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Biomedical subjects

J Bradford

Publications and source records attributed to J Bradford.

At least 19 recordsLinked to original sources
PubMed2006

Pig characteristics associated with mortality and light exit weight for the nursery phase.

One thousand and ten weaned pigs that were reared in 1 nursery in Iowa from weaning (17 +/- 2 days ) until 10 weeks of age were evaluated. A weaning weight threshold of 3.6 kg maximized the sensitivity and specificity to correctly predict the likelihood of dying or being light in weight at exit from the nursery (< or = 14.5 kg). Weaning weight < or = 3.6 kg (OR = 2.92), barrow (OR = 1.75), and sow unit (A versus B, OR = 2.14) were significant predictors of mortality in the nursery. Birth weight < or = 1.0 kg (OR = 2.66), weaning weight < or = 3.6 kg (OR = 8.75), gilt (OR = 1.4), sow unit (OR = 2.38), and gilt as nursing sow at weaning (OR = 1.66) were significant predictors of being lightweight at nursery exit. Eighteen per cent of the nursery deaths and almost half of lightweight nursery pigs could be prevented if there were no lightweight pigs at weaning.

Age Factors↗
PubMed2002

Association of ancillary services with primary care utilization and retention for patients with HIV/AIDS.

Fenway Community Health Center (FCHC), located in Boston, Massachusetts, provides comprehensive care to persons with HIV/AIDS, including medical, mental health and other health-related services. In this paper, we present results from an analysis of existing data about the demographic and clinical characteristics, service needs and utilization patterns, and primary care retention of HIV-positive primary care patients seen at FCHC during a 24-month study period. Patient data were extracted from Logician, FCHC's electronic medical record system, and imported into Microsoft Access, Microsoft Excel and SAS for manipulation and analysis. A total of 999 unique individuals were included in the study population. Most were men (97%), white (75%) and between 39 and 80 years of age. Patients averaged 6.7 medical visits annually at FCHC, and 61% had at least one medical visit every six months. Significant predictors of primary care utilization were insurance status, HIV disease stage, being on combination therapy, first CD4 count, first viral load level and receipt of ancillary services. Need and receipt of ancillary services were found through medical and case management record review; case management was the most used ancillary service, received by 36% of the study population. For most ancillary services, clients with assessed need had documented receipt of the service. Publicly insured and/or Ryan White CARE Act-funded patients had the greatest ancillary service utilization. The influence of ancillary services upon primary care entry could not be evaluated with available data; however, their influence upon primary care was significant. For patients who received primary care in every continuous six-month period, statistically significant associations were found with receipt of mental health care, case management, drug assistance, food/nutrition, complementary services and housing. Using the more rigorous FCHC standard of care (minimum of four primary care visits per year), significant associations were also found with transportation, legal services and substance abuse treatment. For non-whites and women, mental health care, food/nutrition, housing and transportation had particular significance.

Adult↗
PubMed2001

The evolution of the Fenway Community Health model.

Fenway Community Health was founded by community activists in 1971 in the Fenway neighborhood of Boston, Mass, and within a decade had rapidly expanded its medical services for gay men in response to the AIDS epidemic. Increased expertise and cultural competence in lesbian, gay, bisexual, and transgender (LGBT) care led to expansion of medical services to address broader community concerns, ranging from substance use to parenting issues to domestic and homophobic violence, as well as specialized programs for lesbians, bisexuals, and transgendered individuals. Fenway began as a grassroots neighborhood clinic. In 1975, the center recorded 5000 patient care visits; in 2000, Fenway's clinical departments recorded 50,850 visits by 8361 individuals, including more than 1100 individuals receiving HIV-associated care. The center now has more than 170 staff people responsible for clinical programs, community education, research, administration, planning, and development. Over the past few years, Fenway's annual budget has exceeded $10 million. Fenway has established standards for improved cultural competence about LGBT health issues for other health providers and has developed programs to educate the general community about specific LGBT health concerns. This health center may provide a model of comprehensive LGBT health services that have a local impact.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Expanding the research infrastructure for lesbian health.

