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Biomedical subjects

T E Smith

Publications and source records attributed to T E Smith.

At least 55 records · Page 3Linked to original sources

An evaluation of urinary measures of iodine and selenium status.

The aim of this study was to establish methodology for a survey of the iodine and selenium status of New Zealand residents, more specifically to investigate the correlation between fasting or random casual urine samples and 24 hour urines for iodine and selenium excretion. Sixty-two (31 M, 31 F) adults collected casual, fasting and 24 hour urine samples for analysis of iodide, selenium and creatinine. Plasma and serum samples were collected for analysis of selenium and glutathione peroxidase activity. Results indicated that fasting urine samples, but not casual urines, may give a reasonable estimate of urinary output of iodine and selenium on a population basis, but that 24 hour urines are necessary for diagnosis of iodine deficiency in an individual and for research purposes. The results for iodine also give no support for expressing iodine as the iodide-creatinine ratio, although there was some indication that the selenium-creatinine ratio might be useful. Significant correlations between total daily excretion of selenium and iodine and also for urinary concentrations of the two trace elements in fasting and in 24 hour urine specimens may reflect a relationship of selenium and iodine to body size which may have implications for dietary requirements of these trace elements. Alternatively the correlations may reflect a relationship between dietary intake of the two trace elements in a country in which food concentrations are low, and this needs further investigation.

Adolescent↗

Training hospitalized patients with schizophrenia in community reintegration skills.

OBJECTIVE: The study examined the effectiveness of the Community Re-Entry Program, a brief, time-limited skills training module designed to help acutely ill inpatients become engaged in community-based treatment programs. METHODS: Of 84 consecutive admissions to a chronic psychotic disorders unit, 44 completed assessments and attended the Community Re-Entry Program. The program consists of 16 daily small-group therapy sessions that engage the patient in efforts to define discharge readiness, identify symptoms and medication effects, and assist with discharge planning. Skill levels and positive and negative symptoms were assessed on admission and on completion of training, and a subsample of patients received two-week postdischarge follow-up assessments. RESULTS: From admission to discharge, positive symptoms diminished substantially, negative symptoms diminished to a lesser but statistically significant degree, and skill levels increased significantly. Posttraining skill level was predicted by pretraining skill level and level of participation in the skills training module. Patients' symptom levels did not predict participation in the program or skill acquisition. Skill level at discharge was also more predictive of two-week postdischarge community adjustment than were symptom levels. CONCLUSIONS: Although further controlled studies are required to fully establish the efficacy of the Community Re-Entry Program, these data suggest that brief, focused skills training may play an important role in augmenting optimal pharmacotherapy for hospitalized patients with chronic psychotic disorders.

Activities of Daily Living↗

Transition in an era of reform.

Transition services for students with learning disabilities have not always been a priority in public schools. Although school personnel have long acknowledged the transition needs of students considered to have more severe disabilities, such as mental retardation, physical problems, and emotional disturbance, they do not always consider that students with learning disabilities also need transition programming. The result has been a neglect of these students' transition needs, which has likely contributed to some of the problems experienced by young adults with learning disabilities. This article focuses on the effect of educational reform on transition services for students with learning disabilities. General education reform--fueled by some of the critical reports of the 1980s--inclusion, and some of the more recent efforts to reform public education (namely, Goals 2000) are all discussed as they relate to the transition needs of students with learning disabilities.

Education, Special↗

Response of the Io plasma torus to comet Shoemaker-Levy 9.

Spectroscopic and imaging observations of the Io plasma torus were made in June and July 1994 in conjunction with the encounter of periodic comet Shoemaker-Levy 9 with Jupiter. Characteristic emissions from sulfur and oxygen ions showed a decline of about 30 percent in the extreme ultraviolet and an increase of about 40 percent in the far ultraviolet relative to preimpact observations. Changes in the extreme ultraviolet may be indicative of small changes in the torus electron temperature as a result of quenching of electrons by dust associated with the comet passage. However, no new emission features indicative of fragment dust within the torus were detected. The characteristic torus morphology seen in ground-based imaging was typical of that observed in the past.

Atmosphere↗

Personality traits in schizophrenia.

In recent years there has been a renewed interest in the integration of descriptive and interpersonal approaches to mental illness. Much of the impetus for this stems from the introduction in 1980 of the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) (American Psychiatric Association 1980), with subsequent research and clinical reports documenting important interactions between Axis I syndromes and Axis II personality trait factors. While many research efforts have described comorbidity in affective and anxiety disorders, less attention has been directed toward clarifying the relationships between stable and enduring character traits and Axis I symptoms in schizophrenia. In this paper we propose that schizophrenic patients display both adaptive and pathological personality traits throughout the illness, and that clinical and research efforts to address the interactions between syndromic and personality factors ("trait-state" interactions) will further our understanding of patterns of symptom presentation and treatment response in these patients.

Adult↗

Integrating qualitative and quantitative research methods: a research model.

