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Biomedical subjects

D Staley

Publications and source records attributed to D Staley.

At least 19 recordsLinked to original sources
PubMed1992

A profile of the noncompliant patient: a thirty-month review of outpatient psychiatry referrals.

Missed appointments to outpatient psychiatry programs have been identified as a major form of noncompliance in the literature. Over a two-and-a-half year period, 874 referrals to the outpatient psychiatry department of a large teaching hospital were examined for significant differences between compliant and noncompliant patients. Noncompliant patients comprised 17.8% of the total number of cases dispositions and were significantly more likely to be single, diagnosed personality disorder or substance abuse, and referred from the Emergency Department than complaint patients. Further analysis of emergency referrals, the single most significant predictor, indicated that patients from this referral source were more likely to be male, unmarried, unemployed or on welfare, and diagnosed personality disorder or substance abuse than referrals from general practice and internal sources. The results are discussed in light of previous research, and recommendations are made for increasing compliance to outpatient appointments.

Adult↗
PubMed1992

Tourette syndrome: issues in diagnosis.

Information was accumulated by self-report questionnaire from 462 Canadian Tourette syndrome (TS) patients. The mean age of onset of the syndrome was 7.4 years, while the mean age of medical diagnosis was 15.2 years, suggesting that the mean lag between onset of symptoms and diagnosis was 7.8 years. Seventy-three percent of patients reported initial misdiagnosis by physicians and only 33% of the patients reported receiving their first information about TS from physicians. Respondents indicated that they were typically diagnosed as having Attention Deficit Disorder, Hyperactivity, or Minimal Brain Dysfunction prior to the establishment of the TS diagnosis. Factors involved in the delay in physician diagnosis of the syndrome, as well as the association between TS and other neuropsychiatric disorders, are also discussed.

Adolescent↗
PubMed1992

Adult children of alcoholics in treatment programs for anxiety disorders and substance abuse.

Studies of the first-degree relatives of patients with alcoholism and anxiety disorders have identified a significant overlap of these disorders. Forty percent of the patients in an outpatient anxiety disorder program were adult children of alcoholics (ACOA), a proportion similar to that found in the substance abuse program. The ACOAs in both programs were younger, had higher co-dependency scores and were younger when they had their first psychiatric contact than the controls. The adult children of alcoholics who had anxiety disorders were more likely to be female and their alcoholic parents were less likely to have had psychiatric antecedents to alcoholism. Aside from substance abuse, similarities in sociodemographic variables and the impact of the parents' alcoholism were noted, reinforcing the hypothesis that vulnerabilities to anxiety disorders and alcoholism overlap.

Adult↗
PubMed1991

Who misses appointments? An empirical analysis.

Patient noncompliance is a major problem in clinical practice. In order to better understand this issue, 236 appointments at an outpatient psychiatry clinic of a large urban general hospital were examined. Five variables significantly discriminated patients who kept their appointments from patients who did not. Patients who were younger, had a history of missed appointments, were scheduled to see a resident physician, had a routine appointment and lived a distance from the hospital, were at greater risk of missing their appointment. This information helps to identify patients at high risk of nonattendance and allows clinicians to plan schedules and appointments more efficiently.

Adult↗
PubMed1991

The adult children of alcoholics in a psychiatric population.

The issues confronting adult children of alcoholics (ACOA) are well publicized but their empirical basis remains limited. The screening of 250 consecutive psychiatric admissions to a general hospital revealed a significant prevalence of ACOAs across diagnoses. Compared to the other patients, the ACOA group was younger but with no other socioeconomic difference. The diagnoses of substance abuse and phobic disorders were more frequent. The group was psychiatrically hospitalized at an earlier age. The impact of an ACOA status varied with the parental biological relation and gender, and with the premorbid antecedents of parental alcoholism.

Adult↗
PubMed1991

Psychometric evaluation of the Children of Alcoholics Screening Test (CAST) in a psychiatric sample.

