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S Johnson

Publications and source records attributed to S Johnson.

At least 55 records · Page 3Linked to original sources
PubMed2001

The longer term outcomes of community care: a 12 year follow-up of the Camberwell High Contact Survey.

BACKGROUND: There is as yet little evidence available regarding the long-term outcomes of people with severe and enduring mental illness who have been cared for primarily in the community. METHODS: A 12-year follow-up was carried out of the clinical and social problems and needs for care of a group of long-term mentally ill patients (N = 81) who were heavy users of psychiatric services when originally assessed in the Camberwell High Contact Survey between 1983 and 1985. The MRC Needs for Care Assessment Schedule used in the original baseline study was repeated at follow-up. RESULTS: The clinical and social functioning of the group had remained relatively stable, with high levels of problems and needs at both time points and little evidence of significant improvement or deterioration. The majority had remained in contact with services. There was some increase in levels of unmet as well as met needs, and a decrease in ratings of unmeetable needs, which may have been due to changes in clinical practice. CONCLUSION: The challenge for current service providers is not only to keep clients stable, but also to help improve the clinical and social functioning of people who may no longer be the highest priority of current community mental health services. This could be approached by identifying the continuing needs of this group, and persistently delivering active treatments.

Adolescent↗
PubMed2001

Three new DP alleles identified in a study of 800 unrelated bone marrow donor-recipient pairs.

HLA-DP genotyping of 800 unrelated donor-recipient pairs in phase 5 of a retrospective analysis of unrelated bone marrow transplantation, sponsored by the National Marrow Donor Program (NMDP), has identified two new DPB1 alleles (DPB1*8701 and DBP1*8801) and one new DPA1 (DPA1*0108) allele. Sequencing confirmed that all three of these new alleles represent novel combinations of previously described sequence motifs, reinforcing the notion that "gene conversion-like" events play an important role in generating HLA allelic diversity. The identification of these new alleles brings the total number of DPA1 alleles to 20 and the total number of DPB1 alleles to 94.

Alleles↗
PubMed2001

Mental health service provision in England.

OBJECTIVE: To describe mental health service provision for adults of working age in England. METHOD: Services in an inner London area are described so as to illustrate current patterns of service organization in England. National trends are then discussed. RESULTS: Despite relatively low public expenditure, substantial progress has been made in deinstitutionalization and development of comprehensive community-based services. Persisting difficulties include high staff turnover, a minority of patients. who do not engage with community services, user and carer dissatisfaction with emergency services, and social exclusion because of stigma. Recent government policy advocates resolving some of these problems using new service models such as assertive outreach and crisis teams. CONCLUSION: Closure of the large asylums has largely been accomplished. England is now entering a new phase in community service development, with a range of innovative developments aimed at resolving problems still encountered after the initial phases of integrated community service development.

Adult↗
PubMed2001

The role of androgen receptors in the clinical course of nevus sebaceus of Jadassohn.

Nevus sebaceus of Jadassohn (NSJ) is a benign, congenital hamartoma that often presents at birth, appears to regress in childhood, and grows during puberty, suggesting possible hormonal control. We studied 18 cases of NSJ from children and adults for immunohistochemical evidence of androgen receptor expression. The lesions were evaluated for location and pattern of immunostaining, and these findings were compared between age groups, sexes, and to androgen receptor expression in normal skin. Androgen receptor positivity was seen in the sebaceous glands, in eccrine glands with and without apocrine change, and rarely in keratinocytes in the sebaceous nevi. There were no significant differences in staining location or pattern between the age groups or sexes. Normal skin showed similar staining in the sebaceous glands but did not show staining of the eccrine glands or keratinocytes. Androgen receptors are present in all epithelial components of NSJ, but there is no change in androgen receptor expression during puberty.

Adolescent↗
PubMed2001

The bioavailability of oral fludarabine phosphate is unaffected by food.

