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Zogakis TG, Costouros NG, Kruger EA, Forbes S, He M, Qian M, Feldman AL, Figg WD, Alexander HR, Liu ET, Kohn EC, Libutti SK. Microarray gene expression profiling of angiogenesis inhibitors using the rat aortic ring assay. Biotechniques 2002; 33:664-6, 668, 670. [PMID: 12238776 DOI: 10.2144/02333dd02] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The rat aortic ring assay has been previously described as a useful ex vivo model for analyzing the biological activity of various inhibitors of angiogenesis. Rat aortic rings are exposed to antiangiogenic agents for a five-day incubation period. Then, the degree of microvessel outgrowth from the rings is analyzed and quantified. In contrast to most in vitro angiogenesis assays, the rat aortic ring model provides a unique microenvironment to evaluate the interaction of various cell types and biological factors for their influence on angiogenesis. Microarray analysis is an accepted method for the evaluation of gene expression profiles and can be used to better understand changes in gene expression that occur when rat aortic rings are exposed to a particular biological agent. Here we describe a method of using microarray technology to evaluate the modulation of gene expression in angiogenesis using the rat aortic ring assay.
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Allcock RJN, Atrazhev AM, Beck S, de Jong PJ, Elliott JF, Forbes S, Halls K, Horton R, Osoegawa K, Rogers J, Sawcer S, Todd JA, Trowsdale J, Wang Y, Williams S. The MHC haplotype project: a resource for HLA-linked association studies. TISSUE ANTIGENS 2002; 59:520-1. [PMID: 12445322 DOI: 10.1034/j.1399-0039.2002.590609.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
The purpose of this study was to describe the end of life in one midwestern nursing home from the perspective of residents who are chronically ill and declining, their family caregivers, and staff. Qualitative methods, including formal and informal interviews, participant observation, and health record abstraction, were used to describe the end of life for 13 nursing home residents. One dominating pattern, conflict, and five themes (i.e., communication, quality of life, staff education, teamwork, work environment) emerged as factors that influenced end-of-life care. The results of this study illustrate where and how problems within the nursing home industry, the participating nursing home, and between staff and residents influence and challenge care provided to dying residents.
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Miller PA, Forbes S, Boyle DK. End-of-life care in the intensive care unit: a challenge for nurses. Am J Crit Care 2001; 10:230-7. [PMID: 11432211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Results from several research studies combined with increasing public tensions surrounding physician-assisted suicide have fueled a growing awareness of the inadequacies of end-of-life care. Investigators also suggest that intensive care unit nurses have a limited role in end-of-life decision making and care planning. This article explores cultural issues influencing end-of-life care in intensive care units, explores factors surrounding the limited involvement of critical care nurses in end-of-life decision making and care planning, and offers recommendations for changing nursing practice. Because improving end-of-life care will require cultural changes, an understanding of the cultural issues involved is needed. Recommendations for changing nursing practice include a model of end-of-life care that incorporates the goals of both cure and comfort care, as well as a shared decision-making process. Nurses are essential to improving end-of-life care in today's intensive care units.
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Miller PA, Forbes S, Boyle DK. End-of-life care in the intensive care unit: a challenge for nurses. Am J Crit Care 2001. [DOI: 10.4037/ajcc2001.10.4.230] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Results from several research studies combined with increasing public tensions surrounding physician-assisted suicide have fueled a growing awareness of the inadequacies of end-of-life care. Investigators also suggest that intensive care unit nurses have a limited role in end-of-life decision making and care planning. This article explores cultural issues influencing end-of-life care in intensive care units, explores factors surrounding the limited involvement of critical care nurses in end-of-life decision making and care planning, and offers recommendations for changing nursing practice. Because improving end-of-life care will require cultural changes, an understanding of the cultural issues involved is needed. Recommendations for changing nursing practice include a model of end-of-life care that incorporates the goals of both cure and comfort care, as well as a shared decision-making process. Nurses are essential to improving end-of-life care in today's intensive care units.
