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Biomedical subjects

J L Rogers

Publications and source records attributed to J L Rogers.

At least 19 recordsLinked to original sources
PubMed1996

The influence of signal variation, bias, noise and effect size on statistical significance in treatment studies of the common cold.

Many groups are working on new and improved methods of common cold treatment that include antivirals, synthetic viral receptor, compounds which block symptom pathways, and combinations of these approaches. Because the common cold syndrome is in large part subjective, symptom measurement remains an important parameter in evaluating the effectiveness of cold treatments. This review examines the features of the experimental and natural cold testing methods that effect recognition of illness signal and influence its variance and strength. Also, the importance of changes in signal variance and in the magnitude of therapeutic effect size as they relate to statistical probability were compared using a symptom data set from young adults with experimental rhinovirus colds.

Adult↗
PubMed1993

Appropriate short-term risk in psychiatry and the law.

Effective treatment decisions sometimes require substantial risk of short-term harm, which can be shown after-the-fact to have been preventable, thereby carrying some liability risk. To err on the side of short-term comfort or safety, however, may greatly increase the overall and long-term risks. For instance, to intrusively restrain a borderline patient from threatened acting out, may (1) fuel a regressive cycle that heightens future risk, (2) deprive the clinician of therapeutic leverage, and/or (3) so disrupt the treatment system that other patients unnecessarily suffer. Long-term thinking is not always convincing to judge or juror, because of less direct causal connections; hence, there is pressing need to develop rational criteria for when it should hold sway. Two competing trends of legal doctrine are relevant: risk-benefit analysis (utilitarian) and absolute values (absolutist). Presumptions of appropriate short-term risk separately weigh five relevant factors, in interaction with one another: imminent safety, long-term risk, voluntariness of other agent, therapeutic boundaries, and social values. Forensic psychiatrists are advised to take a stronger stand in support of short-term risk, when needed to enhance long-term safety and optimal standards of care.

Confidentiality↗
PubMed1992

Disruptive medical patients. Forensically informed decision making.

Patients who disrupt medical care create problems for physicians. The risks are not entirely clinical. Although these patients may compromise sound clinical judgment, some are also litigious and express their dissatisfaction in legal or other forums. It then becomes necessary for treating physicians to be aware of the legal and ethical boundaries of their patient care responsibilities. Some disruptive patients are treated by setting limits, which is usually affirmed by health care agreements. A hospital review board may advise clinicians on these agreements and on the management of disruptive patients. If termination of the physician-patient relationship is considered, physicians must follow proper protocol. We examine these forensic considerations and place them in the context of malpractice. Communication, consultation, and documentation are the key elements in reducing liability.

Adult↗
PubMed1991

Dietary intervention and training in swimmers.

To ascertain if muscle damage occurred in swimmers as a result of high-intensity training and to find if fluid and dietary manipulation could affect muscle damage, we studied 40 members of the University of Florida swimming team using creatine kinase (CK) and lactic dehydrogenase (LDH) as markers of muscle damage during a 6-month period of intensive training. During this time, training intensity, fluid intake during exercise and dietary supplementation were all modified one by one to examine their individual effects. During a control period of 4 weeks, all swimmers drank water before and during (120 min) workouts. CK in men at the end of this period averaged 315, SD 122 (normal less than 170 IU.l-1). Half of the swimmers were then given 500 ml of a glucose-electrolyte solution (GES) (Na 21 mmol.l-1, Cl 13 mmol.l-1, K 2.5 mmol.l-1, PO4 5 mmol.l-1 and glucose 6%) before workouts and twice at intervals during the workout, while half continued to drink the same volume of water. One week after division into fluid groups, the workout intensity was increased by about 10%. Another week later CK had increased to 500, SD 180 IU.l-1 in swimmers drinking water, but fell to 280, SD 105 IU.l-1 in those drinking GES (P less than 0.05). The second phase of the study began after a 4-week control period during which all athletes drank water before and during workouts. The swimmers were divided into four matched groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Impact of the Minnesota Parental Notification Law on abortion and birth.

