Equity in health: a challenge for researchers and policy makers.
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Health Policy↗
Biomedical subjects
A Williams
Publications and source records attributed to A Williams.
Improved baseline recognition and modeling of FT NMR spectra
A new approach to baseline correction is presented. A smoothed spectrum is used for both baseline area recognition and modeling. To complete the model an interpolation technique is employed over the signals area; then the model is subtracted from the spectrum giving a flat baseline. The method has been shown to give excellent results even for spectra with large baseline distortions due to different origins. Copyright 2000 Academic Press.
Journal Article↗
The suppression of rat collagen-induced arthritis and inhibition of macrophage derived mediator release by liposomal methotrexate formulations.
OBJECTIVE AND DESIGN: This study was designed to determine whether liposomes are suitable vehicles for the delivery of methotrexate (MTX-gamma-DMPE) for arthritis therapy. MATERIAL OR SUBJECTS: Liposomal formulations containing either egg lecithin (EPC), cholesterol (CHOL) and phosphatidic acid (PA) (MTX-EPC) or distearoylphosphatidylcholine (DSPC), CHOL and distearoylphosphatidylethanolamine conjugated to polyethyleneglycol (PEG) (MTX-PEG) were employed. Rat peritoneal macrophages (rPM phi) were used to test the mechanism of action of these liposomes in vitro, whilst, the rat collagen-induced arthritis (CIA) model was used to evaluate the in vivo efficacy of MTX-EPC and MTX-PEG. TREATMENT: In vitro, rPM phi were incubated with liposomal MTX concentrations ranging from 0 to 15 microg/well. In vivo, rats were given 4 daily intravenous injections of liposomal MTX (2.5 mg/Kg). METHODS: IL-1beta and prostaglandin-E2 (PGE2) release from rPM phi were quantified by immunoradiometric assay. Arthritis progression, in vivo, was measured by serial clinical score and hind paw diameter measurements. RESULTS: MTX-EPC and MTX-PEG respectively (15 microg of MTX and 0.15 mg of lipid) were powerful inhibitors of both IL-1beta (77 +/- 2.3%; 79 +/- 4.0%) and PGE2 (75.5 +/- 4.9%; 68.5 +/- 2.3%) release (mean +/- SEM % inhibition) from lipopolysaccaride stimulated rPM phi. In vivo, only MTX-EPC exerted an anti-inflammatory effect, clinical score (p < 0.001) and paw diameter (p < 0.001) measurements being significantly lower than in control rats, after 2 days treatment. CONCLUSIONS: MTX-EPC and MTX-PEG are potent inhibitors of pro-inflammatory mediators in vitro, but liposomes with long circulation times do not appear to have therapeutic potential for treating arthritis in vivo.
Animals↗
Flavour conditioning and alcohol: a multilevel model of individual differences.
Previous research shows that dependent drinkers respond more strongly to alcohol-related cues and suggests that alcohol cue-reactivity may be relevant to understanding dependence liability. However, a significant weakness in many studies is the fact that cue-reactivity is studied without actually conditioning subjects; responses to alcohol-related cues are simply assumed to be conditioned responses. The current report attempts to overcome this weakness by studying alcohol cue-reactivity following a flavour-conditioning procedure. A statistical model of individual differences in cue-reactivity was constructed using previous alcohol exposure, alcohol tolerance, and personality as predictor variables. Although there was no evidence for overall differences in subjective and psychophysiological responses to alcohol and soft-drink paired flavours, there were marked individual differences in responding to the different flavours. The statistical model showed that reward sensitivity (high extroversion, high neuroticism), heavier levels of drinking, and higher levels of tolerance to the intoxicating effects of alcohol were associated with lower levels of skin conductance in the presence of alcohol paired flavours.
Adult↗
Unrealistic optimism and the Health Belief Model.
Why do people fail to engage in positive behaviors which will promote their health and well-being? Researchers addressing this question adopt primarily one of two perspectives, drawing either on theories of health behavior, such as the Health Belief Model (HBM), or on theories of risk perception, such as unrealistic optimism. To overcome this compartmentalization, two studies of cancer screening behavior assessed the extent to which unrealistic optimism occurred in relation to each of the elements of the HBM: severity and curability of cancer and the benefits of, and barriers to, having a screening test. Data were collected using telephone interviews, dialing numbers randomly selected from the telephone directory. In the first study 164 women aged 50 to 70 years responded to questions about breast cancer and screening mammography, while in the second study 200 men aged 45 to 60 years responded to questions about prostate cancer and screening using the prostate specific antigen test. Women had an optimistic bias in relation to breast cancer risk and severity and barriers to having a screening mammogram but not in relation to the benefits of screening. For prostate cancer, there was an optimistic bias for all HBM variables: risk and severity of prostate cancer and barriers to and benefits of screening. It was concluded that unrealistic optimism is broader than perceived risk, being evident for all elements of the HBM.
