Search PubMed⌕ Search

Biomedical subjects

J Roberts

Publications and source records attributed to J Roberts.

At least 757 records · Page 42Linked to original sources
PubMedDate not supplied

Current perspectives on preeclampsia.

The early recognition of elevated blood pressure in pregnancy is still considered the most critical step in preventing the maternal and perinatal morbidity and mortality associated with preeclampsia-eclampsia. The recognition of hypertension is enhanced by an initial assessment of a women's risk for developing high blood pressure during pregnancy, correct blood pressure measurement, and early prenatal care. The care of the woman with hypertension preceding a pregnancy or during a previous pregnancy includes not only early prenatal care but also pre- or interconceptual care that might minimize the risk of further blood pressure elevation during pregnancy, as well as later in life. Tests to predict preeclampsia, such as the "roll" test and the use of the mean arterial pressure during midpregnancy, have been found to be invalid because of poor predictive validity. Relative increases in blood pressure during pregnancy are also no longer considered diagnostic for preeclampsia, however, consideration of relative increases is still "prudent" in assessing signs and symptoms of this disease. The development of preeclampsia is thought to occur very early in pregnancy as a result of imbalances between vasoconstrictive and vasodilatory factors, probably accompanying implantation and placentation. The use of aspirin to prevent the development of hypertension and preeclampsia is currently being studied because it has been shown to shift the balance toward the metabolism of the vasodilatory prostaglandin, prostacycline. At this time, aspirin is only advised for women at high risk for developing preeclampsia. Calcium may also be a preventative mineral, and a diet that is adequate during pregnancy is advised.

Aldosterone↗
PubMedDate not supplied

The identification of a US serviceman recovered from the Holy Loch, Scotland.

During February and March 2000, human remains were recovered from the Holy Loch, Scotland. Police enquiries identified 13 males that had gone missing, presumed drowned in the Holy Loch or the adjoining lochs, over the previous 35 years. Osteological examination of the remains established they were from a male, aged between 15 and 23 and 168-174 cm tall. This information eliminated ten of the known missing persons. DNA profiles, both STR and mitochondrial were generated from the remains and compared to the profiles generated from relatives of the missing men. A positive match between the unidentified individual and one of the maternal relatives identified the remains as belonging to a US serviceman who had gone missing 35 years ago. The successful identification led to the repatriation of the serviceman's remains.

Forensic Anthropology↗
PubMedDate not supplied

Clinical decision-making regarding intravenous hydration in normal labor in a birth center setting.

Intravenous hydration (IVH) in normal labor is used routinely in most hospital settings despite the lack of support from recent research. However, it is not used routinely at one in-hospital, Alternative Birthing Center (ABC), in the Midwest. The purpose of this study was to explore and describe the criteria and perspectives of the certified nurse-midwives (CNMs) and nurses (RNs) in their decision-making process toward nonroutine use of IVH. In-depth interviews with five CNMs and four RNs that work in the ABC provided insight into how they balanced patient preference, research-based knowledge, and clinical judgments, in making decisions about IVH. The RNs were slightly more in favor of IVH than the CNMs, but not because of philosophic differences. Rather, the different roles and responsibilities of CNMs and RNs seemed to be most important. CNMs had a stronger commitment to client preferences, whereas RNs were more concerned about their responsibility for efficiently starting IVs prior to an emergency situation. Understanding professional differences in the decision-making process for IVH can enhance clinical functioning of the caregiving team by helping CNMs anticipate and address potential conflicts.

Attitude of Health Personnel↗
PubMedDate not supplied

Challenges and opportunities for nurse-midwives.

This article reviews the major indicators of the growth in nurse-midwifery practice and education over the past 10 years. The major issues the profession has addressed are identified, as well as future challenges and opportunities. These challenges and opportunities are identified within the major dimensions of nurse-midwifery, that is, in practice, education, research, and within the public sector. The two major issues facing nurse-midwives are legislative initiatives related to the practice of nurse-midwives, such as reimbursement, and the mixed societal image of midwifery as a contemporary, cost-effective practice versus a peripheral activity by "old fashioned," informally educated individuals. The professional organization of nurse-midwives, the American College of Nurse-Midwives (ACNM), is addressing these issues through interdisciplinary and interorganizational legislative and marketing initiatives.

