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Biomedical subjects

G Sullivan

Publications and source records attributed to G Sullivan.

At least 55 records · Page 3Linked to original sources
PubMed1997

Consumer satisfaction with CMHC services.

To examine the relationship between consumer satisfaction with community mental health clinic (CMHC) services and patterns of outpatient service use, we conducted a survey of 210 schizophrenics in Mississippi, the majority of whom were African American. Subjects with lowest CMHC satisfaction were those who did not identify the CMHC as their primary source of outpatient mental health care. They were more likely to be white, single, and to either receive no outpatient mental health care (46%) or to seek care from sources other than the CMHC (54%), many of which might provide substandard care, such as family doctors, ministers, folk healers, or hospital emergency rooms. Among those who identified the CMHC as their primary source of mental health care, we found little evidence that satisfaction was associated with type, variety, or frequency of services. Even though clinics offered similar services, there were differences in consumer satisfaction ratings by clinics, suggesting that qualities of the clinic itself may influence consumer satisfaction.

Adolescent↗
PubMed1997

The criminalization of persons with serious mental illness living in rural areas.

In the context of restrictive admissions policies at public inpatient facilities, rates of arrest and incarceration of persons with serious mental illness (SMI) have been increasing, leading to the perception that SMI persons are being unduly "criminalized." This paper describes the characteristics of persons with SMI (N = 177) in Mississippi who have been (1) jailed without charges while awaiting a hospital bed and (2) jailed for a criminal offense. Seventy-five percent (N = 132) of the 177 subjects had been held in local jails awaiting state hospital admission at least once in their lives, most for more than five days. Fifteen percent (N = 26) had contact with the police for a criminal offense in the past year. Rural residence markedly increased the risk for waiting in jail (OR = 4.24) but was not related to committing a criminal offense. Protective factors for any type of criminal justice contact were female gender, caucasian ethnicity, better compliance with medication regimes, and nonrural residence. The phenomenon of rural criminalization, i.e., waiting in jail without criminal charges, differs qualitatively from the criminalization that occurs in urban areas and may require a different solution. To avoid criminalization of SMI persons in rural areas, public mental health systems must develop effective crisis interventions in the community or work with local law enforcement officials and medical and mental health facilities to create more immediate access to acute inpatient care.

Adolescent↗
PubMed1997

Is carbamazepine a potential drug of abuse?

A case is reported of a 20-year-old female student who had been abusing carbamazepine with alcohol and described a resulting sense of euphoria. The literature is reviewed for evidence to support this claim, and possible mechanisms to account for the euphorigenic effect of alcohol and carbamazepine are discussed.

Adult↗
PubMed1997

Effect of radionuclide renograms on treatment of patients with spinal cord injuries.

OBJECTIVE: Urinary tract problems stemming from neurologic dysfunction are a major cause of morbidity in patients with spinal cord injury. Radionuclide renograms have been used to monitor renal function in these patients. However, the effect of renographic results on the treatment of patients has not been studied. A retrospective study was done to determine the effect of radionuclide renography on the diagnostic evaluation and therapeutic treatment of patients with spinal cord injury. MATERIALS AND METHODS: The records of 199 patients with spinal cord injuries were reviewed. A decline in effective renal plasma flow of 20% or more, a low effective renal plasma flow for age, and abnormal tracer time-activity curves were correlated with diagnostic procedures and therapeutic interventions. Diagnostic procedures included renal sonography, CT, excretory urography, and urodynamics. Therapeutic interventions included changes in medication, changes in bladder management, and surgery. RESULTS: Patients with abnormal findings on renograms underwent more diagnostic procedures and therapeutic interventions. A significant correlation was found between abnormal tracer time-activity curves and use of excretory urography. A decline in effective renal plasma flow was the best predictor of therapeutic intervention. CONCLUSION: Radionuclide renograms influence the diagnostic evaluation and therapeutic treatment of patients with spinal cord injury.

Female↗
PubMed1997

Guidelines: don't get caught without 'em.

A court ruling emphasizing the legal protection that medical protocols provide should make any employer offering on-site health services sit up and take notice.

Contract Services↗
PubMed1997

Advice or diagnosis? A legal perspective.

