Biomedical subjects

Debra J Brown

Publications and source records attributed to Debra J Brown.

5 recordsLinked to original sources

PubMed2006

Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization.

PURPOSE: This science clinical paper reviews medical literature and examines interventions that are currently used to assist patients in achieving lifestyle change after myocardial infarction or coronary artery revascularization. Interventions that focused on both provider- and patient-implemented strategies were included. The effectiveness of these interventions to significantly reduce coronary heart disease risk factors was explored. DATA SOURCES: Original longitudinal research studies or reviews indexed in PubMed between 1999 and 2004 were included. Eight studies were identified that met the inclusion criteria and presented successful interventions to increase participants' adherence to recommended lifestyle changes. CONCLUSIONS: Current strategies for achieving recommended risk factor reductions include frequent follow-up, intensive diet changes, individualized and group exercise, coaching, group meetings, education on lifestyle modification and behavior change, and formal cardiac rehabilitation programs. IMPLICATIONS FOR PRACTICE: Nurse Practitioners can help close the gap between evidence-based recommendations and clinical practice by implementing education programs in their practices and in the community. Recommendations include frequent follow-up visits, negotiating personalized treatment plans, and a general emphasis on therapeutic lifestyle change as an essential component of the treatment plan.

Aftercare↗

PubMed2005

Porcine endogenous retrovirus encodes xenoantigens involved in porcine cellular xenograft rejection by mice.

BACKGROUND: Identification of the antigens that stimulate transplant rejection can help develop graft-specific antirejection strategies. The xenoantigens recognized during rejection of porcine cellular xenografts have not been clearly defined, but it has been assumed that major histocompatibility complex (MHC) xenoantigens are involved. METHODS: The role of porcine endogenous retrovirus (PERV) as a source of xenoantigens was examined. The authors used morphometry to compare the kinetics of swine leukocyte antigen (SLA) pig thyroid xenograft rejection in control mice and mice immunized with PERV PK15 cells (porcine kidney epithelial cells), PERV SLA pig peripheral blood lymphocytes (PBL), PERV virions purified from PK15 cells, and PERV or PERV A pseudotypes produced from infected human 293 cells. The tempo of rejection for cellular xenografts of PERV A pseudotype-producing human 293 cells, uninfected human 293 cells, and PK15 cells in PERV-preimmunized and control mice was also compared. RESULTS: Mice immunized with PK15 cells rejected pig thyroid xenografts significantly faster at day 5 than control mice and mice immunized with pig PBL. This correlated with the amount of PERV RNA and virions produced, but not with the amount of SLA class I MHC expressed by PK15 cells. Immunization of mice with PERV virions purified from porcine PK15 cells and with PERV virions or PERV A pseudotypes produced by human 293 cells also induced accelerated xenograft rejection by 5 days. Accelerated rejection induced by virus pretreatment was CD4 T-cell dependent and restricted to PERV-expressing cellular xenografts of porcine or nonporcine origin. CONCLUSIONS: PERV acts as a significant source of xenoantigens that target porcine cellular xenografts for rejection.

Animals↗

PubMed2005

Performance evaluation for diversity programs.

This policy paper addresses the problem of underrepresentation of minorities in the health care professions. Projections are that by 2050 minorities will represent 49% of the U.S. population. Several notable reports suggest that the health care of underrepresented minorities is improved when providers of similar ethnic and racial backgrounds provide the care. However, minority representation in the health care professions has not kept pace with the increase of minorities in the population. A variety of groups (federal, state, private, and health professional educational institutions) have provided billions of dollars toward increasing the number of underrepresented minority health care providers. However, the effectiveness of these programs is not readily evident. Therefore, we recommend comprehensive evaluations of programs funded to increase diversity in the health professions and the development of a Minority Health Care Professionals Center to assume accountability for monitoring programs that receive funding to increase the number of underrepresented minority health care providers.

Career Choice↗

PubMed2005

Prevalence of hypertension in a sample of Black American adults using JNC 7 classifications.

High blood pressure is a major health problem, particularly among Black Americans, and many Black Americans are unaware that they have the disease. In 2003, new guidelines (JNC 7) were created for classifying blood pressure including a category designated as "pre-hypertension." We examined the prevalence of hypertension based on JNC 7 guidelines in Black Americans from the study of Everyday Life for Black American Adults: Stress, Emotional and Cardiovascular Responses. In this study, 211 (N = 211) participants had no history of hypertension and were not taking anti-hypertensive medications. Demographic factors were also explored in relationship to the JNC 7 classifications. Using JNC 7, only 28.9% of the participants had normal blood pressures. Of those with abnormal blood pressures, 37.8% were pre-hypertensive. Surprisingly, there was a high prevalence of hypertension, which might be explained by a lack of awareness of their disease status, lack of desire to acknowledge it, or fear of having a disease. The pre-hypertension category allows for earlier identification of those at risk for developing hypertension so that early interventions can deter its debilitating effects.

Adult↗

PubMed2004

Everyday life for black american adults: stress, emotions, and blood pressure.

The purpose of this study was to examine the stress process in Black Americans by exploring chronic stress, emotions, age, body mass index, and blood pressure within the context of gender and socioeconomic position (SEP). The convenience sample of middle-class Black Americans ( N = 211) ranged from ages 25 to 79 years. A sociopsychophysiological model of everyday life for Black American adults was tested using structural equation modeling. The model explained 27% of the variance in systolic and 17% of the variance in diastolic blood pressure. SEP had a significant effect on chronic stress, and chronic stress had a significant effect on negative affect. Although men had lower negative affect scores than women, men's diastolic blood pressures were on average 4 mm Hg higher than women's. These findings are useful to the development and implementation of interventions to eliminate health disparities and improve years of healthy life for Black Americans.

Adult↗