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Biomedical subjects

N Stevens

Publications and source records attributed to N Stevens.

At least 19 recordsLinked to original sources
PubMed2004

The glial cell response to a viral vector in the aged brain.

The normal aged brain undergoes pro-inflammatory changes. We investigated the effect of injecting a potential inflammatory stimulus, an adenoviral vector, on the response of microglia and astroglia in the aged brain. Groups of young (4 months) and old (31 months) male C57BL/Icrfat mice received a unilateral injection into the striatum of adenoviral vector encoding the LacZ gene. After 48 h, the mice were killed and the brains analysed for numbers of activated microglia and macrophages using the biotinylated lectin Griffonia simplicifolia as a marker; astroglia were identified by immunohistochemistry for glial fibrillary acidic protein (GFAP). The cell counts were analysed using two-way analysis of variance (anova). Transgene expression was assessed by beta-galactosidase histochemistry. The numbers of activated microglia in the striatum increased in response to the adenovirus in both young [contralateral 19.5 (3.7), ipsilateral 36 (3.0)] and old [contralateral 23.1 (9.6), ipsilateral 40.8 (6.9)] mice (two-way anova; P < 0.0001), but there was no significant difference between the two age groups. There was a significant age-related increase in the number of GFAP-positive astroglia in the uninjected, contralateral striatum [4 months, 2.5 (1.4); 31 months, 29.7 (9.3)] (two-way anova; P < 0.0001). However, there was no difference in response to the adenovirus in both young [contralateral 2.5 (1.4), ipsilateral 3.2 (1.2)] and old [contralateral 29.7 (9.3), ipsilateral 28.9 (8.2)] mice. We conclude that even though it has been argued that the aged brain is in a pro-inflammatory state, under the experimental conditions used in this study, there was no difference in the nature of the immune response between young and old mice of this strain to an adenoviral load.

Adenoviridae↗
PubMed2001

Maternal smoking cessation and relapse prevention during health care visits.

BACKGROUND: Although effects of maternal smoking during pregnancy could be alleviated if women quit early in pregnancy, most do not. Relapse rates among quitters are high. OBJECTIVE: To test the effects of a low-intensity, smoking-cessation/relapse-prevention intervention delivered by clinic staff and providers and based on stages-of-change constructs of the transtheoretical model and brief motivational interviewing techniques. METHODS: A quasi-experimental prospective cohort design employed in obstetric, in-patient, and pediatric care delivery settings of a large health maintenance organization in Portland, Oregon. Subjects were pregnant smokers registered for their first prenatal visit. Primary outcome measures were sustained (self-reported) quit rates during pregnancy and smoking abstinence between 6 and 12 months after delivery. RESULTS: Regression analyses found statistically significant improvement for intervention women in sustained pregnancy quit rates (OR=2.7, CI=1. 2-5.7) and on smoking abstinence between 6 and 12 months after delivery (OR=2.4, CI=1.1-5.3). CONCLUSIONS: While these outcomes are based on self-report only, they emerged despite variable delivery of the intervention across clinics and represent clinically meaningful improvements in rates of nonsmoking. The intervention supports women who want to quit smoking during pregnancy and improves the likelihood of their remaining nonsmokers for the long term.

Adult↗
PubMed1998

Reaching minority and underserved populations: the impact of the Cancer Information Service's outreach program. Part 3.

Through its regional outreach program, the Cancer Information Service (CIS) develops partnership with organizations that reach minority and underserved populations and connects them with accurate cancer information and an array of support services and resources. To evaluate the usefulness, satisfaction, and impact of the CIS outreach program on partner organizations, a national random sample survey was conducted by an independent research firm in 1996. This paper focuses on the survey results of 359 special population partner organizations that identified their main audience as a specific racial or ethnic group and/or the underserved. Almost all (84% to 93%) rated the services provided by the CIS outreach program to be very important or important to meeting the goals of their projects. A large majority of these special population partners stated that the CIS provided them with the latest cancer information (67%) and National Cancer Institute (NCI) resources (83%), and more than half (57%) utilized CIS expertise to develop and plan programs. Special populations partners were more likely to use an array of CIS assistance than other CIS partners. Furthermore, they were more likely to be heavy users of CIS assistance and more likely than other CIS partners to indicate that the CIS had an important impact on their programs. The results indicate that the CIS's nationally coordinated, regionally focused outreach program provides critical support and has an important impact on the cancer-related programs of partner organizations that reach minority and underserved audiences.

