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Biomedical subjects

L Ouellet

Publications and source records attributed to L Ouellet.

15 recordsLinked to original sources
PubMed2001

Prevalence, incidence, and correlates of chlamydia and gonorrhea among young adult injection drug users.

PURPOSE: To measure prevalence, incidence, and correlates of chlamydia and gonorrhea among injection drug users (IDUs). METHODS: Participants (n = 2129; 63% male, 52% white, ages 18-30 years) in five US cities were tested for chlamydia and gonorrhea by urine LCR assay and completed a standardized questionnaire about demographics and recent sexual behavior. Logistic regression identified correlates of prevalent infection; incidence rates were calculated from 6-month follow-up data. RESULTS: Chlamydia prevalence was 5.2% and did not differ by gender. Gonorrhea prevalence was 0.2% among men and 2.0% among women, P < .001. Among men, younger age [OR (95% CI): 0.89 (0.83-0.96)], age at sexual debut [0.91 (0.83-0.99)], and African American race [2.92 (1.53-5.59)] were associated with chlamydia. Among women, age at sexual debut [1.16 (1.02-1.31)] and commercial sex [1.96 (1.03-3.74)] were associated with chlamydia, and with gonorrhea [1.27 (1.04-1.56)] and [5.17 (1.66-16.11)], respectively. At 6 months, the cumulative incidence of chlamydia was 1.7% among men and 4.4% among women, P = .03; no men and 1.3% of women tested positive for gonorrhea, P = .01. IMPLICATIONS: Prevalence and correlates of chlamydia and gonorrhea were similar to other samples, suggesting that screening criteria need not be modified for IDU populations. The number of behavioral correlates identified was limited; perhaps unmeasured sexual-network-level factors play a role in determining sexually transmitted disease (STD) prevalence.

Adolescent↗
PubMed2000

The multiperson use of non-syringe injection equipment and risk of hepatitis c infection in a cohort of young adult injection drug users, chicago 1997-1999.

PURPOSE: The possibility that hepatitis C virus (HCV) is transmitted via the multiperson use of injection paraphernalia other than syringes has been suggested, but epidemiologic studies to examine the association are difficult to design due to saturation levels of infection in most samples of injection drug users (IDUs). This study (1) assembled a sample of young adult IDUs, among whom hepatitis C infection prevalence was still moderate, (2) measured incident HCV infection, and (3) determined the risk for seroconversion associated with specific forms of sharing injection paraphernalia.METHODS: Between 1997 and 1999, 702 IDUs, 18-30 years old, were interviewed and screened for antibodies to HCV at baseline and at 6 and 12 months post-baseline. Participants were recruited through street outreach, advertising and chain-referral from ethnically diverse neighborhoods in metropolitan Chicago. Data were analyzed using standard survival statistical methods.RESULTS: HCV prevalence was 27% at enrollment. During 296.5 person-years of observation, we observed 37 HCV seroconversions (incidence: 12.5/100 person-years). The adjusted relative hazard (RH) of seroconversion, after controlling for demographic and drug use covariates, was highest for sharing cookers (RH, 3.58; 95% CI 1.47-8.70), followed by sharing rinse water (RH, 2.16; 95% CI 1.03-4.52), and cottons (RH, 1.84; 95% CI 0.95-3.56). Risk associated with syringe sharing was marginally significant, and backloading was unassociated with hepatitis C seroconversion. Adjusting for syringe sharing, the independent effects of sharing cookers and cottons remained significant, and a final model that included each sharing practice demonstrated that sharing cookers had at the strongest association with seroconversion (RH, 3.03; 95% CI 1.05-8.72).CONCLUSIONS: This study suggests that sharing non-syringe paraphernalia may be an important cause of hepatitis C virus transmission between IDUs.

Journal Article↗
PubMed1999

Violence in the emergency department: a survey of health care workers.

