RESUMEN
To evaluate the effect of soybeans roasted at different temperatures on milk yield and milk fatty acid composition, 8 (4 multiparous and 4 primiparous) mid-lactation Holstein cows (42.9±3 kg/d of milk) were assigned to a replicated 4×4 Latin square design. The control diet (CON) contained lignosulfonate-treated soybean meal (as a source of rumen-undegradable protein) and calcium salts of fatty acids (Ca-FA, as a source of energy). Diets 2, 3, and 4 contained ground soybeans roasted at 115, 130, or 145°C, respectively (as the source of protein and energy). Dry matter intake (DMI) tended to be greater for CON compared with the roasted soybean diets (24.6 vs. 23.3 kg/d). Apparent total-tract digestibilities of dry matter, organic matter, and crude protein were not different among the treatments. Actual and 3.5% fat-corrected milk yield were greater for CON than for the roasted soybean diets. Milk fat was higher for soybeans roasted at 130°C than for those roasted at either 115 or 145°C. No differences were observed between the CON and the roasted soybean diets, or among roasting temperatures, on feed efficiency and nitrogen concentrations in rumen, milk, and plasma. Milk from cows fed roasted soybeans had more long-chain fatty acids and fewer medium-chain fatty acids than milk from cows fed Ca-FA. Compared with milk from cows fed the CON diet, total milk fat contents of conjugated linoleic acid, cis-9,trans-11 conjugated linoleic acid, cis-C18:2, cis-C18:3, and C22:0 were higher for cows fed the roasted soybean diets. Polyunsaturated fatty acids and total unsaturated fatty acids were greater in milk from cows fed roasted soybean diets than in milk from cows fed CON. Concentrations of C16:0 and saturated fatty acids in milk fat were greater for CON than for the roasted soybean diets. Cows fed roasted soybean diets had lower atherogenic and thrombogenic indices than cows fed CON. Milk fatty acid composition did not differ among different roasting temperatures. In summary, results showed that cows fed CON had higher DMI and milk yield than cows fed roasted soybean diets. Among different roasting temperatures (115, 130, and 145°C), soybeans roasted at 115°C led to higher milk production and lower DMI. Cows fed roasted soybeans, regardless of the roasting temperature, had more unsaturated fatty acids in milk. Using roasted soybeans in dairy cow rations could, therefore, improve the health indices of milk for human nutrition.
Asunto(s)
Bovinos/fisiología , Culinaria/métodos , Ácidos Grasos/metabolismo , Glycine max/química , Calor , Leche/química , Alimentación Animal/análisis , Animales , Calcio/administración & dosificación , Calcio/metabolismo , Ácidos Grasos/administración & dosificación , Femenino , Distribución Aleatoria , Sales (Química)/administración & dosificación , Sales (Química)/metabolismoAsunto(s)
Procedimientos Quirúrgicos Cardíacos/efectos adversos , Imágenes en Psicoterapia , Cuidados Posoperatorios , Trastornos del Sueño-Vigilia/prevención & control , Síndrome de Respuesta Inflamatoria Sistémica/prevención & control , Proteína C-Reactiva/análisis , Femenino , Humanos , Hidrocortisona/sangre , Masculino , Persona de Mediana Edad , Trastornos del Sueño-Vigilia/etiología , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Síndrome de Respuesta Inflamatoria Sistémica/metabolismoRESUMEN
32 postmenopausal women were randomized to a 16-week home-based walking program or control group. Before and after the intervention, each subject completed a graded maximal treadmill test to establish VO(2)max and resting saliva was collected to determine levels of salivary immunoglobulin A. The 16-week walking program resulted in an increase in VO(2)max (+10.4%; p<0.01). Repeated measures ANOVA revealed a marked increase in the resting secretion rate of salivary immunoglobulin A (+37.4%; p<0.05) in the exercise group following training. Independent of study group, both before and after the intervention, the secretion rate of salivary immunoglobulin A ( - 32.3%) and saliva flow rate (- 29.3%) were reduced following acute maximal exercise (p<0.05). Weekly upper respiratory symptomatology logs revealed that the number of incidences of upper respiratory symptoms throughout the intervention period were the same and the duration per incidence (control: 5.3±1.5 days; exercise: 6.3±2.2 days) were similar between study groups. These findings in postmenopausal women support that the secretion rate of salivary immunoglobulin A and saliva flow rate are reduced immediately following maximal exercise. Moreover, a 16-week moderate intense walking program can increase the secretion of salivary immunoglobulin A without affecting upper respiratory symptomatology.