Community-Institutional Relations↗
PubMed1998

Deciding about hormone therapy: validation of a model.

OBJECTIVE: The purposes of this study were to (1) validate components of a decision process regarding adoption of hormone therapy and (2) compare the decision processes women used with respect to their evaluation of decision quality. DESIGN: A sample of women participating in a population-based study of midlife women's health participated in individual in-depth interviews. RESULTS: Content analysis of 30 recorded interviews provided evidence that each component of the decision process (precontemplation, contemplation, commitment, critical evaluation, and continuance) was replicated. Few additional codes were identified, and these could be subsumed under the phases of the original decision model. CONCLUSIONS: Women's self-reported statuses on a screening questionnaire corresponded to the stages of the decision model coded from their interviews. What women actually decided to do (use hormone therapy or something else) was not associated with their decision process. Satisfaction with the decision, uncertainty about the decision, and other factors related to the decision were independent of the decision phases.

Adult↗
PubMed1997

Synthesis, chromatographic resolution and chiroptical properties of carboxyibuprofen stereoisomers: major metabolites of ibuprofen in man.

The chromatographic resolution of the four stereoisomers of carboxy-ibuprofen, a major metabolite of ibuprofen in man, was achieved using a Chiralpak AD chiral stationary phase (CSP) (J.T. Baker, Milton, Keynes, UK). The elution order of the stereoisomers was determined to be 2'S,2R;2'R,2R;2'R,2S;2'S,2S by a combination of stereoselective synthesis of diastereoisomeric mixtures and analysis of the two diastereoisomers isolated from human urine following the administration of (S)-ibuprofen. The individual stereoisomers were isolated by semipreparative chiral phase chromatography and characterized by circular dichroism spectroscopy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1997

[Friendship as a key to wellbeing: a course for women over 55 years old].

Friendship serves several important functions which contribute to well being in later life. The companionate function of friendship contributes to positive well being under normal circumstances. Friendship also provides social support during stressful events, such as loss of the partner, thus reducing negative well being. In addition to supporting socialization in new situations, friends serve a sustaining function; that is, they help sustain continuity of meaning of self and life experiences from the communal perspective of values and norms developed over the years. Various studies show that friendship is more important for older women than older men; women are more likely to maintain friendships until late in life and benefit from their friendships in adaptation to loss of the partner. A course was developed to assist older women in improving the quality or quantity of their friendships, to help them improve their well being. The course is based on a self-help method and the principles of feminist therapy. A model describing four phases in which relational competence is important in friendship also forms the basis for the course. Disorders in friendship can be understood and influenced in terms of a cognitive perspective, aimed at customary thoughts on self, others and relationships. An evaluation study of the eleven participants in the first course demonstrates a significant decline in loneliness a year after the course as finished, as well as relevant improvements in the quality or quantity of friendships among several participants. The changes appear to be independent of the women's adult attachments styles, which influence their orientation in friendship. The conclusion is that the friendship course supports socially active lonely women, whose loneliness is not too extreme.

Adaptation, Psychological↗
PubMed1996

Aerobic fitness testing: an update.

This study confirms that all three tests are reliable tools for the assessment of cardiorespiratory fitness and the prediction of aerobic capacity. While this particular study consisted of active, youthful subjects, subsequent studies at University College Chester have found similar findings with larger databases and a wider cross-section of subjects. The Astrand cycle test and Chester step test are submaximal tests with error margins of 5-15 per cent and therefore, not as precise as maximal testing. However, they still give a reasonably accurate reflection of an individual's fitness without the cost, time, effort and risk on the part of the subject. The bleep test is a low-cost maximal test designed for well-motivated, active individuals who are used to running to physical exhaustion. Used on other groups, results will not accurately reflect cardiorespiratory fitness values. While all three tests have inherent advantages and disadvantages, perhaps the most important factors are the knowledge and skills of the tester. Without a sound understanding of the physiological principles underlying these tests, and the ability to conduct an accurate assessment and evaluation of results in a knowledgeable and meaningful way, then the credibility of the tests and the results become suspect. However, used correctly, aerobic capacity tests can provide valuable baseline data about the fitness levels of individuals and data from which exercise programmes may be developed. The tests also enable fitness improvements to be monitored, help to motivate participants by establishing reasonable and achievable goals, assist in risk stratification and facilitate participants' education about the importance of physical fitness for work and for life. Since this study was completed, further tests have been repeated on 140 subjects of a wider age and ability range. This large database confirms the results found in this study.

