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Biomedical subjects

J F Quinn

Publications and source records attributed to J F Quinn.

At least 19 recordsLinked to original sources

Effects of a gamma-secretase inhibitor in a randomized study of patients with Alzheimer disease.

LY450139 dihydrate, a gamma-secretase inhibitor, was studied in a randomized, controlled trial of 70 patients with Alzheimer disease. Subjects were given 30 mg for 1 week followed by 40 mg for 5 weeks. Treatment was well tolerated. Abeta(1-40) in plasma decreased by 38.2%; in CSF, Abeta(1-40) decreased by 4.42 +/- 9.55% (p = not significant). Higher drug doses may result in additional decreases in plasma Abeta concentrations and a measurable decrease in CSF Abeta.

Alanine↗

Changes in premorbid brain volume predict Alzheimer's disease pathology.

OBJECTIVE: To assess whether changes in antemortem MRI brain volume measurements are valid predictors of subsequent Alzheimer disease (AD) pathology. METHODS: Thirty-nine subjects, 15 nondemented and 24 with cognitive impairment, were followed until death. Regional postmortem measures of senile plaque (SP) and neurofibrillary tangle (NFT) severity were examined in relationship to cross-sectional and longitudinal volumetric measurements obtained from antemortem MRI. RESULTS: Total brain volume change over time was related to the accumulation of cortical NFT. The rate of ventricular CSF volume increase was related to both cortical NFT and SP. The last hippocampal volume prior to death was related to hippocampal NFT burden; the rate of hippocampal volume atrophy was not related to hippocampal NFT pathology. These significant relationships continue to exist when all nondemented subjects are excluded from analysis. In subjects with cognitive impairment, the best predictor of cortical NFT and SP is the rate of ventricular volume increase. Excluding subjects with long duration between MRI and death did not appreciably alter results. CONCLUSIONS: MRI volumes measured over time are valid biomarkers of pathologic progression of AD across a range of antemortem clinical states. The rate of ventricular volume enlargement can be used to monitor disease progression or response to treatment in future clinical trials that are targeted at NFT and SP pathology.

Aged↗

The origin and course of schizophrenia: implications for clinical practice.

The authors first review current evidence concerning abnormalities of brain structure and function in schizophrenia and interpret them within a "network" pathophysiological model of the disorder. This information is then placed within a contemporary neurodevelopmental framework that "roots" the illness in adverse events during early pregnancy, which result in a developmentally compromised nervous system. They then consider the controversy as to whether the subsequent expression of psychosis reflects an active morbid process and, in a more general sense, whether the disorder is characterized by subsequent progression and clinical deterioration. The authors argue that the developmental and progressive models should not be considered in an either-or manner, since this perspective is not logical and favors nihilistic approaches to intervention and treatment, but rather should be integrated within a lifetime trajectory model. Finally, implications for current psychiatric practice are considered.

Journal Article↗

Cerebrospinal fluid abeta42, tau, and f2-isoprostane concentrations in patients with Alzheimer disease, other dementias, and in age-matched controls.

OBJECTIVE: To test the hypothesis that quantification of cerebrospinal fluid (CSF) F(2)-isoprostanes (F(2)-IsoPs), in vivo biomarkers of free radical damage, along with CSF Abeta(42) and tau levels improves laboratory diagnostic accuracy for Alzheimer disease (AD). PARTICIPANTS: Patients with probable AD (n = 19), dementias other than AD (n = 8), and age-matched controls (n = 10). MAIN OUTCOME MEASURES: Cerebrospinal fluid concentrations of Abeta(42) and tau were determined by a commercially available test (Athena Diagnostics, Worcester, Mass). Cerebrospinal fluid F(2)-IsoP levels were quantified by gas chromatography/mass spectrometry. RESULTS: Individuals were classified as AD or non-AD by a published method using CSF Abeta(42) and tau levels (95% sensitivity, 50% specificity), by CSF F(2)-IsoP levels greater than 25 pg/mL and Abeta(42) concentrations less than 1125 pg/mL (90% sensitivity, 83% specificity), and by combined analysis using CSF F(2)-IsoP, Abeta(42), and tau levels (84% sensitivity, 89% specificity). CONCLUSION: Cerebrospinal fluid F(2)-IsoP quantification may enhance the accuracy of the laboratory diagnosis of AD.

