Biomedical subjects

J Fullerton

Publications and source records attributed to J Fullerton.

11 recordsLinked to original sources

PubMed2004

Unexpected complexity in the haplotypes of commonly used inbred strains of laboratory mice.

Investigation of sequence variation in common inbred mouse strains has revealed a segmented pattern in which regions of high and low variant density are intermixed. Furthermore, it has been suggested that allelic strain distribution patterns also occur in well defined blocks and consequently could be used to map quantitative trait loci (QTL) in comparisons between inbred strains. We report a detailed analysis of polymorphism distribution in multiple inbred mouse strains over a 4.8-megabase region containing a QTL influencing anxiety. Our analysis indicates that it is only partly true that the genomes of inbred strains exist as a patchwork of segments of sequence identity and difference. We show that the definition of haplotype blocks is not robust and that methods for QTL mapping may fail if they assume a simple block-like structure.

Alleles↗

PubMed2001

Relationships of cortisol, perceived stress, genitourinary infections, and fetal fibronectin to gestational age at birth.

The authors investigated the role of stress and cortisol with patients having preterm labor (PTL) and preterm birth (PTB). The relationships of maternal cortisol, perceived stress, fetal fibronectin (fFN), and genitourinary infections to PTL and PTB were studied. A prospective, longitudinal, observational study (n = 78) was conducted in a private practice in central Texas. Subjects had 4 blood draws for cortisol measurements grouped by 15-19, 20-22, 23-26, 27-30, and 31-35 weeks of gestation. Subjects had 2 vaginal swabs forfFN, chlamydia, and bacterial vaginosis screens at 23-26 and 27-30 weeks with assessment of psychosocial stress at 23-26 and 31-35 weeks. Statistical analysis was by analysis of variance, Pearson correlations, Fisher exact test, and logistic regression. There were no significant differences between the PTB, PTL, and term groups on cortisol levels at any of the gestational periods. Cortisol concentrations at any gestational stage did not correlate with gestational age at birth. A relationship of cortisol to race was observed when comparing Caucasians to other ethnic groups. A correlation (r = 0.42, P < 0.001) between the change in Perceived Stress Scale (PSS) score and gestational age was observed. The greater the decrease in PSS scores, the longer was the gestational age. A significant increase in cortisol at 19-21 weeks (P < 0.04), 23-26 weeks (P < 0.05), and 31-35 weeks (P < 0.01) was observed in patients having genitourinary infection. PTL was also significantly increased in subjects having positive genitourinary infections at either 23-26 weeks or 27-30 weeks (P < 0.01). The sensitivity of fFN to predict PTL collected at 27-30 weeks was 40%, specificity 86%, positive predictive value 55%, and negative predictive value 83%. These results indicate that cortisol is a poor predictor of either PTL or PTB. A decrease in perceived stress during the 2nd trimester was associated with an increase in length of gestation, suggesting the possibility of stress reduction as an appropriate intervention for lengthening gestational age.

Adolescent↗

PubMed1999

Identifying genes predisposing to atopic eczema.

BACKGROUND: Genetic and environmental factors are known to play a role in the development of atopic diseases, such as asthma, eczema, and rhinitis. However, the atopy gene (or genes) has yet to be defined. Studies of familial asthma have identified several regions that may contain genes predisposing to atopy, but the data for candidate regions do not show agreement, which may be due to heterogeneity, ascertainment bias, or stochastic factors. Factors such as an early age of onset, a positive family history, and a clearly defined phenotype favor a genetic origin and improve the chance of identifying genes that predispose to atopy. OBJECTIVE: We sought to define genes that predispose to the development of atopic eczema. METHODS: We have studied nuclear families with multiple cases of early-onset atopic eczema for involvement of the candidate regions on chromosomes 5q31 (IL gene cluster), 11q13 (high-affinity FCepsilon receptor), 14q11.2 (mast cell chymase), and 16p12 (IL-4 receptor alpha-chain, IL4RA gene). RESULTS: Using a recessive model, we find a maximum parametric log of the odds of linkage score of 2. 25 and nonparametric score of 2.54 (P =.006) for a region on chromosome 5q31, which we postulate contains a gene predisposing to atopic eczema, but lack of support for linkage to 11q13. Transmission disequilibrium tests do not support an association with candidate polymorphisms in the mast cell chymase and IL4RA genes. CONCLUSION: We have identified a clinically homogeneous cohort of patients with atopic eczema to identify genetic factors predisposing to the development of atopy. We postulate that there are certain loci that predispose to atopy in general and other loci that determine which of the atopic phenotypes is expressed.

