation for the provitamin A carotenoids were consistently significant when the FFQ was used.

Adult↗

PubMed1993

The reproducibility and validity of a self-administered semiquantitative food frequency questionnaire in subjects from South Dakota and Wyoming.

Most validation studies of food frequency questionnaires have been done in populations capable of reporting their diet with unusual accuracy. In this study of ranchers and subjects selected at random, we compared nutrient intakes as assessed with multiple diet records with those assessed with a self-administered food frequency questionnaire (the Harvard-Willett instrument with 116 food items). One hundred thirty-eight subjects from South Dakota and Wyoming, 64 males and 74 females, completed at least one food frequency questionnaire and multiple 1-day diet records (mean = 5 days) during a 6-month to 1-year period. Of invited subjects, 88% participated; 59% of participants had a high school education or less. For 22 dietary nutrients (excluding supplements) and alcohol, the median crude correlation between intakes based on diet records and the food frequency questionnaire completed before the diet records was 0.42; after adjustment for energy, age, and sex, and after correction for attenuation in the correlation coefficients due to error from a limited number of diet records, the median correlation was 0.52. Correlations for men and women were similar. The validity of the food frequency questionnaire in this population was similar to that reported previously and supports the use of self-administered food frequency questionnaires in studies of general populations.

Data Collection↗

PubMed1992

A network model for improving access to food and nutrition data.

In this article we propose a network in which existing food composition and consumption databases are linked through a master database of complete and detailed food descriptions. The proposal arises from an analysis of the importance of food data, their descriptive and analytical nature, and their uses. Lack of detail and standardization in food description hinders the retrieval of food and nutrition data from various databases and the integration of such data. Standardized food descriptions can be developed and maintained in the master database, which can then serve as the interface to the many existing databases of analytical data (especially food composition data) and to databases containing data on food production, consumption, and effects, thereby linking these databases in a coordinated system, or network. The ability to link food-related databases by standardized food descriptions offers a powerful tool for scientists and practitioners in the field of food and nutrition.

Computer Communication Networks↗

PubMed1991

Selenium in diet, blood, and toenails in relation to human health in a seleniferous area.

To determine whether high dietary selenium intake was associated with adverse effects, selenium in diet, blood, and toenails was studied in relation to human health in adults residing in western South Dakota and eastern Wyoming. Over a 2-y period 142 subjects were recruited from households selected at random and from ranches where unusually high selenium intakes were suspected. Subjects completed health questionnaires, underwent physical examinations, provided blood samples for clinical assessment, and provided blood, urine, toenails, and duplicate-plate food collections for selenium analysis. About half of the 142 free-living subjects had selenium intakes greater than 2.54 mumol/d (200 micrograms/d) (range 0.86-9.20 mumol/d, or 68-724 micrograms/d). Physical findings characteristic of selenium toxicity were not present nor were clinically significant changes in laboratory tests or frequency of symptoms related to selenium in the blood, toenails, or diet. We found no evidence of toxicity from selenium in subjects whose intake was as high as 9.20 mumol/d (724 micrograms/d).

Adult↗

PubMed1991

Postnatal depression: its nature, effects, and identification using the Edinburgh Postnatal Depression scale.

Postnatal depression, or clinical depression in mothers during the months after childbirth, occurs at a time when heavy demands are placed on these women's resources, and when infant learning and development are taking place. Identification and treatment are facilitated when health professionals and services are in close contact with the family and can provide beneficial intervention. Two studies examined whether women with nonpsychotic postnatal depression could be recognized and treated within existing services, using the Edinburgh Postnatal Depression Scale and a randomized, controlled trial of counseling intervention with health visitors.

Adult↗

PubMed1990

A team approach to reduce antibiotic costs.

After partial success in reducing antibiotic drug costs by traditional methods (i.e., closed formulary, use of generic drugs, retrospective drug usage review, continuing education), a study of a new "team approach" was implemented. The study involved a clinical pharmacist and physicians working together to select the most appropriate antibiotic therapy. The clinical pharmacist reviewed the culture and sensitivity data and the pattern of infectious disease over the six-month period prior to the initiation of the study and prepared a list of the most appropriate antibiotics based on clinical efficacy and cost effectiveness. He then joined the physicians on morning rounds to monitor therapy and help in the selection of the most appropriate drug regimen. At the end of the study period, antibiotic cost savings of 58.6 percent were achieved.

Aged↗

PubMed1989

Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression.

OBJECTIVE: To determine whether counselling by health visitors is helpful in managing postnatal depression. DESIGN: Controlled, random order trial. SETTING: Health centres in Edinburgh and Livingston. PATIENTS: Sixty women identified as depressed by screening at six weeks post partum and by psychiatric interview at about 13 weeks post partum. Five women did not wish to participate, and a further five did not complete the trial. Age, social and obstetric factors, and diagnosis were similar in women who completed the trial and those who withdrew. INTERVENTION: Eight weekly counselling visits by health visitors who had been given a short training in counselling for postnatal depression. END POINT: Reduction of depression. MEASUREMENTS and main results--Standardised psychiatric interviews and a 10 point self report scale were used to identify depression before and after intervention. The psychiatrist was not told to which group women were allocated. After three months 18 (69%) of the 26 women in the treatment group had fully recovered compared with nine (38%) of the 24 in the control group. The difference between the groups was thus 32% (95% confidence interval 5 to 58). CONCLUSIONS: Counselling by health visitors is valuable in managing non-psychotic postnatal depression.

Adult↗

PubMed1989

Specifications for a mass producible static lounge chair for the elderly.

An adjustable seating rig was used to create the three-dimensional shape of a static lounge chair. Elderly subjects from long-term care and rehabilitation hospital wards tested the chair. Questionnaires and video tapes were used to evaluate their comfort, posture, safety and ease of ingress/egress. The test shape was modified on the basis of results and retested to a total of four shapes. Contours and specifications of the final chair are presented.

Journal Article↗