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Biomedical subjects

S Glover

Publications and source records attributed to S Glover.

At least 19 recordsLinked to original sources

Improving left hemispatial neglect using virtual reality.

BACKGROUND: In hemispatial neglect, space can be dissociated on the basis of "near" peripersonal vs "far" extrapersonal space. The clinical manifestations of neglect can be modified by having patients use a tool to explore "far" extrapersonal space. An explanation for this is that the use of a stick produced an extension of body space resulting in a remapping of "far" space as "near" space. OBJECTIVE: S: To determine whether the remapping of space can be generalized to the amelioration of the "affected" vs the "nonaffected" space, rather than being confined to the selective amelioration of "far" vs "near" neglect; and to determine whether tool use is a necessary condition for the remapping of space. METHODS: Using virtual reality, the authors asked six hemispatial neglect patients to reach and grasp a real object while simultaneously observing the grasping of a virtual object located within a virtual environment by a virtual hand. The virtual hand was commanded in real time by their real hand. RESULTS: After a period of adaptation, hemispatial neglect patients coded the visual stimuli within the neglected space in an identical fashion as those presented within the preserved portions of space. CONCLUSIONS: It is possible to re-create links between the affected and the nonaffected space. Wielding a tool is not a necessary condition in reopening neglected space.

Aged↗

Adolescent health education programmes: theoretical principles in design and delivery.

The patterns of health need in youth have changed over the last three decades with increasing rates of psychosocial problems compromising adolescent development and affecting the patterns of morbidity and mortality in adult years. This has increased the public health interest in health promotion, early detection and preventive health care for adolescents. Yet, young people report significant barriers to accessing the health care system, and health professionals report a self-perceived lack of competency and prior training in adolescent health, especially in these areas of youth health need. There is an imperative to provide quality professional development for existing health professionals and undergraduates in adolescent health care. This paper will discuss a model of professional knowledge in adolescent health and the evidence-based principles in design and delivery of effective education programmes. It will also review the published evaluations of adolescent education programmes and outcomes that still require evaluation in the future.

Adolescent↗

Motor adaptation to an optical illusion.

This research investigated the effects of an orientation illusion on action, as well as the ability of the motor system to adapt to the illusion. Subjects reached out and picked up a small bar placed at various orientations. A background grating was used to induce an orientation illusion. When the direction of the illusion was reversed, the following seven trials revealed a large illusion effect in the early portion of the reach. In the subsequent seven trials, no effect of the illusion was present. This pattern of adaptation was similar to the pattern often obtained with displacing prisms, suggesting that the two types of visual distortions present the motor system with similar challenges that it meets in similar ways. These findings are consistent with a planning/control model that argues for separate visual representations underlying the planning and on-line control of reaching.

Adaptation, Physiological↗

The role of vision in the on-line correction of illusion effects on action.

In this study, participants reached out and picked up a bar placed on a background grating that induced an illusion in the perceived orientation of the bar. The illusion had a large effect on the orientation of the hand early in the reaches, but this effect decreased continuously as the hand approached the target. This pattern occurred whether or not participants were allowed vision of the hand and target while reaching. These results are consistent with a "planning/control" model of action, in which actions are planned using a context-dependent visual representation but monitored and corrected on-line using a context-independent visual representation. The hypothesized neural bases of these representations are discussed.

Adult↗

Higher than normal plasma interleukin-6 concentrations in cancer patients with depression: preliminary findings.

OBJECTIVE: This study investigated whether cancer patients with and without major depression exhibit immune system abnormalities similar to those reported in medically healthy, depressed subjects without cancer. METHOD: The study subjects consisted of patients diagnosed with pancreatic, esophageal, or breast cancer. Other groups consisted of subjects with major depression (without cancer) and healthy comparison subjects. Subjects' diagnoses were made with the Structured Clinical Interview for DSM-III-R. Severity of depression was measured with the Hamilton Depression Rating Scale. Plasma concentrations of interleukin-6 (IL-6) and postdexamethasone cortisol were measured. RESULTS: Cancer patients with depression had markedly higher plasma concentrations of IL-6 than healthy comparison subjects and cancer patients without depression. Although significant correlations were found between Hamilton depression scale scores and plasma concentrations of postdexamethasone cortisol, no significant correlations were found between plasma IL-6 and postdexamethasone cortisol concentrations. CONCLUSIONS: Higher than normal plasma IL-6 concentrations were associated with a diagnosis of major depression in cancer patients. IL-6 may contribute to sickness behavior that has overlapping symptoms with major depression.