Aged↗

The self as healer: reflections from a nurse's journey.

Complementary and alternative medicine is rapidly making its way into the mainstream through the addition of a variety of therapies in existing settings. Yet, in national surveys, the public seems interested not only in alternative therapies, but also in a more holistic form of healthcare. Nurses have a critical role to play in creating such a healthcare system. Recovering their own identity as healers is a first step in that direction. This article explores the topic of the self as healer through four key questions: what is healing, who or what is the locus of healing, how can nurses facilitate healing, and how does one become a healer?

Attitude of Health Personnel↗

Novel [1,5] sigmatropic rearrangements of cyclohexadienones generated from Fischer carbene complexes. A new strategy for installing the C-20 angular ethyl group in Aspidospermidine alkaloids.

[formula: see text] We report here the first examples of a [1,5] sigmatropic rearrangement in a 4a-alkyl-4a-hydrocarbazol-4-one to yield a 3-alkylcarbazol-4-one with a re-aromatized indole nucleus. The reaction of 1-methyl-3-substituted-indole-2-carbene complexes 1 with terminal alkynes yields 3,4a-dialkyl-1-methoxy-9-methylcarbazol-4-ones 2. These 4a-substituted carbazolones thermally rearrange to cleanly give the more highly aromatic 3,3-dialkyl-1-methoxy-9-methylcarbazol-4-ones 3. This reaction provides a convenient entry to the Aspidosperma family of alkaloids, which contain a 3,3-disubstituted carbazole nucleus.

Alkaloids↗

Retirement patterns and bridge jobs in the 1990s.

During most of the post-World War II period, American men have been leaving the labor force at earlier and earlier ages. Evidence suggests that this trend has been under way for more than a century. However, in the mid-1980s, this trend came to an abrupt halt. Male labor force participation rates have been flat since 1985, and have actually increased over the past several years. Understanding these issues is especially important given the looming increase in the Social Security normal retirement age to 67 and the possibility of even more increases in the ages of eligibility under Social Security and Medicare reform. Because of the influx of married women into the labor market in the post-World War II period, older women's participation rates did not decline as men's did. In contrast, their rates were relatively steady, rising or falling very slowly. Since the mid-1980s, however, older women's participation rates have increased significantly. Many more older men and women are working today than the pre-1986 trends would have suggested. Many older Americans leave the labor force gradually, utilizing "bridge jobs" between employment on a full-time career job and complete labor force withdrawal. These bridge jobs are often part-time, often in a new line of work, and sometimes involve a switch from wage and salary work to self-employment. Estimates suggest that between one-third and one-half of older Americans will work on a bridge job before retiring completely, and for these workers retirement is best viewed as a process, not as a single event. These changes in retirement behavior are consistent with societal changes that have altered the relative attractiveness of work and leisure late in life. Mandatory retirement has been outlawed for most American workers. Social Security has become more age-neutral, no longer penalizing the average worker who wants to continue working after age 65. An increasing proportion of employer pension coverage has been in defined contribution plans, which do not contain the age-specific retirement incentives that many defined benefit plans do. The composition of jobs has shifted from manufacturing to service occupations. Americans are living longer and healthier lives, and many look forward to years to productive activity after age 65. These structural changes have been accompanied by an important cyclical factor: the strength of the American economy over the past decade. This has increased the demand for all types of labor, including older workers. Evidence suggests that there is more than this cyclical factor at work, however, and that new attitudes about work late in life are developing. Labor supply decisions late in life are correlated in expected ways with the individual's health (measured in several ways), age, and pension and health insurance status. Retirement patterns in America are much richer and more varied than the stereotypical one-step view of retirement suggests. Public policy is changing in ways that make continued work late in life more likely. If employers are willing to provide flexible job opportunities to meet the needs of these potential employees, then society can tap a growing pool of older, experienced, and willing workers for years to come.

Aged↗

The economic status of the elderly.

The economic status of the elderly improved greatly since the 1960s. This is true in terms of poverty rates, real cash income and broader income measures that include in-kind benefits. Yet, many older Americans remain at risk of economic deprivation, especially the less educated, those living alone, and the oldest old. Most elderly Americans rely heavily on Social Security and Medicare for their economic well-being.

