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Biomedical subjects

K Soeken

Publications and source records attributed to K Soeken.

At least 19 recordsLinked to original sources
PubMed2001

Herbal medicines for the treatment of osteoarthritis: a systematic review.

OBJECTIVE: Limitations in the conventional medical management of osteoarthritis indicate a real need for safe and effective treatment of osteoarthritis patients. Herbal medicines may provide a solution to this problem. The aim of this article was to review systematically all randomized controlled trials on the effectiveness of herbal medicines in the treatment of osteoarthritis. METHODS: Computerized literature searches were carried out on five electronic databases. Trial data were extracted in a standardized, predefined manner and assessed independently. RESULTS: Twelve trials and two systematic reviews fulfilled the inclusion criteria. The authors found promising evidence for the effective use of some herbal preparations in the treatment of osteoarthritis. In addition, evidence suggesting that some herbal preparations reduce consumption of non-steroidal anti-inflammatory drugs was found. The reviewed herbal medicines appear relatively safe. CONCLUSIONS: Some herbal medicines may offer a much-needed alternative for patients with osteoarthritis.

Databases, Factual↗
PubMed1999

Testing an intervention to prevent further abuse to pregnant women.

Although violence against women is recognized as a major public health problem, few interventions have been developed to reduce abuse. In this study, 132 pregnant women received three counseling sessions that were designed to reduce further abuse. A comparison group of 67 abused women were offered wallet-sized cards listing community resources for abuse. Women in both groups were followed at 6 months and 12 months post-delivery. Using repeated measures MANCOVA with entry scores as a covariate, we found significantly less violence reported by women in the intervention group than by women in the comparison group.

Adolescent↗
PubMed1999

Use of counseling by abused pregnant Hispanic women.

The purpose of this study was to determine if there are characteristics of abused women that are associated with the women's use of the services of counseling to help end the abuse. The research design was a prospective, descriptive analysis of 216 abused pregnant Hispanic women receiving prenatal care in urban public health clinics. Women who were abused by their intimate male partner were offered unlimited access to the services of a bilingual English/Spanish-speaking counselor experienced in abuse whose office was located in the public health clinic. Baseline demographic characteristics, severity of abuse experienced by the women, and the women's previous use of community resources were assessed. Analyses were conducted to examine associations between baseline characteristics and the number of visits the abused women made to the counselor. The results of the study show that when an abused pregnant Hispanic woman had an average of two or more children, she was more likely to use the services of an abuse prevention counselor. The study also showed that the women who had used the police most during the previous 12 months made the fewest number of visits to the counselor. Prenatal care may provide a convenient and safe setting for low-income, ethnic minority women with numerous children to conveniently and safely access abuse prevention services. Research is needed on the effectiveness of incorporating abuse intervention services into nontraditional settings, such as neighborhood clinics.

Adolescent↗
PubMed1998

Hypothermic coagulopathy in trauma: effect of varying levels of hypothermia on enzyme speed, platelet function, and fibrinolytic activity.

BACKGROUND: The coagulopathy noted in hypothermic trauma patients has been variously theorized to be caused by either enzyme inhibition, platelet alteration, or fibrinolytic processes, but no study has examined the possibility that all three processes may simultaneously contribute to coagulopathy, but are perhaps triggered at different levels of hypothermia. The purpose of this study was to determine whether, at clinically common levels of hypothermia (33.0-36.9 degrees C), there are specific temperature levels at which coagulopathic alterations are seen in each of these processes. METHODS: Of 232 consecutive adult trauma patients presenting to a Level I trauma center, 112 patients met the inclusion criteria of an Injury Severity Score of 9 or greater and time since injury of less than 2 hours. Of the included patients, 40 were normothermic and 72 were hypothermic (> or =37 degrees C, n = 40; 36.9-36 degrees C, n = 29; 35.9-35 degrees C, n = 20; 34.9-34 degrees C, n = 16; 33.9-33 degrees C, n = 7). Included patients were prospectively studied with thrombelastography adjusted to core body temperature. Additionally, PT, aPTT, platelets, CO2, hemoglobin, hematocrit, and Injury Severity Score were measured. RESULTS: Analysis by multivariate analysis of variance of the relationship between coagulation and temperature demonstrated that in hypothermic trauma patients, 34 degrees C was the critical point at which enzyme activity slowed significantly (p < 0.0001), and at which significant alteration in platelet activity was seen (p < 0.001). Fibrinolysis was not significantly affected at any of the measured temperatures (p > 0.25). CONCLUSIONS: Patients whose temperature was > or =34.0 degrees C actually demonstrated a significant hypercoagulability. Enzyme activity slowing and decreased platelet function individually contributed to hypothermic coagulopathy in patients with core temperatures below 34.0 degrees C. All the coagulation measures affected are part of the polymerization process of platelets and fibrin, and this process may be the mechanism by which the alteration in coagulation occurs.