Humans↗
PubMedDate not supplied

AIDS awareness among women: the benefit of culturally sensitive educational programs.

AIDS affects everyone, regardless of race, age, or religion; hence, information must be accessible to everyone. This descriptive study identified the need to generate culturally sensitive educational programs and evaluated their effect. Culturally sensitive AIDS educational training was offered to culturally diverse women. Training was conducted by women of the same ethnicity as the women in the group. The facilitators were specially trained on the role of a facilitator and the participatory method of learning. To assess any change in attitude, knowledge, and beliefs regarding AIDS, the questionnaire was administered before and after the training programs. Educational training had a positive effect (p < .05) on participants' attitude and knowledge regarding AIDS; they felt comfortable discussing their concerns in their own language, and with their friends from the same community, and they viewed the resources used as culturally sensitive.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Adult psychosocial adjustment following childhood injury: the effect of disfigurement.

The literature investigating the psychosocial adjustment of burn survivors is limited and that addressing such adjustment in burned children is contradictory. Forty-two adults, burned in childhood, were assembled into burn severity cohorts and compared as to burn severity, intensity of stress, and extent of disfigurement and disability. The findings substantiated the hypothesis that the biologic variables of years since burn and severity would not explain psychosocial adjustment in adulthood; lower adjustment correlated with visible disfigurement and less peer support rather than with severity of burn.

Adaptation, Psychological↗
PubMedDate not supplied

Role of the adrenergic nerve terminal in digitalis-induced cardiac toxicity: a study of the effects of pharmacological and surgical denervation.

This study determined whether the protective action of bretylium against ouabain-induced ventricular arrhythmia in the cat is related to an action of bretylium on the adrenergic nerve terminal. Bretylium pretreatment (20 mg/kg, i.v.) administered 2 h prior to ouabain (2 micrograms/kg/min, i.v. until death) increased the dose of ouabain to produce premature ventricular contraction, ventricular tachycardia, and death from 77.2 +/- 5.2 to 107.7 +/- 6.7 micrograms/kg; from 84.9 +/- 5.2 to 113.9 +/- 7.1 micrograms/kg; and from 108.8 +/- 4.0 to 146.7 +/- 5.7 micrograms/kg, respectively (p less than 0.05). Surgical denervation 2 weeks prior to the experiment or 6-hydroxydopamine (6OH dopamine), 20 mg/kg, i.v., administered 3 or 14 days prior to the ouabain infusion did not protect against the arrhythmogenic effects of ouabain. When bretylium was administered to cats pretreated with 6OH dopamine 3 days prior to the ouabain infusion or to surgically denervated cats, the protective action against ouabain-induced arrhythmia did not develop. Since 6OH dopamine and surgical denervation prevented the action of bretylium on ouabain-induced ventricular arrhythmia, it appears that bretylium is acting on the adrenergic nerve terminal. Thus, agents like bretylium that act on the adrenergic nerve terminal, leaving it structurally intact but not functional, are effective against ouabain-induced ventricular arrhythmia while procedures which cause the degeneration of the adrenergic nerve terminal, such as 6OH dopamine and surgical denervation, are not. These observations indicate that for the protective effect of sympathectomy against ouabain-induced arrhythmia to develop, the adrenergic nerve terminal must be present, although not functional as far as adrenergic neurotransmission is concerned. Changes in the heart rate or blood pressure did not appear to be a factor in the protective effect of bretylium.

Animals↗
PubMedDate not supplied

Are the sympathetic neural effects of digoxin and quinidine involved in their action on cardiac rhythm?

