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Biomedical subjects

Elizabeth Jackson

Publications and source records attributed to Elizabeth Jackson.

17 recordsLinked to original sources
PubMed2007

Soluble cell adhesion molecules in late-life depression.

BACKGROUND: Late-life depression has been associated with vascular diseases and with increases in circulating cytokines and cell adhesion molecules in the prefrontal cortex. We hypothesized that soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) would be increased in late-life major depression. METHODS: Serum levels of sICAM-1 and sVCAM-1 were measured in subjects over 60 with major depression (N = 23), subsyndromal depression (N = 20) and controls (N = 25). Depression severity was assessed using the Montgomery-Asberg (MDRS) and Geriatric Depression (GDS) rating scales. RESULTS: There was no significant increase in sICAM-1 (p = 0.240) or sVCAM-1 (p = 0.600) in depression nor was there any correlation of either molecule with depression severity. Adjusting for differences in cognitive impairment did not alter these findings. There was also no difference between subjects with an early onset of depression (before 60) and those with late-onset depression. CONCLUSIONS: These findings do not provide evidence that previously reported increases in serum cytokines in depression are due to peripheral vascular disease. Although we assessed subjects for vascular diseases it is possible that subtle but important differences between groups may still have been present and may have contributed to our negative findings. Our results suggest central nervous system mechanisms, such as related to HPA axis activation, may be responsible for the enhanced inflammatory response in depression.

Age of Onset↗
PubMed2006

Psychometric properties of the Centers for Disease Control and Prevention Health-Related Quality of Life (CDC HRQOL) items in adults with arthritis.

BACKGROUND: Measuring health-related quality of life (HRQOL) is important in arthritis and the SF-36v2 is the current state-of-the-art. It is only emerging how well the Centers for Disease Control and Prevention (CDC) HRQOL measures HRQOL for people with arthritis. This study's purpose is to assess the psychometric properties of the 9-item CDC HRQOL (4-item Healthy Days Core Module and 5-item Healthy Days Symptoms Module) in an arthritis sample using the SF-36v2 as a comparison. METHODS: In Fall 2002, a cross-sectional study acquired survey data including the CDC HRQOL and SF-36v2 from 2 North Carolina populations of adult patients reporting osteoarthritis, rheumatoid arthritis, and fibromyalgia; 2182 (52%) responded. The first item of both the CDC HRQOL and the SF-36v2 was general health (GEN). All 8 other CDC HRQOL items ask for the number of days in the past 30 days that respondents experienced various aspects of HRQOL. Exploratory principal components analyses (PCA) were conducted on each sample and the combined samples of the CDC HRQOL. The multitrait-multimethod matrix (MTMM) was used to compute correlations between each trait (physical health and mental health) and between each method of measurement (CDC HRQOL and SF36v2). The relative contribution of the CDC HRQOL in predicting the physical component summary (PCS) and the mental component summary (MCS) was determined by regressing the CDC HRQOL items on the PCS and MCS scales. RESULTS: All 9 CDC HRQOL items loaded primarily onto 1 factor (explaining 57% of the item variance) representing a reasonable solution for capturing overall HRQOL. After rotation a 2 factor interpretation for the 9 items was clear, with 4 items capturing physical health (physical, activity, pain, and energy days) and 3 items capturing mental health (mental, depression, and anxiety days). All of the loadings for these two factors were greater than 0.70. The CDC HRQOL physical health factor correlated with PCS (r = -.78, p < 0.0001) and the mental health factor correlated with MCS (r = -.71, p < 0.0001). The relative contribution of the CDC HRQOL in predicting PCS was 73% (R2 = .73) when GEN was included in the CDC HRQOL score and 65% (R2 = .65) when GEN was removed. The relative contribution of the CDC HRQOL in predicting MCS was 56% (R2 = .56) when GEN was included and removed. CONCLUSION: The CDC HRQOL appears to have strong psychometric properties in individuals with arthritis in both community-based and subspecialty clinical settings. The 9 item CDC HRQOL is a reasonable measure for overall HRQOL and the two subscales, representing physical and mental health, are reasonable when the goal is to examine those aspects.

Adult↗
PubMed2006

Literacy and perceived barriers to medication taking among homeless mothers and their children.