BACKGROUND: The impact of the Minnesota Parental Notification Law on abortion and birth was examined. METHODS: Using linear models, outcome parameters were compared before and after enactment of the law. Time by age group interactions also were examined. RESULTS: The pre-enactment to post-enactment change in the Minnesota abortion rate reflected a greater decline for minors (less than or equal to 17 years old) than for 18-19 year-olds (who were not under the law). An increase in abortion rate occurred for women ages 20-44. The law appeared to have had no impact on birth rate in minors. Following the enactment of the law, the rate of early abortions (less than or equal to 12 weeks) declined among minors more than the rate of late abortions (greater than 12 weeks). This resulted in a pre-enactment to post-enactment increase in the ratio of late-to-early abortions among minors. CONCLUSIONS: These data suggest that parental notification facilitated pregnancy avoidance in 15-17 year-old Minnesota women. Abortion rates declined unexpectedly while birth rates continued to decline in accordance with a long-term trend.

Abortion, Legal↗
PubMed1990

Muscle stretching as an alternative relaxation training procedure.

The purpose of this program of research was to explore the use of muscle stretching procedures in relaxation training with a clinical population. In the first controlled study, stretching exercises for four muscle groups (obicularis occuli, sternocleidomastoid/trapezius, triceps/pectoralis major, and forearm/wrist flexors) were prepared. A group of people using these procedures (SR, N = 8) was compared to a group using the Bernstein and Borkovec (1973) tense-release (TR; N = 8) techniques for those same muscle groups, as well as compared to an appropriate group of controls (WL; N = 8). Assessment of physiological (multi-site EMG) and subjective (emotions, muscle tension, and self-efficacy) responses showed that persons in the SR displayed less sadness, less self-reported muscle tension at four sites, and less EMG activity on the r.masseter than persons in the TR group. In the second study, 15 subjects were administered an expanded version of the SR relaxation procedures. Results showed that all subjects reported significant decreases in self-reported levels of muscle tension; muscle tension responders showed lowered trapezius EMG and respiration rates and cardiovascular responders showed lowered diastolic blood pressure. The results are discussed in terms of the utility of relaxation procedures based primarily on muscle stretching exercises for lowering subjective and objective states of arousal.

Adolescent↗
PubMed1989

Psychological impact of abortion: methodological and outcomes summary of empirical research between 1966 and 1988.

A systematic "roadmap" through the medical literature that empirically examines the incidence of psychological sequelae of induced abortion is presented. Because outcome incidence rates and methodological profiles vary substantially across studies, selective use of articles from this literature without an accompanying rationale for that selectivity could foster erroneous conclusions. Information compiled here can facilitate a rapid methodological critique of citations in abortion-related materials. Investigations published in English between January 1966 and April 1988 that quantitatively examined psychological sequelae using prospective, retrospective, or comparative methodologies are summarized in tables to produce a synopsis of the demographics, methodological limitations, and gross statistical features of each article. This quantitative guide is designed to facilitate appropriate use of the current literature, provide needed background to assess positions arising from the currently available data, and provide methodological focus for planning better studies in the future.

Abortion, Induced↗
PubMed1989

Longer hospitalization at Veterans Administration hospitals than private hospitals. Verification and additional insights.

Utilizing 1,297 male patients under the primary care of an identical group of house officers and under treatment between 1985 and 1987 for ten common medical diagnoses, length of hospitalization was compared between a private sector (n = 481) and Veterans Administration (VA) (n = 816) facility, both affiliated with the same medical school. All patients were rated by the Horn Severity of Illness Index. After researchers controlled for diagnosis, severity of illness, age, race, and physician, results in this study indicate that an additional 3.2 days of hospitalization were associated with the VA facility. This finding is consistent with earlier reports of inappropriate hospitalization at the VA hospital and suggests that VA facility planners need to evaluate whether longer lengths of stay (LOS) are merited.

Adult↗
PubMed1988

Drug treatment refusal and length of hospitalization of insanity acquittees.