INTRODUCTION: A prospective, open and randomized, two-way crossover study was conducted to evaluate the pharmacokinetics and bioavailability of oral fludarabine phosphate when taken on a full versus an empty stomach. The effectiveness of therapy was also assessed after two cycles of treatment, four weeks apart MATERIALS AND METHODS: Patients with chronic lymphocytic leukemia or low-grade non-Hodgkin's lymphoma were randomly assigned to two groups, both of which received two cycles of treatment with 90 mg of oral fludarabine phosphate administered when either fed or fasted. Patients in Group 1 (n = 8) received oral treatment on a full stomach for the first cycle then on a fasted stomach for the second, while those in Group 2 (n = 10) received their treatment in the reverse sequence. Oral fludarabine phosphate was administered on the first day of the two study cycles and intravenous fludarabine phosphate was administered on days 3-6. RESULTS AND CONCLUSION: Of 22 patients recruited, 18 (CLL n = 10; NHL n = 8) were eligible for efficacy and safety evaluation, and 16 for bioavailability and pharmacokinetic analyses. The response to oral 2-F-ara-AMP was rapid: by two treatment cycles, 12 out of 18 patients (66.7%) had achieved partial response. Of the six patients who did not respond, five patients (27.7%) had stable disease. There was no notable difference in the rate of response between patients with B-CLL and lg-NHL. There was a marginal increase in total systemic availability of fludarabine phosphate when administered orally on a fed stomach (2-F-ara-A AUC((0-24 h)) = 3.28 +/- 1.48 microg.h/ml) compared to a fasted stomach (2-F-ara-A AUC((0-24 h)) = 3.05 +/- 1.56 microg.h/ml). Time to peak plasma concentration was slightly extended by the presence of food (2.2 +/- 1.0 versus 1.3 +/- 0.74 h) but the terminal half-life was unaffected. The minor differences in the pharmacokinetics of oral fludarabine phosphate when taken after food were not statistically significantly different and seem unlikely to be clinically relevant. The efficacy and safety data closely paralleled previous experience with the intravenous formulation.

Administration, Oral↗
PubMed2001

International studies to compare methods for personal sampling of bitumen fumes.

A newly recommended Institute of Occupational Medicine (IOM) sampler, optimized for the inhalable fraction, was compared with 'total particulate' samplers currently used by five laboratories in different countries for the analysis of bitumen fumes. Using a laboratory fume generator, all samplers were uniformly exposed to bitumen fumes from typical USA bitumen (commercial Pen 65). The results show that, for laboratory-generated bitumen fumes, benzene-extractable inhalable particulate data for the IOM sampler are consistent with benzene soluble matter data from the other samplers. Direct comparison of the IOM sampler with the 37 mm closed-face cassette (USA sampler) using an identical protocol in a single laboratory gave a ratio of 1.05:1 (USA:IOM). Similarly, for total particulate matter, the standard previously recommended by the American Conference of Governmental Industrial Hygienists (ACGIH), an average value of approximately 1 between the IOM and the five samplers was obtained. For unadulterated bitumen fumes, the geometry of the cassettes does not appear to affect entry of the particles into the sampler. Field studies may show differences in results as other factors, e.g. wind and its effect on sampling efficiency, and also particulates originating from sources other than bitumen, such as dust, are involved. These will require thorough investigation prior to the assessment of the impact of the new sampler and prior to any reconsideration of occupational exposure limits taking into account practical feasibility. Other tests were conducted on the bitumen fume samples including total organic matter, simulated distillation and polycyclic aromatic compound analysis. These additional tests were performed on the fume collected on the filter plus the volatile portion that passed through the filter and was captured on various adsorbent materials. Protocols for sample collection and analysis varied in different countries with results reflective of these differences, suggesting the need for standardization.

Air Pollution, Indoor↗
PubMed2001

The multifaceted and widespread pathology of magnesium deficiency.

Even though Mg is by far the least abundant serum electrolyte, it is extremely important for the metabolism of Ca, K, P, Zn, Cu, Fe, Na, Pb, Cd, HCl, acetylcholine, and nitric oxide (NO), for many enzymes, for the intracellular homeostasis and for activation of thiamine and therefore, for a very wide gamut of crucial body functions. Unfortunately, Mg absorption and elimination depend on a very large number of variables, at least one of which often goes awry, leading to a Mg deficiency that can present with many signs and symptoms. Mg absorption requires plenty of Mg in the diet, Se, parathyroid hormone (PTH) and vitamins B6 and D. Furthermore, it is hindered by excess fat. On the other hand, Mg levels are decreased by excess ethanol, salt, phosphoric acid (sodas) and coffee intake, by profuse sweating, by intense, prolonged stress, by excessive menstruation and vaginal flux, by diuretics and other drugs and by certain parasites (pinworms). The very small probability that all the variables affecting Mg levels will behave favorably, results in a high probability of a gradually intensifying Mg deficiency. It is highly regrettable that the deficiency of such an inexpensive, low-toxicity nutrient result in diseases that cause incalculable suffering and expense throughout the world. The range of pathologies associated with Mg deficiency is staggering: hypertension (cardiovascular disease, kidney and liver damage, etc.), peroxynitrite damage (migraine, multiple sclerosis, glaucoma, Alzheimer's disease, etc.), recurrent bacterial infection due to low levels of nitric oxide in the cavities (sinuses, vagina, middle ear, lungs, throat, etc.), fungal infections due to a depressed immune system, thiamine deactivation (low gastric acid, behavioral disorders, etc.), premenstrual syndrome, Ca deficiency (osteoporosis, hypertension, mood swings, etc.), tooth cavities, hearing loss, diabetes type II, cramps, muscle weakness, impotence (lack of NO), aggression (lack of NO), fibromas, K deficiency (arrhythmia, hypertension, some forms of cancer), Fe accumulation, etc. Finally, because there are so many variables involved in the Mg metabolism, evaluating the effect of Mg in many diseases has frustrated many researchers who have simply tried supplementation with Mg, without undertaking the task of ensuring its absorption and preventing excessive elimination, rendering the study of Mg deficiency much more difficult than for most other nutrients.