Adult↗
PubMed1995

Dynamic patient data bases: the foundation of an integrated approach to outcome measures for the healthcare professionals.

In recent years there has been a tremendous need among healthcare professionals to assess the effectiveness, efficiency, and appropriateness of the patient care services being provided through criteria-based outcome and program evaluation. Although the need for a tool which could evaluate the effectiveness of patient care is widely recognized, such an undertaking has been severely limited due to the lack of any automated means to collect and analyze patient data on a routine, continuous basis within a clinical setting. We have developed and implemented at Mineral Springs Hospital, Banff, Alberta an integrated and automated hospital information system that not only continuously collects administrative, financial, and patient data, but also contains an intelligent component for automated outcome measure and program evaluation. The system collects various non-duplicated data elements from each routine work process within the facility on a continuous basis. Through the creation of a dynamic patient database, data is transformed into information--a powerful decision support tool. The system provides flexible user-defined reports in patient-specific resource utilization, direct and/or indirect specific financial costs, result reporting of each intervention, service provided and user-defined criteria-based outcome, and program evaluation. The system design incorporates expert rules, dynamic data entry forms, quantitative models, and user-defined access control. Using information derived from the dynamic common database, managers and front-line clinicians can easily evaluate and modify management decisions or careplans on a macro or micro level. An external review is planned to evaluate whether the system has helped the assessment of effectiveness, efficiency and appropriateness of healthcare services being provided at the hospital. The fundamental concept behind the system design is that the patient is the center of activity for data collection. The system provides the answers to the 5 W's (who, what, where, when, and why) together with intervention and service result reports. A dynamic common patient database is the center of the system and is accessible to all with proper authorization. Common data elements are collected from routine work flow without extra data entry and this information is subsequently shared. Data collection is a continuous process. We believe that every process is the outcome of another sub-process or event. The design of the dynamic patient database incorporates patient-specific costing and outcome evaluation, user-defined flexible data entry forms, user-defined access control, outcome evaluation rules and information semantic rules. Such a patient database would provide the flexibility needed to accommodate diverse methodologies to evaluate outcomes whether it they be medical, cost, access and/or other combination of measures. The system was developed on a PC-based Network technology, using FOXPRO (XBase) as the database development tool incorporating advanced technology such as distributed processing and fault tolerant computing. We chose PC-based technology because it is economical, having relatively low maintenance costs and requires no major dependency on vendors. The developed system produces patient-specific reports with many dimensions. The reports are user-defined. The system reports general data, CMG, RGN, LOS, Expected LOS, and other user-defined demographic data. Resource utilization, financial costs, and result reportings are produced together with rule-based outcome assessments of any type of measures, including, but not limited to, pre-set functional/health goals, user satisfaction, clinicianUs text or codified comments etc. It provides the framework for continually capturing data at a practical, work-flow level. The incorporation of a dynamic patient database as the driving forece of an integrated, rule-based administration, financial and patient data system will provdie the tools for healthcar

Databases, Factual↗
PubMed1994

The effect of differences in objective and subjective definitions of childhood physical abuse on estimates of its incidence and relationship to psychopathology.

The relationship between objective and subjective definitions of physical abuse and the lifetime prevalence of depression was examined in 280 women attending a family medicine clinic at a large medical center. Based on their responses to a detailed questionnaire regarding discipline and abuse in childhood, 28.2% of these women were objectively defined as abused. Only 11.4% subjectively defined themselves as abused. The proportion of women who experienced depression during their lifetime was highest among those who defined themselves as abused (83%), intermediate among those who met objective criteria for having been physically abused, but did not define themselves as such (56%), and lowest among those who did not meet objective criteria for a history of physical abuse (35%). Similar relationships were found for history of psychotherapy, receipt of psychoactive medication, history of hospitalization for depression, suicide attempts and self-injury.