Adolescent↗

PubMed1999

Supplemental and complementary alternatives to hormone replacement therapy.

Tables 1 and 2 offer a summary of information currently available on the sources, dosages, and proposed health benefits of the supplemental and complementary nutritional therapies that can be suggested as alternatives to hormone replacement therapy. These therapies have the additional benefit of being broadly available to women of all socioeconomic strata, and should be acceptable to women of various ethnicities and cultures. Adequate intakes (AI) of vitamins are recommended based on observational or experimentally determined approximations of the average nutrient intake, by a defined population or group, that appears to sustain a defined nutritional state (Food and Nutrition Boar, Institute of Medicine, 1997). Reviewing the empirical evidence concerning the use of vitamin supplements leads to the conclusion that doses higher than AI or recommended daily requirements is not warranted. For those individuals who choose to supplement, counseling should be provided to caution about tolerable upper limits, those maximum levels of nutrient intake judged unlikely to pose a risk for adverse health effects (Food and Nutrition Boar, Institute of Medicine). Supplemental and complementary therapy directed at ameliorating symptoms or reducing the risk of menopause related illness (osteoporosis and CHD) becomes a decision balance of the woman's preferences, risk and health history, and personal and financial resources. There appears to be some protection of morbidity and mortality from CHD with antioxidant dietary intake. Osteoporosis appears to be delayed with calcium supplementation. Menopausal symptoms, CHD risk, and osteoporosis risk appears to be reduced with phytoestrogen supplementation, although doses have not been established. Research concerning the safety and efficacy of these therapies continues. Findings from current clinical trials, such as the Women's Health Initiative may render these and additional alternative therapies to HRT more precise in the near future.

Antioxidants↗

PubMed1998

Outcomes of intended home births in nurse-midwifery practice: a prospective descriptive study.

OBJECTIVE: To describe the outcomes of intended home birth in the practices of certified nurse-midwives. METHODS: Twenty-nine US nurse-midwifery practices were recruited for the study in 1994. Women presenting for intended home birth in these practices were enrolled in the study from late 1994 to late 1995. Outcomes for all enrolled women were ascertained. Validity and reliability of submitted data were established. RESULTS: Of 1404 enrolled women intending home births, 6% miscarried, terminated the pregnancy or changed plans. Another 7.4% became ineligible for home birth prior to the onset of labor at term due to the development of perinatal problems and were referred for planned hospital birth. Of those women beginning labor with the intention of delivering at home, 102 (8.3%) were transferred to the hospital during labor. Ten mothers (0.8%) were transferred to the hospital after delivery, and 14 infants (1.1%) were transferred after birth. Overall intrapartal fetal and neonatal mortality for women beginning labor with the intention of delivering at home was 2.5 per 1000. For women actually delivering at home, intrapartal fetal and neonatal mortality was 1.8 per 1000. CONCLUSION: Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary. Intrapartal mortality during intended home birth is concentrated in postdates pregnancies with evidence of meconium passage.

Adolescent↗

PubMed1995

Perceptual and enactment measurement of self-care.

The concept of self-care was conceptualized as having three major components: enabling perceptual elements (motivation, values, responsibility, and decision making); domains for enactment (cognitive/ perceptual, psychosocial/affective, and physical functioning); and self-care enactment factors (capacity), which included self-care action and knowledge adequate for self-care. A new tool, The Self-Care Agency Inventory, was designed to discriminate between those who will enact self-care and those who will not because of either a lack of knowledge or a lack of motivation. Content validity was demonstrated (.77 or greater from each scale) and concurrent validity documented. Alpha reliability for the new scale and principal components factor analysis of the scale items did not achieve desired levels, although a pilot sample demonstrated test-retest reliability of .82. The conceptual model is presented.

