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Biomedical subjects

Thomas Templin

Publications and source records attributed to Thomas Templin.

33 records · Page 2Linked to original sources
PubMed2004

Self-treatment of pain in a rural area.

CONTEXT: In the United States, 42% of adults say they experience pain daily, the majority often relying on self-treatment. In addition, an increasing number of people are seeking complementary/alternative therapies, often without informing their health care providers. PURPOSE: To explore the occurrence of pain and the modalities of self-treatment used by community members (N = 108) from a rural area of Michigan, the potential for interactions between pain self-treatment modalities and other medications currently being taken, and demographic variables that might affect self-treatment choice. METHOD: This exploratory descriptive study was conducted using a survey method. FINDINGS: Findings revealed that 66% were taking prescription medications, 75% over-the-counter medications, 20% herbal supplements, and 35% nonpharmacological treatments. Of the reported prescription and over-the-counter medications, 18% were opioids, 77% were nonopioids, and 18% were adjuvant medications. One-third of the subjects were taking more than 1 medication and/or herbal product or supplement, increasing their risk for potential drug-herb interactions, complicated by the fact that 20% did not inform their primary care practitioner of their self-treatment choices. CONCLUSIONS: This study contributes to the knowledge of current self-treatment choices regarding pain management and potentially harmful interactions that might occur from using multiple medications and supplements.

Adolescent↗
PubMed2004

Barriers to pain management by home care nurses.

This study examined home care nurses' perceived barriers to pain management. Major barriers included lack of knowledge, inadequate pain assessment, and difficulty managing opioid-related side effects. Home care nurses with more knowledge about pain management had significantly lower scores on the Barriers Questionnaire. The study documented the need for continued pain management education for home care nurses. Practice implications are provided.

Analgesics, Opioid↗
PubMed2003

Arab-American adolescent tobacco use: four pilot studies.

OBJECTIVES: Four pilot studies were conducted to determine the (1) current tobacco use patterns and predictors among 14- to 18-year-old Arab-American youths; (2) psychometric properties of study measures (English and Arabic); (3) cultural appropriateness of Project Toward No Tobacco (TNT) for intervention; (4) accessible population for a longitudinal study. METHODS: Three studies were descriptive and one used a pretest-posttest design. From four Pilot Focus groups (N = 28 smokers) key tobacco use themes emerged along with information on study measures and the Project TNT intervention; Pilot Intervention tested the tailored Project TNT intervention with 9 Arab-American teens; Pilot Clinic (N = 44) determined the characteristics of the accessible teen health clinic population; and Pilot School (N = 119) obtained tobacco use data only. RESULTS: From Pilot Focus seven themes (being cool, "nshar ma'a al shabab" [hanging out with the guys], present [time] orientation, smoking feels and tastes good, keeps your mind off trouble, easy to get, and (many) "barriers to quitting") emerged from the data. In the Pilot Intervention a 37.5% cessation rate was found. In the Pilot Clinic study, 24% males and 17% females smoked. The current smoking rate in the Pilot School (N = 119) sample was 17%; 34% admitted to having ever smoked (even a puff). Significant predictors for current tobacco use included poor grades, stress, having many family members and peers who smoke, being exposed to many hours of smoking each day, receiving offers of tobacco products, advertising and mail, and believing that tobacco can help one to make friends. CONCLUSIONS: The four pilots contributed unique and essential knowledge for designing a longitudinal clinical trial on tobacco use by Arab-American adolescents.

Adolescent↗
PubMed2003

A model of mother-child coping and adjustment to HIV.

