Search PubMed⌕ Search

Biomedical subjects

S King

Publications and source records attributed to S King.

At least 127 records · Page 7Linked to original sources
PubMed1995

Expressed emotion, family dynamics and symptom severity in a predictive model of social adjustment for schizophrenic young adults.

While numerous studies have concluded that high expressed emotion (EE) in relatives predicts relapse in schizophrenia, other aspects of patient outcome have not been well studied. Our purpose was to determine the extent to which family dynamics and expressed emotion may predict variance in patient social adjustment when controlling for symptom severity. Sixty-nine schizophrenic outpatients and 108 of their relatives participated. Relatives' EE was assessed, and they were administered the FACES III for perceptions of family cohesion and adaptability. Patients were interviewed at about the same time as their relatives and again 9 months later with the Social Adjustment Scale (SAS-II) and the BPRS. Between 9% and 58% of variance in each of the five SAS scales was explained by selected EE and family dynamics scales, while symptom severity was held constant. Among the results, it was found that better social adjustment in patients was associated with less family adaptability, and with greater emotional overinvolvement in relatives. Adjustment of patients in the work role was associated with more Critical Comments from mothers. In conclusion, some aspects of high EE are associated with better social adjustment in schizophrenic patients.

Adolescent↗
PubMed1995

Improved quality of life and sexuality with continent urinary diversion in quadriplegic women with umbilical stoma.

Quality of life issues prompted us to offer continent urinary diversion to quadriplegic women who required cystectomy for end-stage neurogenic vesical dysfunction complicated by urethral destruction as a result of chronic indwelling catheterization. Three women with spinal cord injury (SCI) and resultant quadriplegia of 5 to 15 years duration underwent continent urinary diversion. Preoperative evaluation and urodynamic studies in each showed a bladder capacity of less than 150mL, bilateral vesicoureteral reflux, recurrent febrile urinary tract infections, an incompetent urethral sphincter, and incontinence around an indwelling catheter in all three patients. Although highly motivated, these women showed minimal dexterity and were unable to perform urethral self-catheterization. Each was opposed to having an incontinent abdominal urinary stoma. The urinary reservoir was created from 30cm of detubularized right colon. The continence mechanism used an intussuscepted and imbricated ileocecal valve. The umbilicus was chosen as the urostomy site because of cosmetic appearance and ease of catheterization for a patient with minimal dexterity. Follow-up ranged from 18 to 30 months. Reservoir capacity ranged from 550 to 800mL without evidence of reflux or stomal leakage. The incidence of symptomatic autonomic dysreflexia and urinary tract infection decreased postoperatively in all patients. Of the two women who were sexually active, the frequency of activity increased from 8 to 15 episodes per month in one and 3 to 4 episodes per month in the other. Both reported improved sexual enjoyment. Body image and satisfaction with urologic management increased in all three patients. In conclusion, continent urinary diversion in selected quadriplegic patients is a reasonable alterative to incontinent intestinal urinary diversion. The umbilical stoma provides an excellent cosmetic result which patients with minimal dexterity are able to catheterize easily. Continent urinary diversion in women results in improved self-image, quality of life, and enables greater sexual satisfaction.

Adult↗
PubMed1995

Chronic childhood illnesses: what aspects of caregiving do parents value?

Parents of children with chronic illnesses are at significantly increased risk to experience mental health problems. Because such families are in frequent contact with the health care system, it is possible that aspects of the organization and content of health services might contribute to the development or prevention of these emotional burdens. The purpose of the present study was to examine the patterns of parental values about a variety of aspects of care and services, assessing both the absolute and relative importance of 22 defined components of care (COCs). Respondents were 80/111 parents (72%) of children with diabetes mellitus and 45/56 parents (80%) of children with cystic fibrosis, followed at a regional university-affiliated children's hospital. They completed a two-part mailed questionnaire, rating independently each COC, and then ranking all 22 COCs using a modified Q-sort technique. While the majority of COCs were judged as 'somewhat' or 'very' important by over 75% of respondents, there was also significant agreement between the two groups on their rankings of the COCs (Spearman rank coefficient r = 0.92, P < 0.001). The COCs ranked most highly by both groups were diagnosis, treatment, education/information, continuity/consistency, accessible and available care, evaluation of chronic illness, and parental involvement. Furthermore, the concordance between this combined medical illness group and a previously-studied neurodevelopmental group was r = 0.72 (P < 0.001). These results are discussed in relation to the non-categorical approach to longstanding childhood illness and disability. Implications for preventive mental health within the content and structure of health services are considered.

