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Biomedical subjects

B Phillips

Publications and source records attributed to B Phillips.

At least 55 records · Page 3Linked to original sources
PubMed1993

Predictors of assistive technology abandonment.

Technology abandonment may have serious repercussions for individuals with disabilities and for society. The purpose of this study was to determine how technology users decide to accept or reject assistive devices. Two hundred twenty-seven adults with various disabilities responded to a survey on device selection, acquisition, performance, and use. Results showed that 29.3% of all devices were completely abandoned. Mobility aids were more frequently abandoned than other categories of devices, and abandonment rates were highest during the first year and after 5 years of use. Four factors were significantly related to abandonment--lack of consideration of user opinion in selection, easy device procurement, poor device performance, and change in user needs or priorities. These findings suggest that technology-related policies and services need to emphasize consumer involvement and long-term needs of consumers to reduce device abandonment and enhance consumer satisfaction.

Adult↗
PubMed1993

Adequate access to posthospital home health services: differences between urban and rural areas.

The health care environment in rural areas changed dramatically in the 1980s. Policy-makers are concerned that these changes have reduced access to care among residents of rural areas. This study measures adequate access to Medicare home health services and determines whether it differs for urban and rural beneficiaries. Adequate access to care is measured by whether a patient with a specific health condition received a level of skilled services predetermined as appropriate for that condition. The predetermined levels of care were developed in an earlier study and were found to correlate with adverse outcomes. This study focused on patients with diabetes mellitus and surgical hip procedures to concentrate on access to skilled nursing services and physical therapy services. To conduct the analysis, a data base was constructed that included both patient utilization and health status data, drawing on three different data sources: Medicare hospital claims data, Medicare home health bill record data, and home health plan of treatment data from patients' utilization review forms (forms 485 and 486). The analysis samples consisted of 404 patients with diabetes and 876 patients who had surgical hip procedures. Significant differences were found between urban and rural areas in access to home health services. The largest differences were found in access to physical therapy services, but differences in access to skilled nursing services also exist. The data suggest that the availability of skilled care services may cause these differences.

Aged↗
PubMed1993

Pain assessment.

Explore the source record for details and available documents.

Humans↗
PubMed1993

The 1990/91 Kentucky hospital smoking policy survey: a follow-up.

We surveyed all Kentucky hospitals regarding smoking policies iin 1989, 1990, and 1991. There were statistically significant increases in the numbers of hospitals which developed smoking policies and became smoke free between 1990 and 1991. The sale of tobacco in hospitals declined significantly between 1989 and 1991, as did the number of institutions providing smoking areas within the hospital. Survey respondents indicated that the JCAHO mandate prompted changes in smoking policies. Kentucky hospitals are leading the way in developing smoke-free environments, but externally imposed regulations have played a major role in promoting this progress.

Health Policy↗
PubMed1993

Preventive medicine: what do future practitioners really need? Are they getting it in medical school?

The purposes of our study were (1) to determine preventive medicine topics most relevant to clinical practice, and (2) to determine if medical education affects medical students' attitudes regarding preventive medicine. Our method of study was two surveys. The first survey asked practicing physicians to rank the 23 topics identified in the Healthy People 2000 monograph and determine their usefulness in clinical practice. The second survey assessed medical students' attitudes about preventive medicine. Practitioners ranked tobacco, cancer, and diabetes as most relevant to the actual clinical practice of medicine. There were no correlations between practitioners' gender, age, or region and their rankings of topics. In terms of specialties, surgeons felt preventive medicine was less important than did family practitioners. Medical students' attitudes about preventive practices became significantly more positive as they progressed through medical school. Survey scores also improved significantly in second year students after their preventive medicine course. Students planning to be surgeons were less positive about preventive medicine. There is a continuing need for prevention education in medical school curricula, especially about tobacco, cancer, diabetes, and nutrition. Epidemiology and disease reporting might best be presented as "how to read the literature."

Adult↗
PubMed1992

Activation of heat shock factor 2 during hemin-induced differentiation of human erythroleukemia cells.

Hemin induces nonterminal differentiation of human K562 erythroleukemia cells, which is accompanied by the expression of certain erythroid cell-specific genes, such as the embryonic and fetal globins, and elevated expression of the stress genes hsp70, hsp90, and grp78/BiP. Previous studies revealed that, as during heat shock, transcriptional induction of hsp70 in hemin-treated cells is mediated by activation of heat shock transcription factor (HSF), which binds to the heat shock element (HSE). We report here that hemin activates the DNA-binding activity of HSF2, whereas heat shock induces predominantly the DNA-binding activity of a distinct factor, HSF1. This constitutes the first example of HSF2 activation in vivo. Both hemin and heat shock treatments resulted in equivalent levels of HSF-HSE complexes as analyzed in vitro by gel mobility shift assay, yet transcription of the hsp70 gene was stimulated much less by hemin-induced HSF than by heat shock-induced HSF. Genomic footprinting experiments revealed that hemin-induced HSF and heat shock-induced HSF, HSF2, and HSF1, respectively, occupy the HSE of the human hsp70 promoter in a similar yet not identical manner. We speculate that the difference in occupancy and/or in the transcriptional abilities of HSF1 and HSF2 accounts for the observed differences in the stimulation of hsp70 gene transcription.