PURPOSE: The relation of medical literacy to women-reported barriers to taking medication themselves or giving medication to their children was studied. METHODS: Women in 18 homeless shelters in four counties in central North Carolina were recruited. Head-of-household homeless mothers with psychiatric or substance-abuse disorders and dependent children were eligible to participate. Trained interviewers administered a site-specific questionnaire on medication use. RESULTS: One hundred sixty-four homeless women participated. Forty-two percent of the women were currently taking a medication. Forty-six percent of the women stated that there was a barrier to taking their medications as prescribed. Medical literacy was not significantly related to whether women felt there were barriers to taking a medication. Seventy-five percent of the women reported having one or more children living with them. Thirty-seven percent reported having a child with asthma live with them, and 12% reported having a child with attention-deficit disorder. Forty percent reported a barrier to giving their child a needed medication. Taste was the most commonly reported barrier. Women with lower medical literacy and younger women were significantly more likely to report a barrier to giving their children a needed medication. Over 80% of women listed pharmacists as their first or second choice for receiving drug information orally. CONCLUSION: Race and perceived barriers to medication use affected the medication-taking behavior of homeless women, while their age and literacy level affected the reporting rates of the barriers to medication use for their children. Homeless women preferred receiving both written and oral drug information from a physician or a pharmacist.

Adult↗
PubMed2006

Racial differences in the use of antidepressants and counseling for depression among homeless women.

The purpose of the current study was to examine how African American race was related to the use of antidepressants and counseling among homeless depressed women. Women were recruited in 18 homeless shelters in four counties in central North Carolina. Head of household homeless mothers with psychiatric and/or substance abuse disorders who had dependent children were eligible to participate. One hundred and sixty four women enrolled into the study. Fifty-six percent (N=92) of the homeless women were currently depressed at the time of enrollment into the study. Nineteen of the depressed women reported having received counseling during the past 3 months and there were no racial differences in counseling use. A total of 19 depressed women were currently taking antidepressants. Non-Black depressed women (60%) were significantly more likely than Black depressed women (16%) to be currently using antidepressant medication (OR=0.14, 95% CI=0.02, 0.90). Fourteen of the 92 depressed women reported needing mental health services but not receiving them during the past 3 months and all of these women were Black.

Adult↗
PubMed2006

Urinary metabolic evaluations in normal and stone forming children.

PURPOSE: Urinary stone disease is relatively rare in children and urinary metabolic evaluations have been the standard in our practice. We have previously reported a high rate of urinary metabolic abnormalities in stone forming children. We compared urinary chemistry values in normal and stone forming children. MATERIAL AND METHODS: A prospective study was performed to assess urinary metabolic profiles in children with no history or a family history of urinary calculi. The 24-hour urine collections were performed and evaluated at an outside central laboratory. Urine chemistry studies were adjusted for creatinine. The data were compared to those on a historical cohort of calcium stone forming children. RESULTS: A total of 58 samples from normal children and 142 from stone forming children were evaluated. Mean age was 10 years in normal children and 12 years in stone forming children. of the normal and stone forming children 45% and 51%, respectively, were female. Supersaturation levels of calcium oxalate as well as calcium to creatinine levels were significantly higher in children with stones. No data confounding by age or sex was identified by stratification. CONCLUSIONS: There are significant differences in urinary metabolic evaluations between normal and stone forming children. This may allow more precise treatment to prevent recurrent stone episodes. We continue to perform metabolic evaluations in all children with documented urolithiasis.

Adolescent↗
PubMed2006

Association between dietary fiber and serum C-reactive protein.

BACKGROUND: High sensitivity C-reactive protein (CRP) is a marker of acute inflammation recently recognized as an independent predictor of future cardiovascular disease and diabetes. The identification of modifiable factors, such as diet, that influence serum CRP concentrations may provide the means for reducing the risk of these diseases. Data on longitudinal associations between dietary fiber intake and CRP are currently lacking. OBJECTIVE: The purpose of this study was to examine longitudinal associations between dietary fiber intake and CRP. DESIGN: Data collection took place at baseline and quarterly (every 13 wk) thereafter for a total of 5 visits, each including measurements of body composition, CRP, diet, and physical activity. Relations between serum CRP and dietary fiber were assessed by using linear mixed models and logistic regression, adjusted for covariates. RESULTS: A total of 524 subjects had multiple measurements of CRP and dietary factors. The average total dietary fiber intake was 16.11 g/d. Average serum CRP was 1.78 mg/L. We observed an inverse association between intake of total dietary fiber (separately for soluble and insoluble fiber) and CRP concentrations in both cross-sectional and longitudinal analyses. The likelihood of elevated CRP concentrations was 63% lower (OR: 0.37; 95% CI: 0.16, 0.87) in participants in the highest quartile of total fiber intake than in participants in the lowest quartile. CONCLUSIONS: Our results suggest that dietary fiber is protective against high CRP, which supports current recommendations for a diet high in fiber.