Adaptation, Psychological↗
PubMed1995

Distribution of HLA and haplotypes of Colombian and Jamaican black populations.

To investigate the genetic background of the black populations of Colombia and Jamaica, we determined HLA types of 78 Colombian and 98 Jamaican blacks from 2 different socioeconomic groups (Jamaican #1 and Jamaican #2) and estimated the frequencies of HLA genes and haplotypes. A phylogenetic tree based on the HLA gene frequencies revealed that Jamaican #1 and Jamaican #2 were distinct from each other, Jamaican #1 being closely related to the Colombian blacks and the Jamaican #2 being closely related to Senegalese and Zairean populations. Three-locus HLA haplotypes of Colombian and Jamaican #1 blacks were an admixture between Africans and Caucasians or South American Indians, while Jamaican #2 blacks were relatively homogeneous and appeared to conserve African lineages. The major five-locus HLA haplotypes were not shared among Colombian, Jamaican #1 and Jamaican #2 blacks. These results indicated that the black populations of Colombia and Jamaican were originated from African blacks and admixed variably with Caucasians and South American Indians to make genetic subpopulations in Colombia and Jamaica.

Black People↗
PubMed1995

Parent orientation meetings to improve attendance and access at a child psychiatric clinic.

As one of several strategies to improve attendance and reduce the size of the waiting list at a child psychiatric clinic serving urban, multiproblem clients, parents were required to attend a free pretreatment orientation group meeting. The rate of missed appointments among families not oriented to the clinic was compared with that of families who attended the orientation meeting. The orientation process significantly improved attendance at intake appointments but did not appear to affect attendance at subsequent appointments. It screened out unmotivated parents, reduced the size of the waiting list, and allowed greater access to clinic services.

Adolescent↗
PubMed1995

Differential effects of dimethylsulfoxide on steroidogenesis in mouse MA-10 and rat R2C Leydig tumor cells.

The effects of dimethylsulfoxide (DMSO) on steroidogenesis in MA-10 mouse Leydig tumor cells and R2C rat Leydig tumor cells were compared. MA-10 cells produce low basal levels of progesterone (as the major steroid synthesized), which increase several hundred-fold when stimulated with tropic hormone or the cAMP analog (Bu)2cAMP. R2C cells, on the other hand, constitutively produce high levels of progesterone in the absence of hormone stimulation of any kind. When incubated in the presence of 5% DMSO, MA-10 cells demonstrated an almost complete inhibition of progesterone production, whereas the synthesis of this steroid was virtually unaffected in R2C cells. The inhibition of steroid production in the MA-10 cell could not be attributed to an effect on protein synthesis, because this was unaffected by DMSO during the course of the incubations. The activity of the cholesterol side-chain cleavage enzyme was also unaffected by DMSO, as demonstrated by incubation of the cells with 22R-hydroxycholesterol. The production of cAMP in response to tropic hormone (hCG) and forskolin stimulation was significantly inhibited in MA-10 cells, but was much less affected in R2C cells in response to forskolin treatment. However, DMSO appeared to have no effect on the overall phosphorylation of proteins when tested either in a completely in vitro system or when MA-10 cell homogenates were used as a source of exogenous protein. Strikingly, DMSO treatment resulted in the highly specific inhibition of a series of 30-kilodalton mitochondrial proteins (named StAR for Steroidogenic Acute Regulatory protein), which we have recently shown to be indispensable for the production of steroids in MA-10 cells. The synthesis of these same proteins was much less affected in R2C cells. Although the mechanism of action by which DMSO inhibits steroidogenesis remains unknown, these results show that its action results in the complete cessation of synthesis of the StAR protein, which is required for the acute regulation of steroidogenesis in MA-10 cells.

