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Biomedical subjects

Susan Roberts

Publications and source records attributed to Susan Roberts.

12 recordsLinked to original sources

Computerized binary scale of auditory speech hallucinations (cbSASH).

BACKGROUND: Evidence indicates that the neuropathology of auditory verbal hallucinations (AVH) varies according to their phenomenological characteristics. Therefore, AVH should be subgrouped accordingly in hallucinations research. As evaluation of these characteristics depends entirely on the patient report, obtaining measurement of the reliability of these reports is crucial. METHOD: A computerized binary scale of auditory speech hallucinations (cbSASH) was developed to evaluate the phenomenology of AVH. It includes two subscales (inconsistency and malingering) to assess the reliability of the patient report. The cbSASH was administered along with MMPI-2, a general psychopathology scale, which includes similar validity subscales. Thirty-four psychotic patients with history of AVH were enrolled in this study. RESULTS: The scores on the inconsistency and malingering subscales of the cbSASH were correlated with the scores on the corresponding validity subscales in the MMPI-2. The combination of the malingering and inconsistency subscales provided robust measures of the reliability and ability of the patients' descriptions of their hallucinations. CONCLUSION: The cbSASH provides a reliable and comprehensive evaluation of the phenomenology of AVH. Consequently, it is possible to subgroup patients according to the characteristics of their hallucinations. This refinement of AVH phenotypes could reduce the noise and inconsistency noted in AVH and psychosis research.

Adult↗

Graft-vs-host disease: nutrition therapy in a challenging condition.

Graft-vs-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation. Both acute and chronic forms of GVHD are challenging to manage medically and nutritionally. Patients with advanced GVHD commonly become depleted nutritionally, with loss of lean body mass (LBM) and functional status. We present 2 case reports of patients who developed GVHD and subsequent nutrition decline. Although both patients were candidates for specialized nutrition support (SNS), only 1 was able to receive enteral and parenteral nutrition due to GVHD complications preventing access for provision of SNS. Fortunately, the patients have remained in remission from their hematologic malignancy, but they continue to cope with chronic GVHD and its consequences. These cases exhibit the complexity of managing a patient with extensive GVHD and nutrition interventions for clinicians to consider to optimize outcomes.

Adult↗

Functional imaging during covert auditory attention in multiple sclerosis.

Recent literature suggests that the brain in multiple sclerosis (MS) undergoes reorganization that subserves the performance of visual and motor tasks. We identified sites of cerebral activity in 16 MS patients while performing a covert attention (CA) task, presented in the auditory modality. Positron emission tomography (PET) revealed activation of rostral/dorsal anterior cingulate cortex (ACC) in normal subjects studied previously. Activity in this region was not significant in MS patients, but there was a large region of activity in superior temporal cortex. Decreased activation of frontal attentional networks and greater activity in sensory/perceptual cortical areas (auditory association cortex) suggests a reduction of transmission along white matter tracts connecting these regions. This study demonstrates cingulate hypoactivity and cerebral reorganization during auditory attention in MS.

Acoustic Stimulation↗

Stunting and future risk of obesity: principal physiological mechanisms.

There is a fair amount of epidemiological evidence showing that nutritional stunting causes increased risks of obesity. Obesity is increasing dramatically not only in developed countries but also in developing countries, such as Brazil, especially among the poorer. The mere coexistence of undernutrition and obesity among poor people has a great impact, as the burden in the social, economic, and health care systems is remarkable. In addition, an increasing number of studies have shown that nutritional stunting causes a series of important long-lasting changes such as lower energy expenditure, higher susceptibility to the effects of high-fat diets, lower fat oxidation, and impaired regulation of food intake. These findings suggest that a broader and more detailed understanding of the long-lasting effects of early undernutrition, direct cause of nutritional stunting, is needed. Within this context, we present data of some physiological mechanisms that substantiate the association between previous undernutrition and future obesity.

