Home About us Contact
|
Home About us Contact | ||
|
|
||
Adult Family Members (adult + family_member)
Selected AbstractsCare for the Adult Family Members of Victims of Unexpected Cardiac DeathACADEMIC EMERGENCY MEDICINE, Issue 12 2006Robert Zalenski MD Abstract More than 300,000 sudden coronary deaths occur annually in the United States, despite declining cardiovascular death rates. In 2000, deaths from heart disease left an estimated 190,156 new widows and 68,493 new widowers. A major unanswered question for emergency providers is whether the immediate care of the loved ones left behind by the deceased should be a therapeutic task for the staff of the emergency department in the aftermath of a fatal cardiac arrest. Based on a review of the literature, the authors suggest that more research is needed to answer this question, to assess the current immediate needs and care of survivors, and to find ways to improve care of the surviving family of unexpected cardiac death victims. This would include improving quality of death disclosure, improving care for relatives during cardiopulmonary resuscitation of their family member, and improved methods of referral for services for prevention of psychological and cardiovascular morbidity during bereavement. [source] Surgical Excision of Pedunculated Supernumerary Digits Prevents Traumatic Amputation NeuromasPEDIATRIC DERMATOLOGY, Issue 2 2003Geoffrey E. Leber The first group consisted of three patients who had among them five traumatic amputation neuromas. In each case these lesions resulted from primary suture ligation of accessory digits in infancy. Secondary surgical excision of the vestigial digit with high ligation and retraction of the accompanying nerve tissue was required in all cases. The second group consisted of six patients who had 12 pedunculated supernumerary digits. Primary surgical excision of these digits was performed with high transection and retraction of the accompanying accessory digital nerve. All patients in this group had excellent cosmetic results with no postoperative neuroma formation. Adult family members who had undergone suture ligation of similar supernumerary digits in infancy accompanied seven of the nine patients in this series. On careful examination, each of these family members had signs and symptoms attributable to traumatic amputation neuromas. We feel identification and high transection of the accessory digital nerve is essential in the treatment of pedunculated supernumerary digits. This treatment prevents traumatic amputation neuromas and yields a better cosmetic result than the traditional method of suture ligation in infancy. [source] Post-Traumatic Stress Disorder Symptomology Associated with Witnessing Unsuccessful Out-of-hospital Cardiopulmonary ResuscitationACADEMIC EMERGENCY MEDICINE, Issue 3 2009Scott Compton PhD Abstract Objectives:, The objective was to assess symptoms of post-traumatic stress disorder (PTSD) associated with witnessing unsuccessful out-of-hospital cardiopulmonary resuscitation (CPR) on a family member. Methods:, Adult family members of deceased, adult, nontraumatic out-of-hospital cardiac arrest victims who were transported to a large, Midwestern hospital were contacted by telephone beginning 1 month after the event. Subjects were dichotomized as to whether or not they were physically present during the patient's resuscitation. A structured interview obtained the patient's prearrest functioning, whether the family member witnessed or performed CPR, patient and family demographic data, key cardiac arrest events, and a measure of subject PTSD symptoms (PTSD Symptom Scale-Interview [PSS-I]). Results:, There were 34 witnesses and 20 nonwitnesses. Each group was similar in race, religion, age, gender, and relationship to the patient. Patients in each group were similar in prearrest functioning. Witnesses' total PTSD symptom scores were nearly two times higher than nonwitnesses (14.47 vs. 7.60, respectively; mean difference = 6.87, 95% confidence interval [CI] = 0.57 to 13.17). Two PSS-I subscales were higher for witnesses than nonwitnesses: Avoidance (5.41 vs. 2.25; mean difference = 3.16, 95% CI = 0.74 to 5.58) and Increased Arousal (4.26 vs. 2.20; mean difference = 2.06, 95% CI = 0.08 to 4.05), while Reexperiencing was not (4.79 vs. 3.15; mean difference = 1.64, 95% CI = ,0.62 to 3.91). Linear regression analysis indicated that witnessing CPR of a loved one was associated with a mean increase of nearly 12 points on the PSS-I after controlling for the possibility of other potentially influential events and characteristics. Results were similar when CPR providers (n = 6) were removed from the witness group. Conclusions:, Witnessing a failed CPR attempt of a loved one in an out-of-hospital location may be associated with displaying symptoms of PTSD in the early term of the bereavement period. While preliminary, these data suggest that the relationship exists even after controlling for other potential factors that may also affect the propensity for displaying such symptoms, such as the suddenness and location of the patient's cardiac arrest. [source] Non-supportive interactions in the experience of women family caregiversHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2007Anne Neufeld RN PhD Abstract The purpose of this ethnographic study was to identify and describe types of non-supportive interactions perceived by 59 women family caregivers in four diverse situations. Participants included 15 mothers of infants born prematurely, 14 mothers of a child with a chronic disease (asthma or diabetes), and women caring for an adult family member with either