The Children of Alcoholics Screening Test (CAST) is a 30-item screening instrument developed to identify children who are either living with or have lived with alcoholic parents. In a sample of 250 psychiatric patients, the CAST exhibited substantial item-total scale correlations and a high level of internal consistency reliability. Total CAST scores discriminated self-identified children of problem drinkers from control subjects and were significantly correlated with the severity of parental psychological and social complications due to alcohol misuse. Factor analysis indicated a unidimensional scale structure. CAST cut-off scores produced a low false positive and false negative rate. The psychometric properties of the CAST suggest that it is a useful screening instrument for identifying the offspring of problem drinkers and alcoholics.

Adult↗
PubMed1990

Psychometric properties of the Drug Abuse Screening Test in a psychiatric patient population.

The Drug Abuse Screening Test (DAST) is a 28-item screening instrument developed by Skinner for clinical screening and treatment evaluation research in the substance abuse field. In a sample of 250 psychiatric patients drawn from four treatment programs, the DAST evidenced high internal consistency reliability and good item-total score correlations. A factor analysis of the DAST item correlation matrix revealed a predominantly unidimensional scale with the possibility of rotating five additional factors reflecting a continuum of drug abuse. The five factors were interpreted as (a) self-recognition of a drug problem, (b) serious social consequences of drug use, (c) help-seeking for drug abuse, (d) illegal drug-related activities, and (e) inability to control drug use. The diagnostic validity of the DAST in discriminating patients according to DSM-III Substance Abuse diagnostic criteria was high and a range of valid clinical DAST cutoff scores from 5/6 through 10/11 was identified. The DAST appears to be a valid measure of drug involvement and abuse in a psychiatric patient population, a finding of increasing clinical relevance.

Adult↗
PubMed1990

Staying well. Factors contributing to successful community adaptation.

1. Friends were rated as the most important factor in assisting former psychiatric patients to avoid rehospitalization. 2. When respondents were asked to comment on rehospitalization in their own words, the most frequent responses dealt with factors related to keeping active, developing a healthy lifestyle and positive self-image, and accepting their illness. 3. Self-help groups, community health workers, and community nurses were rated as the least beneficial in preventing rehospitalization.

Adaptation, Psychological↗
PubMed1989

The relationship of age, level of formal education, and duration of employment toward attitudes concerning the use of computers in the workplace.

The introduction of computer technology in the Canadian health care environment necessitates an adaptation by hospital employees in order to perform their jobs. One thousand twenty-two hospital staff were surveyed immediately following their initial orientation to computers. The survey identified attitudes toward change, and the use of computers in the workplace. Demographic data and job classifications of all respondents were tabulated. Hypotheses were tested regarding the relationships between age, formal education, and duration of employment, and attitudes toward computers and change. Results indicated a generally positive response toward the use of computers in the workplace and to change in general. However, statistically significant results were obtained indicating that age, level of education, and length of employment affect the degree of positive response to both computers and change. The results suggest that demographic variables such as age, level of education, and employment duration must be taken into consideration when planning for the implementation of computer systems in the health care setting.

Adult↗
PubMed1988

Release of gonadotropin alpha subunit from rat pituitary cultures in response to GnRH.

Gonadotropin releasing hormone (GnRH)-stimulated release of the alpha subunit common to the gonadotropins and to thyrotropin was studied in rat pituitary cell cultures. In these studies we took advantage of a recently prepared antiserum specific for the alpha subunit. We show that pituitary cells treated with GnRH released alpha subunit in a similar pattern to intact luteinizing hormone (LH) during short-term incubations (0-12 h); during prolonged incubations (12-48 h), however, release of alpha subunit did not desensitize in response to the releasing hormone and the pattern became different from that measured for intact LH. Further, we assessed the relative requirement for Ca2+ in the release of LH and alpha subunit. When pituitary cells were treated with 10(-8) M GnRH in the presence of a range of concentrations of the Ca2+ ion channel antagonist, methoxyverapamil (D-600), release of both LH and alpha subunit was inhibited in a similar and dose-dependent manner; 10(-4) M D-600 showed maximum inhibitory efficacy (IC50 = 10(-5) M). The calmodulin antagonist, pimozide, also inhibited both GnRH-stimulated LH and alpha subunit release (IC50 = 0.75 microM). These data suggested that although the Ca2+/calmodulin system appears to mediate both the release of LH and alpha subunit in response to GnRH, these processes appear differentially regulated during long-term exposure to the releasing hormone.

