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Health History (health + history)
Selected AbstractsRespiratory Effect of Prolonged Electrical Weapon Application on Human VolunteersACADEMIC EMERGENCY MEDICINE, Issue 3 2007Jeffrey D. Ho MD Background: Conducted electrical weapons (CEWs) are used by law enforcement to subdue combative subjects. Occasionally, subjects will die after a CEW has been used on them. It is theorized that CEWs may contribute to these deaths by impairing respiration. Objectives: To examine the respiratory effects of CEWs. Methods: Human volunteers received a 15-second application of electrical current from a CEW while wearing a respiratory measurement device. Common respiratory parameters were collected before, during, and after exposure. Health histories and demographic information were also collected. Results: Fifty-two subjects were analyzed. Thirty-four underwent a 15-second continuous exposure, and 18 underwent three 5-second burst exposures. In the continuous application group, the baseline mean tidal volume of 1.1 L increased to 1.8 L during application, the baseline end-tidal CO2 level went from 40.5 mm Hg to 37.3 mm Hg after exposure, the baseline end-tidal oxygen level went from 118.7 mm Hg to 121.3 mm Hg after exposure, and the baseline respiratory rate went from 15.9 breaths/min to 16.4 breaths/min after exposure. In the 5-second burst group, the baseline mean tidal volume increased to 1.85 L during application, the baseline end-tidal CO2 level went from 40.9 mm Hg to 39.1 mm Hg after exposure, the baseline end-tidal oxygen level went from 123.1 mm Hg to 127.0 mm Hg after exposure, and the baseline respiratory rate went from 13.8 breaths/min to 14.6 breaths/min after exposure. Conclusions: Prolonged CEW application did not impair respiratory parameters in this population of volunteers. Further study is recommended to validate these findings in other populations. [source] Family health effects: complements or substitutesHEALTH ECONOMICS, Issue 8 2001Michael Lee Ganz Abstract Genetic endowments play a fundamental role in the production of health. At birth individuals have different capacities to be healthy, largely due to genetic dispositions. Whether or not individuals realize this health depends on their choice of health behaviours. Previous research has linked negative factors beyond the individual's control, which include genetic endowments, to both poor health and poor health behaviours. The health economics literature proposes that behaviours and genetic (or family health) endowments can be either substitutes or complements in the production of health. The goal of this paper is to investigate the behavioural consequences of changes in knowledge about one's genetic endowment. Using two waves of the National Health and Nutrition Examination Survey I Epidemiologic Followup Study, I find that for smokers, smoking intensity substitutes for newly diagnosed smoking-related family cancers, while smoking intensity is complementary to newly diagnosed non-smoking-related family cancers. I find no evidence for the hypothesized relationships with respect to alcohol consumption among drinkers. These results have implications for the growing field of genetic testing and test development. These results also reinforce current practices of ascertaining family health histories in the context of medical history taking. Copyright © 2001 John Wiley & Sons, Ltd. [source] Autism and other neuropsychiatric symptoms are prevalent in individuals with MeCP2 duplication syndrome,ANNALS OF NEUROLOGY, Issue 6 2009Melissa B. Ramocki MD Objective There have been no objective assessments to determine whether boys with MECP2 duplication have autism or whether female carriers manifest phenotypes. This study characterizes the clinical and neuropsychiatric phenotypes of affected boys and carrier females. Methods Eight families (9 males and 9 females) with MECP2 duplication participated. A detailed history, physical examination, electroencephalogram, developmental evaluation, Autism Diagnostic Observation Schedule, and Autism Diagnostic Interview,Revised were performed for each boy. Carrier females completed the Symptom Checklist-90-R, Wechsler Abbreviated Scale of Intelligence, Broad Autism Phenotype Questionnaire, and detailed medical and mental health histories. Size and gene content of each duplication were determined by array comparative genome hybridization. X-chromosome inactivation patterns were analyzed using leukocyte DNA. MECP2 and IRAK1 RNA levels were quantified from lymphoblast cell lines, and western blots were performed to assess MeCP2 protein levels. Results All of the boys demonstrated mental retardation and autism. Poor expressive language, gaze avoidance, repetitive behaviors, anxiety, and atypical socialization were prevalent. Female carriers had psychiatric symptoms, including generalized anxiety, depression, and compulsions that preceded the birth of their children. The majority exhibited features of the broad autism phenotype and had higher nonverbal compared to verbal reasoning skills. Interpretation Autism is a defining feature of the MECP2 duplication syndrome in boys. Females manifest phenotypes despite 100% skewing of X-inactivation and normal MECP2 RNA levels in peripheral blood. Analysis of the duplication size, MECP2 and IRAK1 RNA levels, and MeCP2 protein levels revealed that most of the traits in affected boys are likely due to the genomic region spanning of MECP2 and IRAK1. The phenotypes observed in carrier females may be secondary to tissue-specific dosage alterations and require further study. Ann Neurol 2009;66:771,782 [source] Unintentional methadone-related overdose death in New Mexico (USA) and implications for surveillance, 1998,2002ADDICTION, Issue 2 2005Nina Shah ABSTRACT Aims To determine death rates from methadone over time, to characterize methadone-related