Adolescent↗
PubMed1998

Severity of abuse to pregnant women and associated gun access of the perpetrator.

To investigate the relationship between abuse to pregnant women and gun access by the abuser, an ethnically stratified cohort of 199 pregnant abused women (70 African-Americans, 63 non-Hispanic Anglo-American, and 66 Hispanic women were interviewed using: (1) The Index of Spouse Abuse, a measure of the severity of physical and nonphysical abuse; (2) The Danger Assessment Scale, a measure of potential danger of homicide; and (3) The Severity of Violence Against Women Scale, a measure of threats of violence and actual violence. There were no significant differences by ethnicity among the 41.2% of the abused women who reported that their male partner had access to a gun. Among these same women reporting gun access, 17% reported the abuser kept the gun on his body. Women reporting gun access by the abuser reported higher level of abuse on all scaled instruments (P = < 0.01). To protect women's safety and prevent further trauma and potential homicide, routine assessment for abuse and gun access is recommended. Additionally, policy initiatives to remove firearms from abuse perpetrators may reduce the severity of violence experienced by abused women.

Adolescent↗
PubMed1998

Violent pornography and abuse of women: theory to practice.

To examine violent pornography use and associated violence against women, an ethnically stratified sample of 198 abused women were asked about their partners' use of pornographic materials, and if they had been asked or forced to look at, act out, or pose for pornographic scenes or pictures. Overall, 40.9% of the women reported the abuser used pornographic material, with the proportion significantly higher for Whites (58.7%), compared to Blacks (27.1%) or Hispanics (38.5%). When groups were formed according to the abuser's use of pornography and associated involvement of the woman, violence scores as measured on the Index of Spouse Abuse, Danger Assessment, and Severity of Violence Against Women scales were significantly higher (p = <.001) for women reporting the abuser requested or forced her to look at, act out, or pose for pornographic scenes. Severity of violence was not related simply to whether or not the abused used pornography. This analysis is a beginning step toward understanding how pornography influences woman abuse.

Adolescent↗
PubMed1997

Symptoms of post-traumatic stress disorder in abused women in a primary care setting.

Abuse is a major source of trauma to women, and post-traumatic stress disorder (PTSD) results from exposure to extreme trauma. To describe the relationship between symptoms of PTSD and severity of abuse, an ethnically stratified cohort of 131 abused women in a primary care setting was interviewed. Symptoms of PTSD, both intrusion (i.e., trouble falling asleep, strong waves of feelings about the abuse) and avoidance (i.e., trying not to think or talk about the abuse, staying away from reminders of the abuse), were significantly (p < 0.01) correlated to severity of abuse, regardless of ethnicity. When asked about childhood physical or sexual abuse, women reporting physical abuse had significantly (p < 0.05) higher intrusion scores, whereas those reporting sexual abuse had significantly (p < 0.004) higher avoidance scores. Sixty-five percent of the women reported dreams, flashbacks, or terror attacks and had significantly (p < 0.001) higher mean results on both intrusion and avoidance. The need to offer abused women information about the connection between severity of abuse and symptoms of PTSD is discussed. We recommend that clinicians ask all abused women about dreams, flashbacks, or terror attacks to assess for further symptoms of PTSD.

Adolescent↗
PubMed1997

Resource use by abused women following an intervention program: associated severity of abuse and reports of abuse ending.

Although violence against women is recognized as major public health problem, little is known about the effectiveness of interventions. To evaluate severity of abuse and use of community resources following an intervention program, 132 pregnant abused women received three counseling sessions in a prenatal setting. A comparison group of 67 abused women were offered a wallet-sized card listing community resources for violence. Resource use, severity of abuse, and reports of the abuse ending were measured for both groups at 6 and 12 months after delivery. Resource use was significantly (p < .001) related to severity of abuse, irrespective of whether the woman had received the intervention. Women using resources at 6 months were also users at 12 months. These findings indicate a "survivorship model" whereby abused women assertively and persistently seek a variety of community resources to end the abuse. The recommendation that primary care providers go beyond traditional identification and referral for abuse to coordination and evaluation of service delivery is discussed.

Adolescent↗
PubMed1996

Physical abuse, smoking, and substance use during pregnancy: prevalence, interrelationships, and effects on birth weight.

