Biomedical subjects
Publications and source records attributed to J Haber.
This paper outlines strategies for all nurses to participate in nursing's research agenda, which aims to enhance the scientific basis of nursing practice. The emphasis here is on generating data for the outcomes movement as a tool for transforming the American health care delivery system.
Wound botulism is a rare infectious and toxicologic complication of trauma and i.v. drug abuse. Only 39 cases have been reported in detail in the English literature. This case report describes a patient with wound botulism who presented to four medical facilities before receiving definitive diagnosis and treatment. Although his history and physical examination were consistent with wound botulism, diagnosis and therapy were delayed because this rare disease was not considered initially in the differential diagnosis. Wound botulism should be considered in trauma patients and i.v. drug abusers who present with cranial nerve palsies and descending paresis.
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Cigarette smoking is a risk factor for many diseases, and recent evidence indicates that it adversely affects periodontal health. A number of epidemiologic studies have shown strong associations between smoking and the prevalence and severity of periodontitis, as well as interproximal bone loss. Although the pathogenesis of periodontitis in smokers is poorly understood, there are data suggesting that smoking causes defects in neutrophil function, impaired serum antibody responses to periodontal pathogens, and potentially diminished gingival fibroblast function. The prevalence and severity of periodontitis in former smokers is decreased compared to current smokers, providing evidence that smoking cessation is beneficial. Smoking markedly influences response to treatment, and a subset of smokers predominates among refractory periodontitis patients who are resistant to conventional treatment. A patient's smoking history is a useful clinical predictor of future disease activity. Current estimates suggest that smoking is associated with a large proportion of periodontitis cases and constitutes a major public dental health problem.
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Cigarette smoking is a risk factor for many diseases, and recent evidence indicates that smoking adversely influences periodontal health. A number of epidemiologic studies have shown strong associations between smoking and the prevalence and severity of periodontitis, as well as interproximal bone loss. Whereas the pathogenesis of periodontitis in smokers is poorly understood, there are data suggesting defects in neutrophil function, impaired serum antibody responses to periodontal pathogens, and potentially diminished gingival fibroblast function. The prevalence and severity of periodontitis in former smokers is decreased compared with current smokers, providing evidence that smoking cessation is beneficial. Smoking markedly influences response to treatment, and a subset of smokers predominates among patients with refractory periodontitis whose disease is resistant to conventional treatment. Smokers are a high-risk group for periodontitis, and smoking history is a useful clinical predictor of future disease activity. Current estimates suggest that smoking is associated with a large proportion of periodontitis cases and constitutes a major dental public health problem. A new disease category, smoking-associated periodontitis, is proposed, given the unique characteristics of smokers with periodontitis.
Spectroscopic properties such as ultraviolet-visible spectroscopy, circular dichroism, steady-state fluorescence and the catalytic activity of bovine liver catalase (BLC) have been studied in reverse-micelles microemulsions formed by sodium bis(2-ethylhexyl)sulfosuccinate (AOT) in isooctane. Activity measurements were carried out with the highly water soluble hydrogen peroxide as substrate as a function of temperature and pH, at various concentrations of substrate, enzyme, AOT and at different w0 values (w0 = [H2O]/[AOT]). The folding of catalase in reverse micelles is not drastically altered, although there are changes in the local surrounding of the prosthetic group. Kinetic measurements have been carried out under first-order conditions at low substrate concentration. They indicate that the measured substrate decomposition rate is limited by the exchange of substrate molecules between the substrate-filled and the enzyme-containing micelles. The specificity constant, ks = kcat/KM, as related to water pool concentrations, k(s,wp)rm, was, at all w0 values, considerably lower than ks measured in buffer (ksb). In contrast, overall values of ks in reverse micelles, k(s,ov)rm, were always 2-4-times higher than ksb. This apparent superactivity can, however, be ascribed to concentration effects. No 'bell-curve' to describe the w0 dependence of catalase activity in reverse micelles was found, k or ks increasing monotonously up to w0 = 50.