Aged↗
An adenovirus E1A mutant that demonstrates potent and selective systemic anti-tumoral efficacy.
Replication-selective oncolytic viruses constitute a rapidly evolving and new treatment platform for cancer. Gene-deleted viruses have been engineered for tumor selectivity, but these gene deletions also reduce the anti-cancer potency of the viruses. We have identified an E1A mutant adenovirus, dl922-947, that replicates in and lyses a broad range of cancer cells with abnormalities in cell-cycle checkpoints. This mutant demonstrated reduced S-phase induction and replication in non-proliferating normal cells, and superior in vivo potency relative to other gene-deleted adenoviruses. In some cancers, its potency was superior to even wild-type adenovirus. Intravenous administration reduced the incidence of metastases in a breast tumor xenograft model. dl922-947 holds promise as a potent, replication-selective virus for the local and systemic treatment of cancer.
Adenoviridae↗
Systemic lupus erythematosus with C1q deficiency.
We report a case of systemic lupus erythematosus associated with C1q deficiency. Our patient presented at the age of 6 years with cutaneous lupus. She later developed Raynaud's phenomenon, non-scarring alopecia, oral ulceration and grand mal seizures due to cerebral vasculitis. Complement C3 and C4 levels were consistently normal during flares of her lupus and haemolytic activity of her complement was absent, suggesting a deficiency of an early component of the complement cascade. No C1q could be detected.
Alopecia↗
Survival of mycobacterial species in aerosols generated from artificial saliva.
Tuberculosis is transmitted primarily by the aerosol route and the aim of this study was to measure the ability of pathogenic mycobacteria to survive in aerosols generated from artificial saliva. Aerosols of Mycobacterium avium, Mycobacterium intracellulare and Mycobacterium tuberculosis were generated and maintained in air under controlled conditions using a Henderson apparatus and a rotating drum. There were no differences in aerosol survival between the three species, and all had a poor survival rate over a period of 1 h. These data confirm epidemiological studies that close and prolonged contact with a TB patient is required for transmission of infection.
Aerosols↗
The physiology and pathogenicity of Mycobacterium tuberculosis grown under controlled conditions in a defined medium.
A chemically-defined culture medium was developed which supported batch growth of Mycobacterium tuberculosis, strain H37Rv, at a minimum doubling time of 14.7 h. This medium also facilitated chemostat culture of M. tuberculosis at a constant doubling time of 24 h. Chemostat growth was optimized at a dissolved oxygen tension of 20% (v/v) and 0.2% (v/v) Tween-80. Chemostat cultures were dispersed suspensions of single bacilli (1.5-3 microm long), or small aggregates, at a mean density of log10 8.3 cfu ml-1. A limited number of amino acids was utilized (alanine, asparagine, aspartate and serine were depleted by >50%; glycine, arginine, isoleucine, leucine and phenylalanine, by approximately 40%). Chemostat-grown cells were pathogenic in aerosol-infected guinea pigs, producing disseminated infection similar to that caused by plate-grown cells. Cells from chemostat culture were significantly more invasive for J774A.1 mouse macrophages than agar- or batch-grown cells. This study demonstrates the suitability of chemostat culture for the growth of pathogenic mycobacteria in a defined physiological state with potential applications for the controlled production of mycobacterial components for therapeutic and vaccine applications.
Animals↗
Clarification of the process of separation of the cloaca into rectum and urogenital sinus in the rat embryo.