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Younger RM, Amadou C, Bethel G, Ehlers A, Lindahl KF, Forbes S, Horton R, Milne S, Mungall AJ, Trowsdale J, Volz A, Ziegler A, Beck S. Characterization of clustered MHC-linked olfactory receptor genes in human and mouse. Genome Res 2001; 11:519-30. [PMID: 11282967 PMCID: PMC311051 DOI: 10.1101/gr.gr-1603r] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Olfactory receptor (OR) loci frequently cluster and are present on most human chromosomes. They are members of the seven transmembrane receptor (7-TM) superfamily and, as such, are part of one of the largest mammalian multigene families, with an estimated copy number of up to 1000 ORs per haploid genome. As their name implies, ORs are known to be involved in the perception of odors and possibly also in other, nonolfaction-related, functions. Here, we report the characterization of ORs that are part of the MHC-linked OR clusters in human and mouse (partial sequence only). These clusters are of particular interest because of their possible involvement in olfaction-driven mate selection. In total, we describe 50 novel OR loci (36 human, 14 murine), making the human MHC-linked cluster the largest sequenced OR cluster in any organism so far. Comparative and phylogenetic analyses confirm the cluster to be MHC-linked but divergent in both species and allow the identification of at least one ortholog that will be useful for future regulatory and functional studies. Quantitative feature analysis shows clear evidence of duplications of blocks of OR genes and reveals the entire cluster to have a genomic environment that is very different from its neighboring regions. Based on in silico transcript analysis, we also present evidence of extensive long-distance splicing in the 5'-untranslated regions and, for the first time, of alternative splicing within the single coding exon of ORs. Taken together with our previous finding that ORs are also polymorphic, the presented data indicate that the expression, function, and evolution of these interesting genes might be more complex than previously thought.
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Forbes S, Bui S, Robinson BR, Hochgeschwender U, Brennan MB. Integrated control of appetite and fat metabolism by the leptin-proopiomelanocortin pathway. Proc Natl Acad Sci U S A 2001; 98:4233-7. [PMID: 11259669 PMCID: PMC31208 DOI: 10.1073/pnas.071054298] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Leptin deficiency results in a complex obesity phenotype comprising both hyperphagia and lowered metabolism. The hyperphagia results, at least in part, from the absence of induction by leptin of melanocyte stimulating hormone (MSH) secretion in the hypothalamus; the MSH normally then binds to melanocortin-4 receptor expressing neurons and inhibits food intake. The basis for the reduced metabolic rate has been unknown. Here we show that leptin administered to leptin-deficient (ob/ob) mice results in a large increase in peripheral MSH levels; further, peripheral administration of an MSH analogue results in a reversal of their abnormally low metabolic rate, in an acceleration of weight loss during a fast, in partial restoration of thermoregulation in a cold challenge, and in inducing serum free fatty acid levels. These results support an important peripheral role for MSH in the integration of metabolism with appetite in response to perceived fat stores indicated by leptin levels.
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Bern-Klug M, Gessert C, Forbes S. The need to revise assumptions about the end of life: implications for social work practice. HEALTH & SOCIAL WORK 2001; 26:38-48. [PMID: 11338278 DOI: 10.1093/hsw/26.1.38] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
During the 20th century the experience of dying changed dramatically. At the beginning of the 1900s, dying and death were integral parts of the life experience of most people at any age. Many deaths occurred at home following a short course of illness largely unaffected by the limited medical care available. At the beginning of the 21st century, in many cases, the process of dying has become invisible. Today, most deaths occur in old age. Social workers have a key role as "context interpreters" in helping people at the end of life and their families understand the natural course of the illness, the process of dying, and the advantages and drawbacks of medical interventions. An expanded role for social workers in helping people comprehend the medical and social contexts within which they face end-of-life decisions is discussed.
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Fletcher P, Andrew KN, Calokerinos AC, Forbes S, Worsfold PJ. Analytical applications of flow injection with chemiluminescence detection--a review. LUMINESCENCE 2001; 16:1-23. [PMID: 11180653 DOI: 10.1002/bio.607] [Citation(s) in RCA: 177] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper reviews the literature on analytical applications of flow injection (FI) techniques with chemiluminescence (CL) detection from 1995-1999. The focus is on the application of FI-CL to the quantitative determination of specific analytes in real sample matrices. Therefore, entries have been tabulated under the most appropriate application area, ie pharmaceutical, environmental, foods and beverages and biomedical, as defined by the matrix that has been analysed. Each table lists analytes alphabetically and gives details of the exact sample matrix, the limit of detection (as reported in the original paper) and comments on the CL reaction used.