A historical antagonism between proponents of qualitative methods and quantitative methods has prevented recognition of the benefits to be gained by employing both methods (that is, a multi-method approach) during the same study or program of studies. Increasingly, family therapy researchers have begun to recognize the value of a multi-method approach in bridging the current gaps among theory, research, and practice. However, current writings have yet to move beyond the discussion stage. This article proposes a bidirectional continuum that includes both qualitative and quantitative methods. An ethnographic content analysis approach is presented to illustrate the procedural stages of this continuum. The article ends with a discussion of the challenges in carrying out a bidirectional, multi-method approach and the potential contributions that an integrative research methodology will give both researchers and clinicians.

Family Therapy↗

Neonatal tetanus mortality in Veracruz, Mexico, 1989.

This article describes a survey conducted in the State of Veracruz, Mexico, to estimate neonatal tetanus (NNT) mortality. The survey, which entailed visits to 72,720 households, collected data on 8,401 live births and 209 infant deaths occurring between April 1988 and May 1989. Twenty-six of the 209 fatalities conformed to a WHO standard case definition of death from neonatal tetanus. The estimated neonatal tetanus mortality was thus 3.1 deaths per 1,000 live births (95% confidence limits = 1.7, 4.5). Comparison of this rate to reported figures suggests that for every NNT death recorded in Veracruz during the study period, as many as 50 others went unreported. A case-control study nested within the survey was conducted to assess preventable NNT risk factors. Limited information on 13 NNT deaths and 217 controls showed an increased risk for neonates who were delivered at home and whose parents' ethnic background was Mexican Indian. Five of the 13 fatalities had their umbilical cords cut with a domestic or traditional cutting tool such as a reed cane, as compared to none of the 217 controls. The observed vaccine efficacy of 2+ doses of tetanus toxoid was 70% (95% confidence limits = 52, 100). Both the mothers of neonates who died of NNT and their controls missed an average of five opportunities to receive tetanus toxoid. These findings underscore the need to launch a perinatal health program serving Mexico's high-risk populations.

Case-Control Studies↗

S2 triggered gated blood pool imaging for assessment of diastole.

Evaluation of diastolic function using ECG-Gated Blood Pool (EGBP) imaging is limited by inaccurate reproduction of the ventricular volume curve during diastole. Gating to an end-systolic event may reduce the influence of heart period variability, improving the fidelity of this curve during diastole. Heart Sound-Gated Blood Pool (HSGBP) imaging was employed to initiate acquisition at the Second Heart Sound (S2) using a previously reported Heart Sound Gate, and an accelerometer. Seven patients underwent EGBP imaging at 24 and 56 frames per second (fps), and HSGBP imaging at 24 fps. Utilizing EGBP imaging a mean ejection fraction (EF) of 54% was obtained at 24 fps, with HSGBP imaging yielding 53%. EF obtained by HSGBP and EGBP imaging correlated closely (r = 0.96, p < .002). The mean EF during 56 fps EGBP imaging was greater at 67%, consistent with previous reports. Additionally, peak filling rates by HSGBP and EGBP imaging correlated well (r = 0.95, p < .02). The fidelity of the diastolic ventricular volume curves for HSGBP and EGBP methods were comparable in four patients, and superior with HSGBP imaging in four patients. In conclusion, HSGP imaging is a feasible method for acquisition of the ventricular volume curve, and may assess diastolic function indices with greater accuracy. Further investigation of this application is warranted.

Diastole↗

Induction of human tissue plasminogen activator in the mammary gland of transgenic goats.

Three transgenic females from a first generation transgenic male were induced to lactate between 11 and 12 months of age using a series of estrogen and progesterone injections. The milk contained human longer acting tissue plasminogen activator (LAtPA) at comparable concentrations (1-3 mg/ml) as occurred in the original founder female. In addition, the transgenic male was induced with a hormonal regime and was shown to produce 0.85 mg/ml of LAtPA. Milk protein gels indicated that the milk products (casein, IgG) were essentially normal. These experiments show that expression data for this vector can be evaluated in a shorter period of time in dairy goats than would be required through normal gestation and lactation schedules and can be used to identify the relative expression of transgenes in mammary tissue that would occur during normal lactation.

Animals↗

Reconceptualizing support systems for persons with challenging behaviors.

As human service systems attempt to integrate persons with disabilities, particularly those with challenging behaviors, into the mainstream of society, use of positive behavioral supports must be implemented. Training of persons in the formal and informal support systems must also be reconceptualized in the context of using positive behavioral supports. This paper addresses some current issues related to the use of such supports and training in the delivery of human services.

Activities of Daily Living↗

Gastric emptying. Comparison of anterior only and geometric mean correction methods employing static and dynamic imaging.