OBJECTIVE: To establish the singular and combined occurrence of physical abuse, smoking, and substance use (i.e., alcohol and illicit drugs) during pregnancy and its effect on birth weight. DESIGN: Prospective cohort analysis. SETTING: Urban public prenatal clinics. PARTICIPANTS: 414 African American, 412 Hispanic, and 377 white pregnant women. MAIN OUTCOME MEASURE(S): Occurrence of physical abuse was 16%; smoking, 29.5%; and alcohol/illicit drug use, 11.9%. Significant relationships existed between physical abuse and smoking for African American and white women. For African American women, 33.7% of women who were not abused smoked, versus 49.5% of women who were abused (chi 2 = 8.21; df = 1; p < 0.005). Alcohol/illicit drug use was 20.8% for nonabused women compared with 42.1% for abused women (chi 2 = 18.18; df = 1; p < 0.001). For white women, 46.6% of women who were not abused smoked, versus 59.6% of those who were abused (chi 2 = 5.22; df = 1; p < 0.005). As a triad, physical abuse, smoking, and alcohol/ illicit drug use were significantly related to birth weight (F[3, 1040] = 30.19, p < 0.001). CONCLUSIONS: Physical abuse during pregnancy is common, readily detected with a five-question screen, and associated with significantly higher use of tobacco, alcohol, and illicit drugs. Clinical protocols that integrate assessment and intervention for physical abuse, smoking, and substance use are essential for preventing further abuse and improving smoking and substance cessation rates.

Adolescent↗
PubMed1995

Abuse during pregnancy: frequency, severity, perpetrator, and risk factors of homicide.

To determine the frequency, severity, and perpetrator of abuse during pregnancy as well as the occurrence of risk factors of homicide, a stratified, prospective cohort analysis was completed on 1,203 African-American, Hispanic, and Anglo women in urban public health prenatal clinics. All women were assessed for abuse at the first prenatal visit and twice again during the pregnancy. All women were administered the Conflicts Tactics Scale, the Index of Spouse Abuse and the Danger Assessment Scale. Prevalence of physical abuse during pregnancy was 16%, one in every six women. Women abused during pregnancy had significantly higher scores on all instruments and more risk factors of homicide when compared with women abused prior to but not during pregnancy. To protect women's safety, a protocol of assessment and intervention for abuse must be standard care for all pregnant women.

Adolescent↗
PubMed1994

Abuse during pregnancy: effects on maternal complications and birth weight in adult and teenage women.

OBJECTIVE: To determine the incidence of physical and sexual abuse in a sample of adult and teen pregnant women and to determine the effect of abuse on birth weight. METHODS: One thousand two hundred three African-American, Hispanic, and white urban female residents were screened for abuse on their first prenatal visit and in the second and third trimesters. Infant birth weight was obtained by record review. RESULTS: Abuse during pregnancy was reported by 20.6% of teens and 14.2% of the adult women (P < .01). Both abused teens and adults were more likely than nonabused women to enter prenatal care in the third trimester (21.9 versus 7.5%, P = .001 for teens; 15.8 versus 8.7%, P = .007 for adults). For the aggregate sample of 1203 women, abuse during pregnancy was a significant (P < .05) risk for low birth weight (LBW), as well as low maternal weight gain, infections, anemia, smoking, and use of alcohol or drugs. Using Institute of Medicine risk factors for LBW, abused adults were at significantly greater risk for poor obstetric history, short inter-pregnancy interval, infections, anemia, smoking, and alcohol or drug usage. Abused teens had a significantly greater risk for poor weight gain, first- or second-trimester bleeding, smoking, and alcohol or drug use. CONCLUSIONS: One in five teens and one in six adult women experienced abuse during pregnancy. Abuse is related to LBW and late entry into prenatal care. Abuse can be documented readily with a short abuse assessment screen and interventions then initiated.

Adolescent↗
PubMed1993

Religiousness and hope in Hispanic- and Anglo-American women with breast cancer.

Religiousness has been associated with coping with cancer in the general population, but cultural influences have not been well explicated. The purpose of this study was to compare a sample of Hispanic-American women to a matched sample of Anglo-American women on selected religious variables and on a measure of hope. A sample of 25 Hispanic and 25 Anglo women diagnosed with breast cancer completed a hope scale, a spiritual well-being scale, and a religiousness scale and responded to selected demographic and medical questions. The only significant difference between the two groups was in intrinsic religiousness, with Hispanic women scoring higher (t = 2.07, df = 24, p < 0.05). Among Hispanics, neither intrinsic nor extrinsic religiousness was more important in predicting either existential well-being or hope. However, intrinsic religiousness was a more important predictor of religious well-being and total spiritual well-being than was extrinsic religiousness. Among Anglos, intrinsic religiousness was a stronger predictor of spiritual well-being and of hope. Religiousness may be an important variable affecting both the spiritual and the psychological health of women with breast cancer; this study also suggests cultural differences.

