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Biomedical subjects

M Jarrett

Publications and source records attributed to M Jarrett.

At least 37 records · Page 2Linked to original sources

Research issues in nutrition support.

Nursing scientists have made important contributions to the understanding of individual responses to nutritional support as well as factors that place patients at risk for health complications. In addition, they have begun to incorporate measures of quality of life, function, and satisfaction into their outcome measures. This article focuses on describing the current state of nursing science related to nutrition support and issues related to the evaluation of research for implementation into practice.

Adaptation, Physiological↗

Relationship between gastrointestinal and dysmenorrheic symptoms at menses.

The relationship between gastrointestinal (GI) symptoms and uterine cramping pain at menses, controlling for affective states and prostaglandin synthesis inhibitor use, was examined. A total of 53 women completed a daily diary of symptoms, stool characteristics, and medication use for three consecutive menstrual cycles. There were significant across-women and within-woman relationships between stomach pain, nausea, and uterine cramping pain, but not between cramping pain and constipation, diarrhea, or stool characteristics. These results support the presence of a similar mechanism in the generation of distressing GI symptoms and uterine cramping pain at menses.

Adult↗

Increased urine catecholamines and cortisol in women with irritable bowel syndrome.

OBJECTIVES: There are few data on the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis in individuals with chronic GI symptoms. The current study was designed to describe and compare urine catecholamine (norepinephrine, epinephrine) and cortisol levels in women diagnosed with irritable bowel syndrome (IBS-patients), women who report similar symptom levels but had not sought health care services (IBS-nonpatients; IBS-NP), and asymptomatic (control) women. METHODS: Seventy-three women (24 IBS; 24 IBS-NP; 25 controls) were interviewed for demographic, GI, gynecological, and psychological data and then followed for two menstrual cycles with a daily health diary. Urine samples were obtained in the evening and morning at specific phases across two menstrual cycles. RESULTS: Women in the IBS group had significantly higher PM and AM urine norepinephrine levels. Urine epinephrine and cortisol levels were also generally higher in women with IBS. Differences in neuroendocrine indicators of arousal were not accounted for by differences in demographic variables, lifestyle characteristics, menstrual distress, or average daily measures of anxiety or depression. CONCLUSIONS: Increases in indicators of sympathetic nervous system activation in women seeking health care for IBS may reflect greater symptom distress or may contribute to increased symptom distress.

Adolescent↗

Daily gastrointestinal symptoms in women with and without a diagnosis of IBS.

This study compared daily gastrointestinal symptoms and stool characteristics across two menstrual cycles, and recalled bowel symptoms and psychological distress in women with irritable bowel syndrome (IBS, N = 22), IBS nonpatients (IBS-NP, N = 22), and controls (N = 25). Daily reports of abdominal pain, bloating, intestinal gas, constipation, and diarrhea did not differ significantly between the IBS and IBS-NP groups but both groups reported significantly higher symptoms than the control group. Stool consistencies was significantly looser in the IBS group relative to the control group. Menstrual cycle effects on symptoms were noted in all the groups. There were no significant differences in psychological distress between women with IBS and IBS-NP, but both groups reported significantly higher global distress than the control group. The lack of difference between the IBS and IBS-NP groups in contrast to the results of others, can be understood in terms of differences in recruitment strategies.

Abdominal Pain↗

Comparison of diet composition in women with and without functional bowel disorder.

Nurses are often involved in helping patients alleviate chronic distressing gastrointestinal symptoms such as those associated with irritable bowel syndrome or functional bowel disorder. One therapeutic strategy is to increase dietary fiber intake and to eliminate gastrointestinal (GI) irritants such as caffeine, alcohol, and tobacco smoking. However, little work has been done to establish a relationship between dietary factors and chronic GI symptoms. In this article, the authors: (a) describe and compare caloric and dietary constituent intake in symptomatic (n = 18) and asymptomatic (n = 37) women, and (b) examine the relationships among diet, GI symptoms, and stool characteristics in the two groups. In particular, total calories, fiber, fat, protein, and carbohydrates as well as alcohol and caffeine intakes were compared in women who do not smoke. Because menstrual cycle phase modulates both symptoms and appetite, women were studied during the follicular phase. Groups had similar caloric, fat, and protein intakes. Fiber intakes were similar and similar to national norms in both groups. When compared with asymptomatic women, the symptomatic women consumed more refined carbohydrates. Relationships were observed among dietary intake of refined carbohydrates, fiber, GI symptoms, and stool characteristics in women with functional bowel disorder.