Asunto(s)
Ejercicio Físico/fisiología , Inmunoglobulina A Secretora/metabolismo , Posmenopausia , Saliva/inmunología , Análisis de Varianza , Prueba de Esfuerzo , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Oxígeno/metabolismo , Infecciones del Sistema Respiratorio/epidemiología , Factores de Tiempo , Caminata/fisiologíaRESUMEN
This study provides current data on key questions about retraction of scientific articles. Findings confirm that the rate of retractions remains low but is increasing. The most commonly cited reason for retraction was research error or inability to reproduce results; the rate from research misconduct is an underestimate, since some retractions necessitated by research misconduct were reported as being due to inability to reproduce. Retraction by parties other than authors is increasing, especially for research misconduct. Although retractions are on average occurring sooner after publication than in the past, citation analysis shows that they are not being recognised by subsequent users of the work. Findings suggest that editors and institutional officials are taking more responsibility for correcting the scientific record but that reasons published in the retraction notice are not always reliable. More aggressive means of notification to the scientific community appear to be necessary.
Asunto(s)
Investigación Biomédica/normas , Políticas Editoriales , Retractación de Publicación como Asunto , Autoria , Investigación Biomédica/ética , HumanosRESUMEN
BACKGROUND: Physical activity-induced reduction in obesity-related hyperfibrinogenemia in children has been reported. The underlying mechanisms remain elusive. Further, the effect of such interventions on fibrinolysis in children is scarce. OBJECTIVES: To investigate in obese children, before and after a physical activity-based intervention: (i) the mechanistic role of fractional synthesis rate (FSR) of fibrinogen in the reduction of hyperfibrinogenemia; and (ii) the changes in fibrinolytic factors. METHODS: Subjects included 21 (age > 14 < 18 years; Tanner stage, IV-V) children (15 obese, BMI >95%tile for age and sex and six lean, BMI <85%tile). After baseline measurements of FSR of fibrinogen, and concentrations of fibrinogen, D-dimer, PAI-1 and t-PA in all children, studies were repeated after a 3-month randomized controlled physical activity-based lifestyle intervention in obese children only. RESULTS: FSR of fibrinogen was higher (P = 0.002) in the obese (vs. lean) group, which was reduced (P = 0.001) after intervention. This almost completely accounted for the reduction in obesity-related hyperfibrinogenemia. High levels of D-dimer decreased (P = 0.001) after intervention, whereas fibrinolysis was not enhanced. CONCLUSIONS: The direct reduction in the FSR of fibrinogen and the remarkable correlation between the magnitudes of reduction in fibrinogen FSR and concentration signify a mechanistic role for FSR in the regulation of physical activity-induced reversal of hyperfibrinogenemia in obese children. The congruent reductions in the FSR of fibrinogen and the concentrations of fibrinogen and D-dimer in response to intervention despite depressed fibrinolysis suggest an overall improvement in the hypercoagulable state in obese children with physical activity-based lifestyle intervention.
