Search PubMed⌕ Search

Biomedical subjects

J Lamb

Publications and source records attributed to J Lamb.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

A study of patient clues and physician responses in primary care and surgical settings.

CONTEXT: Patients often present clues (direct or indirect comments about personal aspects of their lives or their emotions) during conversations with their physicians. These clues represent opportunities for physicians to demonstrate understanding and empathy and thus, to deepen the therapeutic alliance that is at the heart of clinical care. A paucity of information exists regarding how physicians address the psychological and social concerns of patients. OBJECTIVES: To assess how patients present clues and how physicians respond to these clues in routine primary care and surgical settings. DESIGN, SETTING, AND PARTICIPANTS: Descriptive, qualitative study of 116 randomly selected routine office visits to 54 primary care physicians and 62 surgeons in community-based practices in Oregon and Colorado, audiotaped and transcribed in 1994. MAIN OUTCOME MEASURES: Frequency of presentation of clues by patients during office visits, nature (emotional vs social) and content of clues, and nature of physician responses to clues, coded as positive or missed opportunity. RESULTS: Fifty-two percent and 53% of the visits in primary care and surgery, respectively, included 1 or more clues. During visits with clues, the mean number of clues per visit was 2.6 in primary care and 1.9 in surgery. Patients initiated approximately 70% of clues, and physicians initiated 30%. Seventy-six percent of patient-initiated clues in primary care settings and 60% in surgical settings were emotional in nature. In surgery, 70% of emotional clues related to patients' feelings about their biomedical condition, while in primary care, emotional clues more often related to psychological or social concerns (80%) in patients' lives. Physicians responded positively to patient emotions in 38% of cases in surgery and 21% in primary care, but more frequently they missed opportunities to adequately acknowledge patients' feelings. Visits with missed opportunities tended to be longer than visits with a positive response. CONCLUSION: This study suggests that physicians in both primary care and surgery can improve their ability to respond to patient clues even in the context of their busy clinical practices. JAMA. 2000;284:1021-1027

Communication↗
PubMedDate not supplied

Alpha-thalassaemia caused by a polyadenylation signal mutation.

Most eukaryotic messenger RNAs have the sequence AAUAAA 11-30 nucleotides from the 3'-terminal poly(A) tract. Since this is the only significant sequence homology in the 3' non-coding region it has been suggested that it may be a recognition site for enzymes involved in polyadenylation and/or termination of polymerase II transcription. This idea is strengthened by observations on the effect of deletion mutations in or around the AATAAA sequence on polyadenylation of late simian virus 40 (SV40) mRNA; removal of this sequence prevents poly(A) addition. Naturally occurring variants of this hexanucleotide are rare and hitherto their functional significance has not been assessed. We have now identified a human alpha 2-globin gene which contains a single point mutation in this hexanucleotide (AATAAA leads to AATAAG). The paired alpha 1 gene on the same chromosome is completely inactivated by a frame-shift mutation. This unique combination has enabled the expression of the mutant alpha 2 gene to be studied in vivo where it has been found that the accumulated level of alpha 2-specific mRNA in erythroid cells is reduced. Furthermore, readthrough transcripts extending beyond the normal poly(A) addition site are detected in mRNA obtained from HeLa cells transfected with cloned DNA from the mutant alpha 2 gene, suggesting that the single nucleotide change in the AATAAA sequence is the cause of its abnormal expression.

Base Sequence↗
PubMedDate not supplied

Functional expression of HLA-DP genes transfected into mouse fibroblasts.

The HLA class II antigens are a highly polymorphic family of dimeric cell-surface glycoproteins, expressed predominantly on the surface of immunocompetent cells. They are intimately involved with the induction of the T-cell response to extrinsic antigen and are important predisposing factors for a wide spectrum of autoimmune diseases. We describe here the expression of a class II product from the HLA-DP (new WHO nomenclature, formerly SB) subregion after transfer of cloned genes into mouse fibroblasts. The transfected DP antigen is recognized by several HLA class II monoclonal antibodies and, though present in a mouse cell background, is able to function in the presentation of influenza antigen to cloned DP-restricted human T lymphocytes.

Animals↗
PubMedDate not supplied

Optimism and its relationship to depression, coping, anger, and life events in rural adolescents.

Optimism is a stable personality trait that has important implications for behavior, yet little attention has been given to examining optimism in adolescents. This article describes levels of optimism in rural adolescents and the relationship of optimism with depression, coping, anger, and life events. The identification of optimism may be a vulnerability factor when screening adolescent mental health and, as such, has implications for the psychiatric nurse clinician.

Adaptation, Psychological↗
PubMedDate not supplied

School-based adolescent mental health project survey of depression, suicidal ideation, and anger.