Body Height↗

External breast prosthesis use: experiences and views of women with breast cancer, breast care nurses, and prosthesis fitters.

After mastectomy, the provision of an appropriate breast prosthesis can help to improve body image and quality of life and reduce associated emotional distress. Although up to 90% of women use an external breast prosthesis after mastectomy, little is known about their experiences and satisfaction with breast prosthesis use. Focus groups were conducted with women who had been fitted with an external breast prosthesis, breast care nurses, and prosthesis fitters to explore women's experiences of prosthesis use. Qualitative thematic content analysis of focus group transcripts indicated that whereas women's initial reaction to the prosthesis generally was negative, this improved over time. Provision of adequate information and support, characteristics of the fitter and the fitting experience, and relationships with breast care nurses and prosthesis fitters were important to women's acceptance and satisfaction with their prosthesis. The study results highlighted the key role that breast care nurses play and the underestimation of the prosthesis fitter's role. Common themes concerning the impact of prosthesis use included body image, appearance, and feminine identity. These findings have important implications for professionals involved in the delivery of breast prostheses services.

Adaptation, Psychological↗

Access to breast prostheses via a government-funded service in Victoria, Australia. Experience of women and service providers.

For many women, the only alternative to breast reconstruction following a mastectomy is to use external prostheses, which need replacing regularly at a cost of up to $395 per prosthesis. Commonwealth and state governments across Australia have responded to this need by providing subsidies to assist in the purchase of breast prostheses. However, current arrangements have been highly variable and sometimes difficult to access. As part of a larger review of breast prosthesis services in Victoria, Australia, the aim of this research was to evaluate client satisfaction among Victorian women who accessed funds through the State Government's Aids and Equipment Program, compare the responses of the program service providers with the experiences of clients accessing funding, and identify opportunities to improve service provision.

Aged↗

Bridging the information and support gap: evaluation of a hospital-based cancer support nurse service.

Health professionals play an important role in meeting the information and support needs of individuals following a diagnosis of cancer. The aim of this study was to evaluate the acceptability and impact of a hospital-based cancer support nurse (CSN) service. A total of 98 patients completed a structured telephone interview after discharge concerning their use, perceptions and satisfaction with the service. The majority of patients perceived service delivery to be appropriate and reported that they had gained both information and support. The service also had a positive impact on behavioural, cognitive and affective outcomes. Overall satisfaction with the service was very high. Results indicate that a hospital-based cancer support nurse service provides a promising model for meeting the early information and support needs of patients, thereby promoting continuity of care.

Adaptation, Psychological↗

Low physical activity reduces total energy expenditure in women with rheumatoid arthritis: implications for dietary intake recommendations.

BACKGROUND: Rheumatoid arthritis (RA) causes cachexia, a metabolic response characterized by loss of muscle mass and elevated resting energy expenditure (REE). However, energy expenditure in physical activity in subjects with RA is lower than that in healthy subjects. It is not known which effect predominates in regulating total energy expenditure (TEE), and thus whether the dietary energy requirements of subjects with RA are higher or lower than those of healthy subjects. OBJECTIVE: Our objective was to determine TEE in women with RA by using the reference method of doubly labeled water ((2)H(2)(18)O). DESIGN: In this case-control study, we examined 20 women with RA and 20 healthy women who were matched for age and body mass index. RESULTS: The patients with RA were cachectic (their body cell mass was 14% lower than that of the controls, P < 0.001), but REE was not elevated, reflecting good disease control. Mean (+/- SD) TEE was 1344 kJ/d lower in the patients than in the controls (9133 +/- 1335 compared with 10 477 +/- 1992 kJ/d; P < 0.02). The energy expenditure in physical activity of the patients was 1034 kJ/d lower than that of the controls (P < 0.04), which accounted for 77% of the difference in TEE between the 2 groups. The physical activity level (TEE/REE) of the patients also tended to be lower than that of the controls (1.70 +/- 0.24 compared with 1.89 +/- 0.36; P < 0.07). CONCLUSION: A low physical activity level is the main determinant of lower-than-normal TEE, and thus energy requirements, in women with RA.

