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Biomedical subjects

J Roberts

Publications and source records attributed to J Roberts.

At least 181 records · Page 10Linked to original sources
PubMed1997

Infant sensitivity to deviations in dynamic facial-vocal displays: the role of eye regard.

Do young infants appreciate the intentionality of adult interactors? In view of recent speculation that infants are innately sensitive to eye direction and that communicative intent is conveyed in part by attentional cues, the reactions of 3- and 5-month infants were compared to video episodes of normally responsive women who either appeared or did not appear to make eye contact. Across three experiments, lack of eye contact was achieved by either averting the eyes (E), averting the head and eyes (H&E), closing the eyes (ECL), or averting the head alone (H). Three-month-olds smiled less at H&E, H, and ECL, but not at E, relative to frontal faces, indicating sensitivity to head but not to eye orientation. By contrast, 5-month-olds smiled less at H&E, E, and ECL, but not at H, indicating sensitivity to both head and eye orientation. The implications of the data for mentalist views of infant social behavior are discussed.

Adult↗
PubMed1997

Late talkers at 2: outcome at age 3.

Age 3 follow-up data are presented for a sample of 34 toddlers diagnosed between the ages of 24 and 31 months with expressive type specific language impairment (SU-E). At age 3, the late talkers scored significantly lower on all language measures than 21 comparison peers matched at intake on age, SES, and nonverbal ability. When seen at follow-up, the former late talkers scored in the average range on the Expressive One-Word Picture Vocabulary Test (EOWPVT) and on the Reynell Expressive Language Scale, but more than 1.5 SDs below age expectations in MLU and on Scarborough's (1990a) IPSyn. The proportion of late talkers performing in the average range at follow-up varied markedly as a function of measure used (EOWPVT: 79%, Reynell: 58%, MLU: 35%, and IPSyn: 24%), indicating that the late talkers made more rapid progress in lexical development and in the use of language to define, explain, and describe than they did in the areas of syntactic and morphological development. The only significant predictor of age 3 outcome was intake expressive language level, with toddlers who had been more severely delayed in expressive language at intake relative to age level having the worst outcomes at age 3.

Child Language↗
PubMed1997

Non-response bias in a lifestyle survey.

BACKGROUND: Monitoring health targets is often undertaken using questionnaire surveys of lifestyle risk factors. Non-response bias is recognized but rarely quantified. METHODS: Following a questionnaire survey on a random sample of 6009 residents of Somerset with a response rate of 57.6 per cent, a telephone survey was undertaken on a random sample of 400 non-responders. A small number of the more important questions from the questionnaire were put to the non-responders over the phone. RESULTS: Fifty-nine per cent of the sample were contacted and agreed to participate. Statistically significant differences between responders and non-responders to the original questionnaire were detected for current smoking, hazardous alcohol consumption and lack of moderate or vigorous activity. CONCLUSIONS: Lifestyle questionnaire surveys need to include an assessment of the non-response bias.

Adolescent↗
PubMed1997

The efficacy and effectiveness of process consultation in improving staff morale and absenteeism.

OBJECTIVES: The purpose of this randomized controlled trial was to test the efficacy and effectiveness of process consultation consisting of a series of nurse manager-consultant problem-solving meetings for leadership development that would lead to their staff's improved morale, quality of care, and reduced absenteeism. METHODS: Thirteen consenting clinical inpatient units were stratified for four variables known to affect outcome and were then randomly assigned to treatment and control conditions. The nurse managers from the seven experimental units were paired with outside nurse consultants from the McMaster University School of Nursing (Hamilton, Ontario, Canada) in a cooperative form of retraining in problem-solving through process consultation. Morale was determined through measures of perceptions of the work environment, an attitude scale concerning work (alienation), a personality measure (hardiness), and one of each scale for work satisfaction and for sources of satisfaction and dissatisfaction. Demographic data and information regarding family life responsibilities were collected as well. Assessment of quality of care was determined by the frequency and type of incident reports and by patients' perception of their satisfaction. A ratio of absence hours to total paid hours of work was used to compare experimental and control units' absenteeism rates. RESULTS: Experimental subjects reported a statistically significant improvement in the characteristics of their work setting and in the quality of working relationships. The consultation process facilitated a perceived change in the organizational context of the experimental hospital units with less centralization of authority and more clarity about expectation. These organizational changes were accompanied by improved working relationships and less alienation from work. There was no statistically significant difference in absenteeism. However, a subanalysis of the units by "dose" of the intervention identified those who benefited from the effects of the consultation. Subjects whose nurse managers participated more actively in the consultation process accounted for the changes in working relationships and perceived organizational changes. The "low-dose" experimental subjects were more like the control subjects, with the exception of absenteeism, for which they had higher rates. CONCLUSIONS: The findings of this study suggest that process consultation can alter the staff's perceptions of the characteristics of the work setting, can reverse negative attitudes (alienation), and can create a more positive and supportive working environment (improved working relationship). However, the results suggest the need to target this type of intervention to managers who have the personal resources to engage in self-evaluation and personal development and thus to participate in the consultative process.