Adult↗

Women with gastrointestinal symptoms: implications for nursing research and practice.

Irritable bowel syndrome and functional bowel disorder are diagnoses used to describe chronic GI symptoms for which no overt pathological condition can be identified. Symptoms are more common in women and are frequently followed in gastroenterology clinics. The purpose of this article is to provide an overview of the research linking GI symptoms and reproductive cycling and to discuss implications for practice. GI symptoms such as stomach pain and nausea are highest during menses compared with other cycle phases; also, stool consistency is loosest at menses. This pattern is present in control subjects. In women with irritable bowel syndrome the same pattern is seen but with higher symptom intensity. Although animal studies have demonstrated that estrogen and progesterone modulate contractile function of some GI segments, in humans, symptoms are highest when these hormones are at the lowest levels. Thus, symptoms in women may be related to decreasing ovarian hormone levels or to other circulating hormones or factors which vary with the menstrual cycle. Additionally, other factors such as stress aggravate symptoms. Therapeutics directed toward increasing patient awareness of cyclic patterns in symptom complaints, for example, via the use of daily symptom diaries may be a useful adjunct to dietary, pharmacological, and other therapies.

Autonomic Nervous System↗

Pattern of gastrointestinal and somatic symptoms across the menstrual cycle.

The pattern of gastrointestinal symptoms and select mood and somatic symptoms was examined across two menstrual cycles in women with (n = 19) and without (n = 39) functional bowel distress (FBD). The women (a) rated their gastrointestinal, perimenstrual, mood, and other symptoms and stool frequency and consistency daily; (b) completed the Menstrual Distress Questionnaire-T; and (c) had serum levels of estrogen and progesterone measured during the menses, follicular, and luteal phases. Stomach pain, nausea, and diarrhea were rated higher at menses in the group with FBD than in the group without FBD. Stomach pain was higher during the remaining days as well. The group with FBD reported higher levels of perimenstrual symptoms also on six of the eight Menstrual Distress Questionnaire-T subscales (P less than 0.01). Other complaints, e.g., poor work/school performance, were higher in women with FBD, but somatic symptoms that were expected to vary over the cycle did not differ between groups, except cramping pain. There were no significant group differences in ovarian hormone levels or stool consistency/frequency scores.

Abdominal Pain↗

Successful treatment of refractory Hodgkin's disease by high-dose combination chemotherapy and autologous bone marrow transplantation.

Forty-four patients with refractory Hodgkin's disease were treated with high-dose combination chemotherapy followed by autologous bone marrow rescue. Twenty-two patients (50%) entered complete remission within 6 months of the procedure and four other patients are free of disease progression. Only two patients have subsequently relapsed from complete remission (CR). Bone marrow suppression was the predictable major toxicity of this procedure, and two patients (4.5%) died of sepsis during the aplastic phase. High-dose therapy with autologous bone marrow transplantation (ABMT) appears to be an effective salvage regimen for patients with refractory Hodgkin's disease.

Adolescent↗

Self-management of hypertension: predictors of success in diastolic blood pressure reduction.

The purpose of this study was to determine which borderline hypertension subjects could succeed in self-regulating blood pressure, and to distinguish the psychologic and physiologic variables that predicted success. Thirty-four white, male, unmedicated, borderline hypertensive subjects participated in a 14-session biofeedback/cognitive self-management training program. Of these, 22 exited with diastolic pressure below 90 mm Hg; 12 exited equal to or above 90 mm Hg. Both groups exited with scores markedly lower on the Symptoms Checklist-90 (SCL-90). The successful group began and ended on all cognitive/affective subscales at a lower level than the unsuccessful group. A discriminant analysis revealed that lower scores on the SCL-90, lower systolic blood pressures, and higher heart rates during a mental task at the beginning of treatment distinguished those who succeeded in self-regulation from those who could not succeed. The possible mechanisms for blood pressure control/change as a consequence of biofeedback are discussed.

