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Biomedical subjects

Sandra Hanson

Publications and source records attributed to Sandra Hanson.

5 recordsLinked to original sources
PubMed2006

The clinical effectiveness of Movicol in children with severe constipation: an outcome audit.

This audit reviewed the clinical effectiveness of polyethylene glycol 3350 plus electrolytes (PEG+E, Movicol) in the management of severe paediatric constipation. A seven-day disimpaction regimen was initiated followed by a maintenance dose as appropriate. An information and support service was provided by the community children's nursing team (CCNT) at Darent Valley Hospital. Twenty-three parents completed questionnaires on their children's experiences with previous and current laxative treatments, bowel movement status, in-patient admissions or home visits required and the perceived value of the back up service. The mean age of children studied was 6.7 years. Prior to PEG+E treatment, 57 per cent of children were admitted to hospital and 26 per cent required home visits for constipation treatment. After treatment, no child needed either intervention. Thirty-nine percent of parents used the support service, of which 96 per cent rated the information it provided as adequate. When asked about their satisfaction with the control of their children's constipation, 96 per cent of parents were 'more than happy' after treatment with PEG+E. The treatment of severe paediatric constipation with PEG+E in conjunction with a support and advice service was both clinically and economically effective.

Aftercare↗
PubMed2003

A community-based intervention for siblings and parents of children with chronic illness or disability: the ISEE study.

OBJECTIVE: Siblings of children with chronic illness or disability have been reported to have a 1.6 to 2.0 risk for behavioral and mental health problems. Our objective was to examine the effects of an intervention for siblings (age 7-15 years) of children with chronic illness or disability. METHOD: A randomized, three-group repeated-measures design was used: full intervention (n=79), partial intervention (n=71), and a waiting list control group (n=102). Outcomes were sibling knowledge about illness, behavior problems, social support, self-esteem, attitude, and mood measured over four postintervention periods. Covariates were family cohesion, maternal mood, socioeconomic status, and well sibling age. The full intervention included structured teaching and psychosocial sessions at a 5-day residential summer camp. The partial intervention included camp only. Treatment effects were estimated by using generalized estimating equation panel analyses. RESULTS: The full treatment group showed significant improvements on all six outcomes over most periods, the partial treatment group on three outcomes, and the control group on two outcomes. Improvements in outcomes ranged from 5% to 25% increases over baseline measures. CONCLUSIONS: A dose-response relationship to intervention was found. Treatment gains were sustained over a period of 12 months.

Adolescent↗
PubMed2002

Markers of increased risk of intracerebral hemorrhage after intravenous recombinant tissue plasminogen activator therapy for acute ischemic stroke in clinical practice: the Multicenter rt-PA Stroke Survey.

BACKGROUND: Intravenous recombinant tissue plasminogen activator (rtPA) is an effective therapy for acute ischemic stroke, but it is associated with risk of intracerebral hemorrhage (ICH). Our aim was to identify, in a large cohort of patients, readily available baseline factors that are associated with thrombolysis-related ICH. METHODS AND RESULTS: In a multicenter retrospective and prospective investigation of individual data from 1205 patients treated in routine clinical practice with intravenous rtPA within 3 hours of stroke symptom onset, 72 patients (6%) developed symptomatic ICH and 86 additional patients (7%) had asymptomatic ICH identified on a routine follow-up CT. In analyses based on clinical variables alone, the main attributes associated with ICH were a history of diabetes mellitus and cardiac disease, increasing stroke severity, advancing age, use of antiplatelet agents other than aspirin before stroke onset, and elevated pretreatment mean blood pressure. In additional analyses that incorporated baseline CT and laboratory findings (in a subset of patients), the main associations were early ischemic CT changes, in particular if exceeding one third of middle cerebral artery territory; increasing stroke severity; diabetes mellitus or elevated serum glucose; and lower platelet counts. Final independent attributes associated with parenchymatous hematoma, defined by purely radiologically based criteria, were similar to those of symptomatic ICH. CONCLUSIONS: Readily available factors can identify acute ischemic stroke patients at high and low risk for rtPA-related ICH. These factors require confirmation in a prospective cohort before clinical implementation.

Acute Disease↗
PubMed2002

Interrelationships among variables affecting well siblings and mothers in families of children with a chronic illness or disability.

A structural equation model (SEM) examined interrelationships among psychosocial variables known to affect the health and development of well siblings and parents when a child with a chronic illness or disability is a member of the family. Using dyads of 252 well children and parents, socioeconomic status (SES) and family cohesion were associated with the parent-reported behavior of the well sibling. SES also influenced the mood of the mother that in turn influenced family cohesion. The well sibling's knowledge about the illness of the brother or sister, attitude toward the illness, mood, self-esteem, and feelings of social support were interrelated and related to the behavior of the well sibling. The SEM suggests that interventions may be directed at several points in these interactions including boosting knowledge levels of the well sibling, improving family cohesion, and assuring adequate "income" support to the family through income transfers or in-kind services.

Attitude to Health↗