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Biomedical subjects

J Ripley

Publications and source records attributed to J Ripley.

9 recordsLinked to original sources
PubMed2001

Immune responses and protection induced by mucosal and systemic immunisation with recombinant measles nucleoprotein in a mouse model of measles virus-induced encephalitis.

In this study the immunogenicity of recombinant nucleoprotein (Np) administered intranasally or intraperitoneally, and its ability to support a systemic protective anti-virus antibody response was examined, in a mouse model of measles virus (MV)-induced encephalitis. Although both intranasal and intraperitoneal routes of immunisation resulted in priming Np- and MV-specific T-cell responses, the intraperitoneal route was shown to prime for a predominantly IgG2a serum anti-MV antibody response of high avidity, which confered complete protection following intracranial challenge with a neuroadapted strain of MV. On the other hand, intranasal priming resulted in a mixed IgG1, IgG2a serum anti-MV antibody response of low avidity, and only 43% of immunised mice survived following intracranial challenge with the neuroadapted strain of MV. These findings suggest that the route of immunisation in combination with an appropriate adjuvant could influence the induction of a quality antibody response with protective capacity.

Animals↗
PubMed2001

Coordinating care for the dual-eligible population.

Many patients who are eligible for Medicare also are eligible for Medicaid. IDSs that deliver care to these patients, called "dual eligibles," face a challenge of conflicting rules and incentives under existing Federal and state laws governing coverage of these patients. Differences in the Medicare and Medicaid payment rules give IDSs a financial incentive to transfer patients from long-term and postacute to acute care settings in situations in which the patients might receive more appropriate care remaining where they are. Many states are implementing pilot programs to allow IDSs to better coordinate care for dual eligibles. Before states begin implementing pilot or statewide programs, IDSs should be involved in the design of the pilot programs, thereby ensuring that the coordinated funding effectively meets an IDS's requirements for optimum care delivery with adequate payment.

Aged↗
PubMed1999

Deconstructing the antigenic profile of a protective epitope from measles virus fusion protein using overlapping peptides.

Three different approaches of using overlapping peptides have been compared to analyse the fine specificity of the antibody response to a protective epitope from measles virus (MV) fusion protein, spanning residues 397-420. Anti-peptide antibodies raised in BALB/c, CBA and C57BL/6 mice were shown to react with the homologous peptide and the MV by ELISA. Results from indirect ELISA using 15mer peptides (overlapping by one residue) as solid phase antigens have shown that anti-peptide antibodies from CBA and C57BL/6 mice recognised the same B-cell epitope(s) located within the 398-414 region, whereas BALB/c mice predominantly recognised epitopes located within the 400-417 region. When the 15mer peptides were used as fluid phase antigens in an inhibition ELISA, peptide 405-419 was shown to be the most effective inhibitor in all three strains of mice. Analysis of serum samples by SPOTs ELISA has shown that the region 407-417 was predominantly recognised by BALB/c mice, whereas antibodies from C57BL/6 mice recognised the 408-420 region. No reactivity was observed with serum samples from CBA mice. Although the majority of the identified B-cell epitopes were shown to overlap by the three methods, the identified boundaries of these epitopes differed, suggesting that the size and the mode of peptide presentation affects their antigenicity.

Amino Acid Sequence↗
PubMed1997

Fine specificity of the antibody response to a synthetic peptide from the fusion protein and protection against measles virus-induced encephalitis in a mouse model.

A synthetic peptide representing residues 397-420 from the measles virus (MV) fusion (F) protein was tested for its structure, immunogenicity and protective capacity against intracerebral challenge with a neuroadapted strain of MV. Analysis of the peptide by mass spectrometry showed that it was linear, despite the presence of two cysteine residues in the sequence. Circular dichroism spectroscopy highlighted a weak preference for the peptide to adopt an alpha-helical conformation. The peptide was shown to be immunogenic in BALB/c and C57BL/6 mice after intraperitoneal immunization in Freund's adjuvant, and anti-peptide antibodies from both strains of mice reacted with the MV as a solid phase antigen on an ELISA plate. When the fine specificity of the anti-peptide antibody response was examined using overlapping 8-mer peptides, serum antibodies from BALB/c mice recognized the region between residues 407-417 whereas antibodies from C57BL/6 mice recognized the region 408-420 of the 397-420 peptide sequence. Although anti-397-420 antibodies had no demonstrable neutralizing activity, protection against challenge with a neuroadapted strain of MV was demonstrated following active immunization with peptide in C57BL/6 mice or after passive transfer of anti-peptide antibodies in BALB/c mice. These findings highlight the importance of the 397-420 region in the induction of protective antibodies in the MV encephalitis mouse model, and suggest that this epitope might be a good candidate for inclusion in a future MV synthetic peptide vaccine.

