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Biomedical subjects

L K Hart

Publications and source records attributed to L K Hart.

17 recordsLinked to original sources
PubMed1995

Pancreatic transplantation. Impact on the quality of life of diabetic renal transplant recipients.

OBJECTIVE: To determine the impact of pancreas transplantation on the quality of life of renal transplant recipients with diabetes. RESEARCH DESIGN AND METHODS: In this quasi-experimental comparative study of 41 successful pancreas transplant (SP) recipients, 13 failed pancreas transplant (FP) recipients, and 28 kidney alone (KA) transplant recipients, we collected data from individuals who had their pancreas/kidney or kidney alone transplants > or = 6 months before at a university tertiary care center. This study was an extension of a 1992 study of SP and FP recipients. The subject group was enlarged with additional pancreas/kidney recipients and a control group of KA recipients. Five dimensions of life quality were measured. RESULTS: Groups did not differ significantly regarding age, gender, marital status, comorbidity, type of prior dialysis, current kidney function, length of time since transplant, physical activity, symptom burden, emotional state, and feelings of well-being. A significant time by group interaction occurred for quality of life (P = 0.0023) and health (P = 0.0001). Patients in the SP and KA groups perceived their past life and health quality to be significantly lower and their present and future life and health quality to be significantly better than did the FP group. The groups' major concerns differed significantly. The FP group's concern related to diabetes, the SP group's to immunosuppression, and the KA group's to graft rejection. CONCLUSION: Patients with failed pancreas but successful kidney transplants see less improvement in their quality of life than do patients who meet their transplant goals, irrespective of whether they receive a pancreas.

Cohort Studies↗
PubMed1994

Hypercatabolism of lipoprotein-free apolipoprotein A-I in HDL-deficient mutant chickens.

The Wisconsin Hypoalpha Mutant (WHAM) chicken has a sex-linked mutation associated with a 90% reduction in high-density lipoprotein (HDL) cholesterol and apolipoprotein A-I (apoA-I). In the present studies, we did not detect a defect in apoA-I synthesis or secretion in liver or intestine. We tested the hypothesis that apoA-I is not binding properly to lipoprotein particles and is undergoing hypercatabolism. We therefore studied the in vivo turnover of lipid-free 125I-apoA-I. Its turnover was fourfold faster in WHAM chickens than in normal chickens. The 125I-apoA-I equilibrated more slowly with HDL in the WHAM chickens, and these animals had a much larger steady-state pool of lipid-free apoA-I than did control chickens. To determine the tissue sites of degradation of apoA- I, the tissue distribution of 125I-tyramine cellobiose apoA-I was assessed. The liver and kidneys were the major sites of apoA-I degradation, but in the WHAM chickens, the kidney made a twofold larger contribution to apoA-I degradation than in normal chickens. Total plasma phospholipid levels are reduced by 44% to 78% in the WHAM chickens. A phospholipid deficit might explain the elevated lipid-free apoA-I pool and, secondarily, the HDL deficiency of the WHAM chickens.

Animals↗
PubMed1994

A Delphi study of the basic principles and corresponding care goals of holistic nursing practice.

This descriptive, non-experimental study using the Delphi survey process identified basic holistic health principles for which holistic nurse practitioners agreed guide their healing practice. Seventeen expert holistic nurse practitioners (and AHNA leaders) comprised the respondent group. On the average these practitioners have been nurses for 25 years and holistic practitioners for 11 years. Seventy percent of the group completed all three Delphi rounds indicating their agreement regarding 25 principles of holistic health, their applicability to practice, and care goals related to each principle. A high level of consensus was reached regarding 17 principles. In addition to affirming principles related to unity, interdependence, evolution, energy fields, and interactions, the AHNA expert nurse practitioners strongly emphasized spirituality. The group addressed reality as a unified whole, not limited by the material universe, supporting a practice model based on holographic perspectives.

Delphi Technique↗
PubMed1992

Quality of life of pancreatic transplant recipients.

