Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 149
Filter
1.
Am J Otolaryngol ; 44(2): 103759, 2023.
Article in English | MEDLINE | ID: mdl-36630733

ABSTRACT

IMPORTANCE: Edema affects outcomes in Rhinoplasty. Edema and bruising influences patient satisfaction in the perioperative period. OBJECTIVE: A qualitative analysis of edema comparing piezoelectric and conventional osteotome, and a qualitative comparison of bruising between these methods. DESIGN: A prospective cohort study of 31 aesthetic Rhinoplasty cases. Participants act as their own control measure. An osteotome is used on one side of the nasal bone and a piezoelectric is used contralaterally. MAIN OUTCOMES AND MEASURES: Edema is calculated by comparing a pre and post-operative 3-D image with volumetric analysis. Ecchymosis is scored and compared. RESULTS: The mean volume of the piezoelectric was 1.37 cc (SD 0.87) and the mean volume of the osteotome was 1.17 cc (SD 0.70) (0.19 absolute difference [95 % CI 0.3 to 0.35], p = 0.02). Bruising scores were 0.35 points lower for the piezoelectric arm (-0.35 absolute difference [95%CI -0.7 to 0.06], p < 0.01). This corresponded to 26 % of lateral piezo osteotomies having significant bruising compared to 38 % of the lateral osteotomies using the conventional technique. CONCLUSION: There is a difference in postoperative edema and bruising with the piezoelectric and conventional osteotome for lateral osteoetomy in Rhinoplasty. There is more edema with the piezoelectric and more ecchymosis with the conventional osteotome.


Subject(s)
Rhinoplasty , Humans , Rhinoplasty/methods , Ecchymosis , Prospective Studies , Osteotomy/methods , Edema/etiology , Postoperative Complications
2.
Perception ; 44(6): 709-23, 2015.
Article in English | MEDLINE | ID: mdl-26489211

ABSTRACT

Hypnotic suggestibility (HS) is the ability to respond automatically to suggestions and to experience alterations in perception and behavior. Hypnotically suggestible participants are also better able to focus and sustain their attention on an experimental stimulus. The present study explores the relation between HS and susceptibility to the rubber hand illusion (RHI). Based on previous research with visual illusions, it was predicted that higher HS would lead to a stronger RHI. Two behavioral output measures of the RHI, an implicit (proprioceptive drift) and an explicit (RHI questionnaire) measure, were correlated against HS scores. Hypnotic suggestibility correlated positively with the implicit RHI measure contributing to 30% of the variation. However, there was no relation between HS and the explicit RHI questionnaire measure, or with compliance control items. High hypnotic suggestibility may facilitate, via attentional mechanisms, the multisensory integration of visuoproprioceptive inputs that leads to greater perceptual mislocalization of a participant's hand. These results may provide insight into the multisensory brain mechanisms involved in our sense of embodiment.


Subject(s)
Body Image/psychology , Illusions/psychology , Suggestion , Touch Perception/physiology , Visual Perception/physiology , Adult , Humans , Individuality , Proprioception/physiology
3.
Conscious Cogn ; 26: 24-36, 2014 May.
Article in English | MEDLINE | ID: mdl-24657632

ABSTRACT

Our sense of self includes awareness of our thoughts and movements, and our control over them. This feeling can be altered or lost in neuropsychiatric disorders as well as in phenomena such as "automatic writing" whereby writing is attributed to an external source. Here, we employed suggestion in highly hypnotically suggestible participants to model various experiences of automatic writing during a sentence completion task. Results showed that the induction of hypnosis, without additional suggestion, was associated with a small but significant reduction of control, ownership, and awareness for writing. Targeted suggestions produced a double dissociation between thought and movement components of writing, for both feelings of control and ownership, and additionally, reduced awareness of writing. Overall, suggestion produced selective alterations in the control, ownership, and awareness of thought and motor components of writing, thus enabling key aspects of automatic writing, observed across different clinical and cultural settings, to be modelled.