Absenteeism↗
PubMed1997

"I gotta push. Please let me push!" Social interactions during the change from first to second stage labor.

BACKGROUND: Forms of social interaction may occur among the participants in medicalized births, in which a woman in labor is experiencing strong involuntary urges to push but has not yet been found to have a completely dilated cervix. This article examines the social events and communications that occur at the change between first and second stages of labor. METHOD: Three cases are described from videotapes of women in the second stage of labor and their caregivers. RESULTS: Several social and interactive features occurred, in which (1) the caregiver, usually a nurse, by invoking the "no pushing rule," insisted that the woman suppress her involuntary urges to push; (2) both the caregiver and the parturient displayed an orientation toward the future and the eventual certification of full cervical dilation by a designated authority, usually a physician, regardless of the actual state of the woman's cervix or her involuntary urges to push; and (3) the certification process marked a ritual transition to "official" second stage labor, in which the woman's involuntary urges were considered appropriate and actively encouraged. CONCLUSION: A discrepancy between a laboring woman's sensations and caregivers' ideas about how labor should be conducted has implications for clinical care of women, wherein the goal should be to facilitate the woman's accomplishment rather than to direct the "delivery."

Adult↗
PubMed1997

Open randomized study of cefepime versus piperacillin-gentamicin for treatment of febrile neutropenic cancer patients.

An open-label randomized trial comparing the efficacy and safety of cefepime versus piperacillin plus gentamicin (P+G) given intravenously for the treatment of febrile episodes in neutropenic patients with underlying malignancy was conducted at two oncology centers. Over a 30-month period 111 patients were enrolled and 99 patients were found to be suitable for evaluation. At the 72-h time of evaluation, cefepime monotherapy and P+G combination therapy produced comparable clinical response rates (78% for both). P+G and cefepime produced comparable response rates in microbiologically documented (78 versus 71%), clinically documented (100 versus 100%), and possible (75 versus 79%) infections. The P+G and cefepime treatments achieved comparable microbiological eradication of gram-negative (100 versus 71%) (P = 0.09) and gram-positive (44 versus 70%) (P = 0.37) organisms. There were no statistically significant differences in the rates of superinfection between the groups; however, more superinfections of fungal origin were noted in the P+G group. Cefepime was demonstrated to be an effective and safe treatment for febrile episodes in neutropenic patients with malignancies, and its lack of nephrotoxicity compared to P+G was noteworthy. Cefepime appears to be a candidate for monotherapy in febrile neutropenic cancer patients.

Adult↗
PubMed1997

Interobserver agreement and disagreement in continuous recording exemplified by measurement of behavior state.

Continuous observational recording was used to measure behavior state of 3 adults with profound and multiple disabilities. Observations were made over 56.7 hours, including 21.9 hours with two observers recording independently. Overall percentage agreement was satisfactory (i.e., exceeded 80%). Agreement on occurrence was, however, generally unsatisfactory at a mean of 63.5%, with 5 of 16 Subject x State Agreement Indices over 80%. Percentage disagreement on occurrence, a previously unreported measure, was computed to quantify sources of disagreement. The agreement data were superimposed on participants' behavior state profiles to demonstrate how conclusions can be drawn from the data, despite their generally inadequate reliability. This approach to interobserver agreement and presentation of data is suggested for researchers investigating entities that are not directly amenable to observation.

Adult↗
PubMed1997

Recovery of kidneys from older donors: is it worthwhile?

