US healthcare. The big grapple.
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Attitude of Health Personnel↗
Biomedical subjects
K Adams
Publications and source records attributed to K Adams.
General practice. A tale of four cities.
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Ethnicity↗
Built out of books: lesbian energy and feminist ideology in alternative publishing.
This paper chronicles the birth of lesbian-feminist publishing in the 1970s, a significant but often overlooked chapter of American alternative publishing history, and one that would help create the circumstances supporting a flourishing lesbian and gay literature in the 1980s and 1990s. Between 1968 and 1973, over 500 feminist and lesbian publications appeared across the country, and what would become an organized network of independent women's bookstores began to appear. In 1976, a group of feminist trades-women-printers, booksellers, and others-would meet in the first of a series of Women in Print conferences that would give a name to the fledgling alternative press movement. Fueled by the energy of the women's movement, lesbians were instrumental actors in a variety of feminist publishing enterprises that, taken together, constituted a unique brand of print activism that illuminated and revised categories of identity; empowered individuals to overcome social isolation and discrimination; and informed nascent lesbian and feminist communities about strategies of resistance.
Civil Rights↗
Sensorineural hearing loss in ECMO survivors. Extracorporeal membraneous oxygenation.
Survivors of extracorporeal membraneous oxygenation (ECMO) treatment are at risk for serious neurodevelopmental disorders or neurologic sequelae, but little has been reported about the prevalence of sensorineural hearing loss in these patients. Of 123 ECMO survivors born between 1987 and 1996, at least 30 survivors have confirmed sensorineural hearing loss. Progressive hearing loss has been confirmed in 10 subjects.
Evoked Potentials, Auditory, Brain Stem↗
Neuropsychological function in mild sleep-disordered breathing.
Although a broad range of neuropsychological deficits has been reported in patients with severe sleep disordered breathing (SDB), little is known about the impact of mild SDB on neuropsychological performance. In this study, we compared neuropsychological test performance in two groups of carefully screened volunteers who differed clearly according to the respiratory disturbance index (RDI). Controls (n = 20) were identified on the basis of an RDI < 5; cases (n = 32) had an RDI in the range of 10-30. Cases and controls were well matched with regard to IQ, age, and sex. Cases had significantly more self-reported snorting and apneas and a higher body mass index than controls but did not differ according to sleepiness as measured by either the multiple sleep latency test or the Epworth sleepiness scale. An extensive battery of neuropsychological and performance tests was administered after an overnight sleep study. Cases performed significantly more poorly on a visual vigilance task (perceptual sensitivity, d': 2.24 +/- 0.64 vs. 2.70 +/- 0.53, p = 0.01, for cases and controls, respectively) and a test of working memory, the Wechsler adult intelligence scale-revised digits backwards test (6.12 +/- 2.20 vs. 7.55 +/- 2.22, p = 0.02), than controls. The groups did not differ in their performance on other tests of memory, information processing, and executive functioning. In summary, subjects with mild SDB may manifest a vigilance deficit in the absence of substantial sleepiness. Subjects with a mildly elevated RDI (10-30) without sleepiness do not appear to suffer appreciable deficits in more complex neuropsychological processes (e.g. executive functions).
Cognition Disorders↗
Proliferation and repair of guinea pig tracheal epithelium after neuropeptide depletion and injury in vivo.
Neuropeptides stimulate airway epithelial cell proliferation and migration in vitro, but the role of neuropeptides in the repair of the epithelium after injury in vivo is not clear. We studied epithelial proliferation and repair in 83 male Hartley guinea pigs. Animals received capsaicin weekly for 3 wk to deplete airway neuropeptides. One week later, the dorsal aspect of the trachea was injured with a metal stylette. Animals were killed 1 h to 1 wk later, after which epithelial cell proliferation was assessed for the presence of proliferating cell nuclear antigen (PCNA). PCNA labeling was < 3% in noninjured animals. PCNA labeling increased substantially in the first 72 h after injury in control animals but was significantly decreased in capsaicin-treated animals within and adjacent to the site of injury. PCNA labeling increased opposite to the injury site in both control and capsaicin animals over the first 72 h. We conclude that neuropeptide depletion significantly attenuates both epithelial cell proliferation and repair in the first 72 h after mechanical injury to the trachea. However, neuropeptide depletion did not slow the ultimate repair of tracheal mucosal injury. Proliferation of epithelial cells in response to injury occurs throughout the airway, even away from the injury site.