Animals↗
PubMed1995

Developing people: a strategy for competitive advantage.

This article will provide vital insights, acquired in a recent study with eight manufacturing companies, to guide the development of a human resource development strategy. This study was a pilot for a larger study, planned for the fall of 1995 with 50 manufacturing companies randomly chosen from the Directory of Massachusetts High Technology Companies.

Economic Competition↗
PubMed1995

Characterization of acute bone marrow graft rejection in T cell-depleted, partially mismatched related donor bone marrow transplantation.

The purpose of this study was to characterize the phenotype and clonality of the T cell population in patients who experience acute rejection (AR) following bone marrow transplantation (BMT) from a partially mismatched related donor (PMRD). Phenotypic analysis was performed using flow cytometry, assignment of donor/host lineage by cytogenetics or HLA-specific flow cytometry, and analysis of the T cell receptor (TCR) by reverse-transcriptase polymerase chain reaction (RT-PCR). We have previously reported the initial appearance in the blood of AR patients of host CD8+brightCD3low T cells that progressively express increasing amounts of CD3+ cells. We now report that this cell population can differentiate into either a cytotoxic T cell phenotype (CD3+CD8+HLA-DR+CD57-) usually associated with AR of grafts from matched unrelated donors or a suppressor T cell phenotype (CD3+CD8+CD57+HLA-DR-) usually associated with AR of grafts from matched sibling donors. Analysis of the TCR V beta subsets from two patients revealed sorted host CD3+CD8+ cells (purity 90-95%) from the first patient to express V beta 18 almost exclusively. In a second patient with late rejection (55 days post-BMT), the CD3+CD8+ cells were predominantly restricted to V beta 1, 5.1, 7, 9, and 18. Although CD3+CD8+ T cells are known to be associated with AR, cytotoxic and suppressor lineages in AR from the same type of BMT and clonal distribution of T cells in AR have not been reported. Preliminary results suggest that V beta expression in AR of PMRD grafts is restricted and host T cell phenotype may vary. Further studies will investigate whether specific mismatches correlate with specific V beta usage and/or host T cell phenotype.

Base Sequence↗
PubMed1995

[The role of expressed emotions in schizophrenia].

In a decade dedicated to the brain, one particular line of research has been demonstrating the value of considering psychosocial factors in the course of schizophrenia. The purpose of this article is to briefly describe the concept of "expressed emotion" which has been shown repeatedly to predict relapse in a variety of severe mental disorders. We will, as well, describe a research program undertaken at the Douglas Hospital Research Centre which has been developed to deepen our understanding of the association between the family and outcome in schizophrenia. Selected results will be presented that highlight the complexity of the family process in mental illness.

Adult↗
PubMed1994

Metastatic cervical cancer and pelvic inflammatory disease in an AIDS patient.

The Center for Disease Control (CDC) recently added invasive cervical cancer to its list of surveillance case-defining diseases, and also included cervical dysplasia, carcinoma in situ, and pelvic inflammatory disease (PID) in the classification system. There are several reported cases of cervical cancer in AIDS patients that behaved in an unusually aggressive fashion and responded poorly to therapy. In light of the above-reported cases, it may be expected that cervical cancer may manifest itself in unusual ways in HIV-positive women. A case of aggressive cervical cancer in an AIDS patient with PID is reported. She was admitted with PID and newly diagnosed cervical cancer with recurrent fever spikes despite adequate antibiotic coverage. An aspiration of a presumed psoas abscess revealed metastatic squamous cell carcinoma. These data suggest that not only are HIV-infected women at risk for aggressive and unusual presentations of cervical cancer, but also that coexistent pelvic infection may contribute to development and spread of the disease. Immunosuppression from the virus may increase the incidence and severity of neoplasia. Data suggest that cervical cancer in HIV-infected women is often of advanced stage and responds poorly to treatment. Unique treatment approaches may need to be developed as conventional strategies do not seem to be adequate. More research is required to determine what these strategies should be. Lastly, universal HIV screening of women with either PID or cervical cancer seems prudent.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Dual chamber safety vacuum--initial experiences with a new suction cup].