One factor that is considered in the search for viable organs is the age of the potential donor. Retrospective data analysis on older donors (those aged 65 years and above) was performed to examine graft outcome. Data were collected on all older donors retrieved in one region from 1990 to 1995. Of those recipients transplanted locally (mean age, 57.6 years), creatinine values were recorded at 3 and 12 months. A recipient control group was selected from younger donors over the same period. Grafts were considered functional if the recipient was dialysis free. After 1 year, 24 recipients (82.3%) remained dialysis free, whereas 28 in the control group (90.3%) remained dialysis free during the same period. No significant differences were found in 1-year graft survival between kidneys retrieved from older donors versus those retrieved from younger donors. It therefore can be concluded that recovery from older donors is worthwhile.

Adult↗
PubMed1997

Getting IT into shape--external factors effecting the potential benefits from health informatics.

The introduction of a computer system will not always result in the expected outcomes. Extensive planning must be carried out for a new technological environment, changes in organisational practices and human reorientation. In addition to the specific requirements for the implementation of a particular application system there are more general issues to be considered. There are a number of organisational, technical and human factors which are thought to have affected demands for informatics support to healthcare and to have affected the level of benefits that can accrue from its operation in the healthcare sector of today. Some of the catalysts and inhibitors (positive and negative factors) can be recognised in advance of any specific implementation and the potential risk from their effects can be minimised. This paper considers some of the identified factors and how they are being addressed across Europe.

Data Collection↗
PubMed1997

The impact of screening for risk factors associated with postnatal depression at the first prenatal visit.

Although 10-15% of Australian women suffer from postnatal depression (PND), few efforts have been made, prenatally, to predict which women may develop the condition. The objective of this study was to evaluate the impact on patients, staff and services of an intervention designed to identify women at risk for PND. Women were screened at their first prenatal visit for factors associated with PND, and were asked to complete a questionnaire at their next clinic visit to assess the impact of the screening questions and the usefulness of a PND information kit. To assess the impact of the intervention on the prenatal clinic routine, all staff associated with the intervention were interviewed individually and their responses were tape recorded and analysed for themes. Patients reported a high level of satisfaction with the intervention. Staff responded well to the new procedure and offered constructive comments to improve the process.

Attitude of Health Personnel↗
PubMed1997

Reduced adenosine A1 receptor and G alpha protein coupling in rat ventricular myocardium during aging.

Adenosine A1 receptor (A1-AdoR) function in rat ventricles has previously been shown to decrease with age. In the present study, using the ligand [3H]8-cyclopentyl-1,3-dipropylxanthine ([3H]DPCPX) and coimmunoprecipitation of A1-AdoRs with their associated G proteins, we determined the specific binding of A1-AdoR and A1-AdoR/G protein coupling in ventricular myocardium of 6- to 24-month-old Fischer 344 rats. The densities (Bmax) of A1-AdoRs were 5.8 +/- 0.8 fmol/mg protein in 6-month-old rats and 6.1 +/- 1.4 fmol/mg protein in 24-month-old rats, and the dissociation constants (Kd) were 0.32 +/- 0.04 nmol/L in 6-month-old rats and 0.34 +/- 0.05 nmol/L in 24-month-old rats (P > .05). Analysis of the dose-dependent displacement of [3H]DPCPX binding by the selective A1-receptor agonist, N6-p-sulfophenyladenosine (SPA), yielded two affinity binding sites in both 6- and 24-month-old rats. However, the proportion of high-affinity A1-AdoRs was significantly lower in 24-month-old rats (23.5%) compared with 6-month-old rats (54.9%) (P < .05). In solubilized ventricular membranes, specific [3H]DPCPX binding sites were detected in immunoprecipitates of G alpha i3 and G alpha o antisera but not with antibodies for other G alpha proteins. The basal coimmunoprecipitation of A1-AdoR with G alpha i3 and G alpha o proteins decreased by 22% and 21%, respectively, in ventricular membranes of 24-month-old rats compared with that in 6-month-old animals. A1-AdoR stimulation with SPA increased the coprecipitation of A1-AdoR with G alpha i3 and G alpha o proteins by 287% and 245%, respectively, in 6-month-old rats but only by 129% and 140%, respectively, in 24-month-old rats (P < .01). In the absence of changes in A1-AdoR density and G alpha protein levels, an age-related decline in high-affinity A1-AdoR binding sites and a reduction in the association of A1-AdoR with G alpha proteins suggest that the age-related decrease in ventricular A1-AdoR-mediated response is related to a reduction in the coupling between A1-AdoR and their G proteins.

Adenylyl Cyclase Inhibitors↗