An increasing proportion of newly diagnosed AIDS cases is being reported among African American urban women. Recent research regarding the psychosocial and behavioral impact of a mother's HIV status on her uninfected children as well as a growing body of clinical evidence suggest that these children are extremely vulnerable and at risk for problems in psychosocial adjustment. The present paper reports the results of research designed to examine the pathways by which a mother's HIV-positive status affects the psychosocial adjustment of her uninfected school-age child. The principal predictor variables of the model are family sociodemographic characteristics, social support available to mother and child, HIV-related symptom distress in the mother, coping strategies of both mother and child, emotional distress of the mother, and quality of the parent-child relationship. The dependent variable is the psychosocial adjustment of the child. Data were collected on 147 mother-child dyads using standardized questionnaires and personal interviews. Eighty-six percent of the mothers were African American and over 96% were on public assistance. Structural equation modeling was used to test the proposed model of mother-child coping and adjustment. After adding three paths, the model had a good fit to the data (comparative fit index=0.94; root mean square estimate of error=0.06). Five model constructs accounted for 36% of the variance in child adjustment. The constructs in order of importance were maternal HIV-associated stressors, maternal emotional distress, child social support, child coping, and quality of parent-child relationship.

Adaptation, Psychological↗
PubMed2003

Lower extremity changes, pain, and function in injection drug users.

Persons who have injected drugs are highly susceptible to a life-long, debilitating condition of the legs called chronic venous insufficiency (CVI). CVI may affect a person's ability to function. The purposes of this study were to examine (a) the functional relationship between CVI severity, pain, and behavior; and (b) the extent to which pain mediates the relationship between CVI severity and functional behavior for persons with a history of injection drug use. The 100 participants had a history of injection drug use and were recruited from a medical clinic and a methadone treatment clinic. Participants responded to a questionnaire that contained demographic, health history, drug history, pain and functioning components. Their legs were examined from the knees to the feet for clinical manifestations of CVI. Pain and functional behavior were monotonically related to severity of CVI. Path analysis showed leg pain as a mediator of the relationship between CVI and behavioral functioning controlling for the effects of other chronic diseases. Treatment center counselors need to be aware of leg changes that occur with injected drugs, realize these changes may affect many aspects of functioning and cause pain, and encourage clients to obtain medical assistance for treatment of their legs.

Activities of Daily Living↗
PubMed2002

Violence exposure, trauma, and IQ and/or reading deficits among urban children.

BACKGROUND: Exposure to violence in childhood has been associated with lower school grades. However, the association between violence exposure and performance on standardized tests (such as IQ or academic achievement) in children is unknown. It is also not known whether violence exposure itself or subsequent symptoms of trauma are primarily responsible for negative outcomes. OBJECTIVE: To examine the relationship between violence exposure and trauma-related distress and standardized test performance among early school-aged urban children, controlling for important potential confounders. DESIGN: A total of 299 urban first-grade children and their caregivers were evaluated using self-report, interview, and standardized tests. MAIN OUTCOME MEASURES: The child's IQ (Wechsler Preschool and Primary Scale of Intelligence--Revised) and reading ability (Test of Early Reading Ability, second edition) were the outcomes of interest. RESULTS: After controlling for confounders (child's gender, caregiver's IQ, home environment, socioeconomic status, and prenatal exposure to substance abuse) violence exposure was related to the child's IQ (P =.01) and reading ability (P =.045). Trauma-related distress accounted for additional variance in reading ability (P =.01). Using the derived regression equation to estimate effect sizes, a child experiencing both violence exposure and trauma-related distress at or above the 90th percentile would be expected to have a 7.5-point (SD, 0.5) decrement in IQ and a 9.8-point (SD, 0.66) decrement in reading achievement. CONCLUSION: In this study, exposure to violence and trauma-related distress in young children were associated with substantial decrements in IQ and reading achievement.

Aptitude↗
PubMed2002

Home care nurses' ratings of appropriateness of wound treatments and wound healing.