Interest in research about lesbian health has increased dramatically since the late 1980s and gained national attention in 1999 when the Institute of Medicine published the groundbreaking report Lesbian Health: Current Assessment and Directions for the Future. In March 2000, the Department of Health and Human Services and partner organizations presented the Scientific Workshop on Lesbian Health, during which invited experts on lesbian health worked with federal representatives to develop action steps to implement recommendations in the Institute of Medicine report. National priorities were thus established for the emerging field of lesbian health research. Although researchers of various sexual orientation and gender identities will contribute to this field, lesbian researchers have a unique perspective and an important role to play. This commentary focuses on the preparedness of these individuals to respond to challenges set forth by the Institute of Medicine and Scientific Workshop reports. Despite differences in their academic backgrounds, lesbian researchers have reported common experiences and needs. Substantial proportions have encountered barriers because they were lesbians or conducted lesbian research, and many expressed willingness to mentor others, to help others to conduct research about lesbians, or both.

Female↗
PubMed2000

Recidivism of child molesters: a study of victim relationship with the perpetrator.

OBJECTIVE: To compare the rates among of recidivism or re-offense among convicted child molesters who offend against biological children, stepchildren, and relationships where the child is an extended family member, acquaintance or stranger to the victim. METHOD: Four hundred male subjects 18 years of age or older and at least 5 years older than the victim at the time of the index offense, were convicted of a hands on sexual offense against one or more children under the age of 16. Subjects were grouped into five categories according to the type of relationship the perpetrator had with the victim. The subjects records of criminal arrests and convictions was obtained from the national Royal Canadian Mounted Police data. Subjects were then followed-up for a period of up to 15 years after conviction when they were at risk to re-offend in the community. Survival outcome data after the index sexual offense was collected for all new sexual, violent, and any criminal offenses. RESULTS: A larger proportion of men ( 16.2%) who sexually offended against children who were acquaintances, were charged with a new sexual offense than men who sexually offended against biological (4.8%) or their stepchildren (5.1%). The percentage of men who were subsequently charged with any type of criminal offense and who offended against their biological children (19%) was smaller than men who offended against children where the relationship is an extended family member (40%), acquaintances (35.9%) or strangers (45.2%). CONCLUSIONS: When comparing the different categories of relationship the victim had with the perpetrator, the category of stranger has been highlighted as a group with a higher risk for re-offense. Our results have shown that comparatively, the risk of acquaintance group is a significantly higher risk category than was previously thought. Although professionals are principally concerned with sexual recidivism, general criminality appears to present in relatively large proportions of all child molesters with the stranger group at the highest risk level. While no single factor will predict recidivism in itself, the importance of defining the relationship between the perpetrator and victim is evident from this study.

Adult↗
PubMed2000

Research ethics and forensic patients.

OBJECTIVE: To discuss ethical and legal issues arising from research conducted on forensic psychiatric patients. METHOD: A review of the literature and ethical and legal guidelines related to research ethics with human subjects. CONCLUSION: Forensic patients who are research subjects are particularly vulnerable to coercion and abuse as a result of the dual vulnerabilities stemming from their status as both prisoners and psychiatric patients. Researchers in the area of forensic mental health must carefully consider ethical guidelines and ensure that the rights of participants are respected and upheld.

Adolescent↗
PubMed2000

Differences in disclosure of sexuality among African American and White gay/bisexual men: implications for HIV/AIDS prevention.

Gay and bisexual men were asked if they had disclosed their sexuality to family members, heterosexual friends, gay friends, coworkers, health care workers, and members of their church; if they had been associated with groups made up of gays, bisexuals, and lesbians; and if they had gay/bisexual friends. White men were much more likely to disclose their sexuality, to have associated with groups and to have gay/bisexual friends. As education increased, white men were more likely, and African American men less likely, to disclose sexuality and associate with groups. Having gay/bisexual friends increased with education with both groups. The difference in disclosure can be traced to the higher social stigma apparently attached to being gay in the African American community, which may be exacerbated for more educated men. As a result, African American gay men may be less likely to participate in the fight against HIV/AIDS.