Adult↗

Building capacity for system-level change in schools: lessons from the Gatehouse Project.

The Gatehouse Project is an innovative, comprehensive approach to mental health promotion in secondary schools. It sets out to promote student engagement and school connectedness as the way to improve emotional well-being and learning outcomes. The key elements of the whole-school intervention are the establishment and support of a school-based adolescent health team; the identification of risk and protective factors in each school's social and leaning environment from student surveys; and, through the use of these data, the identification and implementation of effective strategies to address these issues. The project evaluation used a cluster-randomized controlled trial design involving 26 schools with initial results demonstrating considerable success in reducing smoking rates among Year 8 children. This article describes and accounts for how system-level changes have been made in schools through a process of capacity building. This encourages teachers, parents, and students to view the core business of education differently.

Adolescent↗

Effects of regular and slow speed resistance training on muscle strength.

BACKGROUND: The study assessed a way to increase the intensity and effectiveness of resistance training by comparing training with a slower repetition speed to training with a conventional repetition speed. Slower repetition speed may effectively increase intensity throughout the lifting phase while decreasing momentum. METHODS: Two studies were done with untrained men (N=65) and women (N=82), (mean age=53.6) who trained two to three times per week for eight to 10 weeks on a 13 exercise Nautilus circuit performing one set of each exercise. Participants exclusively trained using regular speed repetitions for 8 to 12 repetitions per set at 7 sec each (2 sec lifting, 1 sec pause, 4 sec lowering) or a Super Slow training protocol where they completed 4 to 6 repetitions per set at 14 sec each (10 sec lifting, 4 sec lowering). All of the participants were tested for either the 10 repetition-maximum (RM) weightload (regular-speed group) or the 5-RM weightload (slow-speed group). RESULTS: In both studies, Super-Slow training resulted in about a 50% greater increase (p<0.001) in strength for both men and women than regular speed training. In Study 1, the Super-Slow training group showed a mean increase of 12.0 kg and the regular speed group showed an increase of 8.0 kg increase (p<0.001). In Study 2, the Super-Slow training group showed a 10.9 kg increase and the regular speed group showed an increase of 7.1 kg (p<0.001). CONCLUSIONS: Super-Slow training is an effective method for middle-aged and older adults to increase strength. Although studies still need to be done with at-risk populations, repetition speed should be considered when prescribing resistance training.

Adult↗

Effects of different resistance training protocols on upper-body strength and endurance development in children.

This study examined the effects of 4 different resistance training protocols on upper-body strength and local muscle endurance development in children. Untrained boys and girls (mean +/- SD age, 8.1 +/- 1.6 years) trained twice per week for 8 weeks using child-sized weight machines and medicine balls weighing 1-2.5 kg. In addition to general conditioning exercises, subjects in each exercise group performed 1 set of the following exercise protocols for upper-body conditioning: 6-8 repetitions with a heavy load on the chest press exercise (HL, n = 15); 13-15 repetitions with a moderate load on the chest press exercise (ML, n = 16); 6-8 repetitions with a heavy load on the chest press exercise immediately followed by 6-8 medicine ball chest passes (CX, n = 12); or 13-15 medicine ball chest passes (MB, n = 11). Twelve children served as nontraining controls (CT). After training, only the ML and CX groups demonstrated significant (p < 0.05) improvements in 1RM chest press strength (16.8% and 16.3%, respectively) as compared with the CT group. Local muscle endurance, as determined by the number of repetitions performed posttraining on the chest press exercise with the pretraining 1RM load, significantly increased in the ML group (5.9 +/- 3.2 repetitions) and CX group (5.2 +/- 3.6 repetitions) as compared with the CT group. In terms of enhancing the upper-body strength and local muscle endurance of untrained children, these findings favor the prescription of higher-repetition training protocols during the initial adaptation period.

Adaptation, Physiological↗

Proposing an algorithm for the pharmacological management of posttraumatic stress disorder.