Adult↗

The impact of psychological distress on the control of hypertension.

Previous research has yielded inconsistent results in the control of essential hypertension. One explanation for response to drug or behavioral therapy may be the patient's psychological status upon entering treatment. Thirty-five borderline hypertensive males entered into a self-management program with biofeedback and cognitive restructuring components. The SCL-90 (Symptom Checklist-90) and the Holmes' Schedule of Recent Events were used to determine if responders and nonresponders could be distinguished prior to treatment on the basis of psychological status. Patients whose hypertension was resistant to treatment (diastolic greater than or equal to 90 mm Hg) reported significantly greater levels of psychological distress and greater life changes than did controlled patients. Pretreatment differences could not be explained by compliance or expectation of success. This study suggests that a relationship exists between psychological distress, life changes and the subsequent control of hypertension; this has implications for treatment selection and design for psychologically distressed individuals.

Adult↗

Enhanced fluoride uptake by teeth through use of iontophoretic techniques.

The effects of electric currents on the uptake of fluoride ions by human teeth, in vitro were determined by measuring the change in fluoride ion concentration of the electrolyte in which teeth were subjected to the electrochemical treatment. There was an enhanced uptake when the gold electrode embedded in the tooth was polarized anodically. Evidence that the fluoride ions were taken upon by the teeth was shown by subsequent cathodic polarization of the gold electrode in a fluoride free electrolyte and by measurement of fluoride release into the solution.

Bicuspid↗

Symptoms and self-care strategies in women with and without dysmenorrhea.

We compared the self-reports of women who reported either none-mild (N = 34) or moderate-extreme (N = 27) pain from uterine cramping regarding, (a) gastrointestinal, perimenstrual, and other symptoms during the 5 days before and after the beginning of menstrual flow; (b) smoking, alcohol use, exercise behaviors, and number of reported stressors; and (c) self-care strategies used for symptom management. Although there were significant differences between the two groups in reported symptoms, there were no significant between groups differences in smoking, alcohol use, exercise behaviors, and number of stressors reported. Despite the number of symptoms reported, relatively few self-care strategies were used. The most commonly reported strategy was the use of medication for cramping pain. The results confirm prior observations that dysmenorrhea is associated with a variety of symptoms and extend our understanding of how women manage these symptoms.

Adult↗

Interventions for irritable bowel syndrome: a nursing model.

Irritable Bowel Syndrome (IBS) is a common problem affecting a significant portion of the U.S. population. Nurses are involved directly in the planning and implementing of therapeutic interventions for this patient population. Using a Human Response Model, the authors of this article review intervention studies for IBS. This model provides a context for integration of Person (vulnerability) and Environment (risk) factors that may modify the patient's response to a given therapeutic regimen. Human responses are categorized as Physiological, Pathophysiological, and Behavioral/Experiential. Interdisciplinary therapeutic strategies include motility manipulations via pharmacological agents, dietary modifications, and self-care enhancement. Areas for nursing research are described.

Colonic Diseases, Functional↗

Women with gastrointestinal symptoms: implications for nursing research and practice.

Irritable bowel syndrome and functional bowel disorder are diagnoses used to describe chronic GI symptoms for which no overt pathological condition can be identified. Symptoms are more common in women and are frequently followed in gastroenterology clinics. The purpose of this article is to provide an overview of the research linking GI symptoms and reproductive cycling and to discuss implications for practice. GIGl symptoms such as stomach pain and nausea are highest during menses compared with other cycle phases; also, stool consistency is loosest at menses. This pattern is present in control subjects. In women with irritable bowel syndrome the same pattern is seen but with higher symptom intensity. Although animal studies have demonstrated that estrogen and progesterone modulate contractile function of some GI segments. In humans, symptoms are highest when these hormones are at the lowest levels. Thus, symptoms in women may be related to decreasing ovarian hormone levels or to other circulating hormones or factors which vary with the menstrual cycle. Additionally, other factors such as stress aggravate symptoms. Therapeutics directed toward increasing patient awareness of cyclic patterns in symptom complaints, for example, via the use of daily symptom diaries may be a useful adjunct to dietary, pharmacological, and other therapies.

