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Biomedical subjects

L K Brown

Publications and source records attributed to L K Brown.

At least 19 recordsLinked to original sources
PubMed1992

Adolescent coping behavior when confronted with a friend with AIDS.

The coping strategies employed by adolescents (n = 871) when presented with a hypothetical situation of a friend with AIDS were examined. Adolescents reported a wide range of imagined responses that were generally adaptive. Girls more than boys and distressed students more than nondistressed students were likely to endorse adaptive coping items. Comparison of the students with a separate sample (n = 472) that responded to a hypothetical situation of a suicidal peer revealed more distress in girls for the AIDS problem and more distress in boys for the suicide problem, contrary to expectations. Adolescents were more distressed and endorsed a wider variety of coping strategies in response to the AIDS scenario than to the suicide problem. Implications for care of adolescents dealing with these significant issues are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Predictors of condom use in sexually active adolescents.

Unprotected sexual intercourse places a substantial number of adolescents at risk for sexually transmitted disease (STD) and human immunodeficiency virus (HIV) infection. While the most effective means of preventing STD/HIV infection among sexually active adolescents is consistent condom use, little is known about the factors that influence their consistent use among adolescents. This study of adolescents (n = 1049, mean age = 16.2 years) found that of the 266 teens who recently became sexually active, only 29% reported using condoms consistently. Consistent condom use was more frequent in males, those with little history of risk behavior and those with stronger intentions to use condoms in the future. Fear and anxiety of HIV, attitudes about risks other than HIV, and other safe behavior intentions were not significantly related to consistent condom use. Although intentions and recent behavior were significantly related, a different group of factors was found to predict intention to use condoms (e.g., perception of condom use by friends, general impulsive attitudes). Identifying and understanding the factors that influence adolescent sexual behavior and intentions is important for developing maximally effective HIV education/prevention programs.

Adolescent↗
PubMed1992

Comparison of human immunodeficiency virus related knowledge, attitudes, intentions, and behaviors among sexually active and abstinent young adolescents.

Although young sexually active adolescents are at greater risk for human immunodeficiency virus (HIV) acquisition than their abstinent peers, little is known about their respective HIV-related knowledge, attitudes, and general risk behaviors. This study of middle school adolescents (n = 1379; mean age, 13.2 years) found that the sexually active boys, compared with their peers, were less knowledgeable about HIV, less fearful of HIV, less tolerant of people with acquired immunodeficiency syndrome (AIDS), riskier in non-HIV-related attitudes and had a greater history of other risk behavior. A similar, but less marked pattern, was found for girls. It is suggested that physicians counsel all adolescents about HIV and sexuality during office visits and that early adolescent sexuality should prompt special efforts in HIV education/counseling.

Adolescent↗
PubMed1992

Pneumothorax due to ball-valve obstruction of an endotracheal tube in a mechanically ventilated patient.

Barotrauma is a well-known complication of mechanical ventilation, thought to be related to alveolar rupture from localized hyperinflation. Mishaps related to endotracheal intubation can lead to barotrauma such as inadvertent intubation of the right mainstem bronchus. In this report, we describe pneumothorax as a consequence of ball-valve occlusion, a previously undescribed endotracheal tube malfunction.

Airway Obstruction↗
PubMed1992

Positive Kveim test in patients with coexisting sarcoidosis and human immunodeficiency virus infection.

We present two cases of sarcoidosis complicated by HIV infection. Each case had a different level of sarcoidosis activity and coexisted with either an AIDS-related infection or a HIV-positive state. Manifestations of sarcoidosis were not apparent in the patient with the AIDS-defining opportunistic infection, but were active in the patient with asymptomatic HIV infection. Both patients had granulomatous reactions to Kveim antigen, and one had such a reaction following an AIDS-defining infection. These findings suggest that non-T-cell mechanisms may be involved in granuloma formation in sarcoidosis.

Adult↗
PubMed1991

The correlates of planning in adolescent suicide attempts.

Adolescent suicide attempts are often impulsive. It has been suggested that individuals who make nonimpulsive (premeditated) attempts have greater suicidal intent and are more hopeless than the impulsive attempters. Eighty-six adolescent suicide attempters were categorized according to the degree of premeditation of their attempt, as measured by two items of the Suicide Intent Scale. Sex, age, method of attempt, and the number of prior attempts were not useful discriminators between these groups. The nonimpulsive attempters were significantly more depressed and more hopeless than the impulsive attempters, as measured by several standardized scales. Measures of depression, hopelessness, and suicidal ideation were highly correlated in both groups. Anger turned inward and hopelessness were strongly correlated only in the premeditated group, suggesting that the nonimpulsive attempter's distress may bear a strong relationship to self anger.

