Biomedical subjects

M Johnson

Publications and source records attributed to M Johnson.

At least 955 records · Page 53Linked to original sources

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Beyond community assessment into the real world of learning aggregate practice.

One certainty for nursing, and therefore for nursing education, is that nurses of the 21st century will be called upon to deliver aggregate-based care. Faculty, seeking ways to prepare students for this challenge, often use community assessment as a strategy to help develop skills required to implement care at the aggregate level. In this unique program, community projects completed during an undergraduate community and family health nursing course are expanded in scope to include community diagnosis, planning, intervention, and outcome evaluation. Projects offer immediate benefit to the agency and may continue for several semesters, involving students in various phases of the nursing process.

Adult↗

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The reverse transcriptase codon 69 insertion is observed in nucleoside reverse transcriptase inhibitor-experienced HIV-1-infected individuals, including those without prior or concurrent zidovudine therapy.

OBJECTIVES: This study was undertaken to examine 6-bp insertions following codon 69 in the reverse transcriptase (RT) coding region of human immunodeficiency virus type 1 (HIV-1) mutations in terms of incidence, presence of additional RT mutations, phenotypic drug resistance, HIV-1 RNA levels, and antiretroviral treatment history. STUDY DESIGN/METHODS: A retrospective study of 121 nucleoside reverse transcriptase inhibitor (NRTI)-experienced subjects infected with HIV-1 was performed. Methods included quantitation of HIV-1 RNA levels, genotypic analyses of the RT and protease coding regions, and determination of phenotypic drug resistance. RESULTS: A 6-bp insertion following RT codon 69 was observed in viral isolates from 4 subjects. Two subjects had a history of zidovudine (ZDV)-based therapy, and two subjects had a history of stavudine (D4T)-based therapy without prior exposure to ZDV. The T69S mutation and the 6-bp insertion following RT codon 69 were the only RT mutations observed in the 2 subjects with a history of D4T-based therapy. CONCLUSIONS: Six-basepair insertions occurred in virus from 4 of 121 (3%) NRTI-experienced subjects, including those without prior ZDV treatment, and was observed in the absence of the T215Y mutation. There was no apparent correlation between insertion incidence and HIV-1 viremia.

Anti-HIV Agents↗

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Respiratory infections in patients with HIV.

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AIDS-Related Opportunistic Infections↗

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Deletions in the beta3-beta4 hairpin loop of HIV-1 reverse transcriptase are observed in HIV-1 isolated from subjects during long-term antiretroviral therapy.

OBJECTIVES: To examine the effect of in-frame deletions in human immunodeficiency virus type 1 (HIV-1) reverse transcriptase (RT) on plasma viremia and phenotypic resistance to antiretroviral drugs. STUDY DESIGN/METHODS: Plasma HIV-1 RNA was isolated from 168 antiretroviral therapy-experienced subjects for quantification of plasma viremia, RT sequence analysis, and phenotypic resistance assays. RESULTS: Four patients were found to harbor HIV-1 strains possessing in-frame, 3-nucleotide deletions at RT codons 67, 69, and 70. In these subjects, phenotypic resistance and high plasma viremia were observed only in a background of multiple resistance mutations. A recombinant virus engineered with an in-frame deletion of RT codon 67 did not have increased resistance to nucleoside reverse transcriptase inhibitors (NRTIs). CONCLUSIONS: Selection for deletions within the beta3-beta4 hairpin loop of the HIV-1 RT is an uncommon event most likely to occur in subjects with long-term antiretroviral experience. The codon 67 deletion does not appear to cause increased phenotypic resistance or increased viremia in the absence of concomitant RT mutations.

Adult↗

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Traumatic brain injuries in Alaska, 1996-1998.

Traumatic brain injuries often lead to severe disability or death. These injuries most often affect younger, more active people and are likely to have enduring physical, emotional, and financial costs. In order to determine the incidence, etiology and severity of traumatic brain injuries in Alaska, the Alaska Department of Health and Social Services has conducted a three-year study of the demographic and epidemiologic characteristics of traumatic brain injuries in Alaska. From 1996 through 1998, 1,932 hospitalized cases or out-of-hospital deaths occurred in the state among Alaska residents, for an average incidence rate of 105.2 per 100,000 population. To analyze the incidence of these injuries, the Traumatic Brain Injury Surveillance Project analyzed the location, demographics, and etiology.