Clinical Nursing Research↗

Irritable bowel syndrome: causes and treatment.

Irritable bowel syndrome (IBS) is a common health care problem worldwide. In the United States and Northern European countries, more women than men seek health care services for IBS. Nurses are often called on to help women with IBS manage their symptoms. This article reviews the literature related to gender differences in diagnosis, symptoms (gastrointestinal, somatic, and disturbed sleep), and physiologic and psychological factors as well as current pharmacologic therapies used in the management of IBS.

Antidepressive Agents↗

Chronic hepatitis C. Implications for health-related quality of life.

Hepatitis C viral infection with its sequelae is a significant healthcare problem. Hepatitis C infects nearly 4 million Americans with almost half of these unaware of their infection. Many of those individuals infected with hepatitis C develop chronic hepatitis C and in 15% of these patients, the infection will progress to cirrhosis within 20 years. Several cross-sectional and longitudinal studies have demonstrated the negative impact of chronic hepatitis C on health-related quality of life. This review describes what is currently known about the impact of chronic hepatitis C on health-related quality of life during pharmacologic treatment and after liver transplantation. It is important to note that few studies have prospectively followed patients over time with respect to quality of life or examined other factors including symptoms, markers of disease progression, or host immune function. Studies suggest that patients with chronic hepatitis C, even without major disease-related complications, perceive themselves to be unwell and have significant changes in their physical and mental well being. Such results have important implications for nursing care and management. Intervention studies focused on self-care management with an emphasis on symptom reduction are warranted.

Antiviral Agents↗

Diet triggers symptoms in women with irritable bowel syndrome. The patient's perspective.

The purpose of this phenomenological analysis was to describe perceptions of women with irritable bowel syndrome regarding the relationship of diet to their symptoms. Thirty-five women ages 18-45 with a medical diagnosis of irritable bowel syndrome or symptoms compatible with a diagnosis of irritable bowel syndrome were interviewed and completed questionnaires as part of a larger study. During the interview, the women were asked what they thought caused their symptoms. Overall, women tried to adjust their diet to achieve a "Range of Comfort" so their symptoms were tolerable or manageable. To do this, women used a process of "Trial and Error." If a link could be made to diet, then women developed "Self-care Strategies" to maintain a "Healthy Diet." Women who failed to find a relationship during the "Trial and Error" process either felt the frustration of "Uncertainty" or, for a few women, decided that adjusting their diet was not worth the bother. This study suggests diet and eating behaviors are an important starting point for many women as they try to manage their irritable bowel syndrome symptoms.

Adaptation, Psychological↗

The relationship between psychological distress and gastrointestinal symptoms in women with irritable bowel syndrome.

BACKGROUND: Individuals with irritable bowel syndrome (IBS) are reported to experience more symptoms compatible with psychopathologic disorders, abnormal personality traits, and psychological distress. Conversely, individuals with psychiatric disorders report higher levels of gastrointestinal (GI) symptoms compatible with IBS. Thus, psychological distress may contribute to GI symptoms in individuals with IBS. OBJECTIVES: To examine psychological distress in women with IBS, women with similar GI symptoms but not diagnosed (IBS nonpatients, IBS-NP), and asymptomatic Control women. METHODS: The women (N=97) were interviewed, completed questionnaires, and maintained daily diaries for 2 months. Across-women and within-woman analyses were used to calculate the results. RESULTS: The IBS and IBS-NP groups had a higher percentage of lifetime psychopathology and recalled psychological distress. At least 40% of the women in the IBS and IBS-NP groups had positive relationships between daily psychological distress and daily GI symptoms. CONCLUSIONS: Psychological distress is an important component of the IBS symptom experience and should be considered when treatment strategies are designed.

Adult↗