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Biomedical subjects

J L Pearson

Publications and source records attributed to J L Pearson.

At least 19 recordsLinked to original sources
PubMed2005

Prevalence of suicidality during pregnancy and the postpartum.

This review examined the available prevalence estimates of suicidality (suicide deaths, attempts, and ideation including thoughts of self harm) in pregnancy and the postpartum. Studies that used defined community or clinic samples were identified through multiple electronic databases and contacts with primary authors. Definitions of and measurement of suicide deaths, intentional self-harming behavior, suicide attempts, and thoughts of death and self-harm were varied and are described with each study. While suicide deaths and attempts are lower during pregnancy and the postpartum than in the general population of women, when deaths do occur, suicides account for up to 20% of postpartum deaths. Self-harm ideation is more common than attempts or deaths, with thoughts of self-harm during pregnancy and the postpartum ranging from 5 to 14%. The risk for suicidality is significantly elevated among depressed women during the perinatal period, and suicide has been found to be the second or leading cause of death in this depressed population.

Adult↗
PubMed2001

High-risk management guidelines for elderly suicidal patients in primary care settings.

Older adults, especially older white men, are more likely to commit suicide than other age-groups. The assessment and management of suicide ideation and behavior for the elderly is especially relevant for primary care physicians because many patients visit their physician shortly before committing suicide. In 1993, the Agency for Health Care Policy and Research (AHCPR) released clinical practice guidelines for the treatment of depression in primary care settings. The AHCPR guidelines offered some assistance with respect to detecting and treating patients who are suicidal. However, these guidelines lacked detailed and specific instructions for managing high-risk patients within the context of intervention research. The current set of guidelines builds upon this previous work by describing (1) a general approach for interacting with suicidal patients; (2) structured assessments for determining the degree of risk for suicide; (3) crisis intervention strategies; and (4) ongoing management procedures for working with suicidal patients in primary care settings.

Aged↗
PubMed2001

Intervention research with persons at high risk for suicidality: safety and ethical considerations.

There is a critical need for studies designed to reduce suicidality. Individuals at high risk for suicidality deserve safe and effective treatments, just as do other individuals with mental disorders who do not experience suicidality. Points for consideration regarding safety and monitoring procedures are offered to help researchers who conduct treatment trials with individuals who have mental disorders and investigators specifically interested in developing treatments to reduce suicidality. Issues such as study design, increased monitoring and supervision, research clinician competencies, and liability concerns are addressed. Points to consider in planning an intervention trial, a checklist of informed consent issues, and a list of relevant active federal regulations are provided.

Adolescent↗
PubMed2000

Recombination within the nonstructural genes of the parvovirus minute virus of mice (MVM) generates functional levels of wild-type NS1, which can be detected in the absence of selective pressure following transfection of nonreplicating plasmids.

Recombination within the coding region of the nonstructural genes of minute virus of mice (MVM), which generates functional levels of wild-type NS1, was observed in the absence of selective pressure following cotransfection of nonreplicating plasmids. P38 activity was used as a measure of recombinant NS1 production, which, together with direct detection of recombinant-generated products by RT-PCR, allowed an estimation of recombination efficiency. In addition, we show that very low levels of wild-type NS1 were able to significantly transactivate P38. Given that recombination following cotransfection can generate NS1 at these levels, our observations have implications for the study of parvoviral genetics, the construction of recombinant parvoviral vectors for gene therapy applications, and perhaps other systems using cotransfection of plasmids that share homologous sequences.

Animals↗
PubMed2000

Suicide prevention in late life: directions for science and practice.

Suicide among the elderly is a critical public health problem, yet there remains limited information on risk factors to target due to the few number of controlled studies that could help isolate and focus on the most potent risk factors. We suggest that because there are no proven, effective interventions showing reduced suicidal behaviors in older adults, the best current approach is to improve detection and treatment of later-life depression. This effort may be especially effective in primary care settings, where the majority of our nation's elderly seek and receive their mental health care. We review approaches to assessment and treatment of later life depression that seem most relevant for later life suicide prevention. Testing and determining whether these treatment approaches are effective is an immediate goal on the path to advancing the science and practice of late-life suicide prevention.