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Ziegler A, Ehlers A, Forbes S, Trowsdale J, Volz A, Younger R, Beck S. Polymorphisms in olfactory receptor genes: a cautionary note. Hum Immunol 2000; 61:1281-4. [PMID: 11163084 DOI: 10.1016/s0198-8859(00)00219-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The hundreds of human olfactory receptor (OR) genes are organized into clusters occurring on nearly every chromosome. Although their sequences are not always closely related, they share stretches of considerable similarity, both at the amino acid and nucleotide levels. We demonstrate here that an HLA complex-linked OR sequence, FAT11, for which recently a number of alleles have been claimed within the Hutterites, contains sequences derived from two closely related, linked OR genes, hs6M1-12 and hs6M1-16. Instead of indicating a difference between alleles of a given locus, two of the polymorphisms described for FAT11 (at amino acids 48 and 220 of the deduced protein sequence, respectively) may in fact reflect distinct sequences of hs6M1-12 and a further, closely related HLA-linked OR locus, hs6M1-13P. As a consequence, recombination rates in Hutterites in the region telomeric of HLA-G may have to be reconsidered.
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Sherson SM, Hemmann G, Wallace G, Forbes S, Germain V, Stadler R, Bechtold N, Sauer N, Smith SM. Monosaccharide/proton symporter AtSTP1 plays a major role in uptake and response of Arabidopsis seeds and seedlings to sugars. THE PLANT JOURNAL : FOR CELL AND MOLECULAR BIOLOGY 2000; 24:849-57. [PMID: 11135118 DOI: 10.1046/j.1365-313x.2000.00935.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The aim of this study was to investigate the in vivo properties and function of the high-affinity monosaccharide/proton symporter AtSTP1 of Arabidopsis. We isolated an Atstp1 knock-out mutant and found that this plant grows and develops normally. The AtSTP1 gene is expressed in germinating seeds and seedlings, with AtSTP1 activity found mainly in the seedling root. The rate of uptake of [(14)C]-3-O-methylglucose and [(14)C]-D-glucose is 60% less in Atstp1 seedlings than in the wild type, showing that AtSTP1 is the major monosaccharide transporter in Arabidopsis seedlings. Transport of D-galactose and D-mannose is also up to 60% less in Atstp1 seedlings compared to wild type, but transport of D-fructose, L-arabinose and sucrose is not reduced. Germination of Atstp1 seed shows reduced sensitivity to D-mannose, demonstrating that AtSTP1 is active before germination. Atstp1 seedlings grow effectively on concentrations of D-galactose that inhibit wild-type growth, even at up to 100 mM D-galactose, indicating that active transport by AtSTP1 plays a major role at very high concentrations of exogenous sugar. These findings provide insight into the physiological function of AtSTP1 and clearly establish its importance in the uptake of extracellular sugars by the embryo and in seedlings.
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Forbes S, Glassey B. Asymmetric sibling rivalry and nestling growth in red-winged blackbirds ( Agelaius phoeniceus ). Behav Ecol Sociobiol 2000. [DOI: 10.1007/s002650000239] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gaudray P, Carle GF, Gerhard DS, Gessler M, Mannens MM, Athanasiou M, Bliek J, Calender A, Debelenko LV, Devignes M, Evans GA, Favier R, Forbes S, Gaudray G, Gawin B, Gordon M, Grimmond S, Grossfeld P, Harris J, Hattori M, Hosoda F, Hummerich H, James M, Kalla J, Katsanis N. Report of the Sixth International Workshop on Human Chromosome 11 Mapping 1998. Nice, France, May 2-5, 1998. CYTOGENETICS AND CELL GENETICS 2000; 86:167-86. [PMID: 10575203 DOI: 10.1159/000015336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Burvill PW, Anderson CS, Stewart-Wynne EG. Five-year survival after first-ever stroke and related prognostic factors in the Perth Community Stroke Study. Stroke 2000; 31:2080-6. [PMID: 10978033 DOI: 10.1161/01.str.31.9.2080] [Citation(s) in RCA: 258] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Few community-based studies have examined the long-term survival and prognostic factors for death within 5 years after an acute first-ever stroke. This study aimed to determine the absolute and relative survival and the independent baseline prognostic factors for death over the next 5 years among all individuals and among 30-day survivors after a first-ever stroke in a population of Perth, Western Australia. METHODS Between February 1989 and August 1990, all individuals with a suspected acute stroke or transient ischemic attack