Nurses cannot diagnose, but they can--and do--assess, inform and advise. A nurse-attorney offers advice on choosing a demand management service and on understanding the sometimes-subtle distinction.

Algorithms↗
PubMed1996

Polydeoxyguanine motifs in a 12-mer phosphorothioate oligodeoxynucleotide augment binding to the v3 loop of HIV-1 gp120 and potency of HIV-1 inhibition independency of G-tetrad formation.

Phosphorothioate oligodeoxynucleotides belong to a class of polyanions that bind to the third variable domain (v3) of HIV-1 gp120 and inhibit infectivity of a wide variety of HIV-1 isolates. This potent v3 binding of phosphorothioate oligodeoxynucleotides, which is relatively independent of the nucleotide sequence of the oligodeoxynucleotides, decreases with chain length (below 18-mers) and is low for 8-mers. However, recent studies have observed a nucleotide sequence-dependent augmentation of phosphorothioate oligodeoxynucleotide binding to v3 for 8-mers that contain the S-dG4 motif (e.g., SdT2G4T2) and have suggested that formation of quadruple helical tetraplexes (G-tetrads) is associated with the acquisition of v3 binding ability by small phosphorothioate oligodeoxynucleotides. In the current study, a series of SdG4-containing oligodeoxynucleotides were synthesized with varying tandem length (including the 8-mer SdT2G4T2, the 12-mer SdG4T4G4, and the 28-mer SdG4(T4G4)3) and compared with phosphorothioate oligodeoxynucleotides (with similar lengths or related sequences) for (1) their inhibition of the binding of mAb 9284, which binds to the N-terminal portion of the v3 loop, (2) the values of Kc when these compounds are used as competitors of the rgp120-binding of an alkylating phosphodiester oligodeoxynucleotide probe, and (3) inhibition of HIV-1 infectivity in a cell-cell transmission model. The presence of S-dG4 motifs and the number of tandem motifs augmented v3 binding and anti-HIV-1 infectivity for small (8-mer or 12-mer oligodeoxynucleotides) but did not significantly augment the potency of 28-mers. Whereas tetraplex formation of SdT2G4T2 may contribute to its v3 binding, the 12-mer SdG4T4G4 does not migrate as the tetraplex on nonreducing gels, suggesting that S-dG4 motifs may augment anti-HIV activity by multiple mechanisms.

Anti-HIV Agents↗
PubMed1996

Characteristics and service use of seriously mentally ill persons living in rural areas.

OBJECTIVE: Data from a cross-sectional survey of 210 current or former inpatients at Mississippi State Hospital and 197 informants, usually patients' family members, were used to compare the demographic, clinical, and service use characteristics of patients living in rural areas with those of patients living in nonrural areas. METHODS: All subjects completed structured face-to-face interviews. Information on recent use of community mental health center (CMHC) services was obtained from CMHC records. Characteristics of rural patients (N = 107) and nonrural patients (N = 103) were compared using chi square and t tests. RESULTS: Rural patients were less likely to have completed high school and more likely to be living with family members. Although rural and nonrural subjects were clinically similar, rural subjects were less likely to have received certain community mental health services such as case management and day treatment and were more likely to have used physical health services and to have been involved with the criminal justice system. CONCLUSIONS: Differences between rural and nonrural patients in patterns of service use are most likely a reflection of less availability or accessibility of mental health services in rural areas, resulting in spillover into physical health and criminal justice sectors. Rural community mental health centers need to formally incorporate families, local medical providers, and law enforcement officials into their network of care.

Activities of Daily Living↗
PubMed1996

Objective life circumstances and life satisfaction: results from the course of homelessness study.

Relations between objective life circumstances and life satisfaction were examined using structural equation modeling of two waves of data obtained from homeless and mentally ill homeless participants (N = 298) in the Course of Homelessness Study (COH). Cross-sectional analyses revealed that objective indexes of life quality were primarily associated with domain-specific, rather than general, life satisfaction. Results could not be attributed to the covariation of life satisfaction with other indexes of subjective well-being (i.e., psychological symptoms and perceived self-mastery). In addition, significant direct ("causal") cross-lagged effects were found linking initial objective housing status with subsequent income and subsequent satisfaction with housing. By contrast, neither life satisfaction nor any other index of subjective well-being exerted a direct impact on subsequent life quality as assessed by objective indexes. Finally, we found no support for previous claims that perceived self-mastery mediates the impact of objective life circumstances on subsequent life satisfaction. Findings are discussed with reference to the utility of a hierarchical model of life satisfaction that incorporates domain-specific, as well as global, satisfaction.