BACKGROUND/PURPOSE: The normal process of division of the cloaca into a rectum and urogenital tract is still not fully understood. The main controversies relate to how the urorectal septum (URS) divides the cloaca and whether the URS fuses with the cloacal membrane. This study used a 3-dimensional reconstruction technique, combined with histologic correlation, to observe the developmental and septational processes of the cloaca of the normal rat embryo from gestational days 11 to 16. METHODS: Normal rat embryos from gestational days 11 to 16 were sectioned serially both transversely and sagittally and stained with H&E. 3-dimensional reconstructions were performed on embryos younger than day 13.5. The relevant structures were examined in a temporo-spatial sequence. RESULTS: The tailgut started to regress by apoptosis on day 12 in a cranio-caudal direction. The URS, first evident in day-12.5 embryos, extended and fused with the cloacal membrane on day 15 of gestation, completing the separation of the cloaca into rectum and bladder. Regression of the tailgut and ventral protrusion of the urogenital sinus markedly changed the configuration of the cloaca. The cloacal membrane did not break down until after it had fused with the URS. CONCLUSIONS: These findings clarify the relative contributions made by active septation of the cloaca by the URS and configurational changes of the cloaca to produce a rectum and bladder. The URS fuses with the cloacal membrane before the anal and urogenital membranes break down.
Animals↗
Team nursing and ITU--a good combination?
Deficits in 'measurable care', in an 11-bedded intensive care unit, prompted a pilot study of team nursing. Team nursing was introduced for three beds out of the total 11 for a period of six months. In order to evaluate the effects, aspects of care and job satisfaction were measured and compared between the team nursing beds and the rest of the unit. The study revealed that job satisfaction and the levels of 'measurable care' did not improve whilst team nursing was practised. Based on this evidence, the authors question the relevance of team nursing in this particular intensive therapy unit (ITU) and maintain that the best method of delivering nursing care in ITU remains unclear.
Attitude of Health Personnel↗
Staffing of undergraduate clinical learning programs in Australia.
Clinical practicum experience arguably forms a critical role in the undergraduate preparation for registration to practice as a professional nurse. Whilst there appears to be a consensus about the importance of practical experience in nursing education, there has been limited research exploring the nature of clinical learning within undergraduate programs and validity of current approaches. A national survey of undergraduate preregistration Bachelor of Nursing courses was conducted to determine the scope and focus of clinical learning programs in Australia. Selected case studies were conducted to develop an understanding of contextual issues influencing the delivery of the clinical learning programs. Findings reveal a range of clinical supervision models employed and the staffing mix used to support those models. Issues associated with the selection and preparation of staff to support clinical learning relate to geographical location and economic resources. There is little empirical evidence that any of the models currently in use lead to quality outcomes, rather an eclectic use of models arguably facilitates meeting short-term demands of a constantly changing educational environment.
Australia↗
Comparison of the protective efficacy of bacille calmette-Guérin vaccination against aerosol challenge with Mycobacterium tuberculosis and Mycobacterium bovis.
The aim of this study was to compare protection by bacille Calmette-Guérin (BCG) vaccination against aerosol challenge with either Mycobacterium bovis or Mycobacterium tuberculosis in guinea pigs. Animals were challenged 5 weeks after vaccination with 10 or 100 lung lesion-forming units (lfu) of M. bovis or M. tuberculosis. Four weeks after challenge, numbers of lung lesions and counts of viable mycobacteria in spleens were high in saline-immunized animals. In contrast, BCG vaccination resulted in fewer lung lesions; after challenge with 10 and 100 lfu, the reduction was greater in animals infected with M. bovis (mean number of lesions, 1.17 and 31.2, respectively; P<.02) than in those infected with M. tuberculosis (mean number of lesions, 16.2 and 75.8, respectively). No mycobacteria were recovered from spleens of BCG-vaccinated animals after challenge with 10 lfu of M. bovis, whereas 4 of 6 animals had detectable spleen mycobacterial counts after challenge with M. tuberculosis. Collectively, the results suggest that BCG vaccination may confer greater protection against challenge with M. bovis than challenge with M. tuberculosis.
Animals↗
Initial cleft size does not correlate with outcome in unilateral cleft lip and palate.
Clinical outcomes in children born with a cleft lip and palate (CLP) have been an area of interest for orthodontists for a number of years. Whilst tools for measurement of these outcomes are available, there is no widely accepted measure of initial cleft severity and no known quantitative indices. Therefore, the potential influence of initial severity remains unmeasured and largely ignored. The aim of this investigation was to determine the importance of initial cleft severity in determining patient outcome. The longitudinal records of 49 children born with a unilateral cleft lip and palate (UCLP), and treated in a single centre were examined. An index of initial cleft severity was developed that categorizes the cleft area as a percentage of the total palate area. The dental arch relationships of the same patients at 6 years of age were also determined. The nature of the association between these was investigated for agreement and correlation by calculation of weighted Kappa and Spearman's correlation coefficient, respectively. No evidence was found in this sample that the initial cleft area had any bearing on the quality of outcome at 6 years of age.
