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Biomedical subjects

James Hyde

Publications and source records attributed to James Hyde.

6 recordsLinked to original sources

Hepatitis C prevention with nurses.

A state campaign to educate nurses about hepatitis C and encourage nurses to fight the epidemic provided an opportunity to assess the relationship between information and safety practices. Baseline and follow-up surveys were sent to random, representative samples (n = 6000) of licensed nurses in Massachusetts, USA. Responses received by 42% (n = 2443) at baseline and 37% (n = 2167) at follow-up were compared to explore the relationship between receiving information and propensity to counsel patients or use safety equipment. Only data from nurses in direct patient care were analyzed. Although few changes were observed, the assessment provided further evidence that more than a single intervention is needed to achieve health behavior change. The number of nurses who never used safety equipment did decrease slightly, from 13.3% (191) to 8.2% (132), and nurses who received information were more likely to talk to patients about the virus: 49% (414) compared to 21% (120). Hepatitis information aimed at nurses may help control this emerging epidemic.

Attitude of Health Personnel↗

Characterization of the cerebral cortical representation of heartburn in GERD patients.

Although symptoms arising from the esophagus such as heartburn and pain can at times become challenging clinical problems, esophageal viscerosensation, especially with regard to chemical stimulation in humans, is incompletely understood. Our aims were 1) to characterize and ascertain the reproducibility of cerebral cortical registration of heartburn and 2) to elucidate the differences between these findings and those of esophageal subliminal acid stimulation in asymptomatic controls. We studied 11 gastroesophageal reflux disease (GERD) patients (9 males, 30-55 yr) and 15 healthy controls (8 males, 21-49 yr). Cerebral cortical functional magnetic resonance imaging (fMRI) activity was recorded twice in each subject, during two 5-min intervals of 0.1 N HCl, separated by 5 min of NaCl perfusion. Time from onset of acid perfusion to instant of fMRI signal increase and first report of heartburn averaged 1.60 +/- 0.80 and 1.85 +/- 0.60 min, respectively. Average maximum percent signal increase in the GERD patients (16.3 +/- 3.5%) was significantly greater than that of healthy controls (3.8 +/- 0.9%; P < 0.01). Temporal fMRI signal characteristics during heartburn were significantly different from those of subliminal acid stimulation in controls (P < 0.01). Activated cortical regions included sensory/motor, parieto-occipital, cingulate and prefrontal regions, and the insula. There was 92% concordance between the activated Brodmann areas in repeated studies of GERD patients. Cortical activity associated with perceived and unperceived esophageal acid exposure in GERD patients and healthy controls, respectively, involves multiple brain regions but occurs more rapidly and with greater intensity in GERD patients than the activity in response to subliminal acid exposure in healthy controls. The cortical pain-processing pathway seems to be involved in perception of esophageal acid exposure and could explain the variations encountered in clinical practice defining this sensation.

Adult↗

Environmental management of asthma at top-ranked U.S. managed care organizations.

We evaluated the status of nationally top-ranked managed care organizations' (MCOs) asthma disease management programs to identify "best practices" in the environmental treatment and control of asthma. Application materials were developed and mailed to the top 34 managed care organizations, as determined by the ranked results from the October 1998 edition of US News and World Report. Based on the results of a staff and panel review, five applicants were selected for site visitation. The results of the site visits determined two finalists and three runners-up. We recommend that MCOs integrate population and community-based strategies and seek an emphasis on prevention. We encourage collaborations with other organizations and agencies. We endorse home visitation to assess environmental factors and also support use of telephonic case management. We think that smoking cessation programs should be coordinated with asthma management. We consider it important to use alternative forms of communication such as the Internet. And we find that it is important to be mindful of language, culture, and literacy.

Asthma↗

Development of targeted message concepts for recent Asian immigrants about secondhand smoke.

Residents of Boston's Chinatown and the Vietnamese community in Boston's Dorchester section are recent immigrants from China and Vietnam, countries whose smoking prevalence rates for men are among the highest in the world and whose rates for women are very low. We conducted exploratory focus groups in these communities to examine issues related to secondhand smoke and to generate message concepts for health education materials that would convince recent Asian immigrants to respond to the public health threat that secondhand smoke poses. The message concepts, which were tailored specifically for Chinese and Vietnamese immigrants, used themes that were consistent with the cultural values of each group as expressed in the focus groups, yet also reflected the fact that, in many ways, these immigrants are seeking to adapt to American norms. We suggest that it is possible to construct culturally appropriate health education materials for recent immigrant populations rather than rely on simple translations of English-language materials. An intervention study using these message concepts is needed.

Asian↗

Rewriting public health information in plain language.

Public health materials are often designed to inform and rally the public to spur action and maintain vigilance on important issues to family, work, community, and public policy. Limited access to public health information certainly curtails knowledge and awareness but may also hamper action and civic involvement. A growth in published assessments of health materials indicates an increased interest in the mismatch between the reading level of most health materials and the reading ability of the average adult. However, while several guidebooks offer suggestions for developing new materials, little attention has been given to the process of rewriting materials and grappling with bureaucratic language. We describe, in this case study, a process we used to assess and then rewrite a federally mandated report to consumers about the quality of their water.

Communication↗