A volumetric MRI study of limbic structures in chronic schizophrenia--relationship to psychopathology.
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Adult↗
Biomedical subjects
C Johns
Publications and source records attributed to C Johns.
A mitochondrial DNA sequence is associated with abnormal pollen development in cytoplasmic male sterile bean plants.
Cytoplasmic male sterility (CMS) in common bean is associated with the presence of a 3-kb unique mitochondrial sequence designated pvs. The pvs sequence encodes at least two open reading frames (297 and 720 bp in length) with portions derived from the chloroplast genome. Fertility restoration by the nuclear restorer gene Fr results in the loss of this transcriptionally active unique region. We examined the effect of CMS (pvs present) and fertility restoration by Fr (pvs absent) on the pattern of pollen development in bean. In the CMS line, pollen aborted in the tetrad stage late in microgametogenesis. Microspores maintained cytoplasmic connections throughout pollen development, indicating aberrant or incomplete cytokinesis. Pollen-specific events associated with pollen abortion and fertility restoration imply that a gametophytic factor or event may be involved in CMS. In situ hybridization experiments suggested that significant reduction or complete loss of the mitochondrial sterility-associated sequence occurred in fertile pollen of F2 populations segregating for fertility. These observations support a model of fertility restoration by the loss of a mitochondrial DNA sequence prior to or during microsporogenesis/gametogenesis.
Amino Acid Sequence↗
The Burford Nursing Development Unit holistic model of nursing practice.
This paper offers a new approach for developing a model of nursing emerging from and hence inherently compatible with a philosophy for practice. It builds on the author's earlier work of describing a paradigm for writing a philosophy for practice. The model is that of the Burford Nursing Development Unit in Oxfordshire, England.
Clinical Nursing Research↗
Arsenic in benthic bivalves of San Francisco Bay and the Sacramento/San Joaquin River Delta.
Arsenic concentrations were determined in fine-grained, oxidized, surface sediments and in two benthic bivalves, Corbicula sp. and Macoma balthica, within San Francisco Bay, the Sacramento/San Joaquin River Delta, and selected rivers not influenced by urban or industrial activity. Arsenic concentrations in all samples were characteristic of values reported for uncontaminated estuaries. Small temporal fluctuations and low arsenic concentrations in bivalves and sediments suggest that most inputs of arsenic are likely to be minor and arsenic contamination is not widespread in the Bay.
Animals↗
Autonomy of primary nurses: the need to both facilitate and limit autonomy in practice.
This paper explores the concept and implications of autonomy in relation to primary nurses. It explores the need to limit this autonomy to ensure assigned patients receive a consistent and congruent quality of care. Methods that enable primary nurses to demonstrate their pluralistic accountability, currently being used and tested in practice, are described, methods that limit the autonomy of primary nurses without compromising it.
Humanism↗
Implementing a philosophy of care on a children's ward using action research.
This paper charts the progress of an action research project initially implemented to assist the staff of a pediatric ward in the development of primary nursing. The use of ward meetings to identify needs and clarify objectives is discussed; from this emerged a broader remit to implement the ward's philosophy of care. Five areas of clinical practice development were identified for work: development of a staff development strategy, identification of resource people, movement to primary nursing, development of standards of care, and development of the ward environment. Progress in these five areas is explored, and the use of evaluation strategies such as visual analogue scales, unstructured interviews and personal diaries are discussed. Description and discussion of some of the difficulties associated with this project are given. In conclusion, the authors address the issue of whether action research is in fact a specific methodology or a philosophy.
Clinical Nursing Research↗
Nursing practice. Developing a philosophy.
Christopher Johns, in Part 2 of this article, illustrates the process of defining a nursing philosophy. A case study is used to illustrate how clinical nurses can set about defining a philosophy of nursing for themselves.
Humans↗
Clozapine pharmacology and tardive dyskinesia.
Clozapine, an atypical neuroleptic, does not cause extrapyramidal symptoms of Parkinsonism and dystonia and appears to have a reduced or absent capacity to produce tardive dyskinesia. 37 subjects, most with chronic schizophrenia, were treated with clozapine and TD outcome was analyzed. A subset of these subjects underwent plasma and CSF studies. TD response was heterogenous, but a proportion of patients improved with clozapine treatment. Neurochemical data differed from published reports of classical neuroleptics with the most robust effect produced by clozapine seen in CSF norepinephrine levels. Other neurochemical data and implications for the mechanism of clozapine in TD are reviewed.
Adolescent↗
Nursing practice. Developing a philosophy.
The application of nursing models has been a recent theme in British nursing. Part of this process is the development of a nursing philosophy which underpins the model. Nurses at clinical level are often required to define their philosophy to meet clinical, educational and managerial objectives. The first part of this two-part article explores the significance of nursing philosophy to practice. In the second part, a case study is used to illustrate how clinical nurses can set about defining a philosophy of nursing for themselves. Dickoff et al (1) indicate that a philosophy is significant in the generation of theory. By identifying the nature of practice, theoretical relationships become apparent. It is also significant as Johnson (2) states in nursing's development as a profession. Johnson further asserts that nurses should use their beliefs to build a conceptual system of the person to be served and an abstract model for practice which allows such purpose to be fulfilled. However a nurse's beliefs and values about nursing may have no theoretical substance to them. They may be purely intuitive in nature. Writing a philosophy legitimates intuition. Kitson (3) considers that nurse theorists who believe that only developing a knowledge base through a scientific approach are at risk of throwing away the intuitive sources of knowledge within nursing. Yet gut reactions have been shown to be critical in the development of excellence in nursing (4). Kitson believes that intuitions can lead to developing 'grassroots standards of care' and a clearer definition of what nursing is.(ABSTRACT TRUNCATED AT 250 WORDS)
Humans↗
Pharmacologic studies of tardive dyskinesia.
