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Biomedical subjects

K Johnson

Publications and source records attributed to K Johnson.

At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

Utilization of a paediatric link collection by health professionals and laypersons.

The Internet is an evolving resource for health-care information. However little information exists on providers' and other web patrons' usage of the 'medical' Internet. This study aims to characterize the users of a large paediatric link collection, describe their objectives and track their use of the information provided by the site. We utilized a paediatric link collection called the Pediatric Points of Interest (POI) and a combination of a questionnaire, unique user identifier and link-tracking system to collect data about POI patrons' demographics and Internet resource utilization. During a five week period, 5216 individuals visited the POI and requested 36,187 links. The majority of users had less than one year of Internet experience and were first-time visitors to the POI. More than 83% of users were from North America. Medical professionals were more likely to return to the POI during the study period and reported visiting the POI mainly for 'medical education', 'research', 'resource identification', and 'disease specific information'; they proceeded primarily to the resource categories 'Medical Institutions and Agencies' (32%) and 'Professional Education and Resources' (28%). Laypersons expressed the greatest interest in 'disease specific information' and 'patient education' and most frequently visited the category. 'Patient Education' (42%). On average, users were able to identify resources related to their stated goals within one level of searching. Health care providers and other web patrons are actively utilizing Internet sites to seek medical information and are able to identify resources with a minimum of searching.

Adolescent↗
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Emerging zoonoses.

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Animals↗
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The evolution of a hospital-based decentralized case management model.

The authors present a case study of a highly integrated case management program and the redefinition of the clinical practice model that evolved across the continuum of care as the integration process was achieved. The central leadership role of the clinical care coordinator (an advanced staff nurse role) as the front-line link between the case manager and the staff nurses was seen as one key in the model's success. Success was further enhanced by: development of objective-based versus time-oriented pathways; involvement of home health earlier, especially in the more complex discharge plans; and a refocus of the patient education process. Future initiatives include refocusing the patient education component as part of a "Steps to Recovery" approach that includes appropriate aspects of the objective-based clinical pathways and expanding the number of case management models to include currently underrepresented patient populations.

Case Management↗
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Adverse effects of the salazopyrine metabolite sulphapyridine on female fertility in the rat.

Salazopyrine, a common therapy for inflammatory bowel disease, is known to have a reversible antifertility effect in men and male rats via its metabolite, sulphapyridine. To determine if there is an adverse effect in females, 20 mature Sprague-Dawley rats were assigned to a treatment (400 mg/kg sulphapyridine daily), or a control group. After three estrous cycles of treatment, the rats were bred to males of proven fertility. When killed at 10 days gestation, there was a significant reduction in the proportion of fertilized oocytes between control (112/174) and treatment (81/212) groups (chi-square = 26.16, d.f. = 1, P less than .00001). These findings suggest an adverse effect of sulphapyridine on female fertility.

Animals↗
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Sexual behaviour changes in a cohort of male sexual contacts of men with HIV disease: a three-year overview.

We describe the sexual behaviour reported by 240 seronegative and seropositive homosexual men over a 3-year period. Sexual partners of men with HIV disease were recruited into a prospective study between July 1984 and July 1985 and were monitored every 3 months thereafter. Data on sexual activities were collected through interviewer-administered questionnaires. The cohort experienced a reduction in both the number of sexual partners and the volume of sexual activity. Reductions in the number of partners were early and dramatic. Changes in sexual activities were gradual and consistent in trend. The greatest reduction occurred in high risk activities (receptive and insertive anal intercourse). After 3 years of follow-up, only 10% of the men continue to be exposed to semen through unprotected receptive anal intercourse and 18% through unprotected receptive oral-genital sex. The proportion of men engaging in oral-genital contact and masturbation remained stable over the 3 years. Once informed of their serostatus, both seropositive and seronegative men reduced their high risk behaviour. The decline in rates of STDs and seroconversion confirmed that this cohort had indeed reduced their high risk behaviour.

Cohort Studies↗
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Women's health as a multidisciplinary specialty: an exploratory proposal.

The purpose of this paper is to encourage the development of women's health as a multidisciplinary specialty. The idea for such a specialty arose from the grass roots women's health movement of the 1960s, whose tenets were rapidly embraced by physicians sympathetic to its ideals, especially members of the American Medical Women's Association. Women's health would be a multidisciplinary specialty offering service to a specific patient population, analogous to geriatric medicine. It would blend primary care, ambulatory obstetrics-gynecology, and psychiatry with additional training in endocrinology, nutrition, sports medicine, and orthopaedics. Suggestions for residency training and specialty certification are included.

Education, Medical↗
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The impact of lifestyle factors on serum 25-hydroxy vitamin D levels in older adults: a preliminary study.

