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Biomedical subjects

S Ryan

Publications and source records attributed to S Ryan.

At least 91 records · Page 5Linked to original sources
PubMed1996

Behavior and injury in urban and rural adolescents.

OBJECTIVES: This study investigates the consistency of factors associated with adolescent injury in separate urban and rural samples. SAMPLES: Adolescents, 11-17 years old, in public schools in urban and rural Maryland (n = 2,712). METHODS: Separate bivariate and logistic regression analyses were conducted for each sample to determine individual and environmental factors associated with major and minor injuries experienced in the previous year. RESULTS: Multivariate analyses revealed that, for both samples, the probability of a major injury was highest for boys and, among both boys and girls, for those who played several team sports. Among rural youth, other significant covariates of both major and minor injuries were a tendency to engage in risky behavior and to use alcohol. For urban youth, being white, carrying a weapon for protection, attending an unsafe school, and working for pay were also significant covariates. Interactions were important and complex. CONCLUSIONS: The consistency of predictive factors, such as multiple sports team participation and risky and aggressive behaviors in completely different physical environments, underscores the need to address the contexts of heightened injury risk that some adolescents create wherever they live by playing sports and/or behaving in an antisocial, aggressive manner. Moreover, the perception of lack of safety in schools and neighborhoods is associated with increased injury rates, suggesting the need for policy interventions to target social environments as well as behavior.

Adolescent↗
PubMed1996

Balance abilities of professional dancers on select balance tests.

Documentation that dancers have better balance abilities than nondancers is important because of the number of dancers who sustain injury and then are referred to physical therapists for treatment. The purpose of this study was to compare balance abilities of professional dancers with nondancers on selected balance conditions. Fifteen dancers and 15 age- and gender-matched nondancers maintained one-legged stance under six combinations of visual and support surface conditions (Foam and Dome Test modified from two feet to one foot). Each condition was maintained for 30 seconds. A composite balance score was obtained for each subject by summing the number of seconds the individual maintained balance for each test condition. There was a significant difference in the mean composite balance score (across the six balance conditions) for the dance group compared with the control group (731 seconds and 563 seconds, respectively). Under sensory challenged conditions, it appeared that dancers were better able to maintain their postures upright against gravity. The balance strategies and techniques learned by professional dancers should be carefully analyzed to determine if they could be incorporated into treatment programs for nondancers who have balance instability and dancers who are injured.

Adult↗
PubMed1995

Uniform prehospital data elements and definitions: a report from the uniform prehospital emergency medical services data conference.

One of the district and universal aspects of emergency medical service (EMS) is the belief that before its implementation many people were dying or being killed by ill-equipped, poorly trained "hearse drivers" and that this tragic state of affairs has been rectified by the advances in the prehospital phase of care. Except for cases of nontraumatic, out-of-hospital cardiac arrest there is almost no convincing scientific evidence to prove that prehospital care has had an impact on morbidity or mortality. At the very foundation of this problem is the lack of a set of broad-based, well-conceived, accurate, reliable, uniform EMS data. Many attempts have been made to develop a uniform EMS data set, but without a national consensus these have not achieved wide distribution. In 1992, with the assistance of the National Highway Traffic Safety Administration, the national consensus process began with a series of meetings involving many EMS agencies and organizations. This culminated in August 1994 with the development of an 81-item uniform EMS data set. We detail the prior attempts at data set development and outline the process leading to the this uniform, national EMS data set.

Data Collection↗
PubMed1995

Oncogenicity of human papillomavirus- or adenovirus-transformed cells correlates with resistance to lysis by natural killer cells.

The reasons for the dissimilar oncogenicities of human adenoviruses and human papillomaviruses (HPV) in humans are unknown but may relate to differences in the capacities of the E1A and E7 proteins to target cells for rejection by the host natural killer (NK) cell response. As one test of this hypothesis, we compared the abilities of E1A- and E7-expressing human fibroblastic or keratinocyte-derived human cells to be selectively killed by either unstimulated or interferon (IFN)-activated NK cells. Cells expressing the E1A oncoprotein were selectively killed by unstimulated NK cells, while the same parental cells but expressing the HPV type 16 (HPV-16) or HPV-18 E7 oncoprotein were resistant to NK cell lysis. The ability of IFN-activated NK cells to selectively kill virally transformed cells depends on IFN's ability to induce resistance to NK cell lysis in normal (i.e., non-viral oncogene-expressing) but not virally transformed cells. E1A blocked IFN's induction of cytolytic resistance, resulting in the selective lysis of adenovirus-transformed cells by IFN-activated NK cells. The extent of IFN-induced NK cell killing of E1A-expressing cells was proportional to the level of E1A expression and correlated with the ability of E1A to block IFN-stimulated gene expression in target cells. In contrast, E7 blocked neither IFN-stimulated gene expression nor IFN's induction of cytolytic resistance, thereby precluding the selective lysis of HPV-transformed cells by IFN-activated NK cells. In conclusion, E1A expression marks cells for destruction by the host NK cell response, whereas the E7 oncoprotein lacks this activity.

