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D Gamble

Publications and source records attributed to D Gamble.

At least 19 recordsLinked to original sources
PubMed2001

Ethics and community-based education: balancing respect for the community with professional preparation.

Community-based education and service learning are becoming increasingly common in health and human services education. As students enter the community, several ethical dilemmas arise regarding the university's interaction with the community. This article explores clinical, agency, and community placements in terms of the relationships they engender between the university and the community. The article then outlines some ethical obligations of universities and faculty members and ethical dilemmas that arise in different placements. Finally, a fundamental ethical framework that may guide universities and faculty members in planning community-based educational experiences is proposed.

Clinical Clerkship↗
PubMed1999

Effectiveness of community-directed diabetes prevention and control in a rural Aboriginal population in British Columbia, Canada.

This report presents the process and summative evaluation results from a community-based diabetes prevention and control project implemented in response to the increasing prevalence and impact of non-insulin-dependent diabetes mellitus (NIDDM) in the Canadian Aboriginal population. The 24-month project targeted the registered Indian population in British Columbia's rural Okanagan region. A participatory approach was used to plan strategies by which diabetes could be addressed in ways acceptable and meaningful to the intervention community. The strategies emphasised a combination of changing behaviours and changing environments. The project was quasi-experimental. A single intervention community was matched to two comparison communities. Workers in the intervention community conducted interviews of individuals with or at risk for diabetes during a seven-month pre-intervention phase (n = 59). Qualitative analyses were conducted to yield strategies for intervention. Implementation began in the eighth month of the project. Trend measurements of diabetes risk factors were obtained for 'high-risk' cohorts (persons with or at familial risk for NIDDM) (n = 105). Cohorts were tracked over a 16-month intervention phase, with measurements at baseline, the midpoint and completion of the study. Cross-sectional population surveys of diabetes risk factors were conducted at baseline and the end of the intervention phase (n = 295). Surveys of community systems were conducted three times. The project yielded few changes in quantifiable outcomes. Activation of the intervention community was insufficient to enable individual and collective change through dissemination of quality interventions for diabetes prevention and control. Theory and previous research were not sufficiently integrated with information from pre-intervention interviews. Interacting with these limitations were the short planning and intervention phases, just 8 and 16 months, respectively. The level of penetration of the interventions mounted was too limited to be effective. Attention to process is warranted and to the feasibility of achieving effects within 24 months.

Adult↗
PubMed1999

Variation by body mass index and age in waist-to-hip ratio associations with glycemic status in an aboriginal population at risk for type 2 diabetes in British Columbia, Canada.

BACKGROUND: It is unclear whether obesity and age modify or confound relations between abdominal adiposity and metabolic risk factors for type 2 diabetes. OBJECTIVE: Our objective was assess the consistency of relations between abdominal adiposity and glycemic variables across discrete categories of obesity and age. DESIGN: We performed a stratified analysis of prevalence data from a rural screening initiative in British Columbia, Canada. Subjects were Salishan Indians, all healthy relatives of individuals with type 2 diabetes [n = 151; age: 18-80 y; body mass index (BMI, in kg/m2): 17.0-48.2]. We measured waist-to-hip ratio (WHR) (2 categories); insulin, glycated hemoglobin (Hb A1c), and 2-h glucose concentrations (2 categories); and BMI (4 categories). BMI and age-specific odds ratios (ORs) and 95% CIs were calculated. RESULTS: WHR-glycemic variable relations were not consistent across BMI and age strata. Risks associated with high WHR were: for persons with BMIs from 25 to 29, elevated insulin (OR: 6.71; 95% CI: 1.41, 34.11) and Hb A1c (OR: 16.23; 95% CI: 2.04, 101.73) concentrations; for persons aged 18-34 y, elevated insulin concentrations [OR: indeterminate (+infinity); 95% CI: 1.89, +infinity]; and, for persons aged 35-49 y, elevated Hb A1c (OR: +infinity; 95% CI: 3.17, +infinity) and 2-h glucose (OR: 9.15; 95% CI: 1.74, 59.91) concentrations. CONCLUSIONS: WHR discriminates risk of type 2 diabetes in overweight but not obese individuals. Abdominal adiposity is associated with elevated insulin concentrations in younger age groups and with impaired glucose control in middle-aged groups, suggesting metabolic staging by age on a continuum from insulin resistance to impaired glucose tolerance.

Adipose Tissue↗
PubMed1999

No evidence for linkage of schizophrenia to DXS7 at chromosome Xp11.

