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Biomedical subjects

J Justice

Publications and source records attributed to J Justice.

At least 19 recordsLinked to original sources
PubMed1995

Evolution of spinal bone loss and biochemical markers of bone remodeling after menopause in normal women.

The main objective of this study was to describe longitudinal patterns of spinal bone loss in normal women who undergo a natural menopause. The second objective was to determine if a proportion of women suffer excessively rapid postmenopausal bone loss from the spine. If this was the case it was the aim to devise a means of predicting the woman at excess risk; but if all women lost bone at similar rates, the aim was to document changing loss rates over the first 5-8 postmenopausal years. Responding women in six suburban general practices recalled for cervical smears who had their last menstrual period 9- 36 months previously were invited to participate in a longitudinal study of bone loss and the biochemical markers plasma osteocalcin and urinary hydroxyproline. Sixty-four subjects agreed to participate, a response rate of 80%. In the ensuing 5 years, six received hormone replacement therapy and are not reported on. The main outcome measures were rates of spinal bone loss over 5 years, measured by dual photon absorptiometry, and radial bone loss over the first 2 years measured to quantitative computed tomography. Spinal bone loss was similar between individuals, with 94% of the variability in the data being accounted for by a statistical model that assumed parallel rates of bone loss. A less restrictive model allowing women to have different rates of spinal bone loss accounted for 12% more of the remaining variance in the data than the previous model. However, rates of radial bone loss were more dissimilar between women than rates of spinal loss. The results of the biochemical data collected serially showed that the plasma osteocalcin rose slowly to a plateau at 5 years postmenopause; in contrast, the hydroxyproline fell progressively with time over the whole period of study. These results were interpreted as being consistent with diminishing rates of bone destruction which gradually reequilibrated with bone formation as time passed after menopause.

Absorptiometry, Photon↗
PubMed1992

Abortion.

Explore the source record for details and available documents.

Abortion, Legal↗
PubMed1992

Use of traditional and modern health services by Laotian refugees.

Although refugee health care emerged as a special interest in the United States following the influx of almost a million Southeast Asians since 1975, few studies have been done of the influence of refugee traditions on the use of Western medical services. The illness patterns, medical beliefs, and health care behavior of a Southeast Asian refugee group, the Mien from Laos are described in this study. A cohort of 119 Mien refugees living in Richmond, California, was observed for a 6-month period. In-home interviews were undertaken about all episodes of ill health, including treatment and health care decisions. This study shows that the Mien integrate traditional healing beliefs and practices with the use of American health services. Such findings are important because the increasing cultural diversity in the United States, particularly in Western states, necessitates that health care professionals understand the importance of cultural factors for access to and the use of health care by all patients including refugees and other immigrant groups.

Adolescent↗
PubMed1990

Tapping employee insights with the Nominal Group Technique.

In our scenario, we brought together the manager, pharmacist, full-time and part-time sales people, the delivery person, and the stock person, to give a perspective from every possible area of operation. We have found that input from all employees often generates ideas that they would not have thought of on their own. We suggest that NGT, used on a quarterly basis, for instance, would be an excellent means of developing team spirit, employee participation, and meaningful and effective solutions to problems. NGT is much better than trying to "go it alone," especially in today's competitive environment. NGT helps us realize that the potential contribution of employees is great, but generally untapped. The process requires planning but little time; yet it can produce astounding results, both in encouraging team spirit and in protecting profitability. The process fosters effective use of a participative style of management. It forces us, in effect, to use our most valuable resource: the people we manage.

Employment↗
PubMed1987

The bureaucratic context of international health: a social scientist's view.

Using primary care as an example, this paper examines how the bureaucratic structures and culture of the international health agencies have affected the planning and delivery of health programs. Many primary health care programs were ineffective, as research undertaken in Nepal has shown, because they reflected the perspective and needs of the health bureaucracies involved rather than those of the local villages receiving services. Similarly, work in other South and Southeast Asian countries reveals that primary health care was interpreted differently in different bureaucratic settings and adapted to bureaucratic needs, but not necessarily adapted to village cultures and conditions. Social scientists, who are trained to analyze and articulate different cultural contexts, can play a key role in helping international health bureaucracies become more sensitive to the rural village cultures they serve.

Asia, Southeastern↗
PubMed1986

Effects of exposure to salty drinking water in an Arizona community. Cardiovascular mortality, hypertension prevalence, and relationships between blood pressure and sodium intake.

A high level of sodium (440 mg/L) in the water supply of Gila Bend, Ariz, caused concern because of apparently elevated rates of hypertension in Gila Bend Papago Indians. We surveyed 342 Gila Bend Papago Indians and 375 non-Indians from July to September 1983. Participants 25 years of age and older were interviewed for health risk factors, water consumption, and dietary sodium and calcium intake and had height, weight, blood pressure, and urinary sodium and potassium levels measured. No consistent associations were found between any of the sodium values and systolic or diastolic blood pressure. Mean blood pressures for the Gila Bend whites were lower in most age groups than in comparison US white populations. The prevalence rates of hypertension in Gila Bend were not significantly higher than national rates.

Adolescent↗
PubMed1984

Can socio-cultural information improve health planning? A case study of Nepal's assistant nurse-midwife.

Nepal's Assistant Nurse-Midwife program demonstrates some of the consequences of ignoring social and cultural information in health planning. Partly in response to national and international pressures to develop careers for women, the program was designed to train young women to provide maternal and child health care in rural areas. But traditional expectations about women, which are widely known, have impaired the program's effectiveness. Thus, even when cultural information is relevant and available--in fact, common knowledge--it still may not influence health planning. This case study pinpoints crucial planning issues in primary health care and recommends changes that could make the Assistant Nurse-Midwife's role more appropriate to its social and cultural setting.