Animals↗
PubMed1986

Mechanism of action of gonadotropin releasing hormone.

GnRH interacts with a plasma membrane receptor to provoke gonadotropin release, as well as regulate numbers of its own receptor and target cell responsiveness. Receptor numbers are altered in different physiological states of the animal. Microaggregation of the GnRH receptor mimics all known actions of the releasing hormone, and therefore is viewed as an early step in the molecular mechanism of hormone action. Internalized hormone is neither necessary nor sufficient for stimulation of known releasing hormone actions. Evidence summarized in the present work suggests that Ca2+ serves a role as a second messenger for GnRH-stimulated gonadotropin release, and that it may be involved in receptor up-regulation in response to the releasing hormone. In the former role, diacylglycerols by their action on protein kinase C, in a fashion independent of the Ca2+ -calmodulin system, may act as a signal amplifier.

Animals↗
PubMed1985

Diacylglycerols release LH: structure-activity relations reveal a role for protein kinase C.

A series of diacylglycerols were synthesized with varying lengths and substituents in order to establish the structure-activity relationship between each with activation of protein kinase C and stimulation of a biological response system (pituitary luteinizing hormone release). This approach enables distinction between actions mediated by direct activation of protein kinase C and those due to other, presumably nonspecific, actions. The ability of diacylglycerols to function as regulators of a biological response system (pituitary luteinizing hormone release) and of protein kinase C was investigated with a series of sn-1,2 diacylglycerols containing fatty acids 4-10 carbons in length and with analogs in which the 3' hydroxyl was replaced with a chloro, hydrogen, or sulfhydryl moiety. Several diacylglycerols stimulated LH release in a saturable, time and dose dependent manner that was independent of extra-cellular calcium. Dioctanoylglycerol (diC8) was the most effective of the diacylglycerols tested; 3' analogs lacking the hydroxyl were inactive. The diacylglycerols activated protein kinase C in vitro whereas the 3' analogs did not. These data implicate protein kinase C in the mechanism of LH release, demonstrate that unsaturated fatty acyl moieties within the diacylglycerol are not required for protein kinase C activation, and establish diacylglycerol-protein kinase C structure-function relationships that should prove useful for investigations in other systems.

Animals↗
PubMed1985

Molecular mechanism of gonadotropin releasing hormone action.

This work summarizes some of our studies related to the mechanism of action of gonadotropin releasing hormone including those leading to identification of the three steps of the gonadotropin releasing process: receptor binding, mobilization of extracellular calcium, and granule exocytosis. Evidence is also presented to suggest how these steps are integrated one to another and how they are integrated to other actions of the releasing hormone such as regulation of target cell sensitivity, and receptor regulation.

Animals↗
PubMed1985

Diacylglycerols and protein kinase C. Potential amplifying mechanism for Ca2+-mediated gonadotropin-releasing hormone-stimulated luteinizing hormone release.

The present study was designed to test the hypothesis that there is a functional interaction between the calcium-calmodulin system, which appears to mediate the action of gonadotropin-releasing hormone (GnRH), and activators of protein kinase C, which stimulate luteinizing hormone (LH) release by a mechanism which does not require extracellular calcium. We have examined a diacylglycerol and a phorbol ester, which both activate protein kinase C and stimulate LH release. These compounds show synergistic action with calcium ionophore A23187 as secretogogues. Pimozide (a calmodulin antagonist), methoxyverapamil (a calcium ion channel inhibitor), and Ac[D-pCl-Phe1,2-D-Trp3-D-Lys6-D-Ala10]GnRH (a potent gonadotropin-releasing hormone antagonist) were used to show that the diacylglycerol and phorbol ester can stimulate LH release in a manner that is independent of both Ca2+ and calmodulin and do not work by means of a direct action on the GnRH receptor. These observations, coupled with previously published reports that extracellular Ca2+ mobilization is both necessary and sufficient for initiation and perpetuation of GnRH-stimulated LH release, indicate that activation of protein kinase C by endogenous diacylglycerols may serve as an amplifier of the GnRH-stimulated signal which appears to be mediated independently by the Ca2+-calmodulin system.

Animals↗