Asunto(s)
Terapia por Ejercicio , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Fibrinógeno/biosíntesis , Obesidad/sangre , Obesidad/terapia , Adolescente , Ejercicio Físico/fisiología , Femenino , Fibrinólisis , Humanos , Cinética , Estilo de Vida , Masculino , Obesidad/complicaciones , Inhibidor 1 de Activador Plasminogénico/sangre , Factores de Riesgo , Trombosis/sangre , Trombosis/etiología , Trombosis/prevención & control , Activador de Tejido Plasminógeno/sangreRESUMEN
Our objective was to determine if beta(1)-adrenergic receptor (beta(1)-AR) and beta(2)-AR gene polymorphisms influence heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) response to dobutamine during dobutamine stress echocardiography (DSE). Patients (n=163) undergoing clinically indicated DSE were enrolled. Dobutamine doses were titrated from 5 to 40 microg kg(-1) min(-1) at 3 min intervals and HR, SBP and DBP were measured. Genotypes were determined for beta(1)-AR Ser49Gly, beta(1)-AR Arg389Gly, beta(2)-AR Arg16Gly and beta(2)-AR Gln27Glu polymorphisms by polymerase chain reaction-restriction fragment length polymorphism analysis, pyrosequencing and single primer extension methods. beta(2)-AR Glu27 homozygotes had a greater HR response at the highest dobutamine dose than Gln27 carriers (P=0.002). Beta(2)-AR Gly16 homozygotes had a lower HR response during 5-30 microg kg(-1) min(-1) of the dobutamine infusion protocol compared to Arg16 carriers (P=0.03). Differences in SBP by beta(2)-AR codon 16 genotype and DBP by beta(1)-AR codon 389 genotype were found at baseline and were maintained throughout DSE (P=0.06 and 0.02, respectively). However, the magnitude of SBP and DBP response to dobutamine did not differ significantly by beta(2)-AR codon 16 or beta(1)-AR codon 389 genotypes, respectively. These data suggest that the four selected beta(1)- and beta(2)-AR polymorphisms do not substantially influence the magnitude of hemodynamic response to dobutamine during DSE.
Asunto(s)
Presión Sanguínea/efectos de los fármacos , Dobutamina/administración & dosificación , Ecocardiografía/métodos , Frecuencia Cardíaca/efectos de los fármacos , Polimorfismo Genético , Receptores Adrenérgicos beta/genética , Anciano , Estudios de Cohortes , Dobutamina/farmacología , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana EdadRESUMEN
In the CYP3A5 gene, the A>G (*3) and G>A (*6) polymorphisms result in severely decreased expression of CYP3A5 enzyme relative to a normal functional allele (*1). We sought to determine if the CYP3A5 genetic polymorphisms were associated with level of blood pressure (BP), risk of hypertension (HTN), and the antihypertensive response to verapamil. A total of 676 normotensive and hypertensive participants (mean age 49+/-8.2 years) from the Hypertension Genes study and 722 patients (mean age 66+/-9 years) from the International Verapamil/Trandolapril Study Genetic Substudy (INVEST-GENES) were genotyped for CYP3A5 to test for associations with BP, HTN, and in the latter cohort, antihypertensive response to verapamil. CYP3A5 haplotypes were determined using PHASE 2, with any allele containing either (*3) or (*6) designated as non functional. In the HTN genes population, there were no significant differences based on the number of functional CYP3A5 alleles, in systolic blood pressure (SBP) or diastolic blood pressure (DBP) among the normotensive whites or blacks (all P> or =0.70) or in allele frequency between normotensives and hypertensives. In INVEST-GENES, when controlled for baseline BP, race, age, and gender, untreated BP in carriers versus non carriers of a CYP3A5 functional allele was 158.2+/-13.7 and 154.8+/-13.7 (P=0.061), respectively. CYP3A5 functional allele status was marginally associated with the SBP response to verapamil in blacks (P=0.075) and Hispanics (P=0.056), but not in whites (P=0.40), with the effect being largely driven by higher SBP in the carriers of two functional alleles. There was no association with DBP response and CYP3A5 allele status. CYP3A5 genotype does not contribute importantly to BP or risk of HTN, but may influence response to calcium channel blockers in populations in which carrier status of two functional alleles is common.