of the brain who were resident in a geographically defined region of Perth, Western Australia, with a population of 138 708 people, were registered prospectively and assessed according to standardized diagnostic criteria. Patients were followed up prospectively at 4 months, 12 months, and 5 years after the index event. RESULTS Three hundred seventy patients with first-ever stroke were registered, and 362 (98%) were followed up at 5 years, by which time 210 (58%) had died. In the first year after stroke the risk of death was 36.5% (95% CI, 31.5% to 41.4%), which was 10-fold (95% CI, 8.3% to 11.7%) higher than that expected among the general population of the same age and sex. The most common cause of death was the index stroke (64%). Between 1 and 5 years after stroke, the annual risk of death was approximately 10% per year, which was approximately 2-fold greater than expected, and the most common cause of death was cardiovascular disease (41%). The independent baseline factors among 30-day survivors that predicted death over 5 years were intermittent claudication (hazard ratio [HR], 1.9; 95% CI, 1.2 to 2.9), urinary incontinence (HR, 2.0; 95% CI, 1. 3 to 3.0), previous transient ischemic attack (HR, 2.4; 95% CI, 1.4 to 4.1), and prestroke Barthel Index <20/20 (HR, 2.0; 95% CI, 1.2 to 3.2). CONCLUSIONS One-year survivors of first-ever stroke continue to die over the next 4 years at a rate of approximately 10% per year, which is twice the rate expected among the general population of the same age and sex. The most common cause of death is cardiovascular disease. Long-term survival after stroke may be improved by early, active, and sustained implementation of effective strategies for preventing subsequent cardiovascular events.
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Jamrozik K, Broadhurst RJ, Forbes S, Hankey GJ, Anderson CS. Predictors of death and vascular events in the elderly : the Perth Community Stroke Study. Stroke 2000; 31:863-8. [PMID: 10753989 DOI: 10.1161/01.str.31.4.863] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The goal of the present study was to identify risk factors for vascular disease in the elderly. METHODS We conducted a prospective study of control subjects from a population-based study of stroke in Perth, Western Australia, that was completed in 1989 to 1990 and used record linkage and a survey of survivors to identify deaths and nonfatal vascular events. Data validated through reference to medical records were analyzed with the use of Cox proportional hazards models. RESULTS Follow-up for the 931 subjects was 88% complete. By June 24, 1994, 198 (24%) of the subjects had died (96 from vascular disease), and there had been 45 nonfatal strokes or myocardial infarctions. The hazard ratio for diabetes exceeded 2.0 for all end points, whereas the consumption of meat >4 times weekly was associated with a reduction in risk of </=30%. In most models, female sex and consumption of alcohol were associated with reduced risks, whereas previous myocardial infarction was linked to an increase in risk. CONCLUSIONS There are only limited associations between lifestyle and major vascular illness in old age. Effective health promotion activities in early and middle life may be the key to a longer and healthier old age.
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Macdonald DW, Courtenay O, Forbes S, Mathews F. The red fox (Vulpes vulpes) in Saudi Arabia: loose-knit groupings in the absence of territoriality. J Zool (1987) 1999. [DOI: 10.1111/j.1469-7998.1999.tb01207.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wambach K, Boyle D, Hagemaster J, Teel C, Langner B, Fazzone P, Connors H, Smith C, Forbes S. Beyond Correspondence, Video Conferencing, and Voice Mail: Internet-Based Master's Degree Courses in Nursing. J Nurs Educ 1999; 38:267-71. [PMID: 10512467 DOI: 10.3928/0148-4834-19990901-07] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The changing health care system and increasing demands for primary care providers have prompted an increase in nurse practitioner programs in the United States. Nurses in rural areas that are underserved by primary care practitioners often are faced with time and distance barriers to returning to school for advanced education. This article describes Internet-based courses as a unique distance learning platform for preparing primary care nurse practitioners at the University of Kansas (KU) School of Nursing. Discussion includes course development process, matching methods to course content, and other information on promoting interaction between students and faculty.