Adult↗
PubMed1995

Irritable bowel syndrome and family history of psychiatric disorder: a preliminary study.

A series of 70 consecutive patients with irritable bowel syndrome (IBS) were interviewed concerning their family history of psychiatric disorders. A series of 60 consecutive patients with major depression (MDE) were also interviewed, as were a control group of 46 relatives of patients with organic brain disease. The results showed that both IBS and MDE groups had a similar, higher prevalence of relatives with psychiatric illness than controls, and that this was due to a higher prevalence of anxiety and depressive disorder in the relatives. The implications of these findings are discussed.

Adult↗
PubMed1995

Exposure to pesticides in ambient air.

Ambient air was monitored for pesticides at four sites in Coffs Harbour, a coastal town (population about 50,000) surrounded by banana plantations. Air was sampled continuously for five consecutive months during the peak agricultural spraying period using vacuum pumps set to sample one litre per minute through ORBO-42 absorption tubes. Six pesticides were detected: three organochlorines and three organophosphates. The most commonly detected pesticide (14 per cent of all samples) was chlorpyrifos (maximum detected level 208.0 ng/m3, mean 3.6 ng/m3). Heptachlor was detected in 7.1 per cent of all samples (maximum detected level 133 ng/m3, mean 2.7 ng/m3). Other pesticides were only rarely detected. The only pesticide applied by air in the district (propiconazole) was not detected. If international health guidelines are used as a yardstick, these levels of exposure appear unlikely to present an appreciable health risk. Chlorpyrifos detection was associated with low wind speed (P = 0.012) and high temperature (P = 0.015), and detection at one site was associated with detection at another (P < 0.001). Chlorpyrifos detection was also associated with domestic applications within the town area as reported by pesticide applicators (P = 0.045). Peak agricultural use of chlorpyrifos did not coincide with peak detection periods. None of the detected organochlorines is registered for agricultural use, although at the time, heptachlor was permitted for use as a domestic termiticide. Even in a semirural town with nearby widespread use of agricultural chemicals, community exposures to pesticides in ambient air may largely relate to their nonagricultural use.

Agriculture↗
PubMed1995

Identifying modifiable risk factors for rehospitalization: a case-control study of seriously mentally ill persons in Mississippi.

OBJECTIVE: The authors sought to identify risk factors for rehospitalization in a seriously mentally ill population, focusing on factors that have the potential to be modified through community-based interventions. METHOD: A case-control design was used in which 101 "case" subjects (recently readmitted psychiatric patients) and a comparison group of 101 subjects living in the community who had been previously hospitalized at the same time as the case subjects, but who in contrast had not been readmitted, were matched on gender, ethnicity, and length of time at risk for rehospitalization. The setting was the Mississippi public mental health system during the first 3 months of 1988, including Mississippi State Hospital and the 10 community mental health regions in its catchment area. The subjects were between the ages of 18 and 55 years, had had at least one previous Mississippi State Hospital admission, and had a primary chart diagnosis of schizophrenia; 197 informants, mostly family members, were also included in the study. Data were collected from structured interviews of subjects and informants, direct observation ratings of subjects, Mississippi State Hospital administrative records, and community mental health center administrative records. RESULTS: Medication noncompliance, comorbid alcohol abuse, and a high level of criticism of subjects by informants were associated with greater risk of rehospitalization, while types and extent of outpatient service use, access to care, quality of life, and demographic variables (other than ethnicity and gender) were not. CONCLUSIONS: These findings imply that interventions aimed at improving medication compliance, reducing alcohol abuse, and helping families cope with their mentally ill relatives could reduce the risk of hospitalization in this population.