Thirty-three insanity acquittees who had refused drug treatment were matched to a sample of nonrefusing hospitalized insanity acquittees in an attempt to measure the effect of treatment refusal on length of hospital stay. No measurable effects on the length of hospitalization were found. However, upon comparing the amount of time under court jurisdiction spent in the hospital and on conditional release in the community, it becomes evident that refusers spent significantly greater proportions of time hospitalized than the average hospitalized insanity acquittee, who had less hospitalization and spent more time on conditional release. These differences do not seem to be related to the issue of treatment refusal.

Adult↗
PubMed1988

The duty to protect others from your patients--Tarasoff spreads to the Northwest.

The California Supreme Court's Tarasoff decision was the seminal case in the area of the duty to protect third parties from the potential of violence from patients. Tarasoff-related issues have now spread to many jurisdictions in the country. This article will pay particular attention to the cases influencing law in Washington and Oregon and will review the clinical duty to protect others from your patients that existed before Tarasoff, as physicians were taught to work between privilege and civil commitment statutes. The California law designed to limit Tarasoff liability and the reasons why legislators should be willing to support such legislation are discussed.

Confidentiality↗
PubMed1987

The legal basis of forensic psychiatry: statutorily mandated psychiatric diagnoses.

Using the Oregon statutory scheme as an example, the authors review certain areas of the law where psychiatric expertise is mandated by statute. This review points out the diversity of determinations where forensic psychiatric expertise is required by law. The authors' thesis is that forensic psychiatry draws its vitality from the law. Legal requirements, however, should not dictate psychiatric response, which should be guided by psychiatric knowledge and ethical concerns.

Capital Punishment↗
PubMed1987

Treatment refusal among forensic inpatients.

Although the United States Supreme Court has not offered a definite opinion, some states have established the qualified right of involuntarily committed patients to refuse treatment. Controversy continues between psychiatry and law over what procedural protections should be provided to patients when therapists seek to override nonemergency refusal of treatment. The authors review Oregon's administrative approach and its application to the treatment refusal of 33 state hospital forensic patients. Patient characteristics, refusal patterns, and implications of treatment refusal are also described.

Adult↗
PubMed1986

Evaluation and treatment of insanity acquittees in the community.

This paper describes the monitored outpatient treatment program for Psychiatry Security Review Board (PSRB) clients in the largest single community treatment agency in the Oregon system. We describe 161 persons referred to this agency for evaluation and treatment. Ninety-one PSRB clients received treatment and of this group 51% had their conditional release revoked by the PSRB. The most frequent cause of revocation was noncompliance with treatment. There were only 11 crimes committed during the study period, four of which were in the felony range. The majority of PSRB clients are chronically mentally ill persons. We discuss both the treatment approach and our results in light of a recently published research agenda for insanity acquittees.

Adult↗
PubMed1985

The determination of specific radioactivity of proteins eluted intact from polyacrylamide gels, utilizing a fluorescamine assay.

The methodology described permits the measurement of the specific radioactivity of diverse proteins resolvable by separatory techniques using cylindrical polyacrylamide gels. Following separation, the proteins are electroeluted; eluted protein is quantitated in the microgram range using a fluorescamine assay, while the major portion of the recovered sample is used for radioactivity measurement. These procedures have been adapted for use in tracer studies of protein metabolism. Their utility in kinetic investigations is demonstrated with data on the time course of changing specific radioactivities of human plasma albumin and apolipoprotein B labeled in vivo with a [3H]leucine tracer.

Apolipoproteins B↗
PubMed1985

Tumorigenicity testing of primate cell lines in nude mice, muscle organ culture and for colony formation in soft agarose.

Primate neoplastic and finite cell lines were tested in one in vivo and two in vitro test systems: adult nude mice, muscle organ culture (MOC) and soft agarose (SA). Comparison of the sensitivity of the systems indicated that nude mice were inferior to either in vitro system: WI-38 VA13 (an SV40 transformed cell line) did not cause tumours in these animals yet it behaved as if it were neoplastic in MOC and formed colonies in SA. There was complete correlation between results obtained in MOC and SA. All cell lines which produced tumors in vivo were positive in both in vitro test systems. None of the lines which showed normal patterns in MOC and in SA was tumorigenic in nude mice. Since testing in vitro is simpler, faster, and is thought to be reliable, we recommend SA followed by MOC as the initial assays for determining tumorigenicity of cells.

Animals↗