Asunto(s)
Bloqueadores de los Canales de Calcio/farmacocinética , Bloqueadores de los Canales de Calcio/uso terapéutico , Sistema Enzimático del Citocromo P-450/genética , Hipertensión/tratamiento farmacológico , Hipertensión/genética , Polimorfismo Genético/genética , Verapamilo/farmacocinética , Verapamilo/uso terapéutico , Adulto , Anciano , Población Negra , Presión Sanguínea/efectos de los fármacos , Estudios de Cohortes , Citocromo P-450 CYP3A , ADN/genética , Femenino , Genotipo , Hispánicos o Latinos , Humanos , Masculino , Persona de Mediana Edad , Farmacogenética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Población BlancaRESUMEN
Two common polymorphisms in the beta1-adrenergic receptor gene, Ser49Gly and Arg389Gly, are associated with variable antihypertensive response to metoprolol. We sought to determine whether similar pharmacogenetic associations were present with the negative chronotropic response phenotype to metoprolol. Metoprolol was titrated in 54 untreated hypertensive patients to achieve blood pressure control. We found no association between either resting or exercise heart rate at baseline (untreated) or in response to metoprolol by codon 389 genotype. In contrast, when compared by codon 49 genotype, Ser49 homozygotes had significantly higher resting heart rates at baseline (untreated) than Gly49 carriers (82+/-10 versus 74+/-11 bpm, respectively, P=0.016). When corrected for plasma concentration, we found no difference in reduction in exercise heart rate in response to metoprolol between Ser49 homozygotes and Gly49 carriers (0.75+/-0.11 versus 0.57+/-0.17%/ng/ml, respectively, P=0.37). However, if one fails to account for plasma concentration, trends toward a significant difference in heart rate reduction are seen between Ser49 homozygotes and Gly49 carriers (31% reduction versus 25% reduction, P=0.05). Our data suggest that neither the beta1-adrenergic receptor Arg389Gly, nor the Ser49Gly polymorphisms are associated with variable negative chronotropic response to metoprolol. In addition, our data highlight the importance of measuring metoprolol concentration in order to account for variable pharmacokinetics and avoid misinterpretation of the data.
Asunto(s)
Antagonistas Adrenérgicos beta/farmacocinética , Antihipertensivos/farmacocinética , Metoprolol/farmacocinética , Farmacogenética , Alelos , Ejercicio Físico , Frecuencia de los Genes , Tamización de Portadores Genéticos , Frecuencia Cardíaca/genética , Homocigoto , Humanos , FenotipoRESUMEN
The purpose of this research was to develop a predictive model that identifies young women at risk for adolescent motherhood. A stratified sample of 357 adolescents was drawn from public health units and public schools in six randomly selected counties in North Central Florida. Data were collected regarding the environmental context (social and family), individual perceptions of self and trajectory, and adolescent motherhood status. A stepwise logistic regression was used to investigate the combined effects of these variables for identification of risk for adolescent motherhood. Using the combination of these variables, practitioners can identify adolescents at highest risk for early motherhood (97.66%) and those with the least risk of adolescent motherhood (approximately 1%).
Asunto(s)
Conducta del Adolescente/psicología , Embarazo en Adolescencia/psicología , Embarazo en Adolescencia/estadística & datos numéricos , Psicología del Adolescente/estadística & datos numéricos , Autoimagen , Adolescente , Familia/psicología , Femenino , Florida/epidemiología , Humanos , Relaciones Interpersonales , Modelos Logísticos , Valor Predictivo de las Pruebas , Embarazo , Embarazo en Adolescencia/prevención & control , Grupos Raciales , Estudios Retrospectivos , Factores de Riesgo , Clase Social , Medio Social , Encuestas y CuestionariosRESUMEN
The adolescent population in America is at increasing risk for acquiring the human immunodeficiency virus (HIV) that causes AIDS (CDC, 1998; 1996; 1994; 1993). Although the total number of reported AIDS cases among adolescents 12 to 19 years of age is, thus far, fairly small, the identified caseload in this age group has increased by over 40% during one year alone. In fact, one-fifth of all reported AIDS cases occur among persons 20 to 29 years of age. Many of these young adults contracted HIV infections as teenagers (CDC, 1996). But the trend is changing. In fact, among younger youths, especially those of African heritage, the infection rates are rapidly increasing (CDC, 1999; CDC, 1998). These increases will require focused attention by all health professionals, and public policy officials (Lai, Tsai, Hardy, 1997; Porter, Oakley, Guthrie & Killion, 1999). The purpose of this current study was to describe risk-related behaviors of incarcerated youths that are significant factors when planning community-based programs for HIV/AIDS prevention. Several research questions were generated in this regard and tested. Several significant findings emerged from the data that indicate that African-American youths incarcerated are at greater risk for development of HIV/AIDS than their other ethnic counterparts.