Subject(s)
Awareness/physiology , Executive Function/physiology , Motor Activity/physiology , Suggestion , Thinking/physiology , Writing , Adult , Female , Humans , Male , Young Adult
4.
Int Nurs Rev ; 57(1): 128-34, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20487485

ABSTRACT

AIM: The aim of this study was to test community-based nursing education about breast self-examination to see whether self-examination frequency could be increased. BACKGROUND: Breast cancer rates in China are rising rapidly, especially in cities. The majority of Chinese women does not know about breast self-examination, and the Chinese health care system cannot provide mammograms for the millions of at-risk women throughout China. METHOD: This study was a randomized clinical trial of nurse-provided, community-based teaching of breast self-examination in the urban and rural areas of Tianjin and urban and suburban areas of Shanghai. Women (n = 1510) never diagnosed with breast cancer and 40 years and older were randomized by community and stratified by urban vs. other residences. RESULTS: At baseline, 9% of the intervention and 6% of the control groups did breast self-examination at least every other month. After 12 months, 34% of the intervention, but only 11% of the control, group did breast self-examination that often (P < 0.001). There was a significant impact in urban, suburban and rural areas, and intervention effects were stronger than any of the other influences tested. CONCLUSION: The clinical trial showed a statistically significant increase in breast self-examination after the nursing education intervention. As no other breast cancer screening method is available in most of China, this method is best suited for the masses of people currently at risk in China.


Subject(s)
Breast Neoplasms/prevention & control , Breast Self-Examination , Community Health Nursing , Health Knowledge, Attitudes, Practice , Patient Education as Topic , Adult , China , Female , Humans , Multivariate Analysis , Regression Analysis , Residence Characteristics , Socioeconomic Factors
5.
East Mediterr Health J ; 15(5): 1254-62, 2009.
Article in English | MEDLINE | ID: mdl-20214139

ABSTRACT

This study explored the relative effects of self-efficacy on oral contraceptive use among a sample of 352 Iranian married women aged 18-49 years. In structured interviews 5 variables based on the Steps to Behaviour Change model (knowledge, approval, intention, practice and advocacy) were assessed and correlated with measures of family planning self-efficacy and general self-efficacy. The results indicated that the 2 independent measures, when taken together, were more effective in predicting behavioural intentions for effective use of oral contraceptives, with family planning self-efficacy making the strongest contribution. It is suggested that self-efficacy intervention techniques will benefit oral contraceptive users in preventing unintended pregnancies.


Subject(s)
Contraception Behavior , Contraceptives, Oral , Health Knowledge, Attitudes, Practice , Medication Adherence , Self Efficacy , Women/psychology , Adolescent , Adult , Contraception Behavior/psychology , Contraception Behavior/statistics & numerical data , Cross-Sectional Studies , Educational Measurement , Family Planning Services/education , Family Planning Services/methods , Female , Humans , Intention , Iran , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , Middle Aged , Models, Psychological , Predictive Value of Tests , Regression Analysis , Statistics, Nonparametric , Urban Health/statistics & numerical data , Women/education
6.
Health Educ Res ; 24(4): 575-85, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19047649

ABSTRACT

The purpose of this study was to explore factors that influence oral contraceptive (OC) use among women in Iran using the Theory of Planned Behavior (TPB) and concept of self-efficacy (SE). The study sample consisted of 360 married OC users, aged 18-49 years recruited at public health centers of Mashhad, 900 km east of Tehran. SE had the strongest association with the intent to use after the clinic visit (r = 0.784) and with actual use (r = 0.452). Family planning self-efficacy combined with TPB variables accounted for 65% of the variance for intent and 27% of the variance in behavior. The results provide support for a theory-based approach to improved family planning care that specifically addresses more effective use. Development and evaluation of culturally appropriate public education and changes in clinical efforts designed to enhance the sense of SE are discussed.