PURPOSE: The purpose of this study was to examine nurses' ratings of appropriateness of wound treatments and wound healing for patients in home care in relation to patient demographic and visit variables. DESIGN: A cross-sectional design was used. SETTING AND SUBJECTS: Data were collected about patients with wounds by 281 nurses from 13 home care agencies located throughout lower Michigan. Patients with wounds (n = 881) ranged in age from 21 to 100 years. They included 492 women and 383 men who were white (72.4%) or African-American (26%). INSTRUMENTS: The Community Wound Assessment Tool was developed for the study and was used to obtain demographic and wound data. The demographic section contained information about the patient's age, sex, reason for the visit, length of visit, and time the case was opened. The wound section included the wound type, treatments, presence of incontinence, nutritional supplementation, and adverse home environmental factors. Nurses rated wounds as healing or not healing. Wound treatments were rated as all appropriate, some appropriate/inappropriate, and all inappropriate. METHODS: Nurses were systematically selected from each agency and collected data about each patient visited on one occasion. MAIN OUTCOME MEASUREMENTS The main outcome measurements were the relationship of patient demographic variables and visit variables to the appropriateness of wound treatments and wound healing. RESULTS: The nurses' rating of wound treatments as appropriate was significantly related to younger patient age and a shorter time for the case to be open. Wound healing was initially associated with younger patient age, continence of urine or stool, shorter home visits, shorter time for the case to be open, and fewer reasons for the visit. When wound healing was controlled for the type of wound in path analysis, the patient's age was no longer significant and incontinence appeared to impair healing of nonsurgical wounds. The appropriateness of the wound treatments was significantly related to wound healing. CONCLUSIONS: Nurses' ratings of appropriateness of wound treatments and healing are significantly related to factors that affect length of service and complexity of care for the home care patient with a wound. Decisions nurses make about wound treatments and healing are important for the patient as well as for the agency.

Adult↗
PubMed2001

Development of an Instrument to Assess Problem Behavior in First Grade Students Prenatally Exposed to Cocaine. Part II: Validation.

In Part I, the initial development of a preliminary tool, the PROBS-14, was reported. The tool was developed and initially tested through a consensus process that tapped the perceptions of early education teachers. Concurrent validity between the PROBS-14 and the Conners' Teacher Rating Scale (CTRS) was established with factor analysis, yielding a hyperactivity-conduct factor, composed of PROBS items and all but two of the CTRS subscales, and a central processing factor, composed of PROBS items and the remaining CTRS scales. The purpose of Part II was to further establish concurrent validity of the PROBS-14 with known pediatric behavior measures (TRF, CTRS) and to ascertain if the PROBS-14 better predicts a cocaine behavioral effect. A sample of 468 African American children with known cocaine exposure (n = 200) and control status (n = 268) were evaluated. Factor analyses produced results similar to those reported in Part I, with PROBS items accounting for problem behavior variance beyond that accounted for by the TRF, and more specific than that accounted for by the CTRS. Additionally, children prenatally exposed to cocaine, particularly those exposed late in pregnancy, differed significantly from controls on the PROBS total, central processing scale, and several PROBS items. The PROBS instrument offers a promising brief measure of child problem behaviors with adequate concurrent and predictive validity, and which outperforms the TRF and CTRS in discriminating prenatal cocaine exposure status.

Journal Article↗
PubMedDate not supplied

Social network structure and social support in HIV-positive inner city mothers.

It has been documented that social support influences health outcomes of persons with chronic illnesses. The incidence of HIV and AIDS among minority women is growing at an alarming rate, but little is known about social support in this vulnerable population, and even less is known about the social network conveying that support. Guided by the convoy of social networks model, this study describes the social networks in a sample of HIV-positive, urban-dwelling mothers (N = 147) by stage of disease (i.e., asymptomatic, symptomatic, AIDS) and examines relationships between social network structure and social support. Hierarchical linear modeling showed that women's social networks were disproportionately populated by children, and network members of women with AIDS were significantly older than network members of HIV-positive women with or without symptoms. Profile analyses showed that women's perceptions of the quality of social support differed according to the proportion of family members populating different segments of the social network.

Adaptation, Psychological↗
PubMedDate not supplied

Ankle mobility in relation to chronic venous insufficiency in HIV-positive persons with and without a history of injection drug use.