Dynamic (continuous) and static imaging techniques were compared in the analysis of gastric emptying patterns in 16 consecutive adult patients with normal gastric half-emptying times assessed by dynamic imaging for 90 minutes under a dual head camera allowing simultaneous anterior and posterior imaging. Gastric t1/2 values were calculated for each patient based on four different data analysis methods: geometric mean corrected dynamic data (GD), anterior alone dynamic data (AD), geometric mean corrected simulated static data (GS), and anterior alone simulated static data (AS). The mean t1/2 values were: GD = 63.8 minutes, AD = 72.1 minutes, GS = 65.3 minutes, and AS = 73.0 minutes. Both the geometric mean corrected methods had a statistically different t1/2 than either of the anterior methods. Lag phase measurements, defined as a 2% decrease in gastric activity were: GD = 7 minutes, AD = 19 minutes, GS = 6 minutes, and AS = 16 minutes. Dynamic and static geometric mean methods provide similar gastric t1/2 calculations that are statistically different than anterior alone methods, and the lag phase is much shorter using either of the geometric mean methods.

Female↗

Three phases of clozapine treatment and phase-specific issues for patients and families.

Based on the authors' experience with more than 40 patients with treatment-refractory schizophrenia, they describe three phases of clozapine treatment. Phase-specific responses of patients and their families during clozapine trials often resemble their reactions during adaptation to chronic schizophrenia. Because the effectiveness of clozapine treatment has been so widely reported, many reactions are based on families' cure and rescue fantasies that resurface and intensify after having previously been worked through. Extreme, paradoxical, and problematic reactions, such as conflicts arising from patients' improved functioning, can threaten the viability of the clozapine trial and must be carefully managed by the therapist. The authors recommend specific treatment approaches for the different phases of the clozapine trial, including family therapy and psychoeducation throughout the trial and an approach based on object relations during the final phase.

Adaptation, Psychological↗

The role of personality in the treatment of schizophrenic and schizoaffective disorder inpatients: a pilot study.

As a prelude to a prospective study of personality functioning in chronically psychotic patients, the medical records of 736 hospitalized schizophrenic and schizoaffective disorder patients were retrospectively reviewed. The authors found much higher rates of Axis II personality disorder (PD) diagnoses among patients on extended-care inpatient units, which was consistent with their belief that clinicians on these units were using Axis II labels to document concurrent as well as premorbid personality factors. In addition, patients with PD diagnoses had significantly different courses of inpatient treatment, as documented by length-of-stay data. Level of function at discharge did not differ between those with and without PD diagnoses. The authors posit various hypotheses about these findings and discuss difficult conceptual and methodological issues regarding the influence of personality factors in schizophrenia.

Comorbidity↗

Afferent projections of the superior and recurrent laryngeal nerves.

The central afferent projections of the superior and recurrent laryngeal nerves were investigated in the rat, utilizing the transganglionic transport of WGA-HRP. Labelled superior laryngeal nerve terminal fields were found bilaterally in the interstitial and medial subnuclei of the nucleus tractus solitarii with the ipsilateral being more dense. The distribution of the recurrent laryngeal nerve terminals were similar to that of the SLN with two major differences: the projections were ipsilateral, and there was a marked decrease in the terminal field density. The terminal field density differences were confirmed by quantitatively identifying the labelled ganglion cells of the vagus nerve. These findings accurately delineate the first integrative components in the mediation of the complex laryngeal reflexes.

Afferent Pathways↗

Motor neurons of the laryngeal nerves.

The present study was undertaken to determine the relationship between the motor neurons of the superior and recurrent laryngeal nerves within the nucleus ambiguus. The retrograde transport of horseradish peroxidase was utilized to identify the motor neurons subsequent to its application to the proximal transected end of the superior and recurrent laryngeal nerves. Labeled superior laryngeal motor neurons were distributed ventrolaterally in the rostral portion the nucleus. The recurrent laryngeal motor neurons were distributed throughout the nucleus with two distinct populations: a rostral group and a caudal group. The rostral group overlaps the motor neurons of the superior laryngeal nerve. The caudal group occupies that portion of the nucleus that is classically described for the recurrent laryngeal nerve. Additional superior laryngeal nerve labeled perikarya were found in the dorsal motor nucleus of the vagus. This study defines the rostral distribution of the recurrent laryngeal nerve motor neurons and suggests that this rostral group is a component of the neuroanatomical substrate that is involved in the co-activation of the laryngeal abductors controlling the laryngeal aperture.

Animals↗

A comparison of demographic, behavioral, and ego function data in borderline and eating disorder patients.

Seven borderline personality and ten eating disorder patients were compared using demographic, descriptive/behavioral, and ego function measures on admission to an inpatient unit. Demographic and descriptive data analysis revealed areas of overlap, consistent with other reports of co-morbidity between the two groups. Ratings of intrapsychic function were made using Bellak's Ego Function Assessment profiles, and showed that the two groups shared deficits in the areas of impulse/affect control and sense of identity, but had otherwise easily distinguishable profiles. The authors feel that studying ego functioning is a useful way of assessing co-morbidity in borderline personality and eating disorder patients.

Adult↗