Adenovirus E1A Proteins↗
PubMed1995

Telling parents their child has severe congenital anomalies.

A large number of potential malformations exist, but the key skills in communicating with the parents of a malformed baby are the same. Dissatisfaction is common in this situation and has prompted a national initiative in improving standards of disclosure of disability and malformation--the Right from the start strategy (see appendix). Key skills include keeping the family together, ie, not removing the baby unnecessarily, knowing how parents like to be informed, listening, checking that parents have understood, being nonderogatory and, most importantly, emphasizing the positive side of their newborn child.

Communication↗
PubMed1995

A quantitative approach to quality improvement and resource allocation.

This report illustrates ways in which routinely collected hospital morbidity data can be used to inform and improve decisions about resource allocation, priorities for services and opportunities for improvement. All hospitals, public and private, Australia-wide collect these data at enormous expense. The resources allocated to processing, analysing and utilizing the data are minimal by comparison. Used appropriately these data can provide valuable information to managers and clinicians alike.

Australia↗
PubMed1994

Posttraumatic stress disorder in a clinical sample of adults sexually abused as children.

Forty-seven help-seeking, adult survivors of childhood sexual abuse (CSA) were assessed to examine the relationship between the level of CSA exposure and the subsequent development of posttraumatic stress disorder. CSA exposure was operationalized to include the overall level of exposure, frequency and duration of the abuse, age of onset, use of force, perceived life threat, and the occurrence of penetration. Participants were administered standardized measures of PTSD, including the Structured Clinical Interview of DSM-III-R (SCID). On the SCID, 69% of the survivors met full DSM-III-R criteria for PTSD. Significant correlations were found between several overall exposure measures and PTSD diagnostic status and the intensity of PTSD symptomatology. Similar relationships were identified with the duration and frequency of the abuse, the age of onset, and the use of force. This study is important in that it utilized standardized measures of PTSD and found a significant incidence of PTSD among adult CSA survivors.

Adolescent↗
PubMed1994

Systemic embolism in thyrotoxicosis without cardiac arrhythmia.

A 39-year-old woman presented with an acute left hemisphere stroke and was found to have severe hyperthyroidism. She developed an acute right brachial artery occlusion while under continuous cardiac monitoring, and at no time exhibited atrial fibrillation. This case, and a review of the literature, suggests that thromboembolism occurs in thyrotoxicosis without atrial fibrillation.

Adult↗
PubMed1994

Functional maturation of the medial efferent olivocochlear system in human neonates.

The effect of contralateral acoustic stimulation on transient evoked otoacoustic emissions (TEOAE) was used to investigate the functional maturity of the medial efferent olivocochlear system in full term neonates and a 6-week-old baby. The technique used was to record the TEOAE alternately with and without contralateral noise. The result was a reduction in TEOAE amplitude and latency. This was best illustrated with a difference waveform obtained from the subtraction of the TEOAE waveform recorded with contralateral noise, from the waveform recorded without contralateral noise. All the full term neonates and also the 6-week-old baby showed significant effects indicating functional maturity of the medial olivocochlear system.

Acoustic Stimulation↗
PubMed1994

Pancreatic enzyme elevations after blunt trauma.

BACKGROUND: Elevations in levels of the pancreatic enzymes amylase and lipase occur frequently after trauma. The purpose of this prospective study was to examine the incidence of these enzyme elevations in patients suffering blunt trauma, their natural history, and their relationship to posttraumatic pancreatitis. METHODS: One hundred consecutive trauma patients were studied on admission to the surgical intensive care unit with daily serum amylase and lipase measurements, which were blinded to the clinical service. If the enzyme levels were elevated after 3 days, the patient was enrolled in the study and observed and examined daily, and enzyme levels were measured every other day. These patients were fed enterally by the clinical service if no symptoms of clinical pancreatitis were present. RESULTS: In 17% of patients persistent pancreatic enzyme elevations developed. These patients more frequently had had hypotension, higher Injury Severity Scores, and were more likely to have had severe head injuries than those whose enzyme levels remained normal. Five percent of those studied displayed evidence of clinical pancreatitis, and none of these patients had only isolated head injuries. Lumbar spine injuries and retroperitoneal hematomas were present more frequently in the group in whom symptomatic pancreatitis developed. CONCLUSIONS: After blunt trauma 17% of patients displayed persistent pancreatic enzyme elevations, but the majority remained asymptomatic despite enteral feeding. Retroperitoneal injury may identify patients at risk for pancreatitis. Patients with isolated head injuries should be fed enterally.