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Themis M, Schneider H, Kiserud T, Cook T, Adebakin S, Jezzard S, Forbes S, Hanson M, Pavirani A, Rodeck C, Coutelle C. Successful expression of beta-galactosidase and factor IX transgenes in fetal and neonatal sheep after ultrasound-guided percutaneous adenovirus vector administration into the umbilical vein. Gene Ther 1999; 6:1239-48. [PMID: 10455432 DOI: 10.1038/sj.gt.3300970] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In utero somatic gene therapy in the later stages of pregnancy may allow targeting of organ systems which are difficult to reach later in life and to prevent the development of tissue damage otherwise caused by the early onset of inherited diseases. We report here on the percutaneous delivery of two adenoviral vectors, containing the beta-galactosidase reporter gene and the human Factor IX gene respectively, to the fetal liver and circulation by ultrasound-guided umbilical vein puncture similar to procedures used in human pregnancy. Vector spread, as detected by PCR analysis for the beta-galactosidase encoding vector, was found in almost all fetal and neonatal organs and in the maternal liver. Expression of the beta-galactosidase transgene was detected in many fetal tissues by RT-PCR. High beta-galactosidase production was shown by immuno-histochemistry predominantly in the liver, where about 30percent of the hepatocytes stained positive, and in the adrenal cortex. Production of factor IX was determined by ELISA in the plasma of treated fetuses and newborn lambs and reached at birth up to 80percent of the normal human plasma concentration. This demonstrates a very hopeful proof of principle for the development of prenatal treatment of many genetic diseases but also requires more detailed investigations with respect to the observed systemic spread of the vector.
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Williamson C, Cavaco BM, Jauch A, Dixon PH, Forbes S, Harding B, Holtgreve-Grez H, Schoell B, Pereira MC, Font AP, Loureiro MM, Sobrinho LG, Santos MA, Thakker RV, Jausch A. Mapping the gene causing hereditary primary hyperparathyroidism in a Portuguese kindred to chromosome 1q22-q31. J Bone Miner Res 1999; 14:230-9. [PMID: 9933477 DOI: 10.1359/jbmr.1999.14.2.230] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A Portuguese kindred with autosomal dominant isolated primary hyperparathyroidism (HPT) that was associated with parathyroid adenomas and carcinomas was investigated with the aim of determining the chromosomal location of this gene, designated HPTPort. Leukocyte DNA from 9 affected and 16 unaffected members and 7 parathyroid tumors from 4 patients was used in comparative genomic hybridization (CGH), tumor loss of heterozygosity (LOH), and family linkage studies. The CGH studies revealed abnormalities of chromosomes 1 and 13, and the results of LOH studies were consistent with the involvements of tumor suppressor genes from these regions. Family segregation studies mapped HPTPort to chromosome 1q22-q31 by establishing linkage with eight loci (D1S254, D1S222, D1S202, D1S238, D1S428, D1S2877, D1S422, and D1S412) (peak two-point LOD scores = 3. 46-5.14 at 0% recombination), and defined the location of HPT Port to a 21 cM region flanked centromerically by D1S215 and telomerically by D1S306. Thus, HPTPort has been mapped to chromosome 1q22-q31, and a characterization of this gene will help to elucidate further the mechanisms that are involved in the development of parathyroid tumors.
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Forbes S, Ashton P. The identity status of African Americans in middle adolescence: a reexamination of Watson and Protinsky (1991). ADOLESCENCE 1999; 33:845-9. [PMID: 9886012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
In contrast to earlier research, Watson and Protinsky (1991) found that African American students did not experience identity foreclosure to a greater extent than did their Caucasian peers. Watson and Protinsky, however, examined only ideological identity. The purpose of the present study was to extend this line of research by examining identity development in the interpersonal domain as well as the ideological domain. Forty-eight African American students completed a revised version of the Extended Objective Measure of Ego Identity Status (EOM-EIS II). Supporting the conclusions of Watson and Protinsky, the results showed that few of the African American students were foreclosed. Instead, most of the students were in moratorium; that is, they were engaged in the identity-exploration process. Results for the interpersonal domain were similar to those for the ideological domain.