Adolescent↗
PubMed1991

AIDS education: the Rhode Island experience.

AIDS prevention, by public school education, is designed to change knowledge, attitudes, and future behavior. This study evaluated the impact of a state-mandated educational program on a sample of 2709 adolescents. Changes from pre to posttest were evaluated using standardized change scores and comparisons between the experimental and a delayed education control group were made. The experimental group, but not the control group, changed to a statistically significant degree (p less than .001). They became more knowledgeable, endorsed slightly more tolerant attitudes, and reported an increased intention to avoid intercourse as a means of AIDS prevention. The extent of change was substantially greater for knowledge than for attitudes. Age, gender, and AIDS-related anxiety were found to be significant variables in the AIDS education process. The modest changes observed emphasize that the dissemination of AIDS information by public schools is only the first step in changing adolescent behavior as a means to AIDS prevention and that other, additional approaches are needed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Pulmonary function testing in bronchial asthma: standard and emerging techniques.

Despite the myriad of tests available to characterize bronchial asthma, the simple forced expiratory spirogram remains the most straight-forward and reliable technique to diagnose the disorder and gauge its severity. When combined with bronchodilator and bronchial challenge testing, a wide range of clinical situations can be evaluated, even in the office setting. A well-performed forced expiratory spirogram remains the cornerstone of pulmonary function testing; the emergence of the additional analytic techniques described holds the promise of even greater utility in the future.

Asthma↗
PubMed1991

Child and adolescent psychiatrists and HIV disease: a survey.

During the spring and summer of 1989, all members of the American Academy of Child and Adolescent Psychiatry in nine states were sent questionnaires to determine the extent of child and adolescent psychiatrists' human immunodeficiency virus (HIV)-related knowledge, experience, comfort in working with HIV patients, and opinions regarding perceived educational needs about HIV. The response rate was 54% (N = 511). Two-thirds of the respondents indicated they had treated or had consulted on an HIV-infected patient. Most psychiatrists indicated reasonable comfort in working with HIV patients. Knowledge about HIV was found to be variable. Results suggest that child psychiatrists are engaging in HIV-related activities in all parts of the country, and further information or education would be welcomed by a majority of Academy members, particularly at nationally sponsored events.

Adolescent↗
PubMed1991

HIV prevention for adolescents: utility of the Health Belief Model.

The Health Belief Model (HBM) has been applied to diverse sets of health behaviors. Research that suggests difficulties of the HBM in predicting future behaviors, especially HIV-related, is reviewed. Prominent features of adolescence that influence HIV-related risk behaviors are discussed including: cognitive immaturity, struggle for psychological autonomy, peer influences, and physical development. It is suggested that a model is needed to guide prevention efforts, and that these adolescent-specific factors need to be incorporated into any such model.

Adolescent↗
PubMed1991

Lung function in former intravenous drug abusers: the effect of ubiquitous cigarette smoking.

PURPOSE: To determine whether former intravenous drug abusers (IVDAs) demonstrate reductions in pulmonary function, especially in the diffusing capacity (DLCO), after adjustment for the effects of their ubiquitous smoking habit. Knowledge of baseline DLCO in this high-risk group is important in evaluating the effects of human immunodeficiency virus (HIV) and ensuing opportunistic infections. PATIENTS AND METHODS: Measurements of single-breath DLCO, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) were compared with predictive values that adjust for the effects of smoking. Patients were 98 ambulatory former IVDAs regularly attending a methadone maintenance program (62 men and 36 women; 94 current smokers, two ex-smokers, and two nonsmokers). RESULTS: When adjusted for smoking, FEV1 and DLCO were no different in the study sample than in cross sections of the general population: mean FEV1 105% predicted (men) and 97% predicted (women), mean DLCO 95% predicted (men) and 99% predicted (women). Eleven percent of the IVDAs had abnormal values for DLCO; only one subject had a value less than 50% of predicted. CONCLUSIONS: Most former IVDAs who regularly attend an ambulatory methadone program have normal DLCO values when the effects of smoking are taken into account. A decrease in DLCO in such subjects is presumptive evidence of superimposed disease, most likely related to opportunistic infections or HIV-associated malignancy or alveolitis.