BACKGROUND: Violence in the workplace is an ill-defined and underreported concern for health care workers. The objectives of this study were to examine perceived levels of violence in the emergency department, to obtain health care workers' definitions of violence, to determine the effect of violence on health care workers and to determine coping mechanisms and potential preventive strategies. METHODS: A retrospective written survey of all 163 emergency department employees working in 1996 at an urban inner-city tertiary care centre in Vancouver. The survey elicited demographic information, personal definition of violence, severity of violence, degree of stress as a result of violence and estimate of the number of encounters with violence in the workplace in 1996. The authors examined the effects of violence on job performance and job satisfaction, and reviewed coping and potential preventive strategies. RESULTS: Of the 163 staff, 106 (65%) completed the survey. A total of 68% (70/103) reported an increased frequency of violence over time, and 60% (64/106) reported an increased severity. Most of the respondents felt that violence included witnessing verbal abuse (76%) and witnessing physical threats or assaults (86%). Sixty respondents (57%) were physically assaulted in 1996. Overall, 51 respondents (48%) reported impaired job performance for the rest of the shift or the rest of the week after an incident of violence. Seventy-seven respondents (73%) were afraid of patients as a result of violence, almost half (49%) hid their identities from patients, and 78 (74%) had reduced job satisfaction. Over one-fourth of the respondents (27/101) took days off because of violence. Of the 18 respondents no longer working in the emergency department, 12 (67%) reported that they had left the job at least partly owing to violence. Twenty-four-hour security and a workshop on violence prevention strategies were felt to be the most useful potential interventions. Physical exercise, sleep and the company of family and friends were the most frequent coping strategies. INTERPRETATION: Violence in the emergency department is frequent and has a substantial effect on staff well-being and job satisfaction.

Adaptation, Psychological↗
PubMed1999

Basic transcription element-binding protein (BTEB) is a thyroid hormone-regulated gene in the developing central nervous system. Evidence for a role in neurite outgrowth.

Thyroid hormone (3,5,3'-triiodothyronine; T(3)) is essential for normal development of the vertebrate brain, influencing diverse processes such as neuronal migration, myelin formation, axonal maturation, and dendritic outgrowth. We have identified basic transcription element-binding protein (BTEB), a small GC box-binding protein, as a T(3)-regulated gene in developing rat brain. BTEB mRNA levels in cerebral cortex exhibit developmental regulation and thyroid hormone dependence. T(3) regulation of BTEB mRNA is neural cell-specific, being up-regulated in primary cultures of embryonic neurons (E16) and in neonatal astrocytes (P2), but not in neonatal oligodendrocytes (P2). T(3) rapidly up-regulated BTEB mRNA in neuro-2a cells engineered to express thyroid hormone receptor (TR) beta1 but not in cells expressing TRalpha1, suggesting that the regulation of this gene is specific to the TRbeta1 isoform. Several lines of evidence support a transcriptional action of T(3) on BTEB gene expression. Overexpression of BTEB in Neuro-2a cells dramatically increased the number and length of neurites in a dose-dependent manner suggesting a role for this transcription factor in neuronal process formation. However, other T(3)-dependent changes were not altered; i.e. overexpression of BTEB had no effect on the rate of cell proliferation nor on the expression of acetylcholinesterase activity.

Animals↗
PubMed1998

HIV-specific cytotoxic T-lymphocyte activity in immunologically normal HIV-infected persons.

