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Biomedical subjects

D Goldenberg

Publications and source records attributed to D Goldenberg.

At least 37 records · Page 2Linked to original sources
PubMed2000

Consortium approach for nurse practitioner education.

In 1995, a 10-university consortium approach to deliver a post-baccalaureate primary care nurse practitioner programme funded by the Ontario Ministry of Health was launched throughout Ontario, Canada. A combination of traditional and distance teaching methods, in English and French, were used. A 5-year research project was initiated to evaluate the entire programme, the effect of nurse practitioners on patient and health-care system outcomes and examine practice patterns. Participants included deans and directors (n = 10), regional co-ordinators (n = 5) and course developers, some of whom were also course professors (n = 8). This article is a report of the evaluation of the consortium programme after the first year from the perspective of groups involved in implementation and delivery. Results of qualitative analyses of participant perceptions from researcher-led focus groups and asynchronous electronic interviews provided the framework for the evaluation, and revealed the rationale for the consortium method, strengths, limitations and recommendations. Sharing ideas, resources and delivery and increased student access in remote areas were perceived as positive outcomes. Limitations included the short time period to develop programme content, identify and plan for distance education resources, and too little communication between universities and students. Researchers concluded that the consortium approach was effective for nurse practitioner education. Key factors identified for programme planning were communication, resources, curriculum and workload. Included among the recommendations was to allow sufficient time for role and course development before beginning a similar programme.

Attitude of Health Personnel↗
PubMed2000

The medical school Web site: medical education's newest tool.

There are few technological advancements that have had as much impact on the dissemination of information as the Internet, and especially the worldwide web. It is not surprising then that this tool is also changing the way medicine is studied, taught and practiced today. This impressive infrastructure enables us to teach and study medicine in an entirely different way. The web provides medical students and physicians with access to continuing medical education, patient education services, telemedicine, and unparalleled communication between colleagues via email. The medical school web site may be used as a dynamic newspaper or bulletin board to disseminate information internally among the faculty as well as to the outside world. It can also be the vehicle for virtual learning modules that enhance the medical school core curriculum by including lectures, exercises, tests, etc. In addition, the web allows the student access to medical literature, medical software applications and medical resource depots. To date no work has been published on the medical school web site, its construction process, and its advantages, drawbacks and future. The purpose of this article is to examine the evolution of the web as a tool for medical schools, medical students and associated physicians. We discuss the building of a web site for a medical faculty, and look to the future.

Computer-Assisted Instruction↗
PubMed2000

The impact of an aging population on curriculum development in Canadian undergraduate nursing education.

The rise in numbers of persons 65 years of age and older due to increased life expectancy is necessitating a revision in undergraduate nursing education. Since additional qualified nurses will be required to care for this expanding population, nursing programs must include sufficient relevant gerontological content delivered by competent faculty to prepare these practitioners. The authors review pertinent literature, present several surveys outlining the current status of gerontology content in nursing and other allied health programs, and argue for gerontological nursing to be a core component of undergraduate programs.

Aged↗
PubMed1999

HU-308: a specific agonist for CB(2), a peripheral cannabinoid receptor.

Two cannabinoid receptors have been identified: CB(1), present in the central nervous system (CNS) and to a lesser extent in other tissues, and CB(2), present outside the CNS, in peripheral organs. There is evidence for the presence of CB(2)-like receptors in peripheral nerve terminals. We report now that we have synthesized a CB(2)-specific agonist, code-named HU-308. This cannabinoid does not bind to CB(1) (K(i) > 10 microM), but does so efficiently to CB(2) (K(i) = 22.7 +/- 3.9 nM); it inhibits forskolin-stimulated cyclic AMP production in CB(2)-transfected cells, but does so much less in CB(1)-transfected cells. HU-308 shows no activity in mice in a tetrad of behavioral tests, which together have been shown to be specific for tetrahydrocannabinol (THC)-type activity in the CNS mediated by CB(1). However, HU-308 reduces blood pressure, blocks defecation, and elicits anti-inflammatory and peripheral analgesic activity. The hypotension, the inhibition of defecation, the anti-inflammatory and peripheral analgesic effects produced by HU-308 are blocked (or partially blocked) by the CB(2) antagonist SR-144528, but not by the CB(1) antagonist SR-141716A. These results demonstrate the feasibility of discovering novel nonpsychotropic cannabinoids that may lead to new therapies for hypertension, inflammation, and pain.