OBJECTIVE: To comprehensively assess and compare pancreas/kidney transplant recipients' quality of life. RESEARCH DESIGN AND METHODS: This quasi-experimental comparative study of 31 successful and 13 failed pancreas transplant recipients collected data from persons who had received pancreas and kidney transplants > or = 6 mo prior at a university tertiary care center. Physical and social function, symptoms, mental state, and sense of well-being of the recipients were assessed. RESULTS: Groups did not differ significantly regarding age, gender, marital status, onset or length of diabetes, comorbidity, type of prior dialysis, current kidney function, length of time since transplant, physical activity, symptom burden, emotional state, feelings of well-being, and present quality of life and health. A significant time by group interaction occurred for quality of life (P = 0.0013) and health (P = 0.0001). The successful group indicated that both quality of life and health were significantly better than in the past, and continued improvement was expected. The unsuccessful group did not have this perception. Members of the failed group were significantly more satisfied with their social support. The unsuccessful group's major concerns related to diabetes, not immunosuppression. CONCLUSIONS: Recipients of successful pancreas transplants perceived their improvement in health and quality of life to be significantly greater than the unsuccessful recipients.

Adult↗
PubMed1991

Pancreas transplantation: assessing secondary complications and life quality.

Two sequential studies of life quality among pancreas transplant recipients are reported. The first study (n = 32) investigated symptoms of neuropathy, enteropathy and retinopathy, along with well-being post successful transplantation. Patients noted improvement in secondary complications, were satisfied with the procedure and expressed hope for the future. The second study compared physical and social function, burden of symptoms, emotional/mental state and sense of well-being in successful (n = 31) and successful (n = 13) pancreas transplant recipients. Patient satisfaction with pancreas transplantation was high. Successful transplant patients perceived their health to be good, believed it would continue to be good, with life quality becoming better over time. The failed group expected life quality to become worse.

Depression↗
PubMed1990

Fatigue.

Fatigue is a pervasive, protective phenomenon affecting the totality of the individual. Assessment and management involve a wide range of activities to address the total human being's physical, psychological, cognitive, and spiritual dimensions. When elimination or neutralization of the effect of an antecedent condition is not an option, redesigning one's life-style may be the primary avenue of fatigue management. This protective mechanism, fatigue, may in fact herald the return of quality and purpose to one's life.

Fatigue↗
PubMedDate not supplied

The relationship between the health belief model and compliance of persons with diabetes mellitus.

Thirty insulin-treated diabetic individuals were interviewed in their homes 6-12 mo after having attended diabetic education classes at a community hospital. Self-report as well as direct observation were used to measure these patients' level of compliance with their insulin administration, urine testing, diet, hypoglycemia management, and foot care prescriptions. All patients were complying with at least 59% of the points measured. Over one-half of the group indicated compliance with at least 70% of the 61 points measured. However, only 7% complied with every one of the 45 points considered to be necessary for good control of their disease. The group was most compliant with regard to insulin administration and least compliant regarding urine testing. The level of these patients' beliefs regarding their disease (severity and susceptibility, treatment benefits, and barriers) and cues to action were also measured. A correlation of 0.5 occurred between these patients' overall compliance levels and a composit of their level of health belief motivation. The highest levels of correlations between the areas of compliance and the motivators occurred with cues to action.

Attitude to Health↗
PubMedDate not supplied

Relationship between health locus of control, health value, and social support and compliance of persons with diabetes mellitus.

Thirty insulin-dependent outpatients were interviewed during one of their diabetes clinic visits. Questionnaires were used to measure the independent variables of health locus of control, health value, and perceived social support. Self-report and direct observation were used to measure the dependent variable, compliance with insulin administration, diet, exercise, hypoglycemia management, self-monitoring of blood glucose (SMBG), and foot care prescriptions. All patients complied with at least 70% of the points measured; half the group complied with at least 80% of the regimen. However, no one complied with all the behaviors deemed essential for good control. The group was most compliant with SMBG, hypoglycemia management, and insulin administration and least compliant with foot care and exercise. A statistically significant relationship was found between compliance and social support (P less than 0.001), powerful others health locus of control (PHLC) (P less than 0.01), and internal health locus of control (IHLC) (P less than 0.05). A multiple regression analysis found that social support and PHLC accounted for at least 50% of the variance in compliance scores. The multiple-R of the independent variables with compliance reached a significance level of P less than 0.005. However, only the two variables of social support and PHLC added significantly (P less than 0.05) to prediction accuracy. The multiple-R of these two variables used as a set reached the significance level of P less than 0.001.

Adolescent↗