Subject(s)
Contraception Behavior/psychology , Contraceptives, Oral/administration & dosage , Psychological Theory , Adolescent , Adult , Analysis of Variance , Chi-Square Distribution , Female , Humans , Interviews as Topic , Iran , Middle Aged , Self Efficacy
7.
(East. Mediterr. health j).
in English | WHO IRIS | ID: who-117756

ABSTRACT

This study explored the relative effects of self-efficacy on oral contraceptive use among a sample of 352 Iranian married women aged 18-49 years. In structured interviews 5 variables based on the Steps to Behaviour Change model [knowledge, approval, intention, practice and advocacy] were assessed and correlated with measures of family planning self-efficacy and general self-efficacy. The results indicated that the 2 independent measures, when taken together, were more effective in predicting behavioural intentions for effective use of oral contraceptives, with family planning self-efficacy making the strongest contribution. It is suggested that self-efficacy intervention techniques will benefit oral contraceptive users in preventing unintended pregnancies


Subject(s)
Contraceptives, Oral , Contraception , Cross-Sectional Studies , Women , Surveys and Questionnaires , Knowledge , Self Efficacy
8.
QJM ; 97(1): 7-13, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14702506

ABSTRACT

Tetralogy of Fallot was the first complex congenital cardiac defect to undergo open repair. The life expectancy and quality of life of those surviving surgery is now good, although late survival is compromised by the occurrence of sudden death. The emergence of successful methods for both the prevention of arrhythmias (including valve replacements and electrophysiological ablation) and the treatment of arrhythmias when they occur (including implantable defibrillators), has meant the identification of those at risk is of even greater importance. This paper reviews the predictive methods currently available to the practising physician caring for these increasingly common patients.


Subject(s)
Death, Sudden, Cardiac/etiology , Tachycardia, Ventricular/etiology , Tetralogy of Fallot/surgery , Adult , Electrocardiography/methods , Humans , Prognosis , Risk Factors
9.
Neuropsychologia ; 41(8): 1058-67, 2003.
Article in English | MEDLINE | ID: mdl-12667541

ABSTRACT

Delusions of alien control, or passivity experiences, are symptoms associated with schizophrenia in which patients misattribute self-generated actions to an external source. In this study hypnosis was used to induce a similar misattribution of self-generated movement in normal, healthy individuals. Positron Emission Tomography (PET) was employed to investigate the neural correlates of active movements correctly attributed to the self, compared with identical active movements misattributed to an external source. Active movements attributed to an external source resulted in significantly higher activations in the parietal cortex and cerebellum than identical active movements correctly attributed to the self. We suggest that, as a result of hypnotic suggestion, the functioning of this cerebellar-parietal network is altered so that self-produced actions are experienced as being external. These results have implications for the brain mechanisms underlying delusions of control, which may be associated with overactivation of the cerebellar-parietal network.


Subject(s)
Brain/physiology , Delusions/physiopathology , Adult , Brain Mapping , Electroencephalography , Emigration and Immigration , Functional Laterality , Humans , Hypnosis , Image Processing, Computer-Assisted , Magnetic Resonance Imaging/methods , Male , Models, Neurological , Movement , Parietal Lobe , Psychomotor Performance , Reaction Time , Rest , Tomography, Emission-Computed/methods
10.
Cogn Neuropsychiatry ; 8(4): 295-312, 2003 Nov.
Article in English | MEDLINE | ID: mdl-16571568