We studied 49 adults between the ages of 60 and 91 to determine the impact of lifestyle factors on serum 25-hydroxy vitamin D levels. The subjects were interviewed to determine their sunscreen use, sun exposure, dietary and supplemental vitamin D intake, current medical problems, and medications used. Serum levels of 25-hydroxy vitamin D (D2 and D3) were measured. Forty-six percent of our subjects had a total vitamin D intake less than 400 IU/day and 49% never used sunscreen. Sunscreen use was positively correlated with 25-hydroxy vitamin D serum levels. Total vitamin D intake was more significant than sun exposure in determining 25-hydroxy vitamin D levels.

25-Hydroxyvitamin D 2↗
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MR of hemorrhage: a new approach.

Using a modification of the partial saturation (PS) pulse sequence, we developed an MR method that permits the acquisition of highly T1- and T2-weighted images of the head and body in as little as 10 sec. The PS images, which were acquired at 0.6 T in a series of six patients with acute and subacute hemorrhage, showed a striking reduction in the signal intensity of hemorrhagic lesions. This effect, which is related to bulk magnetic susceptibility variations, was either minimal or absent on conventional T1- and T2-weighted spin-echo (SE) images. Our results suggest that high-field systems are not needed in order to image acute and subacute hemorrhage.

Brain Diseases↗
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You hold the key.

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Nursing↗
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Prognostic factors in cancer of the testis: an approach to identification.

The clinical experience at the University of Minnesota Hospitals between 1962 and 1977 was reviewed in the hope of defining the biologic features of testicular cancer, knowledge of which is essential to determine the therapeutic needs of each patient. This collaborative effort between clinicians and statisticians has attempted to define important variables in the assessment of risk factors that determine the choice of treatment for testicular cancer. A preliminary analysis of data on the first 78 patients tabulated was performed to test and plan an approach to the final analysis of a larger group of 282 patients. One prognostic factor, staging, is discussed in detail to illustrate the purpose of this exploratory testing. Retrospective analysis, according to stage, of patients who were referred to this cancer center revealed a poorer prognosis than should be anticipated. In reporting the clinical experience of an individual institution, problems of bias are introduced with respect to the nature of the types of tumors studied.

Actuarial Analysis↗
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A decentralized model for case management.

Case management has been implemented in a variety of health care settings. The implementation of case management at one hospital, including rationale for selection and outcomes, is described here. A decentralized model emphasizing staff nurse control is recommended for hospitals with TQM and shared governance programs already in place.

Decision Making, Organizational↗
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Women's health and managed care: implications for the training of primary care physicians.

The growth of managed care is changing the practice of medicine; it has a direct impact on the quality of care offered to women and may erode gains made in the field of women's health. Graduate medical education must be transformed if women's health is to be effectively represented in the evolving health care system. An interdisciplinary primary care specialty in women's health is the best strategy for preparing physicians to deliver cost-effective comprehensive care to women in a changing health care marketplace.

Continuity of Patient Care↗
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Soluble IL-2 receptor beta and gamma subunits: ligand binding and cooperativity.

Biologically relevant interleukin-2 receptors (IL-2Rs) are present in two affinity states on responsive cells. High affinity receptors (HAR) apparently exist as heterotrimers (alpha, beta and gamma) while the other functional complex, the intermediate affinity receptor (IAR), is comprised of beta and gamma chains. The mechanisms by which the beta and gamma subunits contribute the formation of HAR and IAR are still unclear. Soluble forms of the beta and gamma chains were cloned, epitope-tagged, expressed in insect cells and purified. IL-2 binding and neutralization of IL-2 bioactivity by beta and gamma extracellular domains (ectodomains) was analyzed by several biochemical and biological approaches. The results indicate that beta clearly binds IL-2 with low affinity (KI-KD = 3 microM) whereas gamma binding is detectable, but of very low affinity (apparent KI > 15 microM) in the absence of beta. Interestingly, combinations of beta and gamma ectodomains interact to bind IL-2 with higher affinity and greater stability than either chain alone. An apparent stable binding complex is formed when beta, gamma, and IL-2 are combined. Ligand binding by the beta and gamma chains in solution is specific for IL-2 and is of sufficient affinity and stability to effectively neutralize IL-2 in biological assays (binding IC50 = biological IC50). Direct analyses of binding kinetics by surface plasmon resonance reveals that the increased affinity and biological neutralizing ability of beta gamma, as compared to beta, is due to a very slow dissociation rate contributed by the gamma ectodomain. While IL-2R beta and gamma cytoplasmic and transmembrane domains are not essential for interactive binding of IL-2, they may contribute to IL2 binding affinity. The recognition and association of IL-2 by the beta gamma IAR appears to be contributed primarily by the beta chain while the stability and dissociation is likely dominated by the gamma chain. It is anticipated that the gamma subunit functions in a similar manner when participating in high affinity IL-4 and IL-7 binding.

Binding, Competitive↗