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Biomedical subjects

Mary Kane

Publications and source records attributed to Mary Kane.

9 recordsLinked to original sources
PubMed2005

Using concept mapping to develop a logic model for the Prevention Research Centers Program.

INTRODUCTION: Concept mapping is a structured conceptualization process that provides a visual representation of relationships among ideas. Concept mapping was used to develop a logic model for the Centers for Disease Control and Prevention's Prevention Research Centers Program, which has a large and diverse group of stakeholders throughout the United States. No published studies have used concept mapping to develop a logic model for a national program. METHODS: Two logic models were constructed using the data from the concept mapping process and program documents: one for the national level and one for the local level. Concept mapping involved three phases: 1) developing questions to generate ideas about the program's purpose and function, 2) gathering input from 145 national stakeholders and 135 local stakeholders and sorting ideas into themes, and 3) using multivariate statistical analyses to generate concept maps. Logic models were refined using feedback received from stakeholders at regional meetings and conferences and from a structured feedback tool. RESULTS: The national concept map consisted of 9 clusters with 88 statements; the local concept map consisted of 11 clusters with 75 statements. Clusters were categorized into three logic model components: inputs, activities, and outcomes. Based on feedback, two draft logic models were combined and finalized into one for the Prevention Research Centers Program. CONCLUSION: Concept mapping provides a valuable data source, establishes a common view of a program, and identifies inputs, activities, and outcomes in a logic model. Our concept mapping process resulted in a logic model that is meaningful for stakeholders, incorporates input from the program's partners, and establishes important program expectations. Our methods may be beneficial for other programs that are developing logic models for evaluation planning.

Cluster Analysis↗
PubMed2005

The role of state public health agencies in addressing less prevalent chronic conditions.

INTRODUCTION: State-based chronic disease programs typically focus on the most prevalent chronic conditions, such as cancer, diabetes, and cardiovascular disease, but interest in less prevalent chronic conditions (LPCCs), such as epilepsy, is growing. In our study, we examined the perceived roles of state health departments in addressing LPCCs and used this information to develop recommendations for state health departments that are considering developing LPCCs programs. We also compared the identified state health department roles for LPCCs with roles related to healthy aging, as well as to the essential elements of existing state-based chronic disease programs, to determine whether future LPCCs programs would have any unique requirements. METHODS: Participants used concept-mapping techniques to generate a set of 100 statements on steps that state health departments could take to address LPCCs. The participants sorted and rated each statement according to importance and feasibility. We used a sequence of multivariate statistical analyses to generate a series of maps, or clusters, and rating graphics. We reviewed the findings and produced recommendations for state health departments. We used a similar process to examine roles of state health departments in addressing healthy aging. RESULTS: The participants grouped the LPCCs statements into nine clusters, which they rated as moderately feasible and important. The healthy aging statements were grouped into eight clusters. Clusters for LPCCs and healthy aging were similar. We also compared LPCCs clusters and the essential elements of existing state-based chronic disease programs and found that they were similar. CONCLUSION: The similarities between LPCCs clusters and essential elements of existing state-based chronic disease programs highlight an important point. State health departments that are considering establishing LPCCs programs should use strategies that have already been used by other public health agencies to develop chronic disease prevention and control programs.

Chronic Disease↗
PubMed2005

Concept mapping: an introduction to structured conceptualization in health care.

Structured conceptualization is a specific form of concept mapping that is a mixed methods participatory approach that combines group processes (brainstorming, sorting, group interpretation) with a sequence of multivariate statistical analyses (multidimensional scaling, hierarchical cluster analysis). Concept mapping's relevance to health care quality and services is described. The basic steps and analysis sequence in the concept mapping method are outlined and a brief example of the results for a health planning project are presented. Several examples of the use of concept mapping in health are provided.

Cluster Analysis↗
PubMed2005

Development of public health priorities for end-of-life initiatives.

OBJECTIVE: Recently, end-of-life (EOL) issues have captured the attention of the public health community. This study reports a project to help state health departments better understand their potential role in addressing EOL issues and develop initial priorities for EOL activities. METHODS: The project involved two studies. Study 1 (October 2002 to September 2003) involved a concept mapping process to solicit and organize recommendations from key stakeholders. Concept mapping integrates qualitative group processes with multivariate statistical analysis to represent the ideas of stakeholders visually through maps. A key-informant approach was used to identify stakeholder participants with expertise in aging, cancer, public health, and EOL. In two meetings, stakeholders used the maps to develop short-, intermediate-, and long-term recommendations for EOL initiatives. Study 2 (October 2003 to September 2004) involved a modified Delphi process with three iterations to prioritize recommendations for initial action from among a group of short-term recommendations. RESULTS: Study 1 resulted in 103 recommendations for EOL initiatives across nine domains. Study 2 resulted in consensus on five initial recommendations from three domains: identifying an EOL point of contact in state health departments, collecting and analyzing data about EOL, incorporating EOL principles into state comprehensive cancer control plans, educating the public about hospice and palliative care, and educating the public about the importance of advance directives. CONCLUSIONS: Diverse perspectives of key public health stakeholders resulted in a series of short- and longer-term recommendations for EOL action. These recommendations can guide future efforts by state health departments and other public health agencies to address EOL issues.