ABSTRACT

INTRODUCTION: Distinguishing conversion disorder from malingering presents a significant challenge as the diagnosis ultimately depends on the patient's subjective report and the clinician's suspicion of an intention to deceive. Using hypnosis to manipulate the intentionality of movement inhibition in the same subjects, we used positron emission tomography (PET) to determine whether failure to move during intentionally simulated and subjectively experienced paralysis is mediated by different neural structures. METHODS: Using a within-subject design, 12 normal, hypnotised subjects were tested under two paralysis conditions during the same scanning session. Half of the scans were performed with the suggestion that the left leg was paralysed (subjectively experienced paralysis condition) and half with the leg normal but with the instruction that paralysis should be feigned (intentionally simulated paralysis condition). RESULTS: Relative increases in brain activation were seen in the right orbitofrontal cortex, right cerebellum, left thalamus, and left putamen during subjectively experienced paralysis compared to intentionally simulated paralysis, although a previously reported activation of the right anterior cingulate cortex was not seen. During intentionally simulated paralysis compared to subjectively experienced paralysis relative increases in brain activation were seen in the left ventrolateral prefrontal cortex, and a number of right posterior cortical structures. CONCLUSIONS: Our results suggest that subjectively experienced paralysis has a different neural basis to intentionally simulated paralysis. These findings have theoretical and clinical implications for malingering and related attempts to unravel the neuropsychological basis for conversion hysteria.

11.
J Am Vet Med Assoc ; 219(8): 1076-83, 2001 Oct 15.
Article in English | MEDLINE | ID: mdl-11700704

ABSTRACT

OBJECTIVE: To conduct serologic surveillance for Leishmania spp in English foxhounds from a kennel, as well as recipients of blood from these dogs, and determine whether L infantum organisms could be transmitted via blood transfusion. DESIGN: Serologic prevalence survey. ANIMALS: 120 English foxhounds and 51 dogs of various breeds receiving blood from these donors. PROCEDURE: Foxhound blood donors, foxhound nondonors, and nonfoxhound blood recipient dogs were evaluated serologically for Leishmania spp by indirect fluorescent antibody testing. Dogs that received packed RBC (PRBC) transfusions from foxhound donors from mid-1996 through mid-2000 were identified. Furthermore, dogs were serologically evaluated if they had received fresh frozen plasma (FFP) transfusions in 1999 and 2000 from seropositive foxhound blood donors. RESULTS: Thirty percent of the English Foxhounds were seropositive for Leishmania spp (titer > or = 1:16), although the degree of seropositivity varied considerably during the period. Furthermore, 57 foxhounds had been used as donors from 1996 to 2000, and 342 units of PRBC had been transfused to at least 227 patients. All 25 dogs screened that received PRBC from seronegative foxhound donors tested negative, whereas 3 of 7 dogs that received PRBC from seropositive donors tested positive. All 9 dogs that received FFP from seropositive foxhound donors remained seronegative. CONCLUSIONS AND CLINICAL RELEVANCE: To our knowledge, this report documents the first transmission of Leishmania spp by blood transfusion. The use of foxhounds as blood donors may not be advisable in North America.


Subject(s)
Anemia/veterinary , Blood Transfusion/veterinary , Dog Diseases/blood , Dog Diseases/transmission , Leishmaniasis, Visceral/veterinary , Anemia/complications , Anemia/therapy , Animals , Antibodies, Protozoan/analysis , Blood Donors , Dog Diseases/parasitology , Dogs , Female , Fluorescent Antibody Technique, Indirect/veterinary , Leishmaniasis, Visceral/blood , Leishmaniasis, Visceral/transmission , Male , Seroepidemiologic Studies , Transfusion Reaction
13.
Int Nurs Rev ; 48(2): 117-21, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11407457

ABSTRACT

Health is a global concern. Although nursing is a global profession, most schools of nursing concentrate on teaching health exclusively within the context of their own nation. Sister-school partnerships that cross national boundaries are one way of extending the learning opportunities of faculties and students. An example of a 5-year partnership is described and analysed.


