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Biomedical subjects

L Flynn

Publications and source records attributed to L Flynn.

9 recordsLinked to original sources

Expanding the role of the genetic counselor.

The basic components of genetic counseling are informational and educational. The patient's cognitive and emotional presentation and the needs and concerns of the patient are seldom addressed. Females who carry the FMR1 pre and full gene mutation may present with learning, cognitive, and/or emotional difficulties and family members of those diagnosed with fragile X syndrome have ongoing needs and concerns. As a results, genetic counseling for fragile X syndrome offers a unique opportunity within which to expand the role of the genetic counselor. Q-methodology, by using the q-sort, is centered on the family to reproduce the needs and concerns that are consistent with the patient's own experience. Used for sociological research, the q-methodology with specially constructed q-sort items is easily adapted to the genetic counseling setting and can be used for directly assessing the patient's needs and concerns. For our pilot study, 16 items were physically sorted and ranked interdependently by the patient (subject). Thirty-seven patients (29 females and 8 males) participated in our pilot study. Preliminary results show that the age of the proband, length of time of the diagnosis, and parental sex at the time the q-sort is administered impacts the ranking of items thus differentiating needs and concerns. Results have shown that specific items are missing from the lives of subjects. From the information obtained from the q-sort, the genetic counselor can identify needs and concerns of the patient and combine this information with the clinical presentation to work with the patient in a more effective manner.

Adult

A genetic model for absent chylomicron formation: mice producing apolipoprotein B in the liver, but not in the intestine.

The formation of chylomicrons by the intestine is important for the absorption of dietary fats and fat-soluble vitamins (e.g., retinol, alpha-tocopherol). Apo B plays an essential structural role in the formation of chylomicrons in the intestine as well as the VLDL in the liver. We have developed genetically modified mice that express apo B in the liver but not in the intestine. By electron microscopy, the enterocytes of these mice lacked nascent chylomicrons in the endoplasmic reticulum and Golgi apparatus. Because these mice could not form chylomicrons, the intestinal villus enterocytes were massively engorged with fat, which was contained in cytosolic lipid droplets. These mice absorbed D-xylose normally, but there was virtually no absorption of retinol palmitate or cholesterol. The levels of alpha-tocopherol in the plasma were extremely low. Of note, the absence of chylomicron synthesis in the intestine did not appear to have a significant effect on the plasma levels of the apo B-containing lipoproteins produced by the liver. The mice lacking intestinal apo B expression represent the first genetic model of defective absorption of fats and fat-soluble vitamins and provide a useful animal model for studying nutrition and lipoprotein metabolism.

Animals

Effectiveness of pelvic muscle exercises in reducing urge incontinence among community residing elders.

1. Urinary incontinence is a costly and prevalent problem, affecting 15% to 39% of all community residing elders. 2. Some elders suffering from urge incontinence prefer pelvic muscle exercises to bladder training as the behavioral intervention of choice. 3. Although pelvic muscle exercises are frequently associated as an intervention for stress incontinence, they have been found to be effective in significantly reducing urge incontinence. 4. Nurses are in a key position to identify and treat urinary incontinence among the elderly, and should incorporate continence restoration interventions into their practice.

Aged