Black or African American↗
PubMed2000

The effectiveness of resource allocation methods used by RWCA Title II Consortia in Virginia.

The authors sought to determine the following: (1) How rigorous are the current resource allocation methods used by Virginia's five regional Ryan White CARE (Comprehensive AIDS Resources Emergency) Act Title II consortia? (2) How useful are existing databases in allocating resources? (3) Is it feasible to introduce a standardized performance measurement approach for state-level assessment of consortia effectiveness? The authors reviewed proposals and progress reports from each of the consortia to the Virginia public health agency; they then visited each of the consortia to solicit information to refine the study questions and to review the consortia's databases. The authors reviewed the literature on existing models used to allocate resources, and surveyed members of the Virginia consortia about how they used various resource allocation tools, how effective these tools were, and how ready the consortia were to be evaluated regarding resource allocation. The authors found no uniform process for the allocation of Title II funds in Virginia. Consortia members who felt connected and involved with their consortium were significantly more knowledgeable about its operations and more likely to consider it effective. A consortium's use of a continuous quality improvement (CQI) approach to allocating resources was strongly associated with its members' perception that the consortium was effective. Statewide performance and/or outcome measures cannot be set without some standardized expectations for performance. To do this, some expectations for basic resource allocation procedures must be established. Three of Virginia's five consortia will make use of this study's instrumentation in their next resource allocation processes, and, if their experiences are useful, a statewide process may be established. If a statewide process is established, regional consortia must continue to be able to determine local needs and to respond with locally appropriate service planning.

Adult↗
PubMed1999

Treatment of photosensitive epilepsy using coloured glasses.

A recently introduced optometric technique, colorimetry, enables the perceptual effects of ophthalmic tints to be evaluated subjectively, optimized, and then prescribed in tinted spectacles. The new technique is beneficial in reducing visual stress in patients with dyslexia and migraine. We describe an open trial designed to ascertain: (1) whether the colorimetry assessment, as it is now given, is safe for the investigation of photosensitive patients in optometry clinics where colorimetry equipment is most readily available, but where EEG control is not practical; (2) what proportion of patients with photosensitive epilepsy is likely to benefit to the extent already described in individual cases; (3) whether a tint selected by colorimetry could be shown to reduce the incidence of paroxysmal epileptiform EEG activity in response to flicker and patterns, thereby validating the subjective methods and corroborating the reported seizure reduction. Twenty-four females and nine males (aged 12-43 years) took part. All the patients had suffered visually-provoked seizures, had exhibited a photoparoxysmal response on at least one previous EEG recording, and had received a diagnosis of photosensitive epilepsy. Twenty-two were currently experiencing seizures. A further EEG was recorded in all except seven cases: a routine resting record, followed by hyperventilation. Colorimetry was performed after hyperventilation and before photic stimulation. Twenty-three (70%) reported beneficial effects during colorimetry and were prescribed glasses. There was a preponderance of lenses with a rose or purple colour, in contrast to patients with dyslexia. Seventeen of the 23 patients were available at follow-up, an average of 2.4 years later. Thirteen (57%) reported benefits, and said they were still using the lenses. In six of the 13 the benefits were pronounced, including a reduction of dizziness from fluorescent lighting, elimination of aura when using computer screens etc. Only in three cases was there a reduction in seizures that could reasonably be attributed to the use of lenses; in two of these cases no medications were prescribed, and in the third the medications remained unchanged for four years, two before and two after the introduction of the glasses. In an additional four cases a reduction in seizures was observed but medication had been changed. There was a modest reduction in EEG photosensitivity with the coloured lenses but also to an equivalent or lesser extent with grey in all of the eight patients examined in this way. One patient had seizures during colorimetry, but the seizures were not accompanied by scalp EEG changes.

Adolescent↗
PubMed1998

Utility of serum progesterone and prolactin analysis for assessing reproductive status in the Asian elephant (Elephas maximus).

