PubMed Health⌕ Search

Biomedical subjects

Megan Smith

Publications and source records attributed to Megan Smith.

7 recordsLinked to original sources
PubMed2005

Associations among overeating, overweight, and attention deficit/hyperactivity disorder: a structural equation modelling approach.

BACKGROUND: Some recent studies have reported strong links between obesity and ADHD in adults; however, to date, little work has focussed on possible behavioural mechanisms that could account for this association. METHOD: This study used structural equation modelling (SEM) in a sample of healthy adult women to test the predictions that ADHD symptoms predict aspects of overeating, including binge eating and emotionally-induced eating, which in turn are positively correlated with Body Mass Index. RESULTS: The SEM produced a non-significant chi-square and both the measurement model and the structural model fit the data very well. CONCLUSIONS: Plausible mechanisms are discussed to help explain how the symptomatology of ADHD could foster different forms of overeating.

Adult↗
PubMed2005

Cardiothoracic physiotherapy: levels of evidence underpinning entry-level curricula.

BACKGROUND AND PURPOSE: In theory, educational materials should reflect the underlying source and evidence base of the curricula. The purpose of the present study was to identify the levels of evidence represented within the cardiothoracic curricula in undergraduate (entry-level) physiotherapy programmes within Australia. METHOD: Using a retrospective document review, all tertiary institutions providing entry-level physiotherapy programmes were invited to submit paper copies of course materials used during 2003 to the Centre for Allied Health Evidence (CAHE), University of South Australia. A single independent reviewer collated all references cited within the teaching materials and ranked each reference according to a hierarchy of evidence where systematic reviews were regarded as the highest level of evidence and expert opinion or case studies as the lowest level. RESULTS: A total of 974 references were cited within educational materials from the five participating universities. The number of references per university rangedfrom 71 to 256. Each ranking category was calculated as a percentage of the total number of references submitted by each university. All five universities demonstrated the same pattern of reference hierarchy where the lower levels of evidence represented approximately 70% of all references. Less than one per cent of all references were common to all five universities. CONCLUSIONS: Although auditing references cited within education material does not reflect educational process, the results from the present study provide a baseline from which to review and create strategies to strengthen the evidence base of the cardiothoracic curriculum.

Australia↗
PubMed2005

Heart rate variability analysis: a useful assessment tool for diabetes associated cardiac dysfunction in rural and remote areas.

OBJECTIVE: Cardiovascular complications are the main cause of death in people with diabetes. Early, asymptomatic changes are due to autonomic nervous system dysfunction, which if identified can lead to improved health. This study used detrended fluctuation analysis to identify changes in heart rate variability (HRV) associated with short-time electrocardiograph (ECG) recordings. The aim of the study was to determine whether heart rate variability analysis on short ECG recordings has the potential to be a useful adjunct to clinical practice. DESIGN: Comparative design with three independent simple random samples. SETTING: University-based research project. PARTICIPANTS: Forty-eight people with no diabetes or cardiovascular complications had a 20 min ECG recorded, which was subsequently analysed using mathematical procedures. All participants also had a lying-to-standing autonomic nervous system test. Data was analysed using a Student t-test. RESULTS: Heart rate variability expressed as a numeric value (alpha(1)), is reduced in disease states. We found a significant difference in alpha(1)(P = 0.03) between the ECG recordings of the diabetes and control groups. In addition lower alpha(1)values were obtained from people identified with autonomic dysfunction within the diabetes group. CONCLUSION: The importance of our findings is that abnormal HRV identifies people with cardiovascular disease, irrespective of diabetes status, that may have autonomic neuropathy. HRV analysis is easily implemented by primary health care providers and has the potential to lead to improved health care by reducing inequity in rural areas and specifically addressing cardiovascular complications associated with diabetes.

Adult↗
PubMed2003

The impact of medical comorbidity on acute treatment in major depressive disorder.

OBJECTIVE: The authors investigated the impact of medical comorbidity on the acute phase of antidepressant treatment in subjects with major depressive disorder. METHOD: A total of 384 outpatients meeting DSM-III-R criteria for major depressive disorder enrolled in 8-week open treatment with fluoxetine, 20 mg/day. The authors used the Cumulative Illness Rating Scale to measure the burden of medical comorbidity and the 17-item Hamilton Rating Scale for Depression to assess changes in depressive symptoms. The outcome measures were response to treatment (>/=50% reduction in score) and clinical remission (score </=7 at the end of the trial). RESULTS: Compared to responders to fluoxetine, nonresponders had significantly higher Cumulative Illness Rating Scale scores and a greater number of Cumulative Illness Rating Scale categories were endorsed. Compared to subjects who achieved remission with antidepressant treatment, those who did not achieve remission had significantly higher Cumulative Illness Rating Scale scores and a greater number of Cumulative Illness Rating Scale categories were endorsed (i.e., more organs were affected by medical illness). The final Hamilton depression scale score was directly correlated with the total Cumulative Illness Rating Scale score and the number of Cumulative Illness Rating Scale categories endorsed. CONCLUSIONS: The total burden of medical illness and the number of organ systems affected by medical illness had a significantly negative predictive value for clinical outcome in the acute phase of treatment in major depressive disorder.

Adult↗
PubMedDate not supplied

Melancholia and axis II comorbidity.

This study assessed whether the rates of comorbid personality disorders differed between DSM-IV melancholic and nonmelancholic major depressive disorder. We evaluated 260 consecutive depressed outpatients (140 women [53.8%]; mean age, 39.01 +/- 10.4 years) with DSM-III-R major depressive disorder (MDD). MDD was diagnosed with the use of the Structured Clinical Interview for DSM-III-R-Patient Edition (SCID-P); enrolled patients were required to have a score >/= 16 on the 17-item Hamilton Rating Scale for Depression (HAM-D-17). The presence of the melancholic subtype of major depression was determined with the use of a DSM-IV checklist, while the presence of personality disorders was assessed using the Structured Clinical Interview for DSM-III-R-Personality Disorders (SCID-II). Of the 102 (39.2%) patients who met criteria for melancholic depression and the 158 (60.7%) who did not, there were no significant differences in age, gender, or rates of personality disorder diagnoses. We observed no significant difference in rates of individual personality disorder clusters between melancholic and nonmelancholic depressed patients. Our findings of comparable rates of comorbid personality disorders between melancholic and nonmelancholic depression are consistent with the decision made by the DSM-IV task force to drop the DSM-III-R melancholic feature criterion of "no significant personality disturbance before first major depressive episode" as they challenge the usefulness of trying to establish such absence of premorbid personality features in acutely depressed patients.

Adolescent↗