Aged↗

Brain volume preserved in healthy elderly through the eleventh decade.

OBJECTIVE: To determine which brain regions lose volume with aging over time in healthy, nondemented elderly. BACKGROUND: Cross-sectional studies suggest widespread loss of brain volume with aging. These studies may be biased by significant numbers of preclinically demented elderly in the oldest comparison groups. Longitudinal studies may allow closer determination of the effect of aging unaffected by dementia. METHODS: Quantitative volumetric MRI was performed annually on 46 healthy subjects older than age 65 who had maintained cognitive health a mean of 5 years. Comparisons (analysis of variance) were made of rates of volume loss (slopes) divided into 11 young-old (mean age, 70 years), 15 middle-old (mean age, 81 years), and 20 oldest-old (mean age, 87 years) subjects. Regions of interest included CSF spaces, lobar regions, and limbic-subcortical regions. RESULTS: There were significant differences between groups in intracranial, total brain, left hemisphere, right hemisphere, temporal lobe, basilar-subcortical region, and hippocampus volumes, with oldest-old subjects showing the smallest volumes, followed by middle-old and young-old subjects. Oldest-old subjects had significantly greater subarachnoid volumes than the younger groups. There were no significant differences in rates of change of regions of interest across age groups. CONCLUSIONS: After age 65 there is minimal brain volume loss observed over time in healthy elderly. Brain volume differences seen cross-sectionally, at any age, likely reflect small, constant rates of volume loss with healthy aging. Healthy oldest-old subjects do not show greater rates of brain loss compared with younger elderly, suggesting that large changes seen in cross-sectional studies reflect the presence of preclinical dementia in older groups.

Aged↗

Healing: a model for an integrative health care system.

A previous article proposed that healing is the appropriate focus for nursing practice. Healing, the emergence of right relationship at or among the multiple levels of the human experience, was described as a process distinct from the curing of disease. The current article further explicates this theory as the foundation for an integral healing health care system in which advanced practice nurses have a key role to play. The concepts of healing and right relationship are explored in the context of the emerging sciences known collectively as the sciences of complexity.

Delivery of Health Care, Integrated↗

The role of bridge jobs in the retirement transition: gender, race, and ethnicity.

We used the first wave of the new Health and Retirement Study (HRS) to document the importance of transitional stages--bridge jobs--between career employment and complete labor force withdrawal in the early 1990s. We describe the labor force status of a sample of about 9,500 older Americans with some work experience after age 49, and the transition patterns of those for whom we can identify a career job. We observe significant bridge job activity, including part-time work and movement between self-employment and wage-and-salary jobs. Subsequent waves of the HRS will permit researchers to follow this large sample through the labor force withdrawal process and to analyze the determinants and consequences of alternative retirement routes.

Employment↗

Public policy and the plans and preferences of older Americans.

This study compares the retirement plans and preferences of a recent sample of 3,500 men and women of pre-retirement age-50 to 64. The data suggest that a minority of older workers expect to retire earlier than they really want to, and that many would delay retirement if they faced different terms and conditions of employment. Although most older Americans cannot or do not want to work, many do, and they represent a significant underutilized labor market resource.

Aged↗

The effect of information systems architecture on health care data quality.

A rapidly increasing number of health care provider institutions is dealing with data architecture design issues that directly affect the quality of data within their heterogeneous information systems. These problems result from a failure to recognize that they are actually managing a loosely distributed yet integrated database among their many information system platforms. Understanding the issues surrounding data integration, the application available interface standards, and the tools available for implementation is critical to operating a successful distributed health care information systems environment today.

Architecture↗

Psychoimmunologic effects of therapeutic touch on practitioners and recently bereaved recipients: a pilot study.

The purposes of this descriptive pilot study were to address conceptual inconsistencies and several other methodologic problems identified in previous Therapeutic Touch (TT) research, while also providing direction for future TT studies by attempting to determine the appropriateness and suitability of a combination of psychologic and immunologic measures in the ongoing empiric evaluation of TT. Research questions were derived from a unitary perspective. Data on both practitioners and recipients were collected and examined for patterns and relationships. Changes that may be related to TT were observed in immunologic, psychologic, and unitary measures. Directions for future research within a unitary framework were postulated.

Adult↗