Humans↗
PubMed2001

Is Parkinson's disease the heterozygote form of Wilson's disease: PD = 1/2 WD?

Wilson's disease (WD) patients often present with Parkinson's disease (PD). Furthermore, most patients with PD have reduced ceruloplasmin, a characteristic of Wilson's disease. WD is an autosomal recessive disease (requires two faulty copies of a gene to produce a homozygote individual) that afflicts 1 in 1000 people. However, the number of people with one faulty copy (heterozygotes) is much larger, probably about 2% of the population. I hypothesize that the large number of heterozygotes for WD are at greatly increased risk for idiopathic PD, because these people accumulate free copper in the basal ganglia at a slower rate than homozygotes, which accounts for the fact that PD usually develops after 40 years of age. In WD, a ceruloplasmin deficiency results in accumulation of free Cu in the liver, brain, kidneys, etc. The excess Cu results in impaired Zn absorption, which would account for the low levels of Zn in the brains of PD patients. Moreover, the high levels of Fe found in the substantia nigra of PD patients may perhaps be explained by free Cu binding to iron binding protein-1 (IBP-1), causing it to malfunction and preventing it from detaching itself from the transferrin receptor (TfR) inhibition gene, resulting in expression of TfR even when the cell has plenty of Fe. The gradual accumulation of Fe and Cu would explain the damage inflicted on the substantia nigra by free radicals catalyzed by these two metals and which is exacerbated by the low levels of CuZnSOD, due to the Zn deficiency mentioned above. Moreover, if this hypothesis is correct, then PD could be used to help discover the gene (or genes) responsible for WD and vice versa. Furthermore, idiopathic PD could be prevented by identifying the heterozygote individuals and providing them with Zn supplementation, Cu chelation therapy and phlebotomy to eliminate Fe.

Copper↗
PubMed2001

Gradual micronutrient accumulation and depletion in Alzheimer's disease.

Cadmium is a carcinogen that accumulates relentlessly with age, reaching high levels in the liver and kidneys. It is known to hyperactivate the Kupffer cells (hepatic macrophages). On the other hand, the risk of developing Alzheimer's disease increases considerably with age and it involves neuronal damage by hyperactive microglia (brain macrophages). Moreover, many of the metals that accumulate in the liver and kidneys, also accumulate in the brain (Fe, Cu, Zn, Mn, etc.). Therefore, it is possible that Cd also hyperactivates the microglia, playing a role in Alzheimer's disease (AD).Fe also accumulates in the brain as we age and catalyzes super oxide (O2-) formation, which reacts with nitric oxide (NO) to form the very harmful peroxynitrite (ONOO-). ONOO- causes considerable damage that exacerbates the damage caused by the hyperactive microglia, accelerating the progress of AD. Moreover, as we age we become less efficient at absorbing and retaining Cu, Zn and Mg. Since Cu and Zn are necessary for the synthesis of copper-zinc superoxide dismutase (CuZnSOD), which disables the noxious O2-, the deficiencies cause considerable damage as we age. Similarly, Mg is a cofactor for CuZnSOD and is necessary for NO to leave the cell and perform its vasodilating job. Unfortunately, a Mg deficiency traps the NO in the cell, where it reacts with O2-, forming the harmful ONOO-. Furthermore, Se and vitamins B6 and D are required for Mg absorption and vitamin E is required to minimize the oxidative damage.

Alzheimer Disease↗
PubMed2001

Micronutrient accumulation and depletion in schizophrenia, epilepsy, autism and Parkinson's disease?