Concentrations of serum progesterone and prolactin were assessed during the perioestrous period and throughout gestation in the Asian elephant (Elephas maximus) as a means of generating information of potential use to managers. In > 95% of perioestrous periods (n=35), behavioural oestrus (as determined by bull interest, mounting and/or breeding) coincided with the onset of increased serum progesterone concentrations at the beginning of the luteal phase and continued through Day 7 (Day 1 = first significant serum progesterone rise). Within individuals, 1- to 2-day transient decreases (P < 0.05) in serum progesterone occurred between Days 2 and 9. Notably, no sexual behaviour was observed in any female after this transient fall in progesterone. Prolactin concentrations fluctuated randomly throughout the perioestrous period, with no clear pattern. During the study, four females conceived (one conceived twice), and two delivered three viable offspring. Serum progesterone was elevated above baseline throughout gestation, and then declined precipitously 2-3 days before parturition. Serum prolactin concentrations were significantly elevated above baseline (P < 0.05) after 5-6 months of gestation and remained high until after parturition. This study confirms that serum progesterone and prolactin analyses are useful tools for monitoring the reproductive status of Asian elephant females. Specifically, the transition from low to high progesterone secretion during the late interluteal/early luteal phase is predictive of oestrus and can be used to coordinate breeding efforts. Pregnancy can be confirmed by elevated serum prolactin after 6 months postbreeding, whereas the late gestational decrease in progesterone is predictive of impending parturition.

Animals↗
PubMed1998

A model for predicting depression in victims of rape.

This article proposes a model for understanding the factors contributing to long-standing depression in women who have been raped. A path analysis of data obtained from 71 women who had been raped revealed that women with generalized beliefs that they could not control events in their lives were more likely to attribute responsibility for their rape to permanent intrapsychic factors and were more likely to be depressed. Women who perceived that they had higher levels of internal control tended to have higher levels of education, were more likely to be employed, and were less likely to be depressed more than one year after having been raped. Childhood sexual abuse was not associated with internal control or attributions of causality or depression in this analysis. Implications for the determination of prognosis and treatment recommendations in civil litigation assessments are discussed.

Adolescent↗
PubMed1995

Nine steps to better nursing management of incontinence.

This paper describes the development of a new framework for nursing assessment and management of incontinence using action research (Gibb, O'Brien, Bradford and Curtis 1993). The authors worked with nurses and residents in a large extended care setting--clarifying their current understandings of continence issues and looking at ways of improving incontinence management. This process led to the development of a model for assessment and management of incontinence.

Clinical Nursing Research↗
PubMed1995

Infantophilia--a new subcategory of pedophilia?: a preliminary study.

The Diagnostic and Statistical Manual of Mental Disorders has included three subgroups of pedophilic disorder based on the gender of the victim, the exclusiveness of the subject's preference for children, and whether the behavior is limited to incest. This study uses the pedophile's preference for age of victim as a means of delineating two distinct subgroups. The first group of so-called 'infantophiles' had victims who were less than five years old, while the latter subgroup of pedophiles had victims between the ages of 6 and 12 years (n = 38). The primary purpose of this study is to test the hypothesis that these two subgroups, based on the age of the victims, can be further distinguished by descriptive parameters. Various standardized questionnaires were administered to the subjects. The results of the study are discussed and suggestions made with regard to future research efforts.

Adult↗
PubMed1994

National Lesbian Health Care Survey: implications for mental health care.

This article presents demographic, lifestyle, and mental health information about 1,925 lesbians from all 50 states who participated as respondents in the National Lesbian Health Care Survey (1984-1985), the most comprehensive study on U.S. lesbians to date. Over half the sample had had thoughts about suicide at some time, and 18% had attempted suicide. Thirty-seven percent had been physically abused as a child or adult, 32% had been raped or sexually attacked, and 19% had been involved in incestuous relationships while growing up. Almost one third used tobacco on a daily basis, and about 30% drank alcohol more than once a week, 6% daily. About three fourths had received counseling at some time, and half had done so for reasons of sadness and depression. Lesbians in the survey also were socially connected and had a variety of social supports, mostly within the lesbian community. However, few had come out to all family members and coworkers. Level of openness about lesbianism was associated with less fear of exposure and with more choices about mental health counseling.

Adolescent↗