Adult↗
PubMed1990

Differences in AIDS knowledge and attitudes by grade level.

Grade-related similarities and differences in AIDS knowledge and attitudes were assessed in 441 fifth, seventh, and tenth graders from one school district. Grade level was a significant variable (p less than .01) on 53% of items. Grade-related differences in knowledge were apparent when students responded to questions tapping information not covered widely in the media and in attitudes when personal engagement in behavior was implied. Cognitive and emotional factors related to developmental milestones were postulated to account for these differences. These findings need to be considered in planning and implementing AIDS prevention programs, especially as education is begun for younger children.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pulmonary diffusing capacity in left ventricular dysfunction.

The purpose of this study was to determine whether there are any consistent spirometric or Dsb findings in patients with LV dysfunction characterized by a clinical diagnosis of CHF and an EF less than 40 percent. We performed spirometry and Dsb in 34 patients, and found that EF correlated only with Dsb. When we separated the patients into those with rales and those without, Dsb correlated strongly with EF only in those with rales. There was no correlation with other spirometric values. Mean Dsb percent predicted was significantly lower in patients with rales despite similar mean EF. Only two of 23 patients without rales had a reduced Dsb while only one of 11 with rales had a normal Dsb. We conclude that Dsb is a good predictor of clinically evident heart failure. When rales are absent, Dsb should be normal in patients with LV dysfunction; when present, Dsb will be diminished in proportion to the EF.

Aged↗
PubMed1990

Traumatic amputation. Mechanisms of injury, treatment, and rehabilitation.

Traumatic amputations are one of many injuries that can occur to the body's musculoskeletal systems. Degloving, partial and total amputations are common types of traumatic injuries. Since traumatic amputations are very life threatening, emergency treatment must be initiated quickly and directed toward profuse blood loss and potential hypovolemia. Not only do traumatic amputees undergo extreme physiological changes, but they must also encounter the psychological trauma of an amputation. Due to a loss of body part(s) and alteration in body image, the amputee often experiences the stages of grieving which may take months and years to resolve. Extensive rehabilitation with the use of an interdisciplinary team approach is one of the most successful ways to return the amputee to the work place. A combination of occupational therapy, physical therapy, vocational rehabilitation and psychological support generally promote a sense of well being and return the traumatic amputee to a level of independence.

Accidents, Occupational↗
PubMed1990

"What upsets me most about AIDS is ...": a survey of children and adolescents.

While AIDS-related knowledge and attitudes have been studied in different populations, little attention has been given to emotional reactions to the epidemic or to the validity of frequently employed forced-choice questionnaires. Spontaneous emotional reactions to the AIDS crisis were assessed in 441 fifth, seventh, and tenth graders from one school district. Students responded to one open-ended question, "What upsets me most about AIDS is...." Loglinear analysis revealed grade as a significant variable: fifth graders were most upset by AIDS' lethality, while tenth graders felt helpless. Cognitive and emotional factors were postulated to account for these differences. Students who correctly responded to knowledge-related, open-ended questions were likely to correctly answer comparable forced-choice questions. AIDS education strategies that consider grade-specific anxieties are suggested.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The impact of AIDS education on junior and senior high school students. A pilot study.

Prevention, through school-based education campaigns, has been suggested as a response to the AIDS crisis although the impact of such education is unproven. The seventh and tenth grade classes (n = 313) in one Rhode Island school district were surveyed regarding AIDS knowledge, attitudes, and coping skills before and after a two-session educational program. Following instruction, students reported more knowledge, greater tolerance of AIDS patients, and more hesitancy toward high-risk behaviors, but the changes were modest. Using residual change scores to control for baseline levels, two subgroups (seventh grade boys and tenth grade girls) changed the most in tolerance, and the correlations between variables were the strongest. In the general sample, change in knowledge was independent of change in tolerance, attitudes regarding high-risk behaviors, or coping strategies. These data lend support to the potential usefulness of school-based education programs, especially if behavior and coping skills are emphasized in the education. Evaluation of such programs should include assessment of change in subgroups to determine components of programs that can be tailored for more effective education.

Acquired Immunodeficiency Syndrome↗