Animals↗
Child care options for shift workers.
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Child↗
Cultural awareness and cultural vision. The First National Forum of Aboriginal and Torres Strait Islander Nurses.
Thirty-five Aboriginal and Torres Strait Islander nurses from across Australia met for three days of discussion, including the development of strategies to increase the number of indigenous people in the nursing profession. Indigenous nurses shared their stories, experiences and their specific needs as Aboriginals and Torres Strait Islanders.
Australia↗
Breast cancer is the most common cause of cancer death in women.
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Aged↗
Tyrosines in two-stranded coiled coils are CD active near 280 nm even in the absence of interhelix tyrosine-tyrosine interactions.
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Amino Acid Sequence↗
Positron emission tomographic studies of cerebral benzodiazepine-receptor binding in chronic alcoholics.
Positron emission tomography was used with [11C]flumazenil (FMZ) and [18F]fluorodeoxyglucose to study GABA type A/benzodiazepine (GA-BA-A/BDZ) receptors and cerebral metabolic rates for glucose (1CMRg1c) in 17 male patients with severe chronic alcoholism (ALC), 8 with (ACD) and 9 without alcoholic cerebellar degeneration (non-ACD). In comparison with male normal controls of similar ages, the ALC group had significantly reduced FMZ ligand influx (K1), FMZ distribution volume (DV), and 1CMRg1c bilaterally in the medial frontal lobes, including superior frontal gyrus and rostral cingulate gyrus; the ACD group had significant reductions of K1, DV, and 1CMRg1c bilaterally in the same distribution, and also in the superior cerebellar vermis; and the non-ACD group had significant reductions of K1, DV, and 1CMRg1c bilaterally in the same regions of the frontal lobes but not in the superior cerebellar vermis. When compared with the non-ACD group, the ACD group had significant reductions of K1, and DV bilaterally in the superior cerebellar vermis. The results suggest that severe chronic alcoholism damages neurons containing GA-BA-A/BDZ receptors in the superior medial aspects of the frontal lobes, and in patients with clinical signs of ACD, neurons containing GABA-A/BDZ receptors in the superior cerebellar vermis.
Alcoholism↗
Advance directives: making them more available to hospitals patients.
This article details methods developed to facilitate patients' understanding and execution of an advance directive (e.g., living will, treatment preferences, and durable power of attorney for healthcare). The approach takes advantage of the computerization of patient records, using automatically generated e-mail messages sent to an advance directives consultation team.
Advance Directives↗
PEAPS-Q: a questionnaire to measure the psychosocial effects of having an abnormal pap smear. Psychosocial Effects of Abnormal Pap Smears Questionnaire.
We have developed the Psychosocial Effects of Abnormal Pap Smears Questionnaire (PEAPS-Q) which measures distress experienced by women undergoing follow-up investigation after an abnormal Pap smear result. A thorough literature review and qualitative research resulted in the development of a questionnaire which was tested on 350 women attending a Family Planning New South Wales (FPNSW) clinic. This sample included women at different stages of management after detection of a cervical abnormality: 93 first colposcopy clients and 257 follow-up colposcopy clients. Factor analysis identified four dimensions of distress: experience of medical procedures, beliefs/feelings about cervical abnormality and changes in perception of oneself, worry about infectivity and effect on sexual relationships. Repeatability of the PEAPS-Q was indicated by intra-class correlations of 0.88 overall and at least 0.60 for each scale. Internal consistency was shown by Cronbach's alpha of 0.84 overall and at least 0.72 for each scale. Validity was demonstrated by the correlation of scale scores with the 12-item General Health Questionnaire (GHQ) score of 0.32 (95% CI 0.22-0.41). The PEAPS-Q is a valid, reliable and multidimensional instrument for quantifying distress experienced by women with abnormal Pap smears.