Based on the results of two preliminary studies, we concluded that late-developing persistent drug-induced movement disorders are pharmacologically heterogeneous, and this heterogeneity is seen between individual patients (and groups of patients) as well as within body areas of individual patients; dystonic pathology has a distinct and more consistent response to pharmacologic stimulation than does nondystonic tardive dyskinesia (TD); and, although disturbances in dopamine and acetylcholine appear to be involved in these disorders, they do not in all cases exist in functionally opposite relationships. The observed pharmacologic heterogeneity in TD response reflects the limitations of the dopamine/acetylcholine model of TD, which oversimplifies the neuroanatomy of the basal ganglia and the pathophysiology of TD. The chemical and anatomical complexity of this region suggests that other neurotransmitter systems and neuronal circuits within and extending from the basal ganglia may be disturbed in the pathogenesis of TD.
Adult↗
Prostaglandin receptor sensitivity in psychiatric disorders.
The cyclic adenosine monophosphate (cAMP) responses to prostaglandin E1 (PGE1) in platelets and leukocytes from drug-free schizophrenic patients, depressive patients, and normal controls have been compared. Both schizophrenic and depressive patients had a significantly lower platelet cAMP response to PGE1 than controls. The platelet cAMP response to PGE1 did not discriminate among exacerbated, remitted, and poor-prognosis schizophrenic patients, or between exacerbated and remitted depressive patients. The cAMP response to PGE1 was negatively correlated with global symptom severity in actively ill schizophrenic patients, but was not correlated with symptom severity in exacerbated depressive patients. The leukocyte cAMP response to PGE1 did not differ among normal controls, schizophrenic patients, and depressive patients. These data indicate that a diminished platelet cAMP response to PGE1 may be a marker common to both schizophrenia and depression but that this effect does not extend to a cAMP-linked PGE1 receptor on another blood cell type.
Adult↗
Sarcoidosis and its neurological manifestations.
Neurosarcoidosis is a disorder that is difficult to diagnose and manage. We assessed its neurological manifestations in 649 patients seen at The Johns Hopkins Hospital, Baltimore, from 1975 through 1980. Neurological problems could be attributed to neurosarcoidosis in 33 patients (5.1%). The presenting manifestation of sarcoidosis was neurological in 16 (48%) of them. Cranial neuropathy was the most frequent problem, and a peripheral facial nerve palsy was the single most common abnormality. Other manifestations were aseptic meningitis, hydrocephalus, parenchymatous disease of the central nervous system, peripheral neuropathy, and myopathy. Three-quarters of the patients were treated with steroids. The outcome was good in 27 (82%) of 33 episodes of neurological dysfunction in 25 patients with a well-documented clinical course. A thorough investigation of patients with suspected neurosarcoidosis is recommended to establish the diagnosis, delineate the extent of disease, and guide therapy.
Adult↗
Macrophage-related suppressor cells in human renal transplant recipients.
In this study 66 renal transplant recipients were studied by in vitro immunologic monitoring assays in an attempt to delineate some immune reactivity parameters which migh explain the successful long-term survival of HLA incompatible allografts. Ninety percent of the recipients were found to be responsive to their specific donors in one-way mixed lymphocyte culture assays, indicating the presence of antigen reactive proliferating T cells. In contrast, studies of the in vitro generation of cytotoxic T cells showed that 73% of the long-term recipients demonstrated a marked hyporesponsiveness to the donor in cell-mediated lympholysis (CML) assays. Longitudinal studies indicated that specific CML hyporesponsiveness to the donor developed after transplantion. In the majority of recipients, CML hyporesponsiveness could be related to a suppressor cell phenomenon, since recipient mononuculear cells specifically suppressed the CML reactivity of third-party cells to the donor. Recipient CML hyporesponsiveness to the donor could be abrogated by removal of recipient adherent cells, most of which were monocytes or macrophages. The suppressor cell effect on CML is postulated to be related to macrophages which are either acting independently or under the regulation of suppressor T cells. These studies are among the first to suggest that suppressor cell regulation of relevant effector T cell activity may be important in the facilitation of successful human renal transplantation.
Cell Adhesion↗
Donor-specific CML hyporesponsiveness after successful renal transplantation: studies on the mechanism.
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Cytotoxicity, Immunologic↗
Nursing care study: formation of a continent ileostomy.
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Female↗
Considerations in immunologic monitoring of long-term transplant recipients.
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Cytotoxicity Tests, Immunologic↗
Coordination of care and its relationship to continuity and medical records.
Introduction of a computerized printout ("mini record") containing problems and therapies, and listing visits between regularly scheduled ones to a primary care facility, resulted in improved recognition of problems and therapies. Recognition both of the occurrence of the visits which had been made elsewhere and the content of those visits was not improved, even though the mini record listed the dates and place of visit. Recognition was improved more in situations where the practitioners in the primary care clinic changed than when the practitioner remained the same individual who had seen the patient at the previous visit to the primary care clinic. Coordination of care is an essential ingredient of primary care. Recognition of all information generated by patients in a series of visits is evidence of coordination. Continuity (whether achieved by continuity of practitioner or by medical records) is one means of attaining better coordination. In a previous study we showed that continuity of practitioner improves coordination. This study shows that a technologic innovation consisting of an alteration in medical records facilitates coordination, but only with regard to certain aspects of care. Explanations for this finding are postulated.
Adult↗