death and to discuss public health surveillance of methadone-related death. Design We analyzed medical examiner data for all unintentional drug overdose deaths in New Mexico, USA, between 1998 and 2002. Measurements Age-adjusted death rates for methadone-related death, logistic regression models for likelihood of methadone-related death among all unintentional drug overdose deaths and bivariate comparisons within methadone-related death. Findings Of 1120 drug overdose deaths during this period, there were 143 (12.8%) methadone-related deaths; the death rate decreased over the time period, averaging 1.6 per 100 000. Of 143 methadone-related deaths, 22.4% were due to methadone alone, 23.8% were due to methadone/prescription drugs (no illicit drugs), 50.3% were due to methadone/illicit drugs and 3.5% were due to methadone/alcohol. These groups were significantly different in demographics, health history and circumstances of death. Of 79 decedents (55.2%) with a known source of methadone, 68 obtained methadone through a physician prescription (31 for methadone maintenance treatment (MMT), 27 for managing pain and 10 had unknown reason for prescription). Conclusions Methadone-related death rates and the proportion of methadone-related death among all drug overdose deaths decreased in New Mexico from 1998 to 2002. It is important for surveillance of methadone-related death to assess multiple drug causes, not just underlying cause. Also, methadone for pain management must be examined alongside MMT and when possible, methadone co-intoxication should be described in the context of other drugs causing death. [source] Reports of information and support needs of daughters and sisters of women with breast cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 1 2003ASSOCIATE PROFESSOR , K. CHALMERS RN, MSC(A) The aim of this study was to describe the information and support needs of women who have primary relatives with breast cancer. The Information and Support Needs Questionnaire (ISNQ) was developed and revised from previous qualitative and pilot studies. The ISNQ addressed concepts of the importance of, and the degree to which, 29 information and support needs related to breast cancer had been met. The study sample consisted of 261 community-residing women who had mothers, sisters, or a mother and sister(s) with breast cancer. Data were collected using a mailed survey. In addition to the ISNQ, additional items addressed family and health history, breast self-care practices, perception of the impact of the relative's breast cancer and other variables. Also included were established and well-validated measures of anxiety and depression. The findings document women's priority information and support needs. The information need most frequently identified as very important was information about personal risk of breast cancer. Other highly rated needs addressed risk factors for breast cancer and early detection measures. Generally, the women perceived that their information and support needs were not well met. These findings illuminate needs of women for more information and support when they have close family relatives with breast cancer and opportunities for primary care providers to assist women in addressing their needs. [source] Simulation of patient encounters using a virtual patient in periodontology instruction of dental students: design, usability, and learning effect in history-taking skillsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2004M. Schittek Janda Simulations are important educational tools in the development of health care competence. This study describes a virtual learning environment (VLE) for diagnosis and treatment planning in oral health care. The VLE is a web-based, database application where the learner uses free text communication on the screen to interact with patient data. The VLE contains forms for history taking, clinical images, clinical data and X-rays. After reviewing the patient information, the student proposes therapy and makes prognostic evaluations of the case in free text. A usability test of the application was performed with seven dental students. The usability test showed that the software responded with correct answers to the majority of the free text questions. The application is generic in its basic functions and can be adapted to other dental or medical subject areas. A randomised controlled trial was carried out with 39 students who attended instruction in history taking with problem-based learning cases, lectures and seminars. In addition, 16 of the 39 students were randomly chosen to practise history taking using the virtual patient prior to their first patient encounter. The performance of each student was recorded on video during the patient sessions. The type and order of the questions asked by the student and the degree of empathy displayed towards the patient were analysed systematically on the videos. The data indicate that students who also undertook history taking with a virtual patient asked more relevant questions, spent more time on patient issues, and performed a more complete history interview compared with students who had only undergone standard teaching. The students who had worked with the virtual patient also seemed to have more empathy for the patients than the students who had not. The practising of history taking with a virtual patient appears to improve the capability of dental students to take a relevant oral health history. [source] Oral Health of Young Children in Mississippi Delta Child Care Centers: A Second Look at Early Childhood Caries Risk AssessmentJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2008Linda H. Southward PhD Abstract Objectives: To identify the predictors of early childhood caries and urgent dental treatment need among primarily African-American children in child care centers in the Delta region of