Zinc has several crucial functions in brain development and maintenance: it binds to p53, preventing it from binding to supercoiled DNA and ensuring that p53 cause the expression of several paramount genes, such as the one that encodes for the type I receptors to pituitary adenine cylase-activator peptide (PACAP), which directs embryonic development of the brain cortex, adrenal glands, etc.; it is required for the production of CuZnSOD and Zn-thionein, which are essential to prevent oxidative damage; it is required for many proteins, some of them with Zn fingers, many of them essential enzymes for growth and homeostasis. For example, the synthesis of serotonin involves Zn enzymes and since serotonin is necessary for melatonin synthesis, a Zn deficiency may result in low levels of both hormones. Unfortunately, Zn levels tend to be low when there is excess Cu and Cd. Moreover, high estrogen levels tend to cause increased absorption of Cu and Cd, and smoking and eating food contaminated with Cd result in high levels of the latter. Furthermore, ethanol ingestion increases the elimination of Zn and Mg (which acts as a cofactor for CuZnSOD). Increased Cu levels may also be found in people with Wilson's disease, which is a rather rare disease. However, the heterozygote form (only one faulty copy of the chromosome) is not so rare. Therefore, the developing fetus of a pregnant women who is low in Zn and high in Cu may experience major difficulties in the early development of the brain, which may later manifest themselves as schizophrenia, autism or epilepsy. Similarly, a person who gradually accumulates Cu, will tend to experience a gradual depletion of Zn, with a corresponding increase in oxidative damage, eventually leading to Parkinson's disease. Also discussed are the crucial roles of histidine, histamine, vitamin D, essential fatty acids, vitamin E, peroxynitrate, etc. in the possible oxidative damage involved in these mental diseases.

Autistic Disorder↗
PubMed2001

Low-dose, sublingual AZT-monophosphate therapy for HIV+ patients?

AZT concentrations as low as 0.001 mg/l inhibit viral replication, while concentrations above 0.3 mg/l cause considerable damage to erythroid, myeloid progenitor cells and inhibit blastogenesis in mononuclear cells. Furthermore, AZT must be converted first to monophosphate and then to diphosphate and finally to triphosphate by the same enzyme: thymidine kinase (TK). Therefore, large doses of AZT overwhelm TK, causing massive production of monophosphate and reducing the production of di and triphosphate. Yet the recommended dosage of 100 mg AZT every 4 hours results in a peak concentration of 0.5 mg/l and a trough concentration of 0.1 mg/l (harmful to human cells and resulting in reduced production of triphosphate). On the other hand, sublingual administration of 1 mg AZT monophosphate every 8 hours (since the intracellular half life of AZT triphosphate is 3 hours) would be desirable, resulting in more damage to the virus and less harm to the patient. Finally, the small dose of monophosphate ensures that most of the AZT be converted to triphosphate, greatly increasing the efficiency and reducing the likelihood of the virus developing resistance due to reverse transcriptase binding to the similar but non inhibiting mono and diphosphate.

Administration, Sublingual↗
PubMed2001

Clostridial constipation's broad pathology.

Clostridia are normally found in the healthy colon, where their numbers are kept in check by other bacteria. However, when they establish themselves in the ileum they become formidable foes. They produce medium-length fatty acids that increase water absorption, causing hypertension and drying up the feces, causing constipation.Furthermore, they can deconjugate bile (impaired fat absorption), metabolyze tryptophan (the most scarce of the essential amino acids), digest fiber (so that the more fiber the patient takes, the more the constipation is exacerbated), digest lecithin, produce carcinogenic metabolites and copious amounts of extremely foul smelling gas, etc. They can also prevent vitamin B12 absorption in the ileum, causing anemia. The synthetic sugar lactulose, which can only be digested by lactobacilli, can help displace the clostridia and resolve the constipation by causing the lactobacilli to produce short fatty acids that have the opposite effect to that of the medium fatty acids produced by clostridia and their accomplices: they cause water retention in the intestines.

Carbohydrate Metabolism↗
PubMed2001

The possible crucial role of iron accumulation combined with low tryptophan, zinc and manganese in carcinogenesis.