Analgesics↗
PubMed1999

Cholesteatomas associated with ventilation tube insertion.

OBJECTIVES: To determine the incidence of cholesteatoma formation associated with ventilation tube (VT) placement and to identify and analyze the variables and risk factors that may predict or predispose to this complication. DESIGN: We reviewed the medical records of 2829 children following VT insertion between the years 1978 and 1997 to obtain 1- to 20-year follow-up data. SETTING: Departments of Otolaryngology-Head and Neck Surgery and outpatient clinics of 2 tertiary referral academic medical centers. PATIENTS: A study population of 2829 children, ranging in age from 1.2 to 14 years (5575 ears), underwent a total of 6701 VT placements. MAIN OUTCOME MEASURE: Cholesteatomas were considered a complication of VT placement whenever they developed at or near the site of the tube insertion. RESULTS: Cholesteatomas directly attributed to VT placement occurred in 1.1% of the ears that were operated on. A higher incidence occurred (1) in children younger than 5 years, (2) when Goode T-tubes were used, (3) in cases with repeated insertions of tubes, (4) with intubation exceeding 12 months, and (5) in cases with frequent post-operative otorrhea. CONCLUSIONS: Cholesteatoma formation associated with VT placement occurs in 1.1% of the ears that are operated on, and therefore it should be discussed with patients or parents prior to surgery. Periodic and long-term follow-up microscopic examinations of the eardrum should be performed in all patients following tubal extrusion or removal, especially in those at high risk for developing a secondary cholesteatoma, to detect this complication as early as possible.

Adolescent↗
PubMed1999

Achievement motivation, anxiety and academic success in first year Master of Nursing students.

Forty-one first semester master level nursing students from three Canadian universities participated in this descriptive correlational study to identify the influence of achievement motivation and anxiety on their academic success. Academic success was determined by their first semester grade point average (GPA). Participants had high achieving tendencies (M = 73.5) and academic ability (M = 81.9), supporting Atkinson's (1957, 1964) achievement motivation theory which was used as the framework. While state anxiety was negatively correlated, trait anxiety was the only valid predictor of academic success. Academic ability and inherent anxiety had a greater potential for predicting students who would succeed, which has implications for nurse educators, administrators and researchers. However, the need to assess both cognitive and non-cognitive variables to determine master level nursing students' ability to succeed is recommended.

Adult↗
PubMed1999

Health information telephone service for seniors.

The use of the telephone as a medium for providing health information and support specifically to seniors is relatively new. Of the more than 80 Canadian services, apparently only two are dedicated exclusively to older people. Recently, nursing faculty from The University of Western Ontario in London, Ontario, conducted a survey to assess the need for, and probable use of, a free health information telephone service for seniors in the community.

Aged↗
PubMed1998

Transcriptional repression by AML1 and LEF-1 is mediated by the TLE/Groucho corepressors.

The mammalian AML/CBFalpha runt domain (RD) transcription factors regulate hematopoiesis and osteoblast differentiation. Like their Drosophila counterparts, most mammalian RD proteins terminate in a common pentapeptide, VWRPY, which serves to recruit the corepressor Groucho (Gro). Using a yeast two-hybrid assay, in vitro association and pull-down experiments, we demonstrate that Gro and its mammalian homolog TLE1 specifically interact with AML1 and AML2. In addition to the VWRPY motif, other C-terminal sequences are required for these interactions with Gro/TLE1. TLE1 inhibits AML1-dependent transactivation of the T cell receptor (TCR) enhancers alpha and beta, which contain functional AML binding sites, in transfected Jurkat T cells. LEF-1 is an additional transcription factor that mediates transactivation of TCR enhancers. LEF-1 and its Drosophila homolog Pangolin (Pan) are involved in the Wnt/Wg signaling pathway through interactions with the coactivator beta-catenin and its highly conserved fly homolog Armadillo (Arm). We show that TLE/Gro interacts with LEF-1 and Pan, and inhibits LEF-1:beta-catenin-dependent transcription. These data indicate that, in addition to their activity as transcriptional activators, AML1 and LEF-1 can act, through recruitment of the corepressor TLE1, as transcriptional repressors in TCR regulation and Wnt/Wg signaling.

Amino Acid Sequence↗
PubMed1998

The epiglottis and obstructive sleep apnoea syndrome.