BACKGROUND: CD8+ T-cell counts usually increase soon after infection with HIV, whereas CD4+ cell counts decrease. The result of these changes in T-cell subpopulation subsets in most HIV-infected subjects is inversion of the CD4 : CD8 ratio from greater than 1.0 typical of uninfected persons to less than 1.0 after infection. SUBJECTS: Six HIV-infected individuals were identified in whom the CD4 : CD8 ratio remained normal throughout follow-up (4.0-11.25 years). They all maintained levels of CD4+ cells above 500 x 10(6)/l and had never received antiretroviral therapy. Because HIV-specific cytotoxic T lymphocytes (CTL) have been implicated in control of HIV during the asymptomatic phase of disease, we screened these individuals for the presence of HIV-specific CTL activity. METHODS: CTL activity was assessed in freshly isolated peripheral blood mononuclear cells (PBMC) and in phytohaemagglutinin-stimulated interleukin-2 expanded cell lines established from PBMC. Cytotoxicity to HIV-1 env, gag, pol and nef gene products was surveyed in a 4 h 51Cr-release assay using autologous Epstein-Barr virus (EBV) transformed B cells infected with vaccinia constructs expressing each of these HIV genes. The immunodominant CTL epitope and MHC class I antigen restriction specificity of HIV-specific CTL was mapped when present. Plasma viral load was assessed by branched DNA assay. Attempts were made to isolate virus from these individuals by the PBMC coculture assay. RESULTS: None of the six immunologically normal HIV-infected (INHI) subjects exhibited direct HIV-specific CTL activity in their freshly isolated PBMC compared with 16 (47%) out of 34 HIV disease progressors (P = 0.03, chi2 test) and one out of 10 seronegative subjects. Three of the six INHI subjects had detectable memory HIV-specific precursor CTL (pCTL) activity in in vitro-activated T-cell lines compared with 25 (73.5%) out of 34 HIV-1 disease progressors and in none out of 10 seronegative individuals. All three INHI subjects had Gag-specific pCTL, and none had reverse transcriptase-specific pCTL. Plasma HIV viraemia in all six INHI subjects was below the level of detection by branched DNA assay (< 500 copies/ml). Virus could not be isolated from four of these individuals despite multiple attempts to do so by PBMC coculture assays. CONCLUSION: Direct HIV-specific CTL activity mediated by activated circulating PBMC was undetectable in six INHI individuals under conditions where it is frequently observed in HIV disease progressors. Despite the absence of cells activated for killing HIV-infected targets in the circulation of these individuals, they appeared able to control their HIV infection by maintaining normal levels of CD4 and CD8 cells and low viral load.

Adult↗
PubMed1997

Alexithymia and impoverished dream recall in asthmatic patients: evidence from self-report measures.

Early clinical impressions that alexithymia is associated with diminished dream recall have been supported by more recent research. The present study was designed to examine this association using self-report measures and a carefully screened clinical population. Thirty-three male and 43 female asthmatics from an outpatient clinic were administered the Toronto Alexithymia Scale, the Eysenck Personality Questionnaire, and a questionnaire concerning retrospective recall of dreams and nightmares. Multiple regression analyses revealed that, among men, dream recall was negatively related to alexithymia, especially to the TAS analytical mode of thinking subscale, independent of age and neuroticism. Among women, dream and nightmare recall were positively correlated with neuroticism. These results are consistent with early clinical observations of pensée opératoire, with some research findings, and with the notion that dream recall may be differentially associated with components of alexithymia in men and women patients.

Adolescent↗
PubMed1996

Risk behavior and HIV seroincidence among out-of-treatment injection drug users: a four-year prospective study.

We monitored trends in HIV risk behaviors and seroconversion among out-of-treatment injection drug users (IDUs) receiving street-based outreach intervention. Beginning in 1988, 641 HIV-seronegative IDUs were recruited by targeted sampling methods to reflect broader IDU populations and were followed for 4 years (1988-1992). All were active injectors not in treatment when recruited. Cohort members were targets of HIV-prevention outreach. The intervention was guided by the Indigenous Leader Outreach Model: Exaddicts deliver HIV-prevention services targeting IDU social networks in community settings. Primary outcome measures were HIV seroconversion and HIV risk behaviors. Observed incidence of HIV infection decreased, from 8.4 to 2.4 per 100 person-years. Prevalence of drug risk behaviors also decreased, from 100 to 14%. Seroconversion was associated with injection risk behavior [risk ratio (RR) = 9.8]. Sex risk behavior also decreased, but less dramatically, from 71 to 45%. Out-of-treatment IDUs in Chicago have reduced their rates of new HIV infection by reducing their injection risk behavior. New infections were strongly associated with injection risk behavior but not with sex risk behavior.