Adolescent↗
PubMed1995

Immunolocalization of proton pumps (H+-ATPase) in pavement cells of rainbow trout gill

The expression of the V-type proton ATPase (H+-ATPase) was examined in the gill of the freshwater rainbow trout (Oncorhynchus mykiss) using immunocytochemistry in concert with laser scanning confocal or electron microscopy. A synthetic peptide consisting of the carboxy-terminal region of the 31 kDa subunit of the bovine renal H+-ATPase was used to generate an antiserum in rabbits, and its suitability for use in trout gill was confirmed by western blotting. Gill epithelial cells demonstrated specific immunoreactivity, the intensity of which was increased markedly after 18 h of exposure to hypercapnia (1 % CO2 in air). The increased intensity of H+-ATPase immunoreactivity was associated with elevated branchial net acid excretion. In the hypercapnic fish, the specific immunoreactivity was associated with both the apical membrane and cytoplasm. Electron microscopy revealed that specific immunoreactivity was localized to the pavement cells and was particularly associated with the apical membrane and subapical cytoplasmic vesicles. The increased H+-ATPase immunoreactivity in the epithelial cells of hypercapnic fish and the increased intensity of the immunoreactive bands in western blots from hypercapnic fish demonstrate an 'up-regulation' of this protein in response to respiratory acidosis. The results are discussed with reference to current models of acid&shy;base and ion regulation in the gill of freshwater fish.

Journal Article↗
PubMed1994

Isolation of cDNAs encoding T-BAM, a surface glycoprotein on CD4+ T cells mediating contact-dependent helper function for B cells: identity with the CD40-ligand.

"T-cell B-cell Activating Molecule" (T-BAM) is an activation-induced surface protein on CD4+ T cells that mediates a contact-dependent signal for B cell differentiation and immunoglobulin (Ig) secretion. The T-BAM protein on a helper clone of Jurkat (D1.1) was affinity purified using the anti-T-BAM mAb, 5c8. The NH2-terminal amino acid sequence of purified T-BAM was determined and found to be highly homologous to the predicted NH2-terminal sequence of a T cell ligand to the B cell CD40 molecule (CD40-L). From a D1.1 cDNA library, a clone was isolated that encodes CD40-L by sequence and drives expression of T-BAM protein on transfected cells, demonstrating that the T-BAM and CD40-L genes and proteins are identical. Moreover, transfection of T-BAM was shown to confer to non-lymphoid cells, the ability to induce B cells to upregulate the expression of surface CD23 molecules. In previous studies we showed that T-BAM was expressed predominantly on activated CD4+ and on few if any CD8+ cells. Although the current work confirms that T-BAM is largely restricted to activated CD4+ T cells, we now provide definitive evidence that T-BAM can be expressed by a small population of CD8+ T cells after activation. Importantly, a subset of CD8+ T cells do not express T-BAM after activation and this T-BAM- phenotype is maintained on certain CD8+ T cell clones. Taken together, these data unify the biology and structure of T-BAM and CD40-L and this synthesis has implications for understanding the T cell regulation of the humoral immune response.

Amino Acid Sequence↗
PubMed1993

Persistent hypercoagulation associated with heterotopic ossification in patients with spinal cord injury long after injury has occurred.

Three patients are presented with traumatic spinal cord injury (SCI) complicated by acute heterotopic ossification (HO), and concurrent deep vein thrombosis 15 months, 18 months and 22 years after SCI, accompanied by persistent hypercoagulation. The diagnosis of HO preceded deep vein thrombosis in all three patients. All were treated with etidronate disodium and therapeutic heparin followed by oral anticoagulation. As these patients were not acutely injured, the questions arose as to what predisposed them to deep vein thrombosis and when was the appropriate time to discontinue anticoagulation. Over a course of 3 years following deep vein thrombosis, these patients were monitored for evidence of hypercoagulation by D-dimer assay, plasma fibrinogen estimation, and rate of whole blood clotting by Sonoclot coagulation analyzer. The activity of acute HO was assessed by three-phase bone scan. A steady state of hypercoagulation, reflected by an increase in all three parameters, ran parallel to the extent of acute HO for the entire observation period. Moreover, hypercoagulation was persistently greater during increased acute HO activity even when the warfarin-induced prothrombin time ratio was 1.2-1.5. In addition, as acute heterotopic ossification activity decreased, the test values returned to near normal during warfarin therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