The clinical management of posttraumatic stress disorder (PTSD) is as complex as the condition itself. Pharmacotherapy is an important component of this treatment process, which also includes psychosocial interventions and, in most cases, entails long-term efforts. The authors propose a systematic approach to the pharmacological treatment of PTSD using algorithmic techniques. After a careful history-taking phase and a review of available psychotropic agents, the practitioner usually ends up dealing with either PTSD alone or, more frequently, accompanied by other identifiable syndromes. Various antidepressants have demonstrated efficacy in the former, while the latter requires a management aimed at depressive, anxiety/dissociative, hypomanic/manic, or psychotic symptoms. The proposed algorithm provide guidelines for treatment issues such as medication choice, medication dose, maintenance pharmacotherapy, alternative options, and eventual outcomes. Algorithms summarize current information and suggest pharmacotherapy guidelines as a significant component of a comprehensive PTSD management program.

Algorithms↗

The Gatehouse Project: a systematic approach to mental health promotion in secondary schools.

OBJECTIVE: The objective of this paper is to outline the conceptual background and strategy of intervention for a systematic and sustainable approach to mental health promotion in secondary schools. METHOD: The conceptual origins of the Gatehouse Project are described in terms of the epidemiology of adolescent mental health problems, attachment theory, education reform research and health promotional theory and practice. The elements of health promotional work are described in terms of structural change and priority setting; implementation at multiple levels within the participating schools is described. RESULTS: The conceptual framework of the Gatehouse Project emphasises healthy attachments with peers and teachers through the promotion of a sense of security and trust, effective communication and a sense of positive self-regard based on participation in varied aspects of school and community life. A school social climate profile is derived from a questionnaire survey of students. An adolescent health team uses this information to set priorities for change within the school. Interventions may focus on the promotion of a positive social climate of the whole school or in the classroom. Curriculum-based health education is also used and based on materials that are relevant to the normal developmental experiences of teenagers. These are integrated into the mainstream curriculum and incorporate a strong component of teacher professional development. Lastly, the intervention promotes linkage between the school and broader community with a particular emphasis on the needs of young people at high risk of school drop-out. CONCLUSIONS: Educational environments are complex systems undergoing continuous and simultaneous changes. The Gatehouse Project will provide unique information on the relationship between the social environment and the emotional wellbeing of young people. More importantly it outlines a sustainable process for building the capacity of schools to promote the social and emotional development of young people.

Adolescent↗

Randomised controlled trial of an educational strategy to increase school-based adolescent hepatitis B vaccination.

OBJECTIVES: This study aimed to evaluate a specifically designed hepatitis B education/promotion curriculum package as part of a successful hepatitis B vaccination delivery system to adolescents. METHODS: A randomised-controlled trial was used to evaluate the effect of the curriculum package (or intervention) on uptake of vaccine. Schools were randomly selected from the metropolitan region of Melbourne to intervention (66 schools or 7,588 students) or control groups (69 schools or 9,823 students). Class teachers administered the intervention to students over 4 class periods before the vaccination course. RESULTS: The difference in mean school uptake between intervention and control was small at 1-2% per dose. 95% confidence intervals around the differences were -5% to 2% per dose and not significant. Intervention schools taught an average of 7 items out of 12 from the curriculum package. Immunisation rates increased by 4-10% per dose between low and high implementation schools, but this trend was not significant. Impact evaluation demonstrated significantly greater knowledge of hepatitis B and vaccination among students in the intervention than the control group. CONCLUSION: Hepatitis B vaccination of pre-adolescents was not increased by the implementation of a curriculum package that successfully increased knowledge and awareness of hepatitis B in a school-based vaccination program. Additional strategies directed at the education of parents, the cooperative role of schools and pro-active providers might also be required to maximise vaccine uptake in this age group.

Adolescent↗

A clinical study of 57 children with fetal anticonvulsant syndromes.