Adult↗
PubMed2005

Results of a prospective trial to compare normal urine supersaturation in children and adults.

PURPOSE: Urinary stone disease is relatively rare in children but is often due to metabolic abnormalities. Urinary supersaturation (SS) indices have been suggested as more precise predictors of stone recurrence. We previously reported urinary metabolic evaluations in stone-forming children using adult references. We now assess normal SS values in children. MATERIAL AND METHODS: A prospective trial was performed to assess urinary metabolic profiles in children with no personal or family history of urinary calculi. The 24-hour urine collections were performed and evaluated at an outside central laboratory. Urine chemistries were adjusted for urine creatinine. Urine pH and SS for calcium oxalate, calcium phosphate and uric acid were also assessed. The data were compared to a cohort of normal adults. RESULTS: A total of 168 samples from 168 adults (58% males) and 51 samples from 30 children (59% males) were evaluated. The mean age of the children was 8.8 years (range 5 to 18). Calcium oxalate SS was similar between children and adults, and urine pH was the major cause of differences seen in the calcium phosphate and uric acid SS indices. Children had a much higher excretion of calcium, oxalate and citrate when adjusted for creatinine. CONCLUSIONS: There are significant differences in the normal ranges of urine chemistries in children and adults. An understanding of normal supersaturation values may allow metabolic abnormalities in stone-forming children to be more precisely diagnosed and treated.

Adolescent↗
PubMed2005

Increase in interleukin-1beta in late-life depression.

OBJECTIVE: Depression has been associated with increases in circulating cytokines in younger adults, and there is evidence for prefrontal inflammation in late-life depression. The authors tested the hypothesis that levels of cytokine interleukin-1beta (IL-1beta) would be higher in subjects with late-life major depression. METHOD: Serum levels of IL-1beta were measured in three groups of subjects who were older than 60: 19 subjects with major depression, 20 subjects with subsyndromal depression, and 21 healthy comparison subjects. The Montgomery-Asberg Depression Rating Scale and the Geriatric Depression Scale were used to assess severity of depression. RESULTS: Compared with healthy subjects, those with major depression had significantly higher levels of IL-1beta (170%); the higher levels of IL-1beta strongly correlated with current depression severity. There were no significant differences between subjects with subsyndromal depression and the other two groups. CONCLUSIONS: These findings support the existence of an inflammatory response, which may be state dependent, in late-life depression.

Age Factors↗
PubMed2004

5-HT receptors involved in opioid-activated descending inhibition of spinal withdrawal reflexes in the decerebrated rabbit.

The role of 5-HT(1B/1D), 5-HT(2) and 5-HT(3) receptors in mediating descending inhibition of spinal reflexes activated by application of fentanyl to the fourth ventricle has been studied in rabbits decerebrated under N(2)O/isoflurane anaesthesia. In the control state, intraventricular fentanyl (3-30 microg kg(-1)) depressed, to an equal extent, short- and long-latency reflexes in the medial gastrocnemius muscle nerve evoked by electrical stimulation of all sural nerve afferents. Inhibition of reflexes resulted from a decreased base line excitability in the reflex pathway accompanied by a reduction in the rate of temporal summation of responses. Fentanyl-induced suppression of short- and long-latency reflexes was significantly reduced after intrathecal administration of the selective 5-HT(2)-receptor antagonist ICI 170,809 (300 microg). The same dose of the selective 5-HT(1B/1D) blocker GR 127,935 reduced inhibition from intraventricular fentanyl only for long-latency reflexes (i.e. those parts of the response for which the afferent drive is provided mainly by Adelta and C-fibre afferents). The 5-HT(3) antagonist tropisetron (also 300 microg intrathecal) did not significantly alter the descending inhibition of reflexes evoked by fentanyl. Both GR 127,935 and tropisetron reduced temporal summation of reflexes per se, effects that were reversed by intraventricular fentanyl. These data suggest that the descending pathway(s) activated by intraventricular fentanyl liberate 5-HT in the spinal cord to inhibit withdrawal reflexes by acting at 5-HT(2) and 5-HT(1B/1D), but not 5-HT(3) receptors. 5-HT(1B/1D), and to a lesser extent 5-HT(3) receptors also appear to have a role in modulating temporal summation of reflexes evoked by repetitive stimuli.

Afferent Pathways↗
PubMed2003

A survey of anthelmintic resistant nematode parasites in Scottish sheep flocks.