Adolescent↗

PubMed1988

A collaborative intercampus model for graduate studies in primary care nursing.

A feasibility study was conducted to determine the appropriateness of developing an intercampus curriculum for graduate studies in nursing with collaboration between a School of Medicine at one campus and a School of Nursing at another. Methods of data collection included interviews with a broad scope of administrators, faculty and students, synthesis of survey data and other documentation, and a consultation visit by a representative of the United States national accreditation body for nursing. From these data, an advisory committee of faculty administrators from each campus jointly determined the most appropriate criteria upon which to base an intercampus program. A curriculum preparing students in the specialties of either midwifery or family practice was created. The advantages and disadvantages of this collaborative effort are described, along with conclusions regarding factors influencing the effectiveness of the program.

Curriculum↗

PubMed1983

Effects of transportation, surgery, and antibiotic therapy in ponies infected with Salmonella.

Seventeen ponies were infected with Salmonella typhimurium and then 15 were variously stressed by transportation and/or surgery and 9 were given oxytetracycline. Indications of Salmonella reactivation occurred in all the stressed ponies. Diarrhea due to a reactivation of the Salmonella infection did not develop until greater than 3 days after stress, although maximal shedding of organisms occurred within 24 hours. A neutropenia generally occurred within 24 hours after stress and lasted about 5 days. A rectal temperature greater than 39 C usually did not occur. An increase in serologic titer was noticed in about half of the ponies. Transportation had a major role in reactivating the Salmonella infection, and 1 pony died of peracute colitis. The use of oxytetracycline prolonged the excretion of Salmonella; therefore, this drug should not be used after stress, particularly transportation, in ponies that have diarrhea or are known to be Salmonella carriers.

Animals↗

PubMedDate not supplied

Conceptions of prenatal care among Somali women in San Diego.

Studies have shown that culturally sensitive prenatal care improves access to and utilization of that care. Focus groups were used to explore the beliefs and attitudes toward prenatal care among Somali women in San Diego, particularly in regard to their perinatal experiences following immigration. The women were very well informed about healthy prenatal practices, including nutrition and exercise, and very compliant in following such practices, having found ways and means to accommodate these practices into their new American lifestyle. The women were generally pleased with the care that they have received in San Diego and tolerant of most diagnostic and therapeutic interventions. The women preferred to be seen by a female doctor/health care practitioner who is informed about the female circumcision practiced in Somalia and who is conservative in the decision to perform cesarean section deliveries.

Adult↗

PubMedDate not supplied

Computer-mediated distributed learning. An innovative program design in midwifery education.

The State University of New York, Stony Brook (SUNY-SB) Pathways to Midwifery Program offers a distributed learning curriculum that is unique among American nurse-midwifery education programs. The Pathways to Midwifery Program provides asynchronic, computer-mediated instruction. Community-based faculty coordinate, supervise, and evaluate the clinical education of students. The SUNY-SB model offers an opportunity to increase dramatically the number of students who can receive the curriculum. It also provides distinct advantages in maintaining a curriculum database that reflects rapidly changing clinical science and that takes advantage of vast educational resources available through related computer networks. By creating a classroom without walls, the program is cost-effective.

Computer Communication Networks↗

PubMedDate not supplied

Primary and secondary prevention strategies among older postmenopausal women.

Women may choose to initiate, reinitiate, or discontinue hormone replacement therapy (HRT) at any time beyond the perimenopausal period. HRT, exercise, and nutrition are reviewed in terms of their potential benefits as primary and secondary preventive therapies against coronary heart disease, osteoporosis, breast and genital cancers, and the maintenance of cognitive function among older postmenopausal women. Lifestyle alternatives involving nutrition and exercise that offer many of the same benefits as HRT are discussed. Since both pharmacologic and lifestyle interventions offer significant benefit for primary and secondary prevention of disease and disability, each should be offered to women for consideration as they enter the perimenopausal period. Additionally, each can be recommended for initiation even at much older ages and subsequent to adverse health occurrences, such as the experience of breast or genital cancer or a cardiac event. Each should be sustained over the long term. The decision whether to discontinue these interventions among the most elderly will be influenced by other quality of life considerations.

Aged↗