Animals↗
PubMed1997

Post-hospital sub-acute care: an example of a managed care model.

OBJECTIVE: This article describes Transitional Care Centers (TCC), an innovative sub-acute care program developed by a large managed care organization (HealthPartners in Minnesota) in partnership with five area nursing homes. The purpose of the TCC is to promote continuity of care for frail older members covered under a TEFRA risk contract. DESIGN: This is a retrospective study of the experiences and outcomes of enrollees who received TCC compared with a like group of enrollees who received customary continuity care through contract services. SETTING: The TCCs are established contractually in five area nursing homes; these facilities keep at least 15 beds available to the health plan for round-the-clock, 7 days per week admissions for sub-acute care. Designated staff from these facilities and designated geriatric nurse practitioners and geriatricians from HealthPartners follow established targeting, admissions, assessment, care planning, and discharge planning procedures to provide team care for these patients at the facilities. PARTICIPANTS: The TCC program is targeted to patients requiring rehabilitation therapy (post-cardiovascular accident, post-fracture/replacement) who are deconditioned, or those with uncomplicated infections (urinary tract infection, pneumonia). A total of 1144 patients participated in the TCC program in the 1-year program under report, and 253 were surveyed in regard to their experience. One hundred HealthPartners physicians were surveyed about the program. RESULTS: Post-acute length of stay in the TCC was substantially lower than that in customary care settings in contract nursing homes (14.3 versus 20.5 days). Rehospitalization rates from these units were comparable to or better than those from other sub-acute units. Patient and primary care physician satisfaction with the units was high. The program provided economic benefit to both partners. The health plan's negotiated rate for the TCC units was 38% less than that paid in noncontractual facilities. CONCLUSION: The TCC partnership provides rehabilitative and geriatric evaluation services in settings more conducive to and less costly than such care usually, and yields improvements in care and utilization outcomes.

Aged↗
PubMed1995

A simple tool for designing a database: bridging the communication gaps among health care providers, researchers, and programmers.

As databases are used by a greater variety of people, highly technical methods of designing them are giving way to more human, user-centered approaches. The article describes a human approach to designing a complex, multiuse database with limited resources. The article introduces a simple data modeling tool, the entity-relationship (E-R) diagram, that crosses professional boundaries and enables providers, researchers, and programmers to communicate more easily. Constructing an E-R diagram provides a human description of the social health maintenance organization (S/HMO) multisite demonstration project. This project, now in its tenth year, provides integrated acute and community-based in-home services to allow frail elderly HMO members to stay in their homes. After briefly reviewing the three types of databases and three rules of thumb for designing a relational database, the article shows how a simple E-R diagram can clarify the management and research issues of the S/HMO health care model. The article concludes with a brief discussion of the benefits and limits of housing research-related health data in a relational database.

Communication↗
PubMed1980

Self-help groups in a premature nursery-a controlled evaluation.

This study examined the effect discussion groups, held in a neonatal intensive care unit with parents of very small premature infants, had on various measures of later parenting competence. Twenth-eight families who met for seven to ten weeks with a nurse co-ordinator and a "veteran mother" who had given birth to a premature infant within the past year were compared with 29 control families. Parents who had participated in the groups visited their infants significantly more often in hospital than did the control parents. They also touched, talked, and looked at their infants in the en face position more during their visits, and rated themselves as more competent on a number of infant care measures. Three months after discharge of the infants, group mothers continued to show more involvement with their babies during feedings and were more concerned about their general development. The implications of such self-help groups for the later development of high-risk premature infants is discussed.

Adult↗