Subject(s)
Education, Nursing, Baccalaureate/organization & administration , Faculty, Nursing , International Educational Exchange , China , Humans , Michigan , Program Evaluation
14.
J Am Vet Med Assoc ; 218(9): 1449-55, 2001 May 01.
Article in English | MEDLINE | ID: mdl-11345309

ABSTRACT

OBJECTIVE: To document reasons for use of fresh frozen plasma (FFP) in dogs and determine variables that apparently triggered the decision to use FFP. DESIGN: Retrospective study. ANIMALS: 74 dogs. PROCEDURE: Medical records of dogs that received FFP at a veterinary teaching hospital during a 3-month period were reviewed. RESULTS: The 74 dogs underwent 144 transfusion episodes (TE; a TE was defined as 1 day of transfusion therapy) and received 252 units (120 ml/unit) of FFP. Fresh frozen plasma was administered to provide coagulation factors (67 TE), albumin (91), alpha-macroglobulin (15), or immunoglobulins (19); for some TE, multiple clinical indications were identified. Variables that apparently triggered the decision to administer FFP included active hemorrhage with or without prolongation of coagulation times, low total plasma protein concentration, persistent vomiting associated with pancreatitis, and sepsis. Mean doses of FFP for each indication were between 8.5 and 9.4 ml/kg (3.9 and 4.3 ml/lb). Small dogs were generally given higher doses (mean dose, 13.9 ml/kg [6.3 ml/lb]) than large dogs (mean dose, 5.1 ml/kg [2.3 ml/lb]). Fifty (68%) dogs were alive at the time of discharge from the hospital. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that FFP plays an important role in the care of critically ill dogs. Because the supply of FFP is limited, guidelines for when administration of FFP may be clinically useful should be developed.


Subject(s)
Blood Component Transfusion/veterinary , Critical Illness/therapy , Dog Diseases/therapy , Plasma , Animals , Blood Transfusion , Body Weight , Dog Diseases/blood , Dogs , Female , Male , Retrospective Studies
15.
Obstet Gynecol ; 97(1): 17-22, 2001 Jan.
Article in English | MEDLINE | ID: mdl-11152900

ABSTRACT

OBJECTIVE: To assess the associations between specific pregnancy complications and posttraumatic stress disorder based on neurobiologic and behavioral characteristics, using Michigan Medicaid claims data from 1994-1996. METHODS: Two thousand, two hundred nineteen female recipients of Michigan Medicaid who were of childbearing age had posttraumatic stress disorder on the basis of International Classification of Diseases, 9th Revision (ICD-9) codes. Twenty percent (n = 455) of those recipients and 30% of randomly selected comparison women with no mental health diagnostic codes (n = 638; P <.001) had ICD-9 diagnostic codes for pregnancy complications. We used multiple logistic regression to investigate associations between specific pregnancy complications and posttraumatic stress disorder, controlling for demographic and psychosocial variables. Obstetric complications were hypothesized based on high-risk behaviors and neurobiologic alterations in stress axis function in posttraumatic stress disorder. RESULTS: After controlling for demographic and psychosocial factors, women with posttraumatic stress disorder had higher odds ratios (ORs) for ectopic pregnancy (OR 1.7, 95% confidence interval [CI] 1.1, 2.8), spontaneous abortion (OR 1.9, 95% CI 1.3, 2.9), hyperemesis (OR 3.9, 95% CI 2.0, 7.4), preterm contractions (OR 1.4, 95% CI 1.1, 1.9), and excessive fetal growth (OR 1.5, 95% CI 1.0, 2.2). Hypothesized labor differences were not confirmed and no differences were found for complications not thought to be related to traumatic stress. CONCLUSIONS: Pregnant women with posttraumatic stress disorder might be at higher risk for certain conditions, and assessment and treatment for undiagnosed posttraumatic stress might be warranted for women with those obstetric complications. Prospective studies are needed to confirm present findings and to determine potential biologic mechanisms. Treatment of traumatic stress symptoms might improve pregnancy morbidity and maternal mental health.