Adolescent↗
PubMed1993

Steroids for babies.

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMed1993

Health after childbirth: a comparison of normal and assisted vaginal delivery.

413 women were included in the study: 100 who had had a normal delivery and 313 who had participated in a randomised controlled comparison of forceps or ventouse delivery. The study comprised a questionnaire and assessment at 24-48 hours after delivery and a questionnaire in the second year after delivery. There was significantly more morbidity in the women in the instrumental delivery group compared to women in the normal delivery group at both the early assessment and long-term follow-up.

Adult↗
PubMed1993

Adolescent health status measurement: development of the Child Health and Illness Profile.

This report describes the early stages in the development and testing of an instrument, known as the CHIP (Child Health and Illness Profile), for assessing the health of individuals aged 11 through 17. The purpose of the instrument is to assess health in epidemiologic surveys, to determine the existence of systematic differences in health in subpopulations (including the socioeconomically disadvantaged), and to provide a basis for assessing the impact of changes in health services or health policies. An instrument consisting of six domains with 25 subdomains was developed based on the literature, the involvement of focus groups and expert panels, and pretesting in four groups of teenagers known to differ in their health. The results of work with panels of experts suggest that the instrument has content validity. Most domains and subdomains had acceptable reliability as measured by alpha coefficients. Differences in the scores of individuals in the four groups were in the predicted directions, suggesting that the instrument also has construct validity. Additional research is under way to establish other aspects of validity as well as reliability in school populations of adolescents as well as specific clinical settings.

Activities of Daily Living↗
PubMed1992

The dynamics of MS-222 anaesthesia in a marine teleost (Pagrus auratus: Sparidae).

1. MS-222 anaesthesia of the marine teleost Pagrus auratus caused a dose-dependent elevation in haematocrit. 2. At 60 mg/l MS-222 the elevated haematocrit was fully accounted for by erythrocyte swelling, but at 100 mg/l red cell count also increased. 3. Uptake of anaesthetic in all tissues was rapid and the rate of onset of anaesthesia was dose-dependent. 4. Stage III level of anaesthesia (loss of equilibrium) was correlated with critical levels of MS-222 in the blood and brain. 5. The presence of acetylated derivatives of MS-222 in the blood demonstrated degradation of the anaesthetic, and high levels in the liver and kidney suggested that these organs were the sites of drug metabolism.

Aminobenzoates↗
PubMed1991

Lipid and apolipoprotein levels in an Australian community.

Serum levels of total and high density lipoprotein (HDL) cholesterol and apolipoproteins A1 and B were measured in over 600 men and women aged 30-69 years who were selected at random from an Australian community. Total cholesterol and apolipoprotein A1 and B levels increased with age, with this effect being most pronounced for total cholesterol and apolipoprotein B in women. Body mass index and waist-to-hip ratio were positively correlated with apolipoprotein B and total cholesterol levels, and negatively correlated with apolipoprotein A1 and HDL cholesterol levels. All lipid and apolipoprotein A1 levels increased with the quantity of alcohol consumed. After adjusting for age, body mass index and smoking, the association with alcohol was strongest for apolipoprotein A1 and HDL cholesterol levels in men (P = 0.0001), and for apolipoprotein A1 levels in women (P = 0.01). Levels of apolipoprotein A1 and HDL cholesterol were lower, and of apolipoprotein B and total cholesterol were higher, in current cigarette smokers than non-smokers, with significant associations for apolipoprotein B (P = 0.004) and HDL cholesterol levels (P = 0.04) in men. In general, the associations between apolipoprotein A1 levels and the other variables were weaker than those for HDL cholesterol levels, whereas the associations with apolipoprotein B levels were stronger than those for total cholesterol levels (except for alcohol consumption). Thus, obesity, alcohol consumption and cigarette smoking should be considered when interpreting apolipoprotein levels.

Adult↗