This study on adolescent mental health was conducted in a school setting. Sixty-nine subjects, aged 16-18 years, were surveyed to provide data on anger, depression, and suicide ideation. Suicide ideation was present in 15.9% of subjects and depression in 14.1%. Subjects with suicidal ideation demonstrated greater levels of anger and pooer anger control. Recommendations are made for psychiatric nurses to collaborate with school administrators to develop programs with specific evaluation criteria to promote adolescent mental health in the schools.

Adolescent↗
PubMedDate not supplied

Teaching kids to cope: a preventive mental health nursing strategy for adolescents.

TOPIC: The theoretical base, implementation, and effectiveness of Teaching Kids to Cope (TKC). PURPOSE: To inform clinicians about the benefits and uses of TKC, a 10-week psychoeducational group intervention designed to enhance the coping repertoire of adolescents. SOURCE: Authors' clinical experience. CONCLUSIONS: Following the TKC intervention, students demonstrated less depressive symptomatology and improved coping behaviors. Further research is needed to test the intervention on a larger group and to determine its effectiveness.

Adaptation, Psychological↗
PubMedDate not supplied

Life events, problems, stresses, and coping methods of adolescents.

The purpose of this pilot study is to explore the life events, problems, stressful situations, and coping methods used by adolescents. A sample of 69 volunteer adolescents age 16-18 was obtained from a rural western Pennsylvania high school. The following instruments were administered: The Life Event Scale, senior high version (Coddington, 1972); Mooney Problem Checklist (1951); Stress Questionnaire (Lazarus & Folkman, 1984); and the Ways of Coping Questionnaire (Folkman & Lazarus, 1988). Descriptive statistics revealed the most frequent life event listed was breaking up with a boyfriend/girlfriend; most frequent problems were related to adjustment to school; and most common stress situations related to family. Coping methods were delineated with a few gender differences noted. The most common method of coping was self-control. The adolescent population has many issues to deal with during a time of psychosocial and physiological change and vulnerability. The psychiatric-mental health nurse specialist could be a valuable asset to help school systems teach health promotion and prevention concepts about mental health, identify students at high risk for mental health disorders, and offer counseling and guidance for students and consultative services for both teachers and parents.

Adaptation, Psychological↗
PubMedDate not supplied

Microencapsulation in yeast cells.

A method for encapsulating high concentrations of essential oils into bakers' yeast (Saccharomyces cerevisiae) is described. The process involves mixing an aqueous suspension of yeast and an essential oil, which allows the oil to pass freely through the cell wall and membrane and remain passively within the cell. Oil droplets sequestered within the cell were clearly visible using confocal microscopy. Transmission electron microscopy demonstrated that the cell wall and membrane remain intact during the process. Cells quickly lost viability during the process and it appeared unnecessary for the cells to be viable for the process to occur. Encapsulated oil was recovered from the cells using a water/ethanol extraction procedure and analysed by gas chromatography. No significant differences were noted between encapsulated and unencapsulated oil profiles. The rate of permeation of oil into the yeast cells was found to increase significantly at higher temperatures due to the phase transition of the lipid membrane. The rates at which different essential oils permeated the cell varied considerably due to variations in terpene chemistry. The encapsulation of straight chain hydrocarbons highlighted the effects of molecular size, shape and the presence of hydroxl groups on the process. The process occurs by passive diffusion as a result of hydrophobic flavour components partitioning into the cell membrane and intracellular lipid. This paper briefly reviews the patented literature and reports some of the initial observations of the transport mechanisms involved during the accumulation of essential oils by yeast cells.

Capsules↗
PubMedDate not supplied

The role of the psychiatric/mental health nurse clinical specialist in an adolescent coping skills group.

The psychiatric/mental health nurse clinical specialist is a professional who brings unique skills to the area of mental health prevention. Adolescents are an at-risk population in need of preventive mental health services. This article describes the unique features of a nurse-led adolescent prevention program. A specific Adolescent Coping Skills Group format, which uses the skills of the master's prepared psychiatric nurse, is presented.

Adaptation, Psychological↗
PubMedDate not supplied

High touch meets high tech. Distance mental health screening for rural youth using Teleform.

This article presents an overview of distance mental health screening using Teleform. This technology provides nurses with the ability to have questionnaires administered in one location then processed and scored rapidly at a location some distance away by using a facsimile system and Teleform. The authors examine the process of using Teleform, cite its advantages and disadvantages, discuss its application with rural youth, and suggest implications for school personnel and health-care providers. Technology has facilitated many changes in health-care delivery and increasingly will be instrumental in creating changes. Computer technology can help nursing deliver services swiftly to larger populations.

Adolescent↗