The purpose of this study was to examine ankle mobility in relation to chronic venous insufficiency (CVI) in HIV-positive persons with and without a history of injection drug use (IDU) and to examine the extent to which peripheral neuropathy further reduced ankle mobility. A cross-sectional, stratified design with quota sampling was used to recruit 27 persons with no history of IDU and 46 with a history of IDU from an infectious diseases clinic. Goniometric measurements of forefoot inversion-eversion and dorsiflexion-plantar flexion were obtained. CVI was assessed on a clinical scale. Peripheral neuropathy was identified from chart review and self-report. Injection drug users had less ankle flexion-extension right, inversion-eversion left and right, and total ankle motion than those who did not inject drugs (p < .05). Neuropathy was not associated with less mobility of the ankle joint (p < .01). A causal model supported the hypothesis of ankle mobility as a mediator of the effect of IDU on CVI.

Adult↗
PubMedDate not supplied

Chronic venous insufficiency in HIV-positive persons with and without a history of injection drug use.

OBJECTIVE: To examine chronic venous insufficiency in human immunodeficiency virus-positive persons with and without a history of injection drug use and to examine the extent to which neuropathy further increased the risk of chronic venous insufficiency. DESIGN: Cross-sectional stratified design with quota sampling. SETTING: Infectious diseases clinic in a large, urban midwestern city. PARTICIPANTS: Human immunodeficiency virus-positive persons, 27 with no history of injection drug use and 46 with a history of injection drug use, who met the inclusion criteria, including being 30 to 65 years of age, not pregnant, and willing to respond to a questionnaire and have their lower legs examined, were enrolled until the quota for each stratum (no injection drug use and injection drug use) was filled. MAIN OUTCOME MEASURES: Chronic venous insufficiency clinical classification, injection drug use history, and presence of peripheral neuropathy. MAIN RESULTS: Sixty-one percent of injection drug users (28/46) presented with severe chronic venous insufficiency compared with 11% (3/27) of noninjection drug users (P< .001). The presence of lower extremity neuropathy was not significantly related to chronic venous insufficiency classification. CONCLUSIONS: This is the first study to report the high risk of chronic venous insufficiency in human immunodeficiency virus-infected persons who inject drugs. Chronic venous insufficiency should be assessed in human immunodeficiency virus-positive persons when there is a history of injection drug use, and measures to protect the legs should be implemented.

Adult↗
PubMedDate not supplied

Disparities between black and white patients with cancer pain: the effect of perception of control over pain.

CONTEXT: Pain continues to be a problem in ambulatory patients with cancer. Disparities in minority patients with pain have been previously identified. OBJECTIVE: To examine the effect of perception of control over pain on disparities in pain, symptom distress, and functional status in white and black patients with cancer. DESIGN: Cross-sectional, descriptive. SETTING: Outpatient clinic in a large urban cancer center. PATIENTS: A total of 281 patients who reported having pain within the last month and were receiving treatment in the cancer center. OUTCOME MEASURES: Pain intensity, pain-related distress, functional status, perception of control over pain. RESULTS: Black patients had significantly higher pain intensity, more pain-related distress, and reported more pain-related interference with function than white patients. Disparities in pain-related distress and functional status were significantly reduced and only disparities in pain intensity remained when perception of control over pain was held constant. CONCLUSIONS: Perception of control over pain is an important factor in understanding responses to pain. Increasing a patient's perception of control over pain may decrease disparities and increase functional status.

Adult↗
PubMedDate not supplied

Perceptions of quality health care among parents of children with bleeding disorders.

INTRODUCTION: This study examined how parents of children with bleeding disorders defined quality health care, their expectations for care at the clinic, and indicators of quality health care important to them. METHODS: Parents (N = 54) answered two open-ended questions and completed the Quality Health Care Questionnaire, which examined the importance of 33 indicators of quality care. RESULTS: The most important indicators of quality care to parents were being included in decisions about their child's care (M = 4.98), being cared for by nurses who are competent and up-to-date (M = 4.94), and being cared for by doctors who are competent and up-to-date (M = 4.94). DISCUSSION: The results of this study are consistent with earlier research involving other groups of consumers. Parents view quality care as being included in decisions about their child's care and having competent and caring providers with whom they can communicate. In contrast to earlier research, however, waiting time was the least important indicator of quality care.

Blood Coagulation Disorders↗