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S Forbes

Publications and source records attributed to S Forbes.

At least 37 records · Page 2Linked to original sources
PubMed2000

Planning end-of-life care for patients with dementia: roles of families and health professionals.

We examined families' end-of-life decision making and their interactions with health professionals. Twenty-eight family members of institutionalized dementia patients participated in four focus groups. We found that participating family members were not well prepared for their decision-making roles, and that they: 1) experienced substantial burdens and loss in caring for institutionalized elders; 2) had limited understanding of the natural progression of dementing conditions; 3) were uncomfortable in setting goals for their relatives' end-of-life care; 4) had little experience with death, and were ambivalent about the anticipated death of their relative; and (5) reported that they had little substantive communication with health professionals regarding end-of-life care planning. We concluded that many of the needs of such families could be addressed through improved application of the principles of advance care planning, including regular structured discussions, involvement of surrogate decision-makers, and anticipation of clinical decisions. Health professionals should take the lead in 'normalizing' the discussion of death.

Advance Care Planning↗
PubMed1999

Successful expression of beta-galactosidase and factor IX transgenes in fetal and neonatal sheep after ultrasound-guided percutaneous adenovirus vector administration into the umbilical vein.

In utero somatic gene therapy in the later stages of pregnancy may allow targeting of organ systems which are difficult to reach later in life and to prevent the development of tissue damage otherwise caused by the early onset of inherited diseases. We report here on the percutaneous delivery of two adenoviral vectors, containing the beta-galactosidase reporter gene and the human Factor IX gene respectively, to the fetal liver and circulation by ultrasound-guided umbilical vein puncture similar to procedures used in human pregnancy. Vector spread, as detected by PCR analysis for the beta-galactosidase encoding vector, was found in almost all fetal and neonatal organs and in the maternal liver. Expression of the beta-galactosidase transgene was detected in many fetal tissues by RT-PCR. High beta-galactosidase production was shown by immuno-histochemistry predominantly in the liver, where about 30percent of the hepatocytes stained positive, and in the adrenal cortex. Production of factor IX was determined by ELISA in the plasma of treated fetuses and newborn lambs and reached at birth up to 80percent of the normal human plasma concentration. This demonstrates a very hopeful proof of principle for the development of prenatal treatment of many genetic diseases but also requires more detailed investigations with respect to the observed systemic spread of the vector.

Adenoviridae↗
PubMed1999

Mapping the gene causing hereditary primary hyperparathyroidism in a Portuguese kindred to chromosome 1q22-q31.

A Portuguese kindred with autosomal dominant isolated primary hyperparathyroidism (HPT) that was associated with parathyroid adenomas and carcinomas was investigated with the aim of determining the chromosomal location of this gene, designated HPTPort. Leukocyte DNA from 9 affected and 16 unaffected members and 7 parathyroid tumors from 4 patients was used in comparative genomic hybridization (CGH), tumor loss of heterozygosity (LOH), and family linkage studies. The CGH studies revealed abnormalities of chromosomes 1 and 13, and the results of LOH studies were consistent with the involvements of tumor suppressor genes from these regions. Family segregation studies mapped HPTPort to chromosome 1q22-q31 by establishing linkage with eight loci (D1S254, D1S222, D1S202, D1S238, D1S428, D1S2877, D1S422, and D1S412) (peak two-point LOD scores = 3. 46-5.14 at 0% recombination), and defined the location of HPT Port to a 21 cM region flanked centromerically by D1S215 and telomerically by D1S306. Thus, HPTPort has been mapped to chromosome 1q22-q31, and a characterization of this gene will help to elucidate further the mechanisms that are involved in the development of parathyroid tumors.

Adenoma↗
PubMed1999

Beyond correspondence, video conferencing, and voice mail: Internet-based master's degree courses in nursing.

The changing health care system and increasing demands for primary care providers have prompted an increase in nurse practitioner programs in the United States. Nurses in rural areas that are underserved by primary care practitioners often are faced with time and distance barriers to returning to school for advanced education. This article describes Internet-based courses as a unique distance learning platform for preparing primary care nurse practitioners at the University of Kansas (KU) School of Nursing. Discussion includes course development process, matching methods to course content, and other information on promoting interaction between students and faculty.

Curriculum↗
PubMed1998

Long-term risk of first recurrent stroke in the Perth Community Stroke Study.