Obstructive sleep apnoea syndrome (OSAS) is caused by obstruction or narrowing of the airway at various levels. The repair of one site only will not alleviate the syndrome if there are obstructions in other sites. Epiglottis prolapse during inspiration is an unusual cause of airway obstruction and a rare cause of OSA. Twelve cases of OSAS due to an abnormal epiglottis are presented. We present our approach to the diagnosis using fibre-optic examination of the hypopharynx, and our treatment using endoscopic carbon dioxide laser partial epiglottidectomy. We found in our series that in 11.5 per cent of patients who failed the uvulopalatopharyngoplasty procedure, the reason was a narrow airway at the hypopharyngeal level caused by an abnormal epiglottis. It is our suggestion that in these cases a laser partial epiglottidectomy should be performed. The results of this study show that partial epiglottidectomy can increase the cure rate of patients with obstructive sleep apnoea syndrome by 10-15 per cent.

Adult↗
PubMed1998

Temporal bone fracture following blunt trauma caused by a flying fish.

Blunt trauma to the temporal region can cause fracture of the skull base, loss of hearing, vestibular symptoms and otorrhoea. The most common causes of blunt trauma to the ear and surrounding area are motor vehicle accidents, violent encounters, and sports-related accidents. We present an obscure case of a man who was struck in the ear by a flying fish while wading in the sea with resulting temporal bone fracture, sudden deafness, vertigo, cerebrospinal fluid otorrhoea, and pneumocephalus.

Adult↗
PubMed1998

Expression of AML1-d, a short human AML1 isoform, in embryonic stem cells suppresses in vivo tumor growth and differentiation.

The human AML1 gene encodes a heterodimeric transcription factor which plays an important role in mammalian hematopoiesis. Several alternatively spliced AML1 mRNA species were identified, some of which encode short protein products that lack the transactivation domain. When transfected into cells these short isoforms dominantly suppress transactivation mediated by the full length AML1 protein. However, their biological function remains obscure. To investigate the role of these short species in cell proliferation and differentiation we generated embryonic stem (ES) cells overexpressing one of the short isoforms, AML1-d, as well as cells expressing the full length isoforms AML1-b and AML2. The in vitro growth rate and differentiation of the transfected ES cells were unchanged. However, overexpression of AML1-d significantly affected the ES cells' ability to form teratocarcinomas in vivo in syngeneic mice, while a similar overexpression of AML1-b and AML2 had no effect on tumor formation. Histological analysis revealed that the AML1-d derived tumors were poorly differentiated and contained numerous apoptotic cells. These data highlight the pleiotropic effects of AML1 gene products and demonstrate for the first time an in vivo growth regulation function for the short isoform AML1-d.

Animals↗
PubMed1998

Herpes simplex virus type 1 latency-associated transcripts suppress viral replication and reduce immediate-early gene mRNA levels in a neuronal cell line.

During herpes simplex virus type 1 (HSV-1) latent infection in human dorsal root ganglia, limited viral transcription, which has been linked to HSV-1 reactivation ability, takes place. To study the involvement of this transcription in HSV-1 replication in neuronal cells and consequently in viral latency, we constructed stably transfected neuronal cell lines containing (i) the entire HSV-1 latency transcriptionally active DNA fragment, (ii) the same DNA sequence with deletions of the latency-associated transcript (LAT) promoters, or (iii) the DNA coding sequence of the LAT domain. Replication of HSV-1 or a LAT-negative mutant was markedly repressed in the LAT-expressing cells, a phenomenon mediated by the LATs. To study the mechanism responsible for this effect, we examined LAT influence upon expression of HSV-1 immediate-early (IE) genes ICP0, ICP4, and ICP27, by Northern blot analysis. Following infection of a LAT-expressing neuronal cell line with a LAT-negative mutant, the steady-state levels of all three IE mRNAs were reduced compared to those for control cells. Transient transfections into a neuronal cell line indicated that the LAT suppressive effect upon ICP0 mRNA was mediated directly and was not due to the LAT effect upon the ICP0 promoter. We therefore propose that the LATs may repress viral replication in neuronal cells by reducing IE gene mRNA levels and thus facilitate the establishment of HSV-1 latency in nervous tissue.

Animals↗
PubMed1998

Tissue specific distribution of the herpes simplex virus type 1 latency-associated transcripts on polyribosomes during latent infection.