Asunto(s)
Conducta del Adolescente/psicología , Actitud Frente a la Salud , Infecciones por VIH/prevención & control , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Prisioneros/psicología , Psicología del Adolescente , Asunción de Riesgos , Sexo Seguro , Adolescente , Negro o Afroamericano/educación , Negro o Afroamericano/psicología , Servicios de Salud Comunitaria , Condones/estadística & datos numéricos , Femenino , Florida , Humanos , Masculino , Evaluación de Necesidades , Inventario de Personalidad , Prisioneros/educación , Encuestas y Cuestionarios , Población Blanca/educación , Población Blanca/psicologíaRESUMEN
This study examined the efficacy of a worksite-based intervention in reducing blood pressure and personal strain in African-American women. The experimental group (n = 22) was taught a 7-muscle group progressive relaxation intervention. The women, for home practice, used audiocassette tapes and diaries. The control group (n = 21) was asked to set aside 30 minutes for relaxation. All women who participated in the study were visited at the worksite weekly for eight weeks. At the conclusion of the study, the experimental group had a significantly lower mean physical strain score (23.23 [SD = 6.85] v. 27.41 [SD = 8.49]) and interpersonal strain (25.81 [SD = 6.25] v. 23.57 [SD = 6.06]); both groups had significant reductions in psychological strain scores. Although there were no significant differences in the blood pressure of the two groups at the end of the 8-week intervention (121.95 [SD = 13.28] v. 129.33 [SD = 14.30]), the mean systolic blood pressure of the treatment group did decrease from 130 mmHg to 121 mmHg. Findings from this study support the use of the work-place as a means of improving the cardiovascular health of working African-American women.
Asunto(s)
Negro o Afroamericano/psicología , Hipertensión/etnología , Hipertensión/prevención & control , Servicios de Salud del Trabajador/normas , Terapia por Relajación/normas , Estrés Psicológico/etnología , Estrés Psicológico/prevención & control , Servicios de Salud para Mujeres/normas , Mujeres Trabajadoras/psicología , Lugar de Trabajo , Adulto , Población Negra , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/diagnóstico , Hipertensión/genética , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Índice de Severidad de la Enfermedad , Sudeste de Estados Unidos , Estrés Psicológico/diagnóstico , Encuestas y Cuestionarios , Salud de la MujerRESUMEN
This study identified psychophysiologic variables related to successful weaning in 27 ventilator-dependent patients with chronic bronchitis and emphysema (CBE) from two long-term care pulmonary-specialty hospitals in South Central Florida. Subjects were studied from admission until weaning occurred (successful weaning without mechanical ventilation) or until they were transferred without being weaned or died (unsuccessful weaning). The study subjects, 15 males and 12 females, ranged in age from 56 to 89. Baseline data on the variables (age, mastery, hope, social support, dyspnea, and rapid shallow breathing index [RSBI]) were not statistically significant by gender. The logistic regression model identified mastery and RSBI to be the best predictors of successful weaning (model chi 2 = 16.33, df = 2, and p value = .0003; prediction rate 82%).
Asunto(s)
Bronquitis/fisiopatología , Bronquitis/psicología , Enfisema/fisiopatología , Enfisema/psicología , Evaluación en Enfermería , Desconexión del Ventilador , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Psicofisiología , Resultado del TratamientoRESUMEN
Cardiovascular function during cognitive stress using the Stroop Color Test (SCWT) was documented in 25 men with ischemic heart disease (IHD) before and after coronary artery bypass grafting (CABG). Impedance cardiography was used to measure changes from resting baseline in heart rate (HR), stroke volume (SV), cardiac output (CO), myocardial contractility, and total peripheral resistance (TPR). Cognitive stress was associated with significant increases in HR, blood pressure, SV, CO, and myocardial contractility. TPR did not change from resting baseline during cognitive stress before CABG. However, TPR decreased significantly from resting baseline during cognitive stress after CABG. These findings support the theory that cognitive stress is associated with a significant increase in myocardial oxygen demand.