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Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Burvill PW, Anderson CS, Stewart-Wynne EG. Long-term risk of first recurrent stroke in the Perth Community Stroke Study. Stroke 1998; 29:2491-500. [PMID: 9836757 DOI: 10.1161/01.str.29.12.2491] [Citation(s) in RCA: 210] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Few community-based studies have examined the long-term risk of recurrent stroke after an acute first-ever stroke. This study aimed to determine the absolute and relative risks of a first recurrent stroke over the first 5 years after a first-ever stroke and the predictors of such recurrence in a population-based series of people with first-ever stroke in Perth, Western Australia. METHODS Between February 1989 and August 1990, all people with a suspected acute stroke or transient ischemic attack of the brain who were resident in a geographically defined region of Perth, Western Australia, with a population of 138 708 people, were registered prospectively and assessed according to standardized diagnostic criteria. Patients were followed up prospectively at 4 months, 12 months, and 5 years after the index event. RESULTS Three hundred seventy patients with a first-ever stroke were registered, of whom 351 survived >2 days. Data were available for 98% of the cohort at 5 years, by which time 199 patients (58%) had died and 52 (15%) had experienced a recurrent stroke, 12 (23%) of which were fatal within 28 days. The 5-year cumulative risk of first recurrent stroke was 22.5% (95% confidence limits [CL], 16.8%, 28.1%). The risk of recurrent stroke was greatest in the first 6 months after stroke, at 8.8% (95% CL, 5.4%, 12.1%). After adjustment for age and sex, the prognostic factors for recurrent stroke were advanced, but not extreme, age (75 to 84 years) (hazard ratio [HR], 2.6; 95% CL, 1.1, 6.2), hemorrhagic index stroke (HR, 2.1; 95% CL, 0.98, 4.4), and diabetes mellitus (HR, 2.1; 95% CL, 0.95, 4.4). CONCLUSIONS Approximately 1 in 6 survivors (15%) of a first-ever stroke experience a recurrent stroke over the next 5 years, of which 25% are fatal within 28 days. The pathological subtype of the recurrent stroke is the same as that of the index stroke in 88% of cases. The predictors of first recurrent stroke in this study were advanced age, hemorrhagic index stroke, and diabetes mellitus, but numbers of recurrent events were modest. Because the risk of recurrent stroke is highest (8.8%) in the first 6 months after stroke, strategies for secondary prevention should be initiated as soon as possible after the index event.
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Forbes S, Hoffart N. Elders' decision making regarding the use of long-term care services: a precarious balance. QUALITATIVE HEALTH RESEARCH 1998; 8:736-750. [PMID: 10558344 DOI: 10.1177/104973239800800602] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The purpose of this qualitative study was to explore factors that influenced decision making regarding the use and nonuse of long-term care services, with a particular focus on elders' attitudes, values, and beliefs. The sample (N = 27) consisted of high-functional elders recently admitted to nursing homes and community-dwelling, high-risk elders recently diverted from nursing homes following a prescreening program. Data were collected through indepth, face-to-face, semistructured interviews and analyzed using qualitative content analysis. Independence and sense of self were the strongest values to emerge. The attitude of acceptance, both passive and active, helped elders cope with increasing levels of dependency and lifestyle changes. The desire to be part of decisions, both major life planning and day-to-day choices such as meal planning, was pervasive. Decision making was individualistic and complex. Loss of control was threatening to the sense of self, leaving some elders feeling shortchanged.
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Doerr B, Sheil E, Baisch MJ, Forbes S, Howe CJ, Johnson M, Vogtsberger C. Beyond community assessment into the real world of learning aggregate practice. NURSING AND HEALTH CARE PERSPECTIVES 1998; 19:214-9. [PMID: 10446564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
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.
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Nicholls ME, Forbes S. Handedness and its association with gender-related psychological and physiological characteristics. J Clin Exp Neuropsychol 1996; 18:905-10. [PMID: 9157114 DOI: 10.1080/01688639608408312] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Prenatal exposure to a high level of testosterone is thought to result in sinistrality and increased masculinization in females. This paper seeks to determine whether sinistral females show more masculine characteristics relative to dextral females. Demonstration of such a relationship would support the proposition that testosterone affects laterality. Masculine and feminine personality characteristics, breast size, age at menarche, and regularity of menstruation were measured via a questionnaire administered to 40 dextral and 40 sinistral female university students. Sinistrals were found to score significantly higher on the masculine subscale and lower on the feminine subscale of the Bem Sex Role Inventory relative to their dextral counterparts. No differences were found between the groups for breast size, menstrual regularity, or age at menarche. These results demonstrate that hand preference is associated with gender-related psychological characteristics, but not the physiological characteristics measured. Thus, the possibility that the different sex roles adopted by sinistrals and dextrals is the result of socialisation rather than biological mechanisms, such as testosterone, cannot be ruled out.
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