The role of smoking as a risk factor for periodontitis was assessed separately in diabetic and nondiabetic study groups. Subject listings stratified for age (19 to 40 years) and sex were obtained for subjects with insulin-dependent diabetes mellitus (IDDM) and nondiabetic subjects. For both the IDDM group (n = 132) and the nondiabetic group (n = 95), age and sex stratified samples were constructed by random selection of subjects from each subject listing. Patients were recruited by phone, examined, and their medical and dental histories obtained. Among nondiabetic subjects, the prevalence of periodontitis was markedly higher among current smokers compared with never smokers (P < or = 0.005) in both the 19 to 30 year-old (46% vs. 12%) and 31 to 40 year-old groups (88% vs. 33%). The subject mean percent of sites with gingival pocket depth > or = 4 mm was higher among current smokers than never smokers (P = 0.001) in the 19 to 30 (8.2% vs. 3.4%) and 31 to 40 (14.3% vs. 4.3%) age groups. The effects of smoking among IDDM subjects were similar to that observed in the nondiabetic population. There were no differences between current and never smokers in the proportion of sites positive for plaque. Attributable risk percents from prevalence data suggest that among nondiabetic subjects, a large proportion, perhaps as much as 51% of the periodontitis in the 19 to 30 year old group and 32% of the periodontitis in the 31 to 40 year old group, is associated with smoking.(ABSTRACT TRUNCATED AT 250 WORDS)
This article explores the gap that currently exists between nursing research and nursing practice. The aim is to promote the conversion of new knowledge into practical innovations. Barriers to research utilization in practice settings come from both the academic and clinical arenas. Innovative models and strategies are needed to overcome these barriers. The purposes and value of research utilization and the clinical and academic strategies that facilitate research are discussed. Supporting clinical studies are provided as exemplars.
The purpose of this study was to establish construct validity of the Haber Level of Differentiation of Self Scale (LDSS) that measures selected aspects of the construct, differentiation of self, the key concept of the Bowen Theory. During stage one of this study, a 32-item Likert-type LDSS, which contained two subscales, Emotional Maturity, (EM), and Emotional Dependency (ED), was administered to 372 volunteer subjects. Factor analytic and correlational findings indicated support for a 24-item unidimensional rather than a 32-item two subscale instrument. Recalculation of coefficient alpha (.90) also supported the unidimensional structure of the LDSS. During stage two of this study, the revised 24-item LDSS was administered to 372 volunteer subjects, who also completed the State-Trait Anxiety Inventory, the Life Experience Survey, and the Behavior Checklist. Hypotheses predicted that there would be negative relationships between differentiation of self and trait anxiety, state anxiety, adult psychological dysfunction, and negative impact stress. Findings indicate support for all hypotheses at the p < .01 level of significance or greater. Data from this study suggest that the 24-item LDSS is a valid and reliable unidimensional family assessment tool that accurately measures specific aspects of the construct, differentiation of self. The LDSS can be used by nurses and other professionals to assess individual and family functioning in a variety of health care settings.
This case-control study compares the prevalence of cigarette smoking among patients in a periodontal practice (cases) with that of patients in referring general dental practices (controls). Smoking histories of patients (age greater than or equal to 25 years) in a periodontal practice and five general dental practices were obtained by questionnaire. From the general practices, only patients reporting negative histories for periodontitis were studied. Periodontal status of the periodontal practice patients was based on bone loss from full mouth radiographic surveys and gingival pocket depths. Patients were stratified by age (25 to 40, 41 to 55, and greater than 55 years) and sex. The combined frequency of current or former cigarette smoking reported by 196 periodontal practice patients with moderate or advanced periodontitis (M-A perio group) was higher than that reported by 209 general dental practice patients (gen prac group) in all age and sex categories. The age and sex adjusted summary odds ratio for a positive smoking history among M-A perio subjects relative to gen prac subjects was 2.6 (P less than 0.001). Separate corresponding odds ratios (age and sex adjusted) for current smoking versus never smoking in the two groups were 3.3 (P less than 0.001) and for former smoking versus never smoking 2.1 (P less than 0.004). Among current smokers, patients in the M-A perio group reported heavy smoking (greater than 10 cigarettes/day) relatively more often than control subjects (adjusted R.O. = 5.7; P less than 0.001). In the M-A perio group the frequency of current smoking increased with disease severity.(ABSTRACT TRUNCATED AT 250 WORDS)
A group of poorly-controlled insulin dependent diabetes mellitus (IDDM) patients were examined in a cross-sectional design for total microbial levels, microbial incidence, and the percent levels of selected periodontal microorganisms. These organisms were selected on the basis of prior reports that associated them with either periodontal disease or health. One periodontally-healthy and one periodontally-diseased site were examined in each IDDM patient. Increased levels of the periodontal pathogens Prevotella intermedia, P. melaninogenica spp., Bacteroides gracilis, Eikenella corrodens, Fusobacterium nucleatum and Campylobacter rectus (formerly Wolinella recta) were found at the periodontal diseased sites. Increased prevalence of the organisms P. intermedia, P. melaninogenica spp., and C. rectus were found at the diseased sites. A significantly higher percentage of P. intermedia was found at the sites exhibiting deep pockets and attachment loss.