BACKGROUND AND PURPOSE: Few community-based studies have examined the long-term risk of recurrent stroke after an acute first-ever stroke. This study aimed to determine the absolute and relative risks of a first recurrent stroke over the first 5 years after a first-ever stroke and the predictors of such recurrence in a population-based series of people with first-ever stroke in Perth, Western Australia. METHODS: Between February 1989 and August 1990, all people with a suspected acute stroke or transient ischemic attack of the brain who were resident in a geographically defined region of Perth, Western Australia, with a population of 138 708 people, were registered prospectively and assessed according to standardized diagnostic criteria. Patients were followed up prospectively at 4 months, 12 months, and 5 years after the index event. RESULTS: Three hundred seventy patients with a first-ever stroke were registered, of whom 351 survived >2 days. Data were available for 98% of the cohort at 5 years, by which time 199 patients (58%) had died and 52 (15%) had experienced a recurrent stroke, 12 (23%) of which were fatal within 28 days. The 5-year cumulative risk of first recurrent stroke was 22.5% (95% confidence limits [CL], 16.8%, 28.1%). The risk of recurrent stroke was greatest in the first 6 months after stroke, at 8.8% (95% CL, 5.4%, 12.1%). After adjustment for age and sex, the prognostic factors for recurrent stroke were advanced, but not extreme, age (75 to 84 years) (hazard ratio [HR], 2.6; 95% CL, 1.1, 6.2), hemorrhagic index stroke (HR, 2.1; 95% CL, 0.98, 4.4), and diabetes mellitus (HR, 2.1; 95% CL, 0.95, 4.4). CONCLUSIONS: Approximately 1 in 6 survivors (15%) of a first-ever stroke experience a recurrent stroke over the next 5 years, of which 25% are fatal within 28 days. The pathological subtype of the recurrent stroke is the same as that of the index stroke in 88% of cases. The predictors of first recurrent stroke in this study were advanced age, hemorrhagic index stroke, and diabetes mellitus, but numbers of recurrent events were modest. Because the risk of recurrent stroke is highest (8.8%) in the first 6 months after stroke, strategies for secondary prevention should be initiated as soon as possible after the index event.

Age Factors↗
PubMed1998

Elders' decision making regarding the use of long-term care services: a precarious balance.

The purpose of this qualitative study was to explore factors that influenced decision making regarding the use and nonuse of long-term care services, with a particular focus on elders' attitudes, values, and beliefs. The sample (N = 27) consisted of high-functional elders recently admitted to nursing homes and community-dwelling, high-risk elders recently diverted from nursing homes following a prescreening program. Data were collected through indepth, face-to-face, semistructured interviews and analyzed using qualitative content analysis. Independence and sense of self were the strongest values to emerge. The attitude of acceptance, both passive and active, helped elders cope with increasing levels of dependency and lifestyle changes. The desire to be part of decisions, both major life planning and day-to-day choices such as meal planning, was pervasive. Decision making was individualistic and complex. Loss of control was threatening to the sense of self, leaving some elders feeling shortchanged.

Activities of Daily Living↗
PubMed1998

The identity status of African Americans in middle adolescence: a reexamination of Watson and Protinsky (1991).

In contrast to earlier research, Watson and Protinsky (1991) found that African American students did not experience identity foreclosure to a greater extent than did their Caucasian peers. Watson and Protinsky, however, examined only ideological identity. The purpose of the present study was to extend this line of research by examining identity development in the interpersonal domain as well as the ideological domain. Forty-eight African American students completed a revised version of the Extended Objective Measure of Ego Identity Status (EOM-EIS II). Supporting the conclusions of Watson and Protinsky, the results showed that few of the African American students were foreclosed. Instead, most of the students were in moratorium; that is, they were engaged in the identity-exploration process. Results for the interpersonal domain were similar to those for the ideological domain.

Adolescent↗
PubMed1996

Control of expression of the I factor, a LINE-like transposable element in Drosophila melanogaster.

I factors are LINE-like transposable elements in the genome of Drosophila melanogaster. They normally transpose infrequently but are activated in the germline of female progeny of crosses between males of a strain that contains complete elements, an I or inducer strain and females of a strain that does not, an R or reactive strain. This causes a phenomenon known as I-R hybrid dysgenesis. We have previously shown that the I factor promoter lies between nucleotides 1 and 30. Here we demonstrate that expression of this promoter is regulated by nucleotides 41-186 of the I factor. This sequence can act as an enhancer as it stimulates expression of the hsp7O promoter in ovaries in the absence of heat-shock. Within this region there is a site that is required for promoter activity and that is recognized by a sequence-specific binding protein. We propose that this protein contributes to the enhancer activity of nucleotides 41-186 and that reduced I factor expression in inducer strains is due to titration of this protein or others that interact with it.

Animals↗
PubMed1996

Handedness and its association with gender-related psychological and physiological characteristics.