The state of anthelmintic resistance in Scottish sheep flocks was evaluated during April-August 2000 using in vitro bioassays, egg hatch assays for detecting thiabendazole (TBZ) resistance and larval development assays for levamisole, ivermectin and TBZ resistance. Anaerobic sampling kits and detailed questionnaires outlining farm demographics and current management practices were mailed to 227 Moredun Foundation member farms, replies were received from 98 farms. Kits received from 90 farms contained sufficient material to conduct one or more of the assays. A majority of the farms examined (64%) exhibited TBZ resistance but there were both farm locality and regional variations in the percentage of resistant farms. Teladorsagia was the predominant genera detected from farms. No resistance to levamisole or ivermectin was detected in any of the samples. There was no strong evidence from this survey that any of the management practices examined greatly affected TBZ resistance.

Animal Husbandry↗
PubMed2003

Sex differences in survival after acute myocardial infarction in patients with diabetes mellitus (Worcester Heart Attack Study).

BACKGROUND: Women with diabetes mellitus are at particularly high risk for coronary heart disease-related morbidity and mortality compared with men with diabetes mellitus. However, recent data comparing hospital and long-term outcomes in women with diabetes mellitus and men hospitalized with acute myocardial infarction (AMI) are scarce. The objectives of our multi-hospital observational study were to examine sex differences and temporal trends (1975-99) in hospital and long-term case-fatality rates (CFRs) in patients with diabetes mellitus and AMI from a population-based perspective. METHODS: A community-wide study of residents of the Worcester, Mass, metropolitan area who were hospitalized with confirmed AMI was conducted. Data were collected in 12 1-year periods between 1975 and 1999. The study sample consisted of 1354 men and 1280 women with diabetes mellitus. RESULTS: Overall hospital CFRs were significantly greater for women with diabetes mellitus (21.3%) than for men with diabetes mellitus (14.9%). Between 1975 and 1999, hospital CFRs declined from 39.2% to 17.5% for women and from 18.9% to 9.5% in men. In examining long-term survival patterns for as long as 10 years after hospital discharge, there were no significant sex differences in long-term survival rates after adjustment for a limited number of known potentially confounding factors. CONCLUSIONS: Hospital death rates after AMI in men and women with diabetes mellitus have declined in the last 2 decades. The gap in hospital CFRs between men and women with diabetes mellitus has decreased considerably with time, although women have a higher risk of dying after AMI than men. Patients with diabetes mellitus continue to represent a high-risk group who will benefit from enhanced surveillance efforts and increased use of effective cardiac treatments.

Aged↗
PubMed2002

How much do doctors know about consent and capacity?

To assess knowledge of capacity issues across different medical specialties we conducted a cross-sectional survey with a structured questionnaire at academic meetings, lectures and conferences. Of 190 individuals who received the questionnaire 129 (68%) responded-35 general practitioners, 31 psychiatrists, 29 old-age physicians [corrected] and 34 final year medical students. Correct answers on capacity to consent to or refuse medical treatment were given by 58% of the psychiatrists, 34% of the geriatricians, 20% of the general practitioners and 15% of the students. 15% of all respondents wrongly believed that a competent adult could lawfully be treated against his or her will, with no obvious differences by specialty. As judged by this survey, issues of capacity and consent deserve more attention in both undergraduate and postgraduate medical education.

Adult↗
PubMed2002

Dementia.

Explore the source record for details and available documents.

Aged↗
PubMedDate not supplied

Aging memory self-efficacy: elders share their thoughts and experience.

Twenty-six elders responded to an open-ended question as part of a study that examined the relationships among depression, health, memory self-efficacy, and metamemory. Participants rated their overall memory function as fair to average (M = 4.26, standard deviation [SD] = 1.29). The average memory efficacy scores were high (M = 51.35, SD = 23.56). The final question invited participants to share any additional information they thought might be important to this item. This article represents a content analysis of these comments. The mean age of responders was 68.78; all had high perceived health and no depression. No differences on memory self-efficacy arose among age groups. Themes included memory management, rationalization, reflection, information seeking, and correlation establishment. Therefore, it is important for clinicians to ask elders about memory function during routine health care encounters, as individuals are interested in memory assessment and management.

Adaptation, Psychological↗
PubMedDate not supplied

An overview of chronic fatigue syndrome.

This article provides an overview of the condition known as chronic fatigue syndrome, or myalgic encephalomyelitis. The author describes common symptoms and their treatment, and discusses a model of patient care, piloted in the community, which includes elements of a range of therapeutic strategies.

Activities of Daily Living↗