Asunto(s)
Sistema Cardiovascular/fisiopatología , Trastornos del Conocimiento/fisiopatología , Puente de Arteria Coronaria/psicología , Estrés Psicológico/fisiopatología , Adulto , Anciano , Determinación de la Presión Sanguínea , Cardiografía de Impedancia , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/fisiopatología , Isquemia Miocárdica/psicología , Isquemia Miocárdica/cirugía , Periodo Posoperatorio , Pruebas PsicológicasRESUMEN
A meta-analysis of the effects of nonnutritive sucking (NNS) on heart rate and transcutaneous oxygen tension (TcPaO2) was performed. Four studies of NNS on heart rate without stimulations, three studies on heart rate during painful stimulations, and three studies on TcPaO2--all conducted over the past 30 years--were found through a computer search. Using the Fisher combined test, NNS significantly decreased heart rate without stimulations (p = .002) and during painful stimulations (p = .0001), and significantly increased TcPaO2 (p = .0001). The total weighted effect size for heart rate without stimulations was small (0.17); however, it was large for heart rate during painful stimulations (1.05) and TcPaO2 (0.69). Larger effects were noticed for preterm infants than for term infants and for longer NNS. More studies of NNS effects with independent treatment and control groups, using the physiological outcome variables of heart rate and oxygenation for different age groups of preterm infants, are needed to examine the fundamental mechanisms of NNS effects. Clinically, a low-risk intervention such as NNS can be more broadly used during any painful procedures to decrease infant distress.
Asunto(s)
Frecuencia Cardíaca , Recién Nacido , Oxígeno/metabolismo , Conducta en la Lactancia , Factores de Edad , Monitoreo de Gas Sanguíneo Transcutáneo , Modificador del Efecto Epidemiológico , Humanos , Lactante , Recién Nacido/fisiología , Recién Nacido/psicología , Dolor/fisiopatología , Estimulación FísicaRESUMEN
Use of both prescription and non-prescription pharmaceuticals has increased among children. Many of these drugs are taken during school hours and dispensed by school personnel who are not health professionals. They know little or nothing about the drugs themselves or the medical conditions requiring their use. This survey examined the extent to which pharmaceuticals are dispensed in schools in one Florida county. Public elementary, middle, and high schools and six private schools were surveyed for one week. All medications dispensed by school personnel during that time were recorded. Of 28,134 children surveyed, 1,016 children received 5,411 doses of medication. Thirty-one categories of drugs were dispensed including controlled substances. Methylphenidate was the most widely dispensed drug, comprising about half of all the medications given in school. Medication use was evaluated in terms of gender, race, and socioeconomic status of the children.
Asunto(s)
Preparaciones Farmacéuticas/administración & dosificación , Servicios de Salud Escolar , Adolescente , Niño , Recolección de Datos , Femenino , Florida , Humanos , Masculino , Medicamentos sin Prescripción/administración & dosificaciónAsunto(s)
Análisis Discriminante , Personalidad Tipo A , Femenino , Humanos , Programas InformáticosRESUMEN
Hypothesis testing is the process of making a choice between two conflicting hypotheses. The null hypothesis, H0, is a statistical proposition stating that there is no significant difference between a hypothesized value of a population parameter and its value estimated from a sample drawn from that population. The alternative hypothesis, H1 or Ha, is a statistical proposition stating that there is a significant difference between a hypothesized value of a population parameter and its estimated value. When the null hypothesis is tested, a decision is either correct or incorrect. An incorrect decision can be made in two ways: We can reject the null hypothesis when it is true (Type I error) or we can fail to reject the null hypothesis when it is false (Type II error). The probability of making Type I and Type II errors is designated by alpha and beta, respectively. The smallest observed significance level for which the null hypothesis would be rejected is referred to as the p-value. The p-value only has meaning as a measure of confidence when the decision is to reject the null hypothesis. It has no meaning when the decision is that the null hypothesis is true.