There have been claims that a gene on the X chromosome may contribute to susceptibility to schizophrenia. Crow (1988) initially proposed that such a gene might lie in the pseudoautosomal region, but when evidence that weakened this hypothesis accumulated, he proposed that a susceptibility locus might be present elsewhere on the sex chromosomes instead. DeLisi et al. (1994) found a small nonsignificant positive lod score between the marker DXS7 and schizophrenia, but other failed to replicate this finding. Another study reported by Crow and DeLisi's group was also weakly positive for this marker (Dann et al., 1997). This locus was then investigated in a collaborative study by Laval et al. (1997), which produced a nonparametric lod score of 2.44. Using a sample of 17 pedigrees from Britain and Iceland, we have also tested the hypothesis of linkage between DXS7 and schizophrenia. The 17 families were selected from a larger sample on the basis of an absence of male-to-male transmission for schizophrenia. These families were originally selected for having multiple cases of schizophrenia within them and for having no cases of bipolar affective disorder. We genotyped subjects for a marker at DXS7 and performed classical lod score and model-free linkage analysis using broad and narrow definitions of affection with schizophrenia. We found strongly negative lod scores and no evidence for linkage using model-free analysis. Therefore, this study does not support the hypothesis of linkage of schizophrenia to DXS7, and the evidence for a susceptibility locus on this part of the X chromosome is weakened.

Chromosome Mapping↗
PubMed1995

Diabetes and Canada's aboriginal peoples: the need for primary prevention.

The high prevalence of non-insulin-dependent diabetes mellitus (NIDDM) in Canada's native communities corresponds with high diabetes prevalence rates in other populations of indigenous peoples that have undergone changes associated with acculturation. Behavioural risk factors can be particularly amenable to public health action. There exists a need to develop, implement and test in collaboration with native people, interventions aimed at reducing the incidence and impact of NIDDM, by reducing the risk of its onset, and by early detection and treatment. Intervention programmes should be conceived with sensitivity to the overall health, social, economic, educational and cultural environment within a community. Although this review focuses specifically on diabetes in Canada, many of the points relating to the need for primary prevention of the disease will be appropriate in other situations.

Acculturation↗
PubMed1994

Distribution and function of multiple anion transporter proteins in brain tumor cell lines in relation to glucose transport.

The anion transport, "band 3," family of proteins in mammalian brain performs the same functions as that of erythroid band 3. These functions are anion transport, ankyrin binding, and generation of senescent cell antigen, an aging antigen that terminates the life of cells. The presence of 5-7 band 3 related proteins in brain tissue was suggested by the reaction of antibodies to synthetic peptides of erythroid band 3 with a number of bands in immunoblots. Since there are a number of different cell types in brain, tissue cultures of neural cell types were examined to determine whether multiple band 3 related proteins are present in each cell type or whether several band 3 related proteins are present in each cell type. The tumor cell lines exhibit anion transport and are inhibited by the anion transport inhibitors 4,4'-diisothiocyano-2,2' disulfonic acid (DIDS), phenylglyoxal, and furosemide. Glucose transport is inhibited by cytochalasin B and the anion transport inhibitor, phenylglyoxal, in these cell lines, but not by 4,4'-diisothiocyano-2,2' disulfonic acid. Furosemide gave partial inhibition of most, but not all, cell lines. Since phenylglyoxal inhibits anion transport by binding to an arginine near the transport site, inhibition of glucose transport by phenylglyoxal suggests that an arginine lies in the substrate binding site. The number of cytochalasin B and DIDS binding sites was quantitated on cell lines as an approximation of the number of glucose transporter and anion transporter sites, respectively.

Amino Acid Sequence↗
PubMed1993

Out of entitlement. A nursing organization's journey.

The authors describe a major reorganization that took place in an 850-bed academic teaching hospital in the southwestern United States. This reorganization facilitated a paradigm shift and the journey from a deeply entrenched attitude of "entitlement" to one of earning.

Achievement↗
PubMed1991

Pathophysiology of vascular smooth muscle in renin promoter-T-antigen transgenic mice.

The pathophysiological consequence of targeted production of SV-40 T-antigen to renin-expressing cells in the kidney of transgenic mice is reported. A histopathologic analysis of the kidney from adult transgenic mice (12-16 wk old) revealed the presence of severe vascular lesions manifested by marked atypical hyperplasia of vascular smooth muscle. The levels of plasma renin, kidney renin, and kidney renin mRNA were examined in 6- and 9-wk-old transgenic mice and were found to be significantly lower than their age-matched non-transgenic littermates and were nonresponsive to captopril treatment. However, there was no significant difference in conscious mean arterial pressure between transgenic and non-transgenic mice. The levels of renal renin mRNA in transgenics and nontransgenic littermates were compared throughout ontogeny and were found to be equal in newborns, elevated 3- to 5-fold in 1-wk-old transgenics, and yet decreased 10-fold by 6 wk of age in transgenic mice. Expression of the transgene in the kidney exhibited the proper developmental pattern and was properly restricted to juxtaglomerular cells in neonatal mice. Nevertheless, in adult mice, T-antigen-containing cells were found throughout the entire renal arterial tree. The observed ability of renal vascular cells to be recruited to express both renin and T-antigen suggests a mechanism that can explain the development of the renal pathology in these mice.