Adult↗
Myelo-ablative therapy with peripheral blood progenitor cell (PBPC) support in patients with haematological malignancy.
BACKGROUND: Myelo-ablative therapy with peripheral blood progenitor cell (PBPC) support is increasingly being used in patients with haematological malignancy considered to be at high risk for recurrence. The results of this approach, in comparison with the previous experience at St. Bartholomew's Hospital (SBH) using autologous bone marrow transplantation form the basis of this report. PATIENTS AND METHODS: 42 patients (age range 18-63 years, median 42 years), deemed to have a poor prognosis with conventional therapy received myelo-ablative therapy with PBPC support. Diagnoses comprised: non-Hodgkin's lymphoma (NHL): 16 patients, Hodgkin's disease (HD): 9, Multiple Myeloma (MM): 12, and solid tumours (ST): 5. PBPC were mobilised using adriamycin: 35 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 orally, days 1-5, followed by G-CSF: 5 micrograms/kg, subcutaneously, for a median of 7 days (range 6-9 days). RESULTS: A total of 67 PBPC collections were performed, 1 being 'sufficient' (i.e. mononuclear cells > or = 1.5 x 10(8)/kg and CD34+ cells > or = 1 x 10(6)/kg) in 21 of the 42 patients. The median time to haematological recovery following reinfusion of PBPC was 13 days for both neutrophils > 0.5 x 10(9)/l and platelets > 20 x 10(9)/l (ranges: 8-27, and 8-48 days, respectively) which is significantly shorter than for patients in the historical control group. Supportive care requirements were also significantly reduced, as was the duration of hospital stay i.e., median 19 days (range 12-73 days) compared with 29 days (range 9-180 days). CONCLUSION: These results confirm rapid blood count recovery following myelo-ablative therapy with PBPC support and the feasibility of this approach.
Adolescent↗
The factor analytic structure of seven physical CHD risk factors: a replication study.
An attempt was made to replicate the results of an earlier confirmatory factor analysis of the seven traditionally employed physical risk factors for CHD. As with the first investigation, a two-factor solution was confirmed; only family history loaded on factor 1; the remaining six risk variables (smoking, serum cholesterol, blood pressure, diet, exercise, and weight control) comprised factor 2. These findings may reflect a broad personality trait, i.e., generalized lack of self-control, which could underlie much CHD risk not associated with a family history of heart disease. Implications are drawn for research and practice in the areas of cardiac rehab and prevention.
Adult↗
Dependence of laser photocoagulation on interstitial delivery parameters.
Photocoagulation was performed ex vivo between tissue slabs by delivering continuous-wave laser energy from an optical fiber either directly, or by depositing the energy into a 2.4 mm diameter steel sphere at the fiber tip. The dependence of photocoagulation lesions on the following variables was assessed: (1) energy source: Nd:YAG-532 nm, 1,064 nm +/- steel sphere, (2) tissue type: porcine muscle (light), bovine muscle (dark), (3) delivered power: P = 1.5-3.0 W (porcine), 1.0-2.5 W (bovine), (4) exposure duration: T = 300-1500 s. The resulting cross-sectional photocoagulation lesions are summarized as follows: 532 nm: elongated; central charring in all cases; 1,064 nm: circular; central charring only in bovine for P > or = 2.0 W, T > or = 500 s; sphere: circular; central charring in bovine for P > or = 1.5 W and porcine for P > or = 2.0 W. These experiments suggest photocoagulation lesion size decreases as optical penetration increases. The results indicate that interstitial laser photocoagulation lesions > 10 mm diameter can be made without charring in both lightly and heavily pigmented tissues ex vivo by delivering 1,064 nm laser energy at sufficiently low power for at least 1,000 s from well-polished optical fibers.
Animals↗