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Biomedical subjects

K A Peterson

Publications and source records attributed to K A Peterson.

At least 19 recordsLinked to original sources
PubMed2004

Molecular structure, spectroscopy and matrix photochemistry of fluorocarbonyl iodide, FC(O)I.

The molecular structure of FC(O)I has been determined by gas electron diffraction. High-level ab initio methods, including coupled-cluster and the new correlation-consistent basis sets for fourth row elements, have been used to calculate the structure of FC(O)I. A comprehensive vibrational spectroscopic study (both IR and Raman) complemented by high-level calculations has also been performed. Furthermore, UV, mass, and NMR spectra have been recorded for FC(O)I. The matrix photochemistry of FC(O)I has been studied with a low-pressure mercury lamp and with a high-pressure xenon lamp in combination with interference and cut-off filters. UV photolysis revealed the formation of the OC. IF and OC.FI complexes and further photolysis of these complexes at lambda>320 nm resulted in a re-formation of FC(O)I. The structural conformation of the complexes has been characterized by comparing shifts in their CO and IF vibrational modes with respect to those of the free species. The structures, vibrational properties, and stability of the complexes were analyzed with the aid of coupled-cluster ab initio calculations.

Journal Article↗
PubMed2001

Identification of human serum interferants in the recombinant P-selectin glycoprotein ligand-1 clinical ELISA using MALDI MS and RP-HPLC.

A colorimetric enzyme-linked immunosorbent assay (ELISA) was developed to detect circulating levels of rPSGL to permit pharmacokinetic analysis of clinical samples. The ELISA is an asymmetric sandwich utilizing a monoclonal antibody pair. Initial validation studies indicated that 57% of normal individuals scored above the limit of detection of the assay. Specificity experiments indicated that the signal was not due to circulating endogenous P-selectin glycoprotein ligand-1 (PSGL-1). Using matrix-assisted laser desorption ionization mass spectrometry (MALDI MS) and sampling within the individual microplate wells, the interferant was detected in the vicinity of 6.6 kDa in lipemic and normal human sera, but not delipidized sera. These results were consistent with the ELISA data where 97.5% of known lipemic, 57% of normal, and 0% of delipidized sera scored above detectable limits in the ELISA. Preparative isolations of the 6.6 kDa species were performed using reversed-phase high performance liquid chromatography (RP-HPLC) with UV and MS detection. Edman N-terminal sequencing identified the 6.6 kDa unknown as Apolipoprotein C-I. Additional apolipoproteins were found by MALDI and RP-HPLC. Digestion of sera with liposome lipase and extraction of sera with anti-apolipoprotein C-I, C-II, and C-III antibody beads significantly reduced the ELISA interference. These experiments combined with the MALDI detection of phosphatidylcholine-type lipids from NHS eluate suggested that lipoprotein particles or remnants were causing the interference. A method combining Triton-X 100 with sonication was developed to overcome this interference without altering rPSGL recovery in the ELISA.

Apolipoproteins↗
PubMed1998

Strategies to improve diabetes care delivery.

Although the primary care office is an important location for integrating new advances in the treatment of diabetes, the current delivery of preventive primary care for patients with diabetes falls short of clinical recommendations. Barriers within the existing health care system, practice structure, and physician and patient support services are among the most commonly cited obstacles to initiating better preventive care. As public health groups demand greater accountability from the medical system, regulatory efforts focus more scrutiny on systems, clinic practices, and even individual physician practices. Although improving care delivery effectively and efficiently is difficult, strategies to exist that can increase the likelihood of improving patient outcomes. Successful diabetes initiatives are often characterized by the consensual adoption of an evidence-based treatment plan. Effective physician-oriented interventions include the use of reminder systems, local opinion leaders, and academic detailing. In addition, several national diabetes initiatives are likely to influence primary care practice. New measures of accountability will be widely used to determine the quality of primary diabetes care delivery.

Delivery of Health Care↗
PubMed1995

Measuring substance abuse program treatment orientations: the Drug and Alcohol Program Treatment Inventory.