This study was initiated to determine if ventricular arrhythmia induced by digoxin was associated with a nonuniform neural discharge in the cardiac sympathetic postganglionic fibers. In addition, splanchnic neural discharge was monitored to explore the role of adrenal medullary catecholamines in digoxin-induced arrhythmia. Experiments were performed to ascertain whether the antiarrhythmic effects of quinidine in digoxin-induced arrhythmias were related to an action on cardiac sympathetic neural discharge induced by digoxin. All cats were anesthetized with alpha-chloralose and given atropine; some were pretreated with quinidine (10 or 20 mg/kg i.v. 15 min before digoxin). Digoxin was given every 15 min until death; the first three doses were 50 micrograms/kg i.v., and all subsequent doses were 25 micrograms/kg. The mean +/- SE time to arrhythmia was 32 +/- 4 min (n = 16) and was significantly increased only after 20 mg/kg quinidine (64 +/- 7 min; p less than 0.001). Mean +/- SE time to death was also increased from 74 +/- 4 to 98 +/- 7 min (p less than 0.001). Postganglionic cardiac sympathetic neural discharge before digoxin-induced arrhythmia was depressed. Of the 28 nerves monitored in 16 animals receiving digoxin, in the minute before development of arrhythmia, 22 nerves were depressed, 3 were increased, and 3 showed no change when compared with the predigoxin control. Following this depression of neural discharge, arrhythmia developed, and the neural discharge began to rise, eventually increasing above control levels. During this time the variability of the neural discharge increased greatly, as evidenced by large SE values, so that the mean values were not significantly different from control levels. Splanchnic neural discharge (n = 9) progressively decreased, reaching 66% of control values after the third injection of digoxin; the discharge then began to increase gradually toward control levels in the next 10 min and arrhythmia developed. The data indicate that the arrhythmias caused by digoxin are not associated with the development of nonuniform discharge patterns in the cardiac sympathetic nerves. Furthermore, action on the splanchnic nerve discharge is not involved in the arrhythmogenic effects of digoxin. Pretreatment with quinidine, 20 mg/kg, decreased both splanchnic and post-ganglionic cardiac sympathetic neural discharge, arterial blood pressure, and heart rate. Although quinidine, 20 mg/kg, increased the time to arrhythmia induced by digoxin, the depression of postganglionic cardiac or splanchnic neural discharge did not seem to be a major component of the antiarrhythmic effect of quinidine.

Animals↗
PubMedDate not supplied

The effect of age on the tyramine-sensitive intraneuronal pool of norepinephrine in rat heart.

The effect of age on the amount of norepinephrine (NE) released by tyramine (TYR) was investigated in hearts from Fischer 344 rats, 6, 12, and 24 months of age. Isolated hearts were perfused through an aortic cannula with Krebs-Ringer solution containing 1.6 X 10(-4) M TYR. alpha-Methyl-p-tyrosine (7.5 X 10(-5) M) and fusaric acid (10(-5) M) were added to inhibit de novo synthesis of NE. The effluent from the heart was collected continuously throughout 4 h of perfusion with TYR. The content of NE in the perfusion effluent was measured by electrochemical (EC) detection methods after alumina extraction and high-performance liquid chromatography (HPLC) separation. In addition, the amount of NE remaining in the heart after TYR perfusion was measured with HPLC/EC methodology. The amount of NE released from hearts was not significantly different among the ages [6 months, 612.5 +/- 68.2 ng; 12 months, 640.2 +/- 53.0 ng; 24 months, 593.8 +/- 38.2 ng; p greater than 0.05, analysis of variance (ANOVA)]. These amounts represent more than 93% of total cardiac NE at all ages (6 months, 97.6 +/- 0.5%; 12 months, 94.8 +/- 1.3%; 24 months, 93.7 +/- 1.7%). The t1/2 for the decline in NE in hearts was also similar at the three ages (6 months, 45.0 +/- 4.9 min; 12 months, 53.6 +/- 5.2 min; 24 months, 60.4 +/- 7.8 min; p greater than 0.05, ANOVA). These results indicate that the amount of NE released by TYR does not change with increasing age.

Aging↗
PubMedDate not supplied

British nurses at war 1914-1918: ancillary personnel and the battle for registration.

The purpose of this study was to examine the use of ancillary personnel to augment nursing staff, a recurring theme in the history of nursing. The focus was the use of untrained nursing personnel in Great Britain during the years 1914-1918. The findings demonstrate both the nature and extent of dilution within nursing and its effects in terms of social relationships and occupational structure.

Female↗