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Type 1 fimbriae from Actinomyces viscosus T14V, composed of a complex protein of Mr 65,000, mediate the adherence of A. viscosus T14V to the host, whereas type 1 fimbriae-specific antibodies inhibit adherence. Genetic control of the serum IgG response to type 1 fimbriae was evaluated in a series of inbred, hybrid, recombinant inbred, and back-cross mice. Mice were given i.p. injections of 10(8) A. viscosus T14V cells in saline on days 0 and 14, and IgG anti-type 1 fimbriae in sera obtained on day 26 were measured by ELISA. Segregation analysis of the responses of (BALB/cJ x A/J)F1 x A/J backcross mice suggested polygenic control. Linkage analysis in (BALB/cJ x A/J)F1 x A/J backcross and SWXL recombinant inbred mice suggested control by genes linked with H-2 and with Ly-17 and Akp-1. In several F1 hybrid strains derived from H-2-disparate high and low responder parental strains, low responsiveness was dominant. The F1 derived from the H-2-identical high and low responder strains CBA/J and C3H/HeJ was a low responder, suggesting that dominant low responsiveness was mediated by non-H-2-linked genes. A three-gene model is proposed for regulation of the type 1 fimbriae response, including an MHC-linked gene, a gene linked with Ly-17 and Akp-1 on the telomeric portion of chromosome 1, and a background gene whose linkage is unknown.
This report summarizes the results of the 1989 California Medical School Matching Program Pilot Study. The study demonstrated that the technical aspects of a matching program for medical school applicants can be successfully operated. The applicant participation was 48.7%, with 76.1% of the ranked students responding. The schools ranked 1,122 students, with approximately 38% being ranked by more than one school. Of the 905 students who were matched to a school, 88% were matched to one of their top three choices. Of the students who had actually accepted a position at a school under the normal admission procedure, 60% had been matched to the same school by the matching program. The conclusions are that the program operates properly, that it fulfills the wishes of the students as well as could be expected, and that it parallels the current admission process to a reasonable degree.
Antibodies reactive with type 1 and type 2 fimbriae from Actinomyces viscosus T14V specifically inhibit the adherence of A. viscosus T14V to salivary pellicle-coated tooth surfaces and other bacteria, and these antibodies are thought to modulate colonization by this microorganism. These studies were done to determine whether previously noted differences in the antibody responses of inbred mice to type 1 and type 2 fimbriae might be under genetic control. The serum immunoglobulin G (IgG) and IgM antibody responses of inbred, F1 hybrid, and H-2 congenic mice, immunized with A. viscosus T14V cells, were analyzed by enzyme-linked immunosorbent assays for antibodies reactive with A. viscosus T14V whole-cell type 1 and type 2 fimbriae. The results confirmed earlier findings and indicated striking variations in the amounts of IgG anti-type 1 (23-fold) and anti-type 2 (48-fold) fimbria antibodies elicited. The responses of the 17 inbred strains tested showed a relatively continuous distribution from high to low, as well as marked differences in the responses of H-2 and Igh-C identical strain pairs. An analysis of the responses of F1 hybrid and H-2 congenic mice indicated dominance of the low-responder gene(s) and control by H-2-linked genes. Antisera from two high-responder strains inhibited in vitro bacterial adherence to a much greater degree than antisera from a low-responding strain. These data suggest polygenic control of the magnitude of the IgG anti-type 1 and anti-type 2 fimbria antibody responses by H-2-linked genes as well as background genes not associated with H-2 or Igh-C loci.
The treatment of masticatory muscle and temporomandibular joint pain constitutes an important area in dentistry. Current information supports the use of reversible treatments for these disorders. Several recent references are discussed in relation to reversible treatment, the role of occlusion, and appliance therapy for internal derangement.
The dissolution of a marriage through divorce represents a major loss in the lives of all family members. Losses can include those of a physical, social, and emotional nature. The self as it was defined within the marital context and the loss of that self as a result of divorce is a significant source of potential dysfunction in adult family members during and after the divorce. From a family systems' perspective, the lower the level fo differentiation of self in family members, the greater is the likelihood that the self was defined in a fusional way during the marriage. As such, when the fused common self is lost through divorce, one or both spouses is likely to experience a significant sense of loss as well as potential dysfunction. The purpose of this article is to propose a model that helps divorced people deal with the loss of self and assists them to define a more differentiated sense of self.