Subject(s)
Pregnancy Complications/etiology , Stress Disorders, Post-Traumatic/complications , Adult , Female , Humans , Logistic Models , Odds Ratio , Pregnancy , Pregnancy, Ectopic/etiology , Substance-Related Disorders/complications
16.
J Community Health Nurs ; 18(4): 223-34, 2001.
Article in English | MEDLINE | ID: mdl-11775556

ABSTRACT

Community health nurse practitioners are often the major contraceptive counselors who may use anticipatory guidance to help clients' use behaviors. Because pregnancy rates during typical use are much higher than during "perfect" use, more effective anticipatory guidance could help improve use behaviors. Principles of cognitive theory were used to explore the implications of specific words and approaches associated with discussing young adults' contraceptive use. Qualitative results are reported here, and potential implications are made for nurse practitioners' anticipatory guidance related to contraceptive use.


Subject(s)
Cognitive Science , Contraception Behavior/psychology , Contraceptives, Oral/therapeutic use , Counseling , Adult , Female , Focus Groups , Humans , Nurse Practitioners , Psychological Theory
18.
Seizure ; 9(5): 314-22, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10933985

ABSTRACT

Although literature in this area is relatively sparse, the occurrence of psychogenic non-epileptic seizures (pseudoseizures) has been linked to stress, anxiety and possible dissociative tendencies. An association between dissociation and hypnotic susceptibility has also been proposed and dissociative tendencies have themselves been found to relate to the use of emotion-focused coping strategies. In order to investigate the hypothesis that pseudoseizure patients may exhibit higher levels of dissociation, a more emotion-focused coping style, and greater hypnotic susceptibility than the general population, the questionnaire responses of 20 patients with pseudoseizures were compared with those obtained from a non-clinical control group. As predicted, pseudoseizure patients demonstrated some evidence of higher levels of dissociation and escape-avoidance coping strategies. They also expressed a greater belief in external control over health and higher depression scores, compared to the control group, but the previously reported elevation in hypnotizability scores in the pseudoseizure patients was not found. Possible explanations for this pattern of results are discussed.


Subject(s)
Adaptation, Psychological , Attitude to Health , Dissociative Disorders , Hypnosis , Internal-External Control , Seizures/psychology , Adult , Analysis of Variance , Case-Control Studies , Female , Humans , Intelligence Tests , Male , Middle Aged , Psychiatric Status Rating Scales , Somatoform Disorders/psychology
20.
J Midwifery Womens Health ; 45(2): 87-93, 2000.
Article in English | MEDLINE | ID: mdl-10812853

ABSTRACT

Recent, large, randomized, controlled trials of the effects of episiotomy on perineal damage have confirmed that episiotomy is associated with an increased risk of damage to the perineum. Yet episiotomy remains the most common surgical procedure women undergo. This article examines if clinician experience, rather than scientific evidence, forms the basis for continuing this practice. Perineal outcome data are analyzed for 865 low-risk women who were attended at birth by the staff nurse-midwives or faculty obstetricians at a university-based, tertiary-care hospital. Data were collected under routine, nonexperimental conditions such that the circumstances of the labor and the clinician's preferences were allowed to determine management decisions regarding the use of episiotomy or other techniques of perineal management. Multivariate findings indicate that in the absence of episiotomy, rates of perineal integrity were highest among clinicians who usually had the lowest rate of episiotomy use. When an episiotomy was done, rates of third- and fourth-degree extensions were highest among clinicians who used episiotomy most frequently. This finding challenges the idea that clinicians who were very experienced with the use of episiotomy would avoid complications such as extensions. Future research should explore the use of nonsurgical techniques such as those employed by midwives to promote perineal integrity. Then interdisciplinary research and evidence-based education regarding these techniques can occur to improve perineal outcomes for all women.


Subject(s)
Episiotomy/adverse effects , Episiotomy/statistics & numerical data , Midwifery , Outcome Assessment, Health Care , Perineum/injuries , Professional Practice/statistics & numerical data , Female , Humans , Logistic Models , Medical Records , Midwifery/methods , Pregnancy , United States/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL
...