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Coral reefs of north Jamaica, normally sheltered, were severely damaged by Hurricane Allen, the strongest Caribbean hurricane of this century. Immediate studies were made at Discovery Bay, where reef populations were already known in some detail. Data are presented to show how damage varied with the position and orientation of the substraturn and with the shape, size, and mechanical properties of exposed organisms. Data collected over succeeding weeks showed striking differences in the ability of organisms to heal and survive.
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OBJECTIVE: We examined the extent to which preoperative state and trait anxiety, general need to control, need to control analgesia, expectations regarding postoperative pain, and demographic variables predict the severity of postoperative pain, discomfort, anxiety, duration of recovery, and patient-controlled analgesia (PCA) behaviors. DESIGN: Preoperative and outcome variables were analyzed using Pearson product-moment correlations and forward stepwise multiple linear regression. SETTING: This study was conducted at a university hospital in preoperative and postoperative settings. PATIENTS: Ninety-nine consecutively consenting ASA physical status I-II women (age 46 +/- 11 years, 70% caucasian, 28% Afro-American, 2% Hispanic) undergoing simple hysterectomy procedures with no known cancer were included in the study. INTERVENTIONS: Standardized general anesthesia, surgery, and PCA therapy was conducted. OUTCOME MEASURES: The McGill Pain Questionnaire (MPQ), patient requests and delivered analgesic medication, visual analog scales (VAS) for pain and anxiety, time to oral medications and hospital discharge, and Likert scale measurements of overall pain and discomfort were utilized. RESULTS: Older patients generally reported less pain, but used the same amount of analgesic medication as younger patients. Preoperative trait anxiety correlated with increased PCA requests, but not with postoperative pain. In contrast, preoperative state anxiety correlated positively with postoperative pain and with shorter time to hospital discharge. The patients' need for control was positively correlated with the Present Plan Index scale of the MPQ, with morphine requirement, and with PCA requests. CONCLUSIONS: Psychological factors do influence postoperative recovery and pain control in women receiving PCA therapy after abdominal hysterectomy, and attention to individual patient differences may lead to improved postoperative outcomes.
Assuntos
Analgesia Controlada pelo Paciente , Dor Pós-Operatória/psicologia , Dor Pós-Operatória/terapia , Adulto , Fatores Etários , Analgésicos/uso terapêutico , Ansiedade , Etnicidade , Feminino , Humanos , Pessoa de Meia-Idade , Medição da Dor , Satisfação do Paciente , Inquéritos e QuestionáriosRESUMO
This review summarizes information obtained from published literature to determine to what degree biomagnification of organic compounds and metals occurs in freshwater and marine food webs. This review was conducted by: (1) examining data from studies conducted in laboratory experiments to establish body burden ratios between trophic levels (trophic transfer coefficients; TTCs); (2) comparing laboratory-derived TTCs with data obtained from field studies; and (3) comparing biomagnification predictions described by published aquatic food-web models with data obtained in this review. It was determined that: (1) the majority of chemicals evaluated (both organic and metals) do not biomagnify in aquatic food webs; (2) for many of the compounds examined, considerable trophic transfer does occur in aquatic food webs; (3) DDT, DDE, PCBs, toxaphene, methyl mercury, total mercury, and arsenic have the potential to biomagnify in aquatic systems; (4) the lipid fraction of receptors directly influences biomagnification of lipophilic compounds; (5) the food web model reviewed provided similar estimates for most of the organic compounds examined (log Kow values between 5 and 7), with model predictions falling within the range of values of all compounds except dieldrin; (6) for many organic compounds, lack of information precludes assessing the relative importance of biomagnification for these contaminants; and (7) even those compounds for which evidence for biomagnification is strongest show considerable variability and uncertainty regarding the magnitude and existence of food-web biomagnification in aquatic systems.
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Ecossistema , Metais/farmacocinética , Praguicidas/farmacocinética , Poluentes Químicos da Água/farmacocinética , Animais , Carga Corporal (Radioterapia) , Metais/análise , Praguicidas/análise , Distribuição Tecidual , Poluentes Químicos da Água/análiseRESUMO
This study assessed the efficacy of a comprehensive behavioral health program designed to promote self-initiated change in overweight healthy middle-aged adults (M = 49 years). Three treatment groups (total n = 25) differing in type of social support provided (i.e., group plus professional versus group plus peer versus group only) received 13 treatment sessions and 6 maintenance sessions scheduled over a full year. A self-directed change intervention taught several cognitive-behavioral techniques as they applied to exercise adherence, weight reduction/maintenance, and stress management. Combined treatment groups (n = 25) improved significantly more than an assessment only control group (n = 9) in weight, percentage body fat, cardiovascular fitness, exercise adherence, health-risk appraisal, chronic tension (MBHI, scale A), and systolic and diastolic blood pressure at both post-treatment and 6-month follow-up assessments. Self-motivation, group treatment attendance, and health-risk appraisal significantly related (r's = .30-.56) to several posttreatment and follow-up measures of behavioral health change. No significant differences were found among the three treatment groups on any of the outcome measures.