Aged↗
PubMed2000

Intervention research in psychosis: prevention trials.

Prevention trials have not been a central focus in mental health research in general and in the psychoses in particular. In this article we provide the basis for development of a model for prevention trials, define the parameters of the model, and provide some illustrative examples. The article expands upon traditional approaches to prevention by incorporating perspectives from the fields of treatment and services research. Approaches to prevention are based upon models of etiology, pathophysiology, and risk. A number of barriers to the development of a major emphasis on prevention are identified, and those that are embedded in the infrastructure of the field are highlighted.

Aged↗
PubMed1999

Studies of suicide in later life: methodologic considerations and research directions.

Later-life suicide is a tragedy that occurs worldwide. Often it is preventable. Here, the authors summarize an international workshop where they review four research approaches to studying putative risk factors: epidemiologic studies of suicidal behaviors, clinic-based follow-up studies, studies of suicide attempters, and psychological autopsy studies. They provide brief descriptions of the approaches, examples of questions best addressed by each approach, and their weaknesses and limitations; they also recommend promising areas for future research and propose opportunities for research that could be conducted cross-nationally.

Aged↗
PubMed1998

Connected and separate selves: development of an inventory and initial validation.

We describe the development and validation of the Relationship Self Inventory (RSI), which assesses 2 general self-orientations, (a) the Separate Self (SS) and (b) the Connected Self (CS), as well as two manifestations of connection, (a) Primacy of Other Care and (b) Self and Other Care. The CS reflects the importance of interconnectedness with others and a "voice of caring," whereas the SS reflects autonomy, independence, and a "voice of justice." Adequate reliability was demonstrated for the RSI on samples consisting of 927 women and 218 men ranging in age from 26 to 78. Construct validity of the RSI was also explored in a subsample (n = 604) by comparing its scales with measures of personality, temperament, and psychological adjustment. Although mean scores of men and women differed minimally on the CS and SS scales, gender differences in patterns of correlation with validity measures suggested that the meanings of the scales differed for men and women. The RSI appears to be an adequate survey tool for assessing these self-orientations.

Adaptation, Psychological↗
PubMed1997

Diagnosis and treatment of depression in late life. Consensus statement update.

OBJECTIVE: To reexamine the conclusions of the 1991 National Institutes of Health Consensus Panel on Diagnosis and Treatment of Depression in Late Life in light of current scientific evidence. PARTICIPANTS: Participants included National Institutes of Health staff and experts drawn from the Planning Committee and presenters of the 1991 Consensus Development Conference. EVIDENCE: Participants summarized relevant data from the world scientific literature on the original questions posed for the conference. PROCESS: Participants reviewed the original consensus statement and identified areas for update. The list of issues was circulated to all participants and amended to reflect group agreement. Selected participants prepared first drafts of the consensus update for each issue. All drafts were read by all participants and were amended and edited to reflect group consensus. CONCLUSIONS: The review concluded that, although the initial consensus statement still holds, there is important new information in a number of areas. These areas include the onset and course of late-life depression; comorbidity and disability; sex and hormonal issues; newer medications, psychotherapies, and approaches to long-term treatment; impact of depression on health services and health care resource use; late-life depression as a risk factor for suicide; and the importance of the heterogeneous forms of depression. Depression in older people remains a significant public health problem. The burden of unrecognized or inadequately treated depression is substantial. Efficacious treatments are available. Aggressive approaches to recognition, diagnosis, and treatment are warranted to minimize suffering, improve overall functioning and quality of life, and limit inappropriate use of health care resources.

Age Factors↗
PubMed1997

Late-life suicide and depression in the primary care setting.