Adolescent↗
PubMed1994

Intonation and speech rate in dysarthric speech.

Ten dysarthric speakers of various etiologies, type, and severity were compared to age-matched and gender-matched nondysarthric speakers on 40 short sentences. These sentences were presented in both declarative and interrogative versions. Measures of (1) mean intonation difference (average difference in fundamental frequency between the last syllables of interrogative and declarative sentences) and (2) speech rate were obtained using the IBM Speech Viewer system. Analyses of variance were performed on the resulting measures with subject group, sentence type, and sentence sets as independent variables. Results indicate that (1) intonation values are significantly reduced in the dysarthric group as compared to those for the nondysarthric group; (2) rate varies as a function of subject group, sentence type, and sentence set. Moreover, intonation varies with severity of dysarthria, but not speech rate. These findings concur with the notion that dysarthria is a deficit in performance rather than in competence. The results are also discussed in reference to "breath-group" theory for intonation (Lieberman, 1967).

Brain Damage, Chronic↗
PubMed1993

Pain in dreams.

Little is known about pain in dreams. Some studies indicate that it is rare and that it may be beyond the representational capability of dreaming. However, the present study describes experiences of dreamed pain that were reported incidentally in experiments on the effects of somatosensory stimulation administered during rapid eye movement (REM) sleep. Dreams were selected from five subjects who had reported at least one instance of dreamed pain in these studies. The subjects had undergone 42 stimulation trials over 20 nights and had reported a total of 13 dreams (31%) with one or more references to pain. Most often, these references appeared to be direct, untransformed incorporations of real sensations produced by stimulation. Pain was the principal motivating agent in a majority of these dreams and was in many cases associated with strong emotion--typically anger. Dreams often depicted the subjects' attempts to obtain relief from pain, in some cases by repetition of actions, in others by metaphoric renditions of the goal. The results indicate that although pain is rare in dreams, it is nevertheless compatible with the representational code of dreaming. Further, the association of pain with dream content may implicate brainstem and limbic centers in the regulation of painful stimuli during REM sleep.

Adult↗
PubMed1992

The effects of speech and language therapy for a case of dysarthria associated with Parkinson's disease.

We report the results of a single-subject multiple baseline across behaviours experiment of a 74-year-old woman presenting with Parkinson's disease. Her speech was typical of a hypokinetic dysarthria. The main features of her dysarthric speech were: a restriction in the modulation of fundamental frequency, an inappropriate pitch level and a rate disturbance. Three measures of prosody were operationally defined as follows: (1) linguistic modulation of fundamental frequency, (2) mean fundamental frequency and (3) rate. Treatment focused on ameliorating these aspects employing a multiple baseline design. Measures during and post-therapy documented improvement for each of these three aspects of prosody. Independent judges were also more capable of understanding her speech and her speech prosody after therapy. Upon follow-up measures 10 weeks later, most of the improvement was maintained.

Aged↗
PubMedDate not supplied

Guidelines for selecting a nursing model for practice.

Nursing models can provide direction to the practicing nurse. In this article, the process of selecting a nursing model is outlined. Noteworthy is the need for administrative support in this process in terms of providing release time, adequate coverage of the unit, scheduling, secretarial support, praise, and encouragement. It is suggested that nurses from various levels form an ad hoc committee so that there be representatives from both management and staff nurses as well as those who have been exposed to the use of models on the committee. Initially, the committee members should examine beliefs about nursing, the client, and the environment so that the model selected will reflect the beliefs and goals of the staff. Factors to consider in model selection are outlined so that the selected model will provide direction to each phase of the nursing process. Once a model is selected, it is recommended that individuals with experience in using it be approached to share their successes and difficulties. It is imperative that staff nurses be involved in the decision-making process.

Decision Making, Organizational↗