Mississippi. The purpose of this study was to replicate predictors of caries and urgent dental treatment needs that were identified in an earlier study conducted in Delta child care centers and to assess additional caries risk factors not collected in the original study. Methods: Children in 19 child care centers were examined by the dentists, and the parents provided data on oral health practices, oral health history, and on children's oral health-related quality of life (QOL). The dentists also assessed visible plaque and tested levels of mutans streptococci. Predictors of caries and treatment need among children 24 to 71 months of age were examined using logistic regression. Results: Two parent predictors of caries identified in the earlier study (parent flossing and soft/sugary drink consumption) were not predictive in the current study. Parent history of abscess continued to predict their child's urgent need for treatment. Young children's level of salivary mutans streptococci, maxillary incisor visible plaque, and parents' reports of child oral health-related QOL measures predicted the presence of both caries and urgent treatment need. Some expected predictors, such as frequency of child's toothbrushing, were not predictive of caries. Conclusions: Parental abscess and parent's report of the child's oral health-related QOL are risk indicators for poor oral health outcomes that could be used by nondental personnel to identify young children in need of early preventive intervention and dental referral. [source] Personality disorder scale predictors of depression stability over time as a partial function of mental health historyPERSONALITY AND MENTAL HEALTH, Issue 4 2009Alan R. King The high comorbidity of personality disturbance and psychiatric symptomatology has been well established. Diagnostic and Statistical Manual-IV (DSM-IV) personality disorder symptom clusters often represent aberrant, intense and labile emotional reactions to stressors. The role of personality disorder traits on the variability of depression symptoms as expressed over time, however, has gained relatively little research attention. The presence and number of personality disorder diagnoses have been associated with earlier depression onset and less favourable treatment outcomes suggesting that this form of mood disturbance may be more durable over time when associated with Axis II features. The present study examined Beck Depression Inventory (BDI) temporal stability as a function of Millon Clinical Multiaxial Inventory (MCMI-II) personality disorder base rate scores among 406 college students with and without reported histories of significant mental health concerns. Instability of BDI scores across time was shown to be predicted (r = 0.15) by selected personality disorderscale dimensions (antisocial, self-defeating, borderline and total number of MCMI-II personality disorder elevations). BDI reliability did drop significantly among participants reporting a mental health treatment history and multiple personality disorder elevations. Gender differences were not found in the strength of these bivariate correlations. Women generated smaller BDI absolute differences than men. While BDI test,retest reliability was only linked modestly to personality disorder attributes in this college sample, further study may be warranted to evaluate similar relationships within a clinical sample. Copyright © 2009 John Wiley & Sons, Ltd. [source] Encouraging Psychological Outcomes After Altruistic Donation to a StrangerAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010E. K. Massey In a growing number of transplant centers worldwide, altruistic donors are accepted to anonymously donate a kidney to a stranger. An important hesitation to expand these transplantation programs is the fear of evoking psychological distress in the altruistic donor after donation. To what extent this fear is justified has not yet been systematically investigated. In this study, 24 altruistic donors were interviewed on average 2 years after donation. Lifetime mental health history, current psychological complaints, satisfaction with and impact of the donation on well-being, motives for donation, communication with recipient and donation experience were assessed. Altruistic donors report a considerable positive impact of donation on psychological well-being, whereas negative impact was limited. Satisfaction with donation was very high. Although a history of a psychiatric diagnosis was ascertained in almost half of the donors, psychological complaints before and after donation were comparable to national average norm scores. Motives for donation were genuine and the experience of donation generally conformed to their expectations. In conclusion, living kidney donation to a stranger does not appear to exacerbate psychological complaints. Moreover, altruistic donors report considerable satisfaction and personal benefit. The exceptional gift of altruistic donors can contribute toward solving the current organ shortage issue. [source] Phytochemical intake and relationship to past health history in Japanese womenBIOFACTORS, Issue 1-4 2004Melissa K. Melby Abstract We calculated functional food factor (FFF) intakes using a new database and examined their relationship to health conditions commonly affecting Japanese women in midlife. One-day DRs were collected weekly for 6 months from 67 Japanese women, aged 45,55 yr, living in Kyoto prefecture, Japan. Macro- and micronutrient and FFF intake were calculated from the resulting 1528 DRs. Factor analysis and logistic regression were performed to identify relationships between FFFs and past health history. Fourteen of 17 FFF factors, as well as age, BMI and menopausal status, exhibited both positive and negative correlations with past history of hypertension, diabetes, allergy, migraine, and menopausal syndrome. [source] | ||||||||||