Adolescent↗
A genetic screen for novel components of the Ras/Mitogen-activated protein kinase signaling pathway that interact with the yan gene of Drosophila identifies split ends, a new RNA recognition motif-containing protein.
The receptor tyrosine kinase (RTK) signaling pathway is used reiteratively during the development of all multicellular organisms. While the core RTK/Ras/MAPK signaling cassette has been studied extensively, little is known about the nature of the downstream targets of the pathway or how these effectors regulate the specificity of cellular responses. Drosophila yan is one of a few downstream components identified to date, functioning as an antagonist of the RTK/Ras/MAPK pathway. Previously, we have shown that ectopic expression of a constitutively active protein (yan(ACT)) inhibits the differentiation of multiple cell types. In an effort to identify new genes functioning downstream in the Ras/MAPK/yan pathway, we have performed a genetic screen to isolate dominant modifiers of the rough eye phenotype associated with eye-specific expression of yan(ACT). Approximately 190,000 mutagenized flies were screened, and 260 enhancers and 90 suppressors were obtained. Among the previously known genes we recovered are four RTK pathway components, rolled (MAPK), son-of-sevenless, Star, and pointed, and two genes, eyes absent and string, that have not been implicated previously in RTK signaling events. We also isolated mutations in five previously uncharacterized genes, one of which, split ends, we have characterized molecularly and have shown to encode a member of the RRM family of RNA-binding proteins.
Amino Acid Sequence↗
Thoracic epidural anesthesia for thoracoscopy, rib resection, and thoracotomy in a patient with a bronchopleural fistula postpneumonectomy.
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Aged↗
Identification of a Mycobacterium bovis BCG auxotrophic mutant that protects guinea pigs against M. bovis and hematogenous spread of Mycobacterium tuberculosis without sensitization to tuberculin.
Tuberculosis remains one of the most significant diseases of humans and animals. The only currently available vaccine against this disease is a live, attenuated vaccine, bacillus Calmette-Guérin (BCG), which was originally derived from Mycobacterium bovis and despite its variable efficacy is the most widely administered vaccine in the world. With the advent of the human immunodeficiency virus-AIDS pandemic concern has been raised over the safety of BCG. Moreover, since BCG sensitizes vaccinated individuals to the tuberculin test, vaccination with BCG prevents diagnosis of infection in vaccinated individuals. Recently, auxotrophic strains of BCG have been generated by insertional mutagenesis which have been shown to be safer than the parent BCG strain following administration to mice with severe combined immunodeficiency disease. These strains have also been shown to give comparable protection against intravenous and intratracheal challenge of BALB/c mice with M. tuberculosis relative to conventional BCG. Here we report that one of these mutants, a leucine auxotroph of BCG, conferred significant protection of the lungs and spleens of guinea pigs infected with M. bovis and protection of the spleens of guinea pigs infected with M. tuberculosis in the absence of a cutaneous hypersensitivity reaction to tuberculin. Therefore, protective immunity to tuberculosis may, at least in part, be achieved without sensitization to the tuberculin skin test. These results indicate that it may be possible to develop a new generation of vaccines based on BCG that are protective, are safe for use in the immunocompromised, and do not preclude the use of the tuberculin skin test in both humans and animals.
Animals↗
MTSA-10, the product of the Rv3874 gene of Mycobacterium tuberculosis, elicits tuberculosis-specific, delayed-type hypersensitivity in guinea pigs.
In a search for new skin test reagents specific for tuberculosis, we found that the antigen encoded by gene Rv3874 of Mycobacterium tuberculosis elicited delayed-type hypersensitivity in M. tuberculosis-infected guinea pigs but not in control animals immunized with Mycobacterium bovis bacillus Calmette-Guérin (BCG) or Mycobacterium avium. The antigen, which was named MTSA-10 (for M. tuberculosis-specific antigen 10), is a prime candidate for a component of a new tuberculin that will allow discrimination by a skin test of latent M. tuberculosis infection from vaccination with BCG or from sensitization with environmental, nontuberculous mycobacteria.
Animals↗