Assessment of therapeutic orientation is a significant problem in substance abuse program evaluation. This study reports the initial results of a new approach to measuring treatment orientation through a self-report survey that focuses on distinctive features of substance abuse treatment orientations. The Drug and Alcohol Program Treatment Inventory (DAPTI) assesses treatment goals and activities specific to eight orientations: AA/12 Step, Therapeutic Community, Cognitive-Behavioral, Insight/Psychodynamic, Rehabilitation, Dual Diagnosis, Medical and Marital/Family Systems. We present findings from a nationwide assessment of 327 Veterans Administration (VA) Substance Abuse treatment programs that demonstrate promising subscale internal consistency, discriminant validity, and concurrent validity. In addition, the DAPTI distinguishes between programs with independently verified orientations and between inpatient, extended care, outpatient, and methadone maintenance programs. The DAPTI may be helpful in systematically assessing differences in treatment orientations between different types of programs, such as inpatient, community residential, and outpatient care.

Alcoholism↗
PubMed1994

Picosecond infrared study of the photodynamics of carbonmonoxy-cytochrome c oxidase.

Time-resolved infrared (TRIR) techniques have been employed to study the reactions of carbon monoxide with the cytochrome alpha 3-Cu(B) site of cytochrome c oxidase (CcO). The ligation dynamics immediately following photodissociation have been investigated using picosecond TRIR spectroscopy and linear dichroism. The rate of photoinitiated transfer of CO from cytochrome alpha 3 to CuB was measured directly by monitoring the development of the transient CuBCO absorption. In less than 1 ps, a stationary CuBCO spectrum develops, which together with the CO infrared linear dichroism is constant until the CO dissociates from CuB on a microsecond time scale. These observations indicate that the CO is transferred between metals and reaches its equilibrium conformation in less than 1 ps. This unprecedented ligand transfer rate has profound implications with regard to the structure and dynamics of the cytochrome alpha 3-CuB site, the functional architecture of the protein, and coordination dynamics in general.

Animals↗
PubMed1994

Determinants of readmission following inpatient substance abuse treatment: a national study of VA programs.

This study examines program determinants of one aspect of VA inpatient substance abuse treatment program performance. Performance was measured by the ratio of a program's readmission rate to the expected rate for programs with similar patients. Six-month readmission rates in 101 VA treatment programs were analyzed. Preliminary analyses indicated that patient differences across programs accounted for 36% of the variance in readmission rates. Program differences accounted for 47% of the variance in case-mix-adjusted readmission rate. Among program factors selected through a literature review, better than expected readmission performance was associated with having fewer early discharges, a longer intended treatment duration, more patient participation in aftercare, more family or friend assessment interviews, and treating more patients on a compulsory basis. Performance was not related to stress management training, patient attendance at more self-help meetings during treatment, staff characteristics, or average staff costs per patient day. The findings indicate that treatment retention, duration, and increased aftercare may be targeted to reduce high readmission rates. Last, there were only small differences in the model over 30, 60, 90, and 365 day follow-up intervals, suggesting substantial stability of the findings.

Aftercare↗
PubMed1994

Comparison of home glucose monitoring with the oral glucose tolerance test to detect gestational glucose intolerance.

BACKGROUND: Recent evidence suggests that infant morbidity is increased among women who have abnormal prenatal glucose screening tests but who do not have gestational diabetes mellitus (GDM). These women fall into a diagnostic gray zone and historically have not been treated. METHODS: Forty-eight pregnant women with abnormal oral glucose challenge test results performed self-monitored blood glucose (SMBG) testing seven times per day for 1 week before undergoing a diagnostic 100-g oral glucose tolerance test (OGTT). At delivery, perinatal complications and birthweights were recorded. Results of SMBG tests for women with normal OGTTs were correlated with infant birthweights. RESULTS: Thirteen infants (37%) were found to be large for gestational age (LGA). Significant correlation was found between increasing birthweight and increasing average fasting SMBG values (P < .001), increasing percentage of SMBG values above 120 mg/dL (6.7 mmol/L) (P < .01), and increasing average SMBG values (P < .016). CONCLUSIONS: Maternal home glucose values at 28 weeks correlate with the risk of LGA infant births among women in the diagnostic gray zone. Women with average fasting SMBG values > 95 mg/dL (5.3 mmol/L) are at increased risk for giving birth to LGA infants and may be more likely to exhibit complications usually associated with GDM.