Cultural Characteristics↗
PubMed1984

Atypical vitelliform macular dystrophy in a 5-generation family.

Five generations of a family with autosomal dominant atypical vitelliform macular dystrophy (A-VMD) were studied. This dystrophy is similar to autosomal dominant Best's vitelliform dystrophy (B-VMD) but clinically more closely resembles sporadic pseudovitelliform macular degeneration (P-VMD). Of the family members who were 14 years or older 43 (24 females and 19 males) of the 101 at risk (43%) were affected. Vision varied from 20/20 to 20/200. Field defects and tritan colour defects were invariably present only when vision was less than or equal to 20/200, but these defects were sometimes present when vision was good. The electrooculographic studies (LP/DT ratios) in this family were found to be normal or reduced and did not correlate with visual acuity. Minimal retinal findings consisted of macular or extramacular punctate yellow lesions or both in the retinal pigment epithelium, which were hypofluorescent by angiography, and retinal pigment epithelial defects in the temporal nerve fibre bundle, which were hyperfluorescent by angiography. Fluorescein angiographic changes were invariably present when retinal lesions were noted, and this was the most reliable test in identifying genotypically affected family members with minimal phenotypic expression.

Adolescent↗
PubMed1980

Variable expressivity in autosomal dominant aniridia by clinical, electrophysiologic, and angiographic criteria.

Of 39 members in a family with autosomal dominant aniridia with variable expressivity, 16 members, representing 50% (15 out of 30) of those at risk, were affected. Of these, ten of 16 (63%) had visual acuity of 6/12 (20/40) or better in at least one eye, and six of 16 (37%) had visual acuity between 6/15 (20/50) and 6/60 (20/200) in at least one eye. Affected patients had nystagmus (12, 75%), cataracts (nine, 56%), strabismus (15, 94%), amblyopia (six, 37%), corneal pannus (one, 6%) glaucoma (one, 6%), macular hypoplasia (five, 31%), and optic nerve hypoplasia (one, 6%). The good visual acuity in this family indicates that absence of iris tissue is not responsible for the decreased visual acuity usually associated with aniridia. The decreased visual acuity correlates instead with a decreased macular reflex and with a decreased electroretinogram amplitude. Affected family members have abnormal persistence of vessels in the macular region angiographically, and when sufficient iris tissue is present to be studied angiographically, there are abnormal vascular loops and leakage of dye at the pupillary border.

Adolescent↗
PubMed1977

Clinical comparison of 10 percent and 25 percent intravenous sodium fluorescein solutions.

Sodium fluorescein solutions, 3 ml of 25% solution and 5 ml of 10% solution, were compared with a double-blind crossover method in a group of 41 normal volunteers and in a group of 42 patients who had diverse ophthalmic disorders. Following injection of the solutions into the antecubital vein, visualization, serial fluorescein angiograms, and five-minute phase angiograms were studied and compared. The untoward reactions reported in both studies were of types usually associated with sodium fluorescein, the most common of which was a mild, transient nausea. On the basis of our results, there is no significant difference in the incidence and severity of adverse reactions between the 10% and 25% solutions. In the volunteer study, the 25% solution was significantly superior in visualization and paired comparison (P less than .001) in the patient study, the 25% solution was significantly superior in angiogram quality (P less than .01), five-minute phase angiogram (P less than .05), and paired comparison (P less than .005). The overall superiority of the 25% concentration in a 3-ml volume was demonstrated both subjectively and objectively in the volunteer study and in the patient study.

Clinical Trials as Topic↗
PubMed1977

Voluntary nystagmus.

Voluntary nystagmus is a pendular, rapid, conjugate, primarily horizontal, benign nystagmus initiated and maintained by voluntary effort. The amplitude is variable, but always low. The rate is constant and rapid. Convergence is variable--apparently essential in some, nonessential in others, but related in all of our cases. This condition appears to have a familial component and is more common than originally thought. Voluntary nystagmus should be considered when dealing with any patient exhibiting nystagmus in order to minimize the possibility of misdiagnosis as occurred in one of our cases.

Adolescent↗
PubMed1976

Cilioretinal arteries. A study based on review of stereo fundus photographs and fluorescein angiographic findings.

The incidence of cilioretinal arteries in 2,000 eyes of 1,000 consecutive patients was determined by review of stereo color fundus photographs and fluorescein angiographs. One or more cilioretinal arteries were present in 49.5% of all patients or in 32.1% of the eyes. The arteries occurred bilaterally in 14.6% and contributed to some portion of the macular circulation in 18.7% of the patients. A great deal of variability of size, number, and distribution of cilioretinal vessels was observed. Prior studies that were based on direct visualization of the fundus have reported cilioretinal arteries in 7% to 29.6% of patients examined. Careful review of stereo fundus photographs and early phase fluorescein angiographs aided in the observation of these vessels that might otherwise have been unrecognized. We believe the method of review accounts for the high incidence of cilioretinal arteries in our series.

Ciliary Body↗
PubMed1976

Autosomal recessive retinitis pigmentosa and Coats disease: a presumed familial incidence.

Three of four siblings of normal parents had a combination of Coats disease and retinitis pigmentosa bilaterally. Our report of their respective cases is, to our knowledge, the first report of a familial incidence of the combination of the two diseases in an individual and supports the implication that Coats disease may be a genetic abnormality. The pathological process was essentially the same in all three patients, although it occurred differently in one of the three siblings and gave rise to an altered functional and clinical picture. The similarities may indicate that the convenient categories of "tapeto-retinal degenerations" are clinical variations of the same genetic abnormality.

Adolescent↗