Base Sequence↗
PubMed1991

Carbon-13 nuclear magnetic resonance spectroscopy of lipids: differential line broadening due to cross-correlation effects as a probe of membrane structure.

We have obtained proton-coupled carbon-13 nuclear magnetic resonance (NMR) spectra of a variety of lipid-water and lipid-drug-water systems, at 11.7 T, as a function of temperature, using the "magic-angle" sample-spinning (MAS) NMR technique. The resulting spectra show a wide range of line shapes, due to interferences between dipole-dipole and dipole-chemical shielding anisotropy interactions. The differential line-broadening effects observed are particularly large for aromatic and olefinic (sp2) carbon atom sites. Coupled spectra of the tricyclic antidepressants desipramine and imipramine, in 1,2-dimyristoyl-sn-glycero-3-phosphocholine-water mesophases, show well-resolved doublets having different line shapes for each of the four aromatic methine groups, due to selective averaging of the four C-H dipolar interactions due to rapid motion about the director (or drug C2) axis. 2H NMR spectra of [2,4,6,8-2H4]desipramine (and imipramine) in the same 1,2-dimyristoyl-sn-glycero-3-phosphocholine-water mesophase exhibit quadrupole splittings of approximately 0-2 and approximately 20 kHz, indicating an approximate magic-angle orientation of the C2-2H(1H) and C8-2H(1H) vectors with respect to an axis of motional averaging, in accord with the 13C NMR results. Selective deuteration of imipramine confirms these ideas. Spectra of digalactosyl diglyceride [primarily 1,2-di[(9Z,12Z,15Z)-octadeca-9,12,15-trienoyl ]-3- (alpha-D-galactopyranosyl-1-6-beta-D-galactopyranosyl)-sn-glycerol]-H2O (in the L alpha phase) show a large differential line broadening for C9 but a reduced effect for C10, consistent with the results of 2H NMR of specifically 2H-labeled phospholipids [Seelig, J., & Waespe-Saracevic, N. (1978) Biochemistry 17, 3310-3315].(ABSTRACT TRUNCATED AT 250 WORDS)

Carbon Isotopes↗
PubMed1991

A modeling framework for AIDS/HIV nonacute care services.

This paper describes the conceptual structure underlying the microcomputer-based modeling system developed by Mathematica Policy Research, Inc. The modeling system was developed to assist communities in planning nonacute care services for symptomatic human immunodeficiency virus (HIV)-infected persons. The modeling system is based on the assumptions that (1) the characteristics of the HIV epidemic and the availability of nonacute care service vary across communities and (2) combinations of nonacute care services can be appropriately substituted for one another and for hospital-based nonacute care to meet the varying medical and social needs of symptomatic HIV-infected persons.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Shift work, sleep quality, and worker health: a study of police officers.

The Planning and Analysis Unit of the Lexington Police Department changed from rotating to permanent shift assignments. We report herein the results of patrol officers' responses to the Florida Sleep Questionnaire, the SCL-90 (a symptom checklist), and absentee data. Sleep quality and sleep hygiene improved after changing from rotating to permanent shifts. The SCL-90 demonstrated improved psychologic well-being. Further, absentee rates fell from 1400 hours during the 6 months preceding the shift change to 883 hours during the 6 months following the change. We review the literature concerning the effects of shift work on worker performance.

Absenteeism↗
PubMed1991

Attenuation of the heat shock response in HeLa cells is mediated by the release of bound heat shock transcription factor and is modulated by changes in growth and in heat shock temperatures.

When HeLa S3 cells are subjected to a continuous 42 degrees C heat shock, activation of heat shock transcription factor (HSF) and transcriptional activation of the heat shock genes hsp70, hsp89 alpha, and hsp60 is transient, peaking at 40-60 min of heat shock, and then attenuating. We have used in vivo genomic footprinting to demonstrate that attenuation of hsp70 transcription is mediated by release of bound HSF from the heat shock element (HSE) of the hsp70 gene promoter. Release of bound HSF in vivo occurs at a higher rate than would be predicted from in vitro measurements of dissociation. Attenuation of HSF activation and heat shock gene transcription occurs only when mild heat shock temperatures are employed (42 degrees C); increasing the heat shock temperature by 1 degree C elicits a much higher level of activation, which does not attenuate during a 4-hr heat shock. Surprisingly, altering the temperature at which cells are grown prior to heat shock modulates the magnitude and temporal pattern of the response to a given heat shock temperature. This finding suggests that HSF does not sense temperature directly but, instead, may be responsive to the magnitude of the difference between growth and heat shock temperatures.

Base Sequence↗