Adult↗
PubMed1992

Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care.

OBJECTIVE: To assess the occurrence, frequency, and severity of physical abuse during pregnancy and associated initiation of prenatal care. DESIGN: Stratified, prospective cohort analysis. SETTING: Public prenatal clinics in Houston, Tex, and Baltimore, Md. PARTICIPANTS: Total population-based sample of 691 black, Hispanic, and white pregnant women. All of the women were urban residents and most of the Hispanic women were Mexican American. All participants were invited into the study at the first prenatal visit and were followed up until delivery. MAIN OUTCOME MEASURE: Identification of abuse status. RESULTS: A three-question Abuse Assessment Screen detected a 17% (1/6) prevalence of physical or sexual abuse during pregnancy, which is more than double all previous published reports. When evaluated against nationally tested research instruments, the three-question screen that was asked at the first prenatal visit was sensitive and specific to abuse status. Abuse was recurrent, with 60% of abused women reporting two or more episodes of assault. Location of abuse focused on the head. Frequency and severity of abuse and potential danger of homicide was appreciably worse for white women. Abused women were twice as likely as nonabused women to begin prenatal care during the third trimester. CONCLUSIONS: A simple clinical assessment screen completed by the health care provider in a private setting and with the male partner absent is as effective as research instruments in identifying abused women. Straightforward, routine clinical assessment is recommended as essential in preventing potential trauma, interrupting existing abuse, and protecting health.

Adolescent↗
PubMed1992

Spiritual well-being, religiousness and hope among women with breast cancer.

The purpose of this study was to clarify spiritual health by examining the role of spiritual well-being (SWB), religiousness and hope in spiritual health. This was accomplished by obtaining questionnaire information from a convenience sample of 175 women diagnosed with breast cancer. Patients classified as intrinsically religious were found to have significantly higher scores on SWB than did those classified as extrinsically religious. There was no difference in hope scores between intrinsically religious and extrinsically religious patients, although hope was positively correlated with SWB. Existential well-being, a component of SWB, was the primary contributor of hope. The two major prognostic variables, stage of disease at diagnosis and number of positive lymph nodes, did not predict any of the scores.

Adaptation, Psychological↗
PubMed1992

Nursing intensity. Going beyond patient classification.

Two patient classification systems, Medicus and GRASP, were compared to the Patient Intensity for Nursing Index (PINI). Approximately 50% of the variability in both classification systems was not accounted for by PINI items. The patterns of correlation between PINI items and GRASP and Medicus scores indicated that these two classification systems do not measure nursing resource use in the same way. Nurse administrators should be aware that estimates of nursing care costs will vary depending on the patient classification system used to measure nursing intensity.

Costs and Cost Analysis↗
PubMed1986

Public perceptions regarding the AIDS epidemic: selected results from a national poll.

A telephone interview of 1256 adults age 18 and over was conducted using a random digit dialing procedure. Participants were queried about their perceptions of being at risk for contracting the acquired immune deficiency syndrome (AIDS), optimism-pessimism about the controllability of the epidemic, whether they take special steps to avoid catching AIDS, and how they would prioritize three possible courses of action. The sample was about evenly divided between optimism and pessimism about controlling AIDS within five years; 10% perceived they were at least at some risk of contracting AIDS (with such "at risk" persons overrepresented among residents in the east, among college graduates, and within the 30-39 age bracket). Forty-one percent indicated taking special steps to avoid AIDS, with higher percentages of Blacks, Hispanics, and persons under age 30 reporting such precautions. Personal preventive action was ranked first among the three possible courses of action by 51%, unlimited governmental spending to find a cure or vaccine and governmental restrictions of certain homosexual behaviors were each ranked first by about 20% of the respondents. The results also indicated that perception of being at risk mediates some opinions about AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Communicating probability in clinical reports: nurses' numerical associations to verbal expressions.

Verbal estimates of probability (such as likely or certain) commonly used in laboratory, radiological, and clinical reports may be a barrier to effective communication between health care professionals. In this study the investigators sought to determine whether a consensus of numerical meaning existed in a sample of nurses for each of 30 widely used verbal expressions of probability. Seventy female nurses enrolled in a graduate course were surveyed by means of a test-retest procedure using a questionnaire designed to elicit assignments of numerical probability (0% to 100%). The results showed wide inconsistency both between subjects and within subjects.

Communication↗