Adolescent↗
PubMed1993

Associations between early experiences with parents and well-being in old age.

This study explores the impact of early experiences with parents on health and well-being in old age. An interview survey was conducted with a representative sample of 267 elderly community residents in the age group 65-74. Standard measures for health, self-esteem, anxiety, depression, and loneliness were included as dependent variables. Quality of parenting was measured by means of a retrospective questionnaire focused on the care dimension of parental behavior. The foremost conclusion of this study is that early experiences with parents have an impact on the well-being of elderly persons. The effect is stronger among those older persons who lack a current attachment figure in the form of an affectionate partner; also, it is stronger for unattached older men than for unattached older women.

Aged↗
PubMed1993

The Back Injury Prevention Project pilot study. Assessing the effectiveness of back attack, an injury prevention program among nurses, aides, and orderlies.

The Back Injury Prevention Project was a pilot study of "Back Attack," an educational program designed to prevent back injuries among nurses, nurses' aides, and orderlies. The pilot tested program feasibility, developed and tested instruments, and generated preliminary data measuring program effectiveness. Fifty-five nurses, aides, and orderlies on two medical/surgical units at two Kaiser Permanente medical centers in Portland, Oregon participated in the study. Intervention group scores on the composite back pain and composite fatigue scales decreased relative to the control group, but this did not reach statistical significance. A 19% improvement in scores for quality of patient transfer was observed for the intervention group (P < .0003), while the control group did not show any significant improvement during the same time period. Results of the pilot suggest that the Back Attack program changes behavior at least in the short term. Further study will be necessary to determine if the behavior change persists and back pain and injury rates are subsequently reduced.

Accidents, Occupational↗
PubMed1991

Xenografts--future prospects for clinical transplantation.

This paper outlines the basic problems that still need to be overcome before xenografting becomes a reality. It presents evidence that if the first of these problems (preformed or natural antibody to pig) can be overcome then pig kidneys will: (a) not hyperacutely reject from a human; and (b) will not, under currently used immunosuppression, induce massive new primary or secondary responses. It also makes brief justification of the use of the pig as the donor of choice and outlines what essential animal work we feel necessary before an actual pig-to-human transplant is contemplated.

Animals↗
PubMed1989

Freedom from fat: a contemporary multi-component weight loss program for the general population of obese adults.

This report summarizes results for the first 2,037 participants in the Freedom from Fat (FFF) weight loss program. FFF combined nutrition education, a low-fat dietary pattern, exercise, behavioral self-management, and social support in a program designed to serve the general population of overweight and obese adults. Participants ranged in age from 18 to 84 and from ideal weight to massively obese. After enrolling, program participants attended professionally led weekly meetings as long as they wished. Participants were encouraged to keep daily food diaries, to reduce the proportion of calories from fat to 30% or less, to exercise at moderate intensity for 30 minutes a day 5 days a week, to keep graphic records of weight change and exercise, and to display their graphs at each weekly group meeting. Attrition rates were comparatively low for a large-scale program, with half of the participants still active in the fifth month and 22% still active after 1 year. Mean weight loss for obese participants (BMI 30 or greater) at 6 months was 7.3 kg (16.2 lb) for men and 5.3 kg (11.6 lb) for women. The best predictors of weight loss at 6 months were number of days per week in which food diaries were kept, baseline body mass index, number of minutes of exercise per week, and age.

Adult↗
PubMed1982

[Aging in a dynamic perspective. Partial report of a workshop].

This article concerns three contributions to the Workshop 'Life Span and Change in a Gerontological Perspective', which represent a dynamic or process-centered approach to the study of aging. Since two participants (Olbrich and Fooken) presented results of the Bonn Longitudinal Study of Aging at the workshop, the theoretical background and general characteristics of this study are reported. Olbrich concentrated on how 'Daseinstechniken' or coping strategies develop over time as older persons deal with the stressful experiences involved in aging. Fooken examined data on a small group of women, divided into groups according to marital status, for evidence of growth and development and for differences on life styles and patterns of adjustment. In his contribution to the workshop, Maas made several recommendations for longitudinal research, based on a critical re-examination of three of his own studies.

Adaptation, Psychological↗