Humans↗
PubMed2004

Photobiomodulation directly benefits primary neurons functionally inactivated by toxins: role of cytochrome c oxidase.

Far red and near infrared (NIR) light promotes wound healing, but the mechanism is poorly understood. Our previous studies using 670 nm light-emitting diode (LED) arrays suggest that cytochrome c oxidase, a photoacceptor in the NIR range, plays an important role in therapeutic photobiomodulation. If this is true, then an irreversible inhibitor of cytochrome c oxidase, potassium cyanide (KCN), should compete with LED and reduce its beneficial effects. This hypothesis was tested on primary cultured neurons. LED treatment partially restored enzyme activity blocked by 10-100 microm KCN. It significantly reduced neuronal cell death induced by 300 microm KCN from 83.6 to 43.5%. However, at 1-100 mm KCN, the protective effects of LED decreased, and neuronal deaths increased. LED significantly restored neuronal ATP content only at 10 microm KCN but not at higher concentrations of KCN tested. Pretreatment with LED enhanced efficacy of LED during exposure to 10 or 100 microm KCN but did not restore enzyme activity to control levels. In contrast, LED was able to completely reverse the detrimental effect of tetrodotoxin, which only indirectly down-regulated enzyme levels. Among the wavelengths tested (670, 728, 770, 830, and 880 nm), the most effective ones (830 nm, 670 nm) paralleled the NIR absorption spectrum of oxidized cytochrome c oxidase, whereas the least effective wavelength, 728 nm, did not. The results are consistent with our hypothesis that the mechanism of photobiomodulation involves the up-regulation of cytochrome c oxidase, leading to increased energy metabolism in neurons functionally inactivated by toxins.

Adenosine Triphosphate↗
PubMed2002

NASA light-emitting diodes for the prevention of oral mucositis in pediatric bone marrow transplant patients.

OBJECTIVE: The purpose of this study was to determine the effects of prophylactic near-infrared light therapy from light-emitting diodes (LEDs) in pediatric bone marrow transplant (BMT) recipients. BACKGROUND DATA: Oral mucositis (OM) is a frequent side effect of chemotherapy that leads to increased morbidity. Near-infrared light has been shown to produce biostimulatory effects in tissues, and previous results using near-infrared lasers have shown improvement in OM indices. However, LEDs may hold greater potential for clinical applications. MATERIALS AND METHODS: We recruited 32 consecutive pediatric patients undergoing myeloablative therapy in preparation for BMT. Patients were examined by two of three pediatric dentists trained in assessing the Schubert oral mucositis index (OMI) for left and right buccal and lateral tongue mucosal surfaces, while the patients were asked to rate their current left and right mouth pain, left and right xerostomia, and throat pain. LED therapy consisted of daily treatment at a fluence of 4 J/cm(2) using a 670-nm LED array held to the left extraoral epithelium starting on the day of transplant, with a concurrent sham treatment on the right. Patients were assessed before BMT and every 2-3 days through posttransplant day 14. Outcomes included the percentage of patients with ulcerative oral mucositis (UOM) compared to historical epidemiological controls, the comparison of left and right buccal pain to throat pain, and the comparison between sides of the buccal and lateral tongue OMI and buccal pain. RESULTS: The incidence of UOM was 53%, compared to an expected rate of 70-90%. There was also a 48% and 39% reduction of treated left and right buccal pain, respectively, compared to untreated throat pain at about posttransplant day 7 (p < 0.05). There were no significant differences between sides in OMI or pain. CONCLUSION: Although more studies are needed, LED therapy appears useful in the prevention of OM in pediatric BMT patients.

Adolescent↗
PubMedDate not supplied

Complex physical and mental health needs of rural incarcerated women.

Despite the growing numbers of incarcerated women, there still remain few systematic analyses of their unique physical and mental health needs. A descriptive design was used in a convenience sample of 30 incarcerated female offenders in a rural detention center to investigate the complex health care needs of this population and formulate appropriate community-based nursing interventions. The participants received a detailed physical and mental health assessment, as well as screening for alcohol and drug abuse. Sixty-three percent of the women reported drug problems and 80% reported alcohol problems, while 84% reported physical or sexual abuse. Serious health problems were identified, including AIDS, STDs, and delirium tremens. Scores on the Global Severity Index of the Brief Symptom Inventory showed that 70% percent of the women were in the clinical range for mental health problems. The scores on the Multidimensional Scale of Perceived Social Support were negatively correlated with the Global Severity Index on the BSI (r = -.377, p = .04) which may indicate some protective effect of social support with regards to psychiatric distress. The data demonstrate a need to develop a brief objective mental health screening test for this specific population to identify psychiatric problems that require immediate attention during the incarceration period. The results also highlight incarceration as an excellent opportunity for the advanced practice nurse to initiate focused health care interventions and other strategies which can foster incarcerated women's re-entry into the community. More research is needed in this underserved group, particularly concerning issues of maternal incarceration, STD prevention, detoxification, psychiatric treatment, and sources of social support.

Adult↗