BACKGROUND: Anticonvulsants taken in pregnancy are associated with an increased risk of malformations and developmental delay in the children. To evaluate the pattern of abnormalities associated with prenatal anticonvulsant exposure further, we undertook a clinical study of 57 children with fetal anticonvulsant syndromes. METHODS: Fifty two children were ascertained through the Fetal Anticonvulsant Syndrome Association and five were referred to the Aberdeen Medical Genetics Service. Pregnancy and medical history were obtained through a standardised questionnaire and interview and the children were examined. RESULTS: Thirty four (60%) were exposed in utero to valproate alone, four (7%) to carbamazepine alone, four (7%) to phenytoin alone, and 15 (26%) to more than one anticonvulsant. Forty six (81%) reported behavioural problems, 22 (39%) with hyperactivity or poor concentration of whom four (7%) had a diagnosis of attention deficit and hyperactivity disorder. Thirty four (60%) reported two or more autistic features, of whom four had a diagnosis of autism and two of Asperger's syndrome. Forty four (77%) had learning difficulties, 46 (81%) had speech delay, 34 (60%) had gross motor delay, and 24 (42%) had fine motor delay. Nineteen (33%) had glue ear and 40 (70%) had joint laxity involving all sizes of joints. Of 46 who had formal ophthalmic evaluation, 16 (34%) had myopia. CONCLUSIONS: Speech delay, joint laxity, glue ear, and myopia are common in the fetal anticonvulsant syndromes and autistic features and hyperactivity form part of the behavioural phenotype.

Abnormalities, Drug-Induced↗

Hospital competition in major U.S. metropolitan areas: empirical evidence.

In response to dramatic rises in health care costs, policy-makers have been debating the relative merits of competitive strategies as a means of containing costs. This article represents a study of the 29 largest MSAs for 1991. Controlling for environmental conditions in each market, the impact of competition on hospital costs was examined. Competition was found to have had a significant positive impact on overall hospital costs.

Catchment Area, Health↗

Periodontopathic bacteria in English HIV-seropositive persons.

Selected periodontopathic bacteria were sought in 20 HIV-infected English patients and eight noninfected control subjects with similar periodontal status, using highly specific DNA probes. Actinobacillus actinomycetemcomitans (A. a), Porphyromonas gingivalis, Campylobacter rectus, Prevotella intermedia, and Fusobacterium nucleatum were more frequently detected and were found at higher levels in HIV-infected individuals than in controls. Significantly increased levels of Treponema denticola but, in contrast, lower levels of Eikenella corrodens were found in nonbleeding sites of HIV-infected patients compared with controls. The results of the present investigation on English patients suggest a periodontopathogenic role for A. a, P. gingivalis and C. rectus, and possibly P. intermedia and are in general accord with most previously reported data from the United States. Longitudinal studies are now required to determine more precisely the association between periodontopathic microflora, immune competence and periodontal health and disease in HIV-infected persons.

AIDS-Related Opportunistic Infections↗

A profile of women CEOs/administrators in community and migrant health centers.

Most of the current research on women executives has focused on models in which few women achieve the highest position (e.g. hospital CEOs). This article looks at the nation's Community and Migrant Health Centers where substantial numbers of women hold the highest executive position. A national profile of women Community and Migrant Health Centers (C/MHCs) Chief Executive Officers/Administrators is provided in terms of their personal and work characteristics, as well as their values and beliefs regarding successful C/MHC attributes and important managerial practices. The study compares C/MHC Chief Executive Officers/Administrators based on gender. The study found that 41 percent of the CEO/Administrators were women and that they shared similar values and beliefs about functions/critical managerial factors and managerial characteristics of C/MHCs with their male colleagues. However, the study did find a comparable salary differential of over $11,000 in favor of male Chief Executive Officers/Administrators. The article reviews the literature of female executives in health care and concludes with recommendations for further study using the C/MHCs CEO/Administrators as a model study population.

Community Health Centers↗

Administrative update: utilization of services. II. Utilization of mental health services in a tri-ethnic sample of adolescents.

In our study of a tri-ethnic sample of 2528 junior and high school students, we examined utilization of outpatient mental health services in relation to a number of variables cited in the literature as leading to potential biases and barriers to care. These include: age, gender, ethnicity, socioeconomic status, family size and composition, and linguistic fluency in Hispanic youth. The impact of service availability was examined through differences between the two regions studied: a well-served region of coastal southeast Texas and the markedly under served lower Rio Grande Valley. The impact of symptomatology was evaluated using the total problem score on the Youth Self Report by Achenbach. Hispanic youth had significantly lower mean service utilization than non-Hispanic whites. Multiple regression analyses demonstrated that socioeconomic status and family composition had a greater relative impact on utilization than all other non-clinical factors, both for the total sample as well as for the Hispanic sample. Ethnicity may play a significant role in child mental health services utilization through its close association to socioeconomic status.

Adolescent↗