Iron can react with citric acid, interfering with the Krebs cycle, hence with oxidative phosphorylation. Free iron (Fe) can cause considerable oxidative damage both through Fenton reactions and by activating xanthine oxidase, which produces both superoxide (O(2-)) and uric acid (abundant in many cancers). It can also react with lactic acid, reducing its elimination and increasing the acidity of the cytoplasm. Fe can also wreak havoc by reacting with tryptophan, the least abundant and most delicate essential amino acid, which is necessary for the production of serotonin and other substances required by the immune system to fight cancer. On the other hand, in the presence of iron, the tryptophan metabolite quinolinate causes intense lipid peroxidation. Similarly, several other carcinogenic metabolites of tryptophan are particularly dangerous in the presence of Fe. Excess Fe may also interfere with manganese superoxide dismutase and impair the initiation of apoptosis by the mitochondrion, rendering the cells impervious to all the signals to undergo apoptosis from without and from within the cell. Moreover, Fe may also play a crucial role on telomere repair, by activating telomerase. Therefore, by inhibiting apoptosis and enhancing chromosome repair, Fe may bestow immortality upon the cancer cell. Furthermore, Fe is one of the triggers for mitosis. Therefore, increased Fe levels may be essential for the rapid growth characteristic of many malignancies. In turn, the rapid growth further depletes resources from the healthy tissues, exacerbating the deficiencies of the other elements and reducing the ability to fight the malignancy.

Brain↗
PubMed2001

Predicting the costs of community care for individuals with severe mental illness in South London.

The objective of this study is to identify factors that predict the costs of community mental health services. A random sample of individuals, selected from all identified cases of psychosis in two geographically defined catchment areas, were interviewed before the establishment of community mental health teams and then after these teams had been operating for approximately 2.5 years. One of the sectors developed an intensive community service, with a more standard service in the other sector. Significant predictors of higher costs were older age and higher levels of disability. Predictors of lower costs were longer duration of illness and more years of education. A reduced model revealed that being male and having more symptoms were also predictors of higher costs. After controlling for background characteristics, it was revealed that services provided to clients from the intensive sector were $1,894 more expensive over 6 months than those provided to standard sector clients.

Adult↗
PubMed2001

Pathogenicity of environmental origin Salmonellas in specific pathogen-free chicks.

Two hundred sixty 1-d-old specific pathogen-free (SPF), Single Comb White Leghorn chicks were used in this study to determine pathology caused by Salmonella enteritidis (SE) isolated from a poultry environment. The chicks were subdivided into 10 equal groups of 26 chicks each. Eight groups of chicks were inoculated individually with 0.5 mL of brain heart infusion broth culture containing 1 x 10(6) cfu of SE phage type (PT) -8 (1, 2, 3), SE PT5 A (1, 2), or SE PT4 (Ch-env-CA, chicken-CA, and human) by crop gavage. One group of 26 chicks were inoculated with 1 x 10(6) cfu of Salmonella pullorum per bird by crop gavage. Another group of 26 chicks were kept as an uninoculated control group. All the chicks were observed daily for clinical signs and mortality. Salmonella was reisolated from different organs at 7, 14, 21, and 28 postinoculation (DPI). All of the chicks were weighed individually at each interval. Two chicks at random from each group were euthanised and necropsied at each DPI for gross pathology. Selected tissues were examined for histopathological changes at 7 and 14 DPI. Dead chicks were examined for gross and histopathological lesions. Mortality rates were 30.7, 15.3, and 7.6% in the groups inoculated with S. pullorum, SE PT5A, and SE PT4 (chicken-CA), respectively. No mortality or clinical sign were observed in other treatment groups or in uninoculated control groups. Cecal pouches were found to be the ideal organ for reisolation of Salmlonella at acute or chronic infection compared with other organs. Mean body weights were reduced to 1.8 to 12.6% in inoculated groups compared with the uninoculated control group. The consistent gross and hispathological lesions were of peritonitis, perihepatitis, yolk sac infection, and enteritis. Subclinical Salmlonella infection identified in this study resulted in reduced body weights of inoculated birds compared with uninoculated controls.

Animals↗
PubMed2001

Family therapy saves the planet: messianic tendencies in the family systems literature.

It is not unusual occasionally to hear individual family therapists describe their work as an effort to "save the world." The messianic notion that family therapy should be the world's salvation is not simply a fancy of individual clinicians, but is deeply imbedded in several of our field's most fundamental theories. This article explores messianic arguments in the work of some of family therapy's most important thinkers, including von Bertalanffy, Bateson, and Keeney, and then discusses the implications that these arguments have for the clinical and theoretical development of our field.

Attitude of Health Personnel↗
PubMed2001

Methods of feminist family therapy supervision.

Although feminist family therapy has been studied and practiced for more than 20 years, writing about feminist supervision in family therapy has been limited. Three supervision methods emerged from a qualitative study of the experiences of feminist family therapy supervisors and the therapists they supervised: The supervision contract, collaborative methods, and hierarchical methods. In addition to a description of the participants' experiences of these methods, we discuss their fit with previous theoretical descriptions of feminist supervision and offer suggestions for future research.

Family Therapy↗