Transcription of herpes simplex virus type 1 (HSV-1) during latency produces two abundant latency-associated transcripts (LATs). We have recently shown, that during HSV-1 latency in mice trigeminal ganglia (TG) LATs are bound to polyribosomes (J Virol, 1997, 71, 2897-2904). In order to study the possible role of this binding in the latency process, we now extend the polyribosomal analysis to brainstem tissues of latently infected mice, that unlike TG do not support viral reactivation. We report here that the relative amounts of the LATs associated with polyribosomes in the brainstems of mice are significantly lower than those present in TG. We therefore show that binding of the 1.5 and 2.0 kilobases LATs to polyribosomes is tissue specific and hypothesize that this association may have a role in the reactivation function of HSV-1.

Animals↗
PubMed1997

Role of Escherichia coli cspA promoter sequences and adaptation of translational apparatus in the cold shock response.

A shift in growth temperature from 37 degrees C to 15 degrees C leads to a dramatic increase in the level of CspA, the major cold shock protein of Escherichia coli. To investigate the molecular basis of this induction, we considered the relevance of transcriptional and posttranscriptional controls by analyzing the steady-state levels of transcripts and the expression of reporter genes in cells carrying a set of cspA promoter fragments of variable length fused to lacZ or cat genes. We demonstrate that: (i) the core cspA promoter (from -40 to +16) responds to cold shock and a mutation at -36 increases the relative activity of the promoter at low temperature by threefold; (ii) the sequences upstream of -40 have a positive effect on expression at 37 degrees C, but no effect on the cold shock response; (iii) by virtue of their influence on mRNA stability, the downstream sequences (from +81 to +165) reduce expression at 37 degrees C and increase the intensity of the cold shock response; (iv) mutations in the GCACATCA and CCAAT motifs, present at +1/-4 and between the -10 and -35 elements, respectively, do not affect the cold shock response of the cspA promoter; (v) following cold shock, a modification of the protein synthetic machinery takes place that allows preferential translation of cspA mRNA relative to the non-cold shock cat and lacZ mRNAs. The quantitatively modest transcriptional activation shown by the core promoter of cspA following cold shock suggests that transcriptional activation can significantly contribute to cold shock induction only when coupled to posttranscriptional controls, such as alterations in mRNA stability and the translational apparatus.

Adaptation, Physiological↗
PubMed1997

Self-efficacy of senior baccalaureate nursing students and preceptors.

The purpose of this descriptive study was to investigate the effects of a senior clinical preceptorship experience on the self-efficacy levels of senior baccalaureate nursing students and their preceptors. Bandura's (1977, 1986) theoretical model of self-efficacy provided the conceptual framework. A non-probability convenience sample of 74 students and preceptors completed the self-efficacy pre-questionnaire; 47 the post-questionnaire. Students' overall self-efficacy scores increased significantly (M = 3.46/4.00; P < or = 0.01) following the 12-week preceptorship. Preceptors' post-scores, although not significantly increased, remained high, suggesting confidence in their role. Continuation of preceptorship programs is recommended.

Adult↗
PubMed1997

Computerized tomographic and ultrasonographic features of Kimura's disease.

Kimura's disease (KD) is an uncommon condition once thought to affect only Orientals. The patients present with swelling of the major salivary glands associated with cervical lymphadenopathy. The clinical, histopathological and radiological findings of a young Caucasian female with KD will be presented and discussed.

Adult↗
PubMed1997

Retropharyngeal abscess: a clinical review.

Retropharyngeal abscesses are uncommon but potentially lethal infections, especially in the paediatric population under the age of five years. Abscesses in this group are classically secondary to upper respiratory infections especially oropharyngeal infections, while in the adult group they are usually secondary to trauma, foreign bodies, or as a complication of dental infections. Early diagnosis and the wide spread use of antibiotics have made these infections less common today. Between the years 1985-1996, 19 cases of retropharyngeal abscesses were treated in our department. Factors such as age, sex, aetiology, presenting signs, symptoms, methods of diagnosis, treatment and complications were reviewed. Thirty-two per cent of the cases were secondary trauma. A lateral neck film showing widening of the prevertebral space was the most important diagnostic tool, computed tomography (CT) scan was used in 63 per cent of cases to verify the signs of an abscess and to provide more accurate anatomical localization. Thirteen cases required surgical drainage. The single most commonly-isolated pathogen was Streptococcus pyogenes. There were no deaths and only one recurrence requiring repeated surgical drainage. One case was complicated by a spinal canal abscess. We also report two cases of retropharyngeal abscess in children caused by swallowing of unusual foreign bodies.

Adolescent↗