cancer (15) or dementia (15). Data collection methods included an initial in-depth interview with all women, followed by a second interview with a smaller group of caregivers including a card sort exercise that was based on thematic content analysis of the first interview data. A typology of non-supportive interactions was developed from analysis of the first two interviews and confirmed in a final interview with a subset of study participants. Interviews were audio-taped and transcribed verbatim. Women in all caregiving situations described experience with three types of non-supportive interactions. These interactions were negative, ineffective, or lacking expected support. The women's appraisal of interactions as supportive or non-supportive was rooted in their personal expectations and the context of their situation. Information about types of non-supportive interactions can sensitise professionals, family and friends to mismatches between their assistance and caregivers' requirements, potentially avoiding negative consequences. [source] Dimensions of Family Functioning: Perspectives of Low-Income African American Single-Parent FamiliesJOURNAL OF MARRIAGE AND FAMILY, Issue 3 2004Linda L. McCreary Family functioning is influenced by socioeconomic status, culture, family structure, and developmental stage, and is assessed primarily using instruments developed for middle-income European American two-parent families. These instruments may not validly assess low-income African American single-parent families. This qualitative study was conducted to provide rich descriptions of families and family functioning in order to inform research on this underrepresented group. Interviews were conducted with 20 low-income African American single mothers and 20 adult family members recruited from a large midwestern city. Content analysis revealed the essential dimensions of family functioning: Effective families provide emotional nurturing, communicate, do things together, help each other, and parent children appropriately. [source] Diagnostic Performance of Various QTc Interval Formulas in a Large Family with Long QT Syndrome Type 3: Bazett's Formula Not So Bad After All ,ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 4 2003Jan Brouwer M.D., M.Sc., Ph.D. Background: Recently, we identified a novel mutation of SCN5A (1795insD) in a large family with LQTS3. The aim of this study was to assess whether the various proposed corrections of the QT interval to heart rate help to improve the identification of carriers of the mutant gene. Methods: The study group consisted of 101 adult family members: 57 carriers and 44 noncarriers (mean age 44.6 ± 14.6 and 40.3 ± 12.8 years, respectively). In all individuals a 12-lead ECG, exercise ECG, and 24-hour Holter ECG were obtained. Results: Correction for heart rate significantly improved the diagnostic performance of the QT interval. Diagnostic performance of the Bazett formula was similar to that of the newer formulas (Fridericia, Hodges, Framingham, and a logarithmic formula). At a cut-off value of 440 ms, the Bazett corrected QT interval was associated with a sensitivity and specificity of 90% and 91%, respectively. Using the 24-hour Holter ECG, a prolonged QTc at heart rates less than 60 beats/min was almost pathognomonic for genetic mutation (sensitivity and specificity both 99%), whereas the QTc calculated at the lowest heart rate using Bazett's formula provided full discrimination. Conclusion: In the present family, the resting ECG gave a good indication about the presence or absence of genetic mutation but a 24-hour Holter recording was mandatory to ascertain the diagnosis. In the diagnosis of this form of LQTS3, Bazett's formula was at least as good as other proposed corrections of the QT interval to heart rate. [source] A novel mutation in the third extracellular domain of the tumor necrosis factor receptor 1 in a Finnish family with autosomal-dominant recurrent feverARTHRITIS & RHEUMATISM, Issue 4 2002Hanna Nevala Objective To investigate the presence of TRAPS (tumor necrosis factor receptor,associated periodic syndrome), which is a recently defined, dominantly inherited autoinflammatory syndrome caused by mutations in the tumor necrosis factor receptor superfamily 1A gene (TNFRSF1A, CD120a), in a Finnish family with recurrent fever. Methods The TNFRSF1A gene was sequenced in both affected and unaffected family members. Flow cytometry and enzyme-linked immunosorbent assay analyses were used to assess membrane expression and serum levels of the TNFRSF1A protein, respectively. Results A missense mutation in exon 4, located in the third extracellular domain of TNFRSF1A and resulting in an amino acid substitution (F112I) close to a conserved cysteine, was found in all 4 affected family members and in 1 asymptomatic individual. The mutation was clearly associated with low levels of soluble TNFRSF1A as well as with the clinical symptoms of recurrent fever and abdominal pain. Impaired shedding of TNFRSF1A after phorbol myristate acetate stimulation was detected in blood granulocytes and monocytes from the 3 adult family members with the mutation, but in the child bearing the mutation and showing clinical symptoms of recent onset, the shedding defect was less marked. Conclusion TRAPS should be suspected in any patient who presents with a history of intermittent fever accompanied by unexplained abdominal pain, arthritis, or skin rash, particularly in the presence of a family history of such symptoms. Screening for low serum levels of soluble TNFRSF1A identifies individuals who are likely to have TNFRSF1A mutations. [source] | ||||||||||