Animals↗
PubMed1990

Initiating breastfeeding: a world survey of the timing of postpartum breastfeeding.

A survey of the 'Human Relations Area Files' and ethnographic infant feeding literature from all cultures on the timing of infant feeding revealed that the practice of withholding colostrum from the infant was widespread. Data obtained from 120 cultures showed that in 50 cultures this delay in implementing breastfeeding was more than two days. In many groups, substitute prelacteal feeds were given, while in others, practices such as the use of purgatives exacerbated the risk of dehydration in the infant. The authors warn that nurses and midwives must be aware of the practice of withholding colostrum from the infant, and note that if a mother does not wish to breastfeed in the immediate postpartum, this does not necessarily mean that she wishes to bottle feed the infant.

Breast Feeding↗
PubMed1990

Defective expression of high affinity IL-2 receptors on activated T cells from aged humans.

The proliferative response of T cells from aged humans to a number of mitogens is significantly reduced. We report here that there is a decrease in high affinity IL-2 receptor (IL-2R) expression on activated T cells from aged humans. Scatchard analysis of the binding of [125I]IL-2 demonstrates fewer high affinity IL-2 binding sites. Autoradiographic techniques demonstrate that this results from there being fewer activated T cells from old as compared to young donors that express high affinity IL-2R. However, T cells from old donors that do not express high affinity IL-2 binding sites express both the IL-2 binding 55 and 75 kd chains. Thus, although the two IL-2 binding peptides are expressed on activated T cells from old donors, expression of the high affinity IL-2R is reduced. This may explain the decreased ability of T cells from old donors to respond to IL-2. The impaired ability of activated T cells from old donors to express high affinity IL-2R while expressing the 55 and 75 kd chains may provide insights into the mechanisms of IL-2 interactions with its receptor.

Adult↗
PubMed1988

The use of a cancer registry in a mass screening program for colorectal cancer.

This paper presents the results of our experiences in utilizing a population-based registry in the follow-up of individuals screened for colorectal cancer. The colorectal screening program under study was conducted in the Western New York area in 1984. A total of 58,934 stool guaiac slide kits were distributed and 11,497 persons returned them for testing. Of these, one or more slides were positive in 264 persons. The names of all persons returning kits for testing were subsequently matched against the names of all individuals reported to the Western New York Tumor Registry as having been diagnosed with colorectal cancer in 1984. Through this mechanism, 18-positive matches were uncovered; 16 were found in the screening registry as having had a positive guaiac test; the remaining 2 were found to have had negative guaiac test results. The results of this screening program and the methods of follow-up employed are discussed.

Colonic Neoplasms↗
PubMed1984

Comparison of patient profiles from a comprehensive cancer center and the general population.

Differences in cancer patient profiles between cases seen at comprehensive cancer centers and those seen in the general population are seldom assessed by means of reliable and systematically collected data. This report compares the characteristics of patients treated at Roswell Park Memorial Institute in Buffalo with all reported patients diagnosed in the Western New York population. Data for this study were generated from the Roswell Park Tumor Registry and the Western New York Tumor Registry. The findings indicate that patients presenting for treatment at Roswell Park Memorial Institute, compared to the WNY cancer patient population, are more frequently diagnosed with rare tumors, are younger, and manifest later stage disease. These data may have implications for the planning and evaluation of cancer patient services at the community level.

Adolescent↗
PubMed1982

Results of the national soft-tissue sarcoma registry.

Of 191 case reports submitted to the National Soft Tissue Sarcoma Registry, 131 qualified for inclusion. Fifty-two percent were males; 80% were whites. Twenty-one different histologies were assigned, with leiomyosarcoma most frequently represented. Localized disease was reported for 29% of patients. Surgery in combination with radiotherapy and/or chemotherapy was reported as the treatment for 45% of patients, and surgery only was reported for 31%. These data reflect increasing used of adjuvant therapy in the treatment of soft tissue sarcoma.

Adolescent↗
PubMed1981

Increasing incidence of adenocarcinoma of the lung.

Review of the histology of 219 lung cancers initially diagnosed at Lutheran General Hospital, Park Ridge, Illinois, in 1963-1967 and 1974-1976, confirms the increasing incidence of adenocarcinoma. This is due to an increase of adenocarcinoma in men. In women, the incidence of adenocarcinoma was higher than squamous carcinoma in the earliest period (44% adeno, 18% squamous). The percentage of women with lung cancer has also significantly increased from 19% to 31%, which increases the overall incidence of adenocarcinoma of the lung. As the number of women with lung carcinoma has increased, there has been no change in the percentage of adenocarcinoma in women.

Adenocarcinoma↗