Late-life depression and suicidal behavior in the primary care setting is a significant public health concern. The prevalence of depression in this population is substantial, yet rates of detection and treatment are far from adequate. Untreated depression has significant consequences with regard to morbidity and mortality. Although suicide is a relatively low-base-rate behavior, a substantial proportion of late-life suicides have contact with their primary care provider prior to their death; thus this offers an avenue for suicide prevention. There is a growing knowledge base concerning what constitutes barriers to the recognition and treatment of late-life depression as well as what constitutes useful screening tools and treatments for the depressed elderly. Important new findings with regard to the functional effects of subsyndromal depression, possible subtypes of late-life depression, the clinical utility of SSRIs and psychotherapeutic interventions, and innovative and collaborative models of care hold promise for advancing the science and practice of treating late-life depression.

Age Factors↗
PubMed1997

Grandmother involvement in child caregiving in an urban community.

In a community-defined, epidemiologic sample in East Baltimore, we examined grandmothers' rates of co-residence and their involvement in four parenting activities. Co-residence rates exceeded the national average. Six types of family households with grandmothers were identified, and their frequency varied by race. Neither grandmother age nor employment was associated with grandmothers' parenting involvement, although family structure was. Grandmothers who were the sole parent (21%) or co-parent with a grandfather (6.5%) were most involved in child care and had the fewest number of helpers. Grandmothers living with single mothers (41%) were the next most involved, while grandmothers in mother/father households (9%) were least involved.

Adult↗
PubMed1996

Parents' attachment histories and children's externalizing and internalizing behaviors: exploring family systems models of linkage.

Twenty-seven mothers and 27 fathers were given the Adult Attachment Interview (M. Main & R. Goldwyn, in press) when their children were 3.5 years old. Continuous ratings of narrative coherence, probable experience quality (parents perceived as loving), and state of mind (current anger at parents) were entered as latent variables in partial least squares structural equation models that included observational measures of marital quality and parenting style. Models that include fathers' attachment histories predicted more variance in kindergarten teachers' descriptions of children's externalizing behavior, whereas models that include mothers' attachment histories predicted more variance in children's internalizing behavior. Marital data added predictive power to the equations. Discussion is focused on the importance of integrating attachment and family systems approaches, and of parents' gender and marital quality, in understanding specific links between parents' attachment histories and their young children's externalizing and internalizing behaviors.

Adult↗
PubMed1994

Family structure and aggressive behavior in a population of urban elementary school children.

OBJECTIVE: This report examined associations between family structure and 393 fourth-grade children's aggressive behavior. METHOD: In an epidemiologically defined urban community population, both teacher and parent ratings of child aggressive behavior were examined among family structures that reflected current demographics. Relative risks for teacher- and parent-rated child aggressive behavior in mother-alone households were compared with those in the next most prevalent family structures (mother-father, mother-grandmother, and mother-male partner families). RESULTS: With all income groups combined, teachers rated boys and girls in mother-alone families as more aggressive relative to mother-father families. Among low-income families, the protective effects for mother-father families were not apparent, and mother-male partner families were associated with an increased risk for teacher-rated aggression for boys. CONCLUSION: Absence of and type of second adult present, child gender, home and school context, and income were important factors that moderated the associations between family structure and child aggressive behavior in this urban setting.

Black or African American↗
PubMed1994

Inservice education needs in geronotological nursing.

This study in the field of gerontological nursing, identified perceived geronotological learning needs of RNs employed in long term care (LTC) facilities in Alberta to obtain a data base upon which the planning and development of inservice education in gerontological nursing could be based. Several conclusions were reached. Many highly perceived gerontological learning needs exist among RNs working in LTC in Alberta. Perceived learning needs remained high throughout the stages of resident flow. Priorities for program development in gerontological nursing were established. Although inservice education attendance over the previous two years was low, programs that address these needs should be available on a regular basis. Time to attend inservice programming is a problem that needs to be addressed. This study has provided useful information upon which inservice programming in gerontological nursing in LTC may be based.

Aged↗