The main problem with vacuum extraction methods, alongside the cephalhaematoma produced, is the premature separation of the suction cup under traction, since the resulting sudden change in pressure can lead to severe intra-cerebral damage to the child. To reduce the risk of vaginal operative delivery, a new double-chamber safety vacuum extractor has been developed by Hepp/King. The basic feature of this instrument is an additional chamber with a thin overlapping area, which surrounds the actual suction cup and serves as a safety vacuum. If the suction cup starts to slip, the external vacuum is released and sounds an alarm. In addition, the inner vacuum has been designed to be convex and to reduce the volume of scalp, which is sucked into the vacuum, thus reducing the size of the cephalhaematoma produced. First experiences in clinical use demonstrated the reliability of the early warning signal, if the direction of traction is false or the applied traction is too strong. The inner vacuum remains constant at 0.8 atu, so that with care, the extraction can continue without interruption. We have used the new instrument in 18 deliveries. In 15 cases, the indication was failure to progress into the second stage of labour; in one case history of retinal detachment and in two cases signs of foetal asphyxia. In all cases, the child was delivered following one or two contractions with traction, without losing the vacuum. The average weight of the newborn was 3566 g. As expected, the cephalohaematoma produced was very much smaller than usual. Further clinical trials are necessary before the value of this new instrument can be assessed.

Asphyxia Neonatorum↗
PubMed1994

A latent variable causal model of the quality of life and community tenure of psychotic patients.

Services are intended to maintain patients in the community while improving the quality of their lives. The purpose of this study was to determine the extent to which psychiatric patients' diagnoses, levels of autonomy, objective living conditions and degree of service utilization are associated with their perceived quality of life and, in turn, community tenure. A latent variable causal model was developed and tested using data from 152 schizophrenic and affective psychotic patients. Information was obtained using a semistructured interview, a quality of life scale, ratings on the Global Assessment Scale and patient hospital records. Results indicate that greater autonomy is significantly associated with greater perceived quality of life and that greater quality-of-life ratings are associated with greater community tenure.

Activities of Daily Living↗
PubMed1994

Community service issues before nursing home placement of persons with dementia.

Family caregivers of persons with dementia (N = 98) [corrected] who placed their relative in a nursing home while participating in a longitudinal study were surveyed about their experiences with community services (adult day care, in-home services, and physician home visits). One third (34%) of the sample reported that at least one service issue (affordability, eligibility, access, or service quality) had a strong influence on the nursing home placement, whereas 40% reported that the availability of at least one additional service would have delayed the nursing home placement of their relative. Caregivers who were employed reported higher levels of unmet service needs. The results of this study support the existence of a group of dementia caregivers with a high need for and willingness to use community service interventions in the preinstitutional period.

Aged↗
PubMed1994

A thirty-year retrospective study of hospitalization among severely mentally ill patients.

This study examines the effects of deinstitutionalization policies on psychiatric hospitalization rates over a thirty-year period. It is based on a retrospective study of successive hospitalizations in severely disabled patients. The data indicate that in any five-year period these patients still spend over 20% of their time in hospital. For patients who have stayed for a total of more than one year every five years in hospital, the average length of stay has been decreasing far less rapidly in the last fifteen years than it had previously. Patients who were first admitted after 1971 spent proportionally as much time in hospital as those whose first stay was earlier. These results show that the groups primarily affected by deinstitutionalization are those who were first hospitalized prior to the 1970s and those who are the heaviest hospital users. However, the data from the patients admitted since the seventies seem to reveal that the process of change may have reached its limits.

Adolescent↗