Adult↗

Andropause: knowledge and perceptions among the general public and health care professionals.

BACKGROUND: Andropause, the natural age-related decline in testosterone in men, has been debated in the literature. The nonsexual benefits of testosterone replacement therapy (TRT) in male hypogonadism are well documented, but whether health care professionals (HCPs) and members of the general public are aware of these benefits is not known. This study assesses the knowledge and perceptions of andropause and TRT among HCPs and members of the general public. METHODS: Brief surveys were administered to HCPs and members of the general public who called a medical information telephone line. Trained clinical interviewers surveyed participants for experiences with andropause and TRT and knowledge about nonsexual effects of low testosterone in men. RESULTS: Of 443 general public callers, 377 (85%) agreed to participate in the survey. Of these participants, 77% had heard of andropause or male menopause, and 63% had taken TRT. Of 88 HCP callers, 57 (65%) participated. Of these participants, 65% were pharmacists, 80% had encountered patients with symptoms of low testosterone, and 50% reported that patients rarely or never initiated conversations about low testosterone. Among HCPs and the general public, respectively, 98% and 91% knew that low testosterone is treatable with medication, and 60% and 57% knew that it results in osteoporosis. Only 25% of HCPs and 14% of the general public knew that low testosterone does not cause loss of urinary control. CONCLUSIONS: HCPs and members of the general public are knowledgeable about some aspects of low testosterone and have misconceptions about others. Educational initiatives are needed.

Climacteric↗

Application of stable isotopic techniques in the prevention of degenerative diseases like obesity and NIDDM in developing societies.

Economic development in developing societies characterized by industrialization, urbanization, and globalization has seen the emergence of an epidemic of diet- and life-style-related chronic degenerative diseases. A research project was initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria under its Coordinated Research Programme (CRP) to promote the use of stable isotopic techniques to document the extent of the problem and to understand the determinants of this epidemic. The principal objectives of this CRP involving countries both in the North and the South are to define the magnitude of the problem of obesity and non-insulin dependent diabetes mellitus (NIDDM) in developing countries, to identify the vulnerable groups at increased risk, and to attempt to describe the metabolic and physiological mechanisms underlying this phenomenon. These comparative international studies of obesity and NIDDM are looking at the effects of childhood malnutrition (Brazil) and socioeconomic differentials (Mexico) on adult risk factors; the composition of the daily diet on obesity (Chile); levels of patterns of physical activity of older adults (China) as well as their influence on weight gain and obesity (Cuba, Nigeria); the impact of body composition and energy expenditure on the evolution frank diabetes from impaired glucose tolerance (Jamaica), and of body compositional changes and the role of inflammatory cytokines on impaired glucose tolerance (India). The last study conducted in New Zealand was aimed at comparing the energy expenditures of Maori (Pacific Island) with New Zealanders of European descent.

Africa↗

Application of modern biotechnology to food and agriculture: food systems perspective.

The purpose of this article is to provide nutrition educators with an introduction to a range of considerations and forces that are driving the application of modern biotechnology in the food and fiber sector based on a food systems perspective. In doing so, the following issues are critically assessed: (1) the global debate on how to regulate genetically engineered (GE) foods and crops, (2) cultural differences in public perceptions of GE foods, and (3) evaluation of selected GE traits against the principles of social, economic, and ecological sustainability, including the potential of modern agricultural biotechnology to enhance global food security. Where appropriate, we also review other agricultural technologies and the broader political, social, and economic contexts in which these technologies have been introduced. Finally, we offer recommendations for how multiple stakeholder groups, including policy makers, biotechnology advocates, and nutrition educators, can move toward a more informed dialogue and debate on this issue.

Biotechnology↗