Asunto(s)
Sesgo , Interpretación Estadística de Datos , Humanos , Investigación en Enfermería , Reproducibilidad de los ResultadosRESUMEN
The purpose of this study was to determine the factorial structure of the Ways of Coping Questionnaire for African American women. A sample of 656 African American women living in the southeastern United States, ranging in age from 22 to 64 years (M = 39.6 years), completed the questionnaire. All were employed, with a mean annual income of $24,300. Factor analysis produced three factors, Active Coping, Avoidance, and Minimize the Situation, that accounted for 67% of the total variance. These factors were compared with the eight factors of the Ways of Coping questionnaire reported by Folkman and Lazarus (1980), which was derived from a sample of middle-aged White subjects. The factors that emerged suggest the need for possible revision of the instrument or the development of a new one.
Asunto(s)
Adaptación Psicológica , Negro o Afroamericano/psicología , Estrés Psicológico/prevención & control , Encuestas y Cuestionarios/normas , Mujeres/psicología , Adulto , Análisis de Varianza , Reacción de Prevención , Estudios Transversales , Análisis Factorial , Femenino , Humanos , Renta , Persona de Mediana Edad , Estrés Psicológico/etnología , Población Blanca/psicologíaRESUMEN
BACKGROUND: Endotracheal suctioning may cause sudden increases in pulmonary arterial pressure, which can result in hypoxia secondary to right ventricular failure and/or increased right-to-left shunting. An adaptor that allows suctioning without disconnecting the ventilator has been proposed to prevent these problems; however, its efficacy has not been rigorously studied. OBJECTIVE: To examine the physiologic responses to two endotracheal suctioning techniques in newborn lambs with and without acute pulmonary hypertension. METHODS: A repeated-measures design was used to compare two endotracheal suctioning techniques in seven newborn lambs with and without acute pulmonary hypertension. An adaptor was used in the ventilator-controlled technique, making disconnection of the ventilator during suctioning unnecessary. In the bag-controlled technique, the ventilator was disconnected and ventilation was done with a manual resuscitation bag. Physiologic variables, pulmonary and mean arterial pressure, peak inspiratory pressure, mixed venous oxygen saturation, cardiac index, and arterial blood gas values were recorded before, during, and after endotracheal suctioning. RESULTS: Endotracheal suctioning caused a statistically significant systemic hypertensive response in lambs with and without acute pulmonary hypertension, regardless of which suctioning technique was used. No statistically significant changes occurred in pulmonary arterial pressure using either technique. CONCLUSIONS: Use of an adaptor resulted in no differences in the physiologic responses to endotracheal suctioning. However, endotracheal suctioning was easier to perform using an adaptor because no extra equipment or person was needed.
Asunto(s)
Hipertensión Pulmonar/terapia , Intubación Intratraqueal/instrumentación , Succión/instrumentación , Animales , Presión Sanguínea/fisiología , Hipoxia/prevención & control , Intubación Intratraqueal/efectos adversos , Análisis Multivariante , Respiración Artificial , Pruebas de Función Respiratoria , Ovinos , Succión/efectos adversosRESUMEN
This study was undertaken to determine differences between caloric intake and requirements of critically ill, enterally fed, neurosurgical and neurotrauma patients and to determine the nature and frequency of interruptions in enteral feedings in this same population. This descriptive, prospective study was conducted in a surgical intensive care unit (ICU) in a university teaching hospital. The sample consisted of 52 mechanically ventilated, critically ill patients with a mean age of 48.96 years who were receiving enteral nutrition for at least two days. Basal energy requirements, daily nutritional intake and enteral feeding interruption characteristics were recorded for a total of 586 study days. Underfeeding due to interruptions occurred in the majority of patients for the first eight days following initiation of enteral feeding. Reasons for underfeeding were interruptions of continuous tube feedings due to medication administration via the feeding tube (31%), feeding tube displacement (27%), surgery (12%), ileus (9%), radiologic studies (9%), airway management (8%), bedside procedures (3%) and agitation (1%). The frequency of these enteral feeding interruptions may indicate inadequate nutritional support, highlighting the importance of performing daily nutritional monitoring to prevent malnutrition.