Prenatal exposure to a high level of testosterone is thought to result in sinistrality and increased masculinization in females. This paper seeks to determine whether sinistral females show more masculine characteristics relative to dextral females. Demonstration of such a relationship would support the proposition that testosterone affects laterality. Masculine and feminine personality characteristics, breast size, age at menarche, and regularity of menstruation were measured via a questionnaire administered to 40 dextral and 40 sinistral female university students. Sinistrals were found to score significantly higher on the masculine subscale and lower on the feminine subscale of the Bem Sex Role Inventory relative to their dextral counterparts. No differences were found between the groups for breast size, menstrual regularity, or age at menarche. These results demonstrate that hand preference is associated with gender-related psychological characteristics, but not the physiological characteristics measured. Thus, the possibility that the different sex roles adopted by sinistrals and dextrals is the result of socialisation rather than biological mechanisms, such as testosterone, cannot be ruled out.

Adult↗
PubMed1995

BS a novel LINE-like element in Drosophila melanogaster.

Transposable elements with long terminal inverted repeats are rare and only one family of elements of this sort has been identified in the genome of Drosophila melanogaster. An insertion associated with the HSBS mutation of the achaete-scute complex has been reported to be a second element of this type. We have determined the complete sequence of this insertion and have shown that it is in fact two copies of a new LINE-like transposable element, that we have called BS, inserted in opposite orientation 337 bp apart. Like other elements of this type, BS has two open reading frames that appear to encode a gag-like polypeptide and a reverse transcriptase. There are few complete BS elements in the five strains of D.melanogaster that we have tested and they appear to transpose infrequently. The events that may have lead to the double BS insertion are discussed in terms of the supposed mechanism of transposition of LINE-like elements.

Amino Acid Sequence↗
PubMed1994

Novel RFLPs and microsatellite repeats increase informativity at four loci mapping to Xq22-q25.

Three microsatellites and five restriction fragment length polymorphisms (RFLPs) have been detected at loci DXS275, DXS97, DXS11 and DXS100. All of the reported polymorphisms are in linkage equilibrium with existing polymorphisms at these loci. However, two RFLPs at DXS275 and two at DXS97 appear to be in linkage disequilibrium with each other. Increased informativity at these loci have enabled exclusion of Xq22-q25 as a candidate region for X-linked spina bifida and anencephaly, and should aid in the mapping of other genes in the region.

Base Sequence↗
PubMed1994

Reliability of aggregated organizational data: an evaluation of five empirical indices.

Nursing systems research has included many levels of measurement such as individuals, work groups, organizations, and systems of organizations. Variables important to organizational survival often are measured at the individual level, with inferences made to the work group or the organization. This study demonstrated a process for determining the reliability of individual level data aggregated to the work group and organization levels. Data were analyzed on four variables: job enjoyment; manager's leadership style in terms of structuring expectations and consideration; and control over nursing practice. Job enjoyment was assessed over time. Registered staff nurses (n = 632), representing 54 nursing units from 4 large acute care hospitals, comprised the sample. The results indicated the assessment of reliability and validity is important at the level of inference and at each time interval. Aggregated data were deemed reliable when the following criteria were met: Cronbach's alpha > .60; intraclass correlation (1,k) > .60; and a significant F ratio. The interpretation of omega 2 as an indicator of effect size suggested that the validity of inference at the aggregated level is in question when effect size is negligible or small.

Data Interpretation, Statistical↗
PubMed1993

Thigmomorphogenesis: the effect of mechanical perturbation on plants.

Thigmomorphogenetic responses occur in many environmental settings. The most pronounced effects are found under conditions of extremely high rates of turbulent wind or water flow. However, it is an ubiquitous phenomenon, since mechanical perturbations are to be encountered under all but the most stringent laboratory conditions. Our present understanding of these phenomena is the result of studies at the ecological, anatomical, physiological, biochemical, biophysical and molecular biological levels.

Cell Respiration↗
PubMed1991

Congenital peripheral vestibular disease attributed to lymphocytic labyrinthitis in two related litters of Doberman pinscher pups.

Five Doberman Pinscher pups from a litter of 10 (litter A) and 3 of 9 pups from a subsequent mating of the same bitch (litter B) had clinical signs consistent with unilateral or bilateral peripheral vestibular disease. Results of CBC, serum biochemical analysis, urinalysis, ophthalmologic examination, deep otoscopic examination, and CSF analysis were normal in all affected pups. Bacteriologic culture results from CSF were negative and affected pups did not have canine distemper antibody titers in CSF. The most severely affected littermates were euthanatized and necropsied at the owner's request. Gross lesions were not found at necropsy, but marked lymphocytic labyrinthitis was discovered microscopically in decalcified sections of the labyrinthine system. The case history and histologic findings were suggestive of an infectious, most likely viral, cause, but organisms were not isolated from specimens of CNS tissue. The involvement of the same bitch in the 2 litters suggests heritable factors. One mildly affected pup apparently recovered or compensated for its vestibular dysfunction.

Animals↗