Accidents↗

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The impact of automatic prescriptions on reducing low-density lipoprotein cholesterol levels.

CONTEXT: Compliance with the National Cholesterol Education Program (NCEP) guidelines for secondary prevention of atherosclerotic disease has been poor. OBJECTIVE: To determine whether an automatic prescription would improve compliance with NCEP guidelines on low-density lipoprotein (LDL) cholesterol for secondary prevention of atherosclerotic disease. DESIGN: Observational study in which physicians chose whether to use an automatic prescription system. PATIENTS: 126 patients with established coronary or cerebrovascular disease whose LDL cholesterol level was greater than 100 mg/dL. INTERVENTION: By signing the automatic prescription, physicians allowed the study team (medical director and pharmacist) to change lipid-lowering medications. One member of the team then contacted the patient, advising him or her of any changes to medications and treatment. The patient was told that his or her doctor was recommending this change on the basis of recent laboratory tests. OUTCOME MEASURES: The proportion of patients reaching the LDL cholesterol goal of 100 mg/dL or less. RESULTS: Physicians used the automatic prescription for 25 patients. Eighteen of the 25 patients in the intervention group (72.0%) achieved the LDL cholesterol goal compared with only 43 of the 101 controls (42.6%) (P = 0.004). After adjustment for differences in age, sex, triglyceride levels, total cholesterol levels, high-density lipoprotein cholesterol levels, and preintervention LDL cholesterol levels, the likelihood of achieving the LDL cholesterol goal was 1.74 times higher in the automatic prescription group than in the control group (P = 0.025). CONCLUSION: An automatic prescription can help physicians comply with the NCEP guidelines.

Anticholesteremic Agents↗

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Aboriginal dance.

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Humans↗

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Small bowel volvulus around feeding jejunostomy tube.

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Adult↗

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The Iowa model: a proposed model for nursing administration.

The purpose of the Iowa Model is to serve both as a heuristic device and as a framework for articulating knowledge for nursing administration research, practice, and education. The model delineates two domains of knowledge (systems and outcomes), each with three levels (patient aggregates, the organization, and the health care system). Concepts useful for knowledge development are identified for each level. Practice, research, and curricular applications of the model are made.

Clinical Competence↗

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Creating a resource database for nursing service administration.

In response to the current information explosion in nursing service administration (NSA), the authors felt a need to collect and organize available resources for use by their faculty and graduate students. An electronic database was developed to facilitate the use of the collected print and software resources. This article describes the creation of the NSA Resource Database from the time the need for it was realized to its completion. There is discussion regarding the criteria used for writing the database, what the database screens look like and why and what the database contains. The article also discusses the use and users of the NSA Resource Database to date.

Databases, Bibliographic↗

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Regional distribution of muscarinic and nicotinic cholinergic receptor binding activities in the human brain.

The distribution of nicotinic and muscarinic receptor subtypes was examined in human brain tissue obtained at autopsy from neurologically normal adult (50-60 years) individuals. Membrane preparations from 15 brain regions were examined for nicotinic (L-[3H]nicotine) binding, both M1 and M2 muscarinic receptor binding (distinguished on the basis of pirenzepine affinity) and high (H) and low (L) affinity muscarinic agonist binding (distinguished on the basis of carbachol displacement). Total muscarinic receptor binding sites were relatively high in striatal and cortical areas, where both M1 subtype and agonist binding type L predominated, compared with thalamic, nigral and cerebellar regions and spinal cord, where the M2 subtype and agonist binding type H predominated. Nicotinic receptor binding sites (predominantly high affinity, measured at low ligand concentrations) did not parallel any of the muscarinic subtypes, being concentrated in thalamic, neocortical and striatal regions. Scatchard analysis indicated the presence of both high and low affinity nicotinic sites, the numbers of the latter generally exceeding the former by over one order of magnitude. Neither muscarinic nor nicotinic receptor binding sites were closely related to the distribution of the cholinergic neuronal marker, choline acetyltransferase, suggesting that individual cholinergic pathways may be distinguished by the relative proportion of the different types of cholinergic receptors present.

Binding, Competitive↗

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