Birth Weight↗
PubMed1994

The psychosocial effects of support group intervention on AICD recipients and their significant others.

The automatic implantable cardioverter defibrillator (AICD) is one treatment method employed for patients with actual or potential malignant ventricular tachyarrhythmias. Support group intervention has been shown to be of value in promoting adaptation and coping skills. This exploratory pilot study compared the psychosocial effects of support group intervention on 11 AICD recipients who regularly attended support group, ten spouses, or significant others who also attended and five AICD recipients who were unable to attend. The Spielberger State Anxiety Inventory, The Anxiety Visual Analogue Study (VAS), the Medical Outcome Study (MOS) Short Form General Health Survey, and anecdotal reports were used. Results showed that quantitative data were not significantly changed by support group interventions. Qualitative data demonstrated improved ability to cope and increased satisfaction with life in group participants, however, it was difficult to ascertain whether this was a result of passage of time.

Activities of Daily Living↗
PubMed1994

Diabetes care by primary care physicians in Minnesota and Wisconsin.

BACKGROUND: The purpose of this study was to identify the characteristics of diabetes care delivered by primary care physicians. METHODS: Twenty-seven primary care physicians recruited through the Minnesota Academy of Family Physicians Research Network and the Wisconsin Research Network recorded a sample of 240 visits for care of patients with diabetes mellitus. Information was collected concerning physician and patient demographics, practice characteristics, and patterns of delivery of diabetes care including referral and clinical outcomes. RESULTS: Seventeen percent of the patients in this study had type I diabetes mellitus; 81% had type II. Fourteen percent of the patients with type I diabetes and 20% of patients with type II were within their target glucose range. Average hemoglobin-A1c was 10.0% +/- 3.4% and 8.9% +/- 2.3% for patients with type I and type II diabetes, respectively (normal, 4.0% to 6.1%). Two distinct patterns of referral existed for patients with newly diagnosed type I diabetes: 44% of physicians rarely referred these patients, whereas 20% almost always referred. Although distance to specialists increased as community size decreased, frequency of referral was not related to practice location. Ninety-five percent of physicians in this study were directly involved in the diabetes education of their patients, and 56% had no certified diabetes educator available. CONCLUSIONS: Over the course of this study, patients frequently persisted with treatment regimens that failed to stabilize blood glucose values. With recent evidence that improved glucose control may delay or prevent diabetes complications, it is increasingly important for the primary care physician to optimize available resources to improve glucose control in patients with diabetes in an effort to improve long-term clinical outcomes.

Adult↗
PubMed1992

New directions in substance abuse services: programmatic innovations in the Veterans Administration.

The purpose of this paper to describe the Department of Veterans Affairs' (VA) recent expansion and enhancement of its substance abuse treatment services. Several treatment innovations are considered from both clinical and administrative perspectives. These services include extended care programs for multiply impaired patients, programs for substance abuse patients with comorbid psychiatry conditions and services designed to improve continuity of care and community re-entry. Emergent themes include a broadening of services to meet the needs of a changing substance abuse population and an emphasis on providing more cost-efficient treatment.

Comorbidity↗
PubMed1992

Symptom monitoring in schizophrenia: potential for enhancing self-care.

In this study a symptom self-regulation model was used as a framework to examine the characteristics and stability of indicators of illness identified by individuals with schizophrenia. Subjects were interviewed to determine if they could identify indicators of illness and describe characteristics of their primary indicator. Primary indicators of illness from 51 subjects were categorized as anxiety-based, depressive, or psychotic. Subjects who identified psychotic indicators were more confident that their indicator occurred when they were getting ill than subjects with anxiety-based or depressive indicators, and subjects who identified psychotic and depressive indicators reported that their indicators were more troublesome than those identifying anxiety-based indicators. Anxiety-based indicators were reported by subjects to occur more frequently than indicators from the other two categories. Findings from a follow-up interview of 28 subjects 1 year later showed that approximately half reported either the same primary indicator of illness or identified an indicator in the same category (anxiety-based, depressive, or psychotic) as they had 1 year previously. The implications of the findings for enhancing self-care through monitoring symptoms are discussed.

Adult↗