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J Spink

Publications and source records attributed to J Spink.

11 recordsLinked to original sources
PubMed2001

Consumer health information. What the research is telling us.

BACKGROUND: Consumer health information is a necessary component of patient care and consumer participation. OBJECTIVE: To outline the findings of the 'Assessing the Quality of Consumer Health Information Project' and discuss strategies for improving consumer information. DISCUSSION: The pamphlets identified in this study were not developed with consumer input with consequent deficits apparent. Providers and consumers appeared to use the information for very different purposes but both groups were critical of the ambiguous terminology and lack of quantified data. The provision of relevant information is a fundamental prerequisite of consumer participation in decision making in health care. Such information needs to be available, accurate, and understandable.

Australia↗
PubMed1999

Isolation, characterization, and avenacin sensitivity of a diverse collection of cereal-root-colonizing fungi.

A total of 161 fungal isolates were obtained from the surface-sterilized roots of field-grown oat and wheat plants in order to investigate the nature of the root-colonizing fungi supported by these two cereals. Fungi were initially grouped according to their colony morphologies and then were further characterized by ribosomal DNA sequence analysis. The collection contained a wide range of ascomycetes and also some basidiomycete fungi. The fungi were subsequently assessed for their abilities to tolerate and degrade the antifungal oat root saponin, avenacin A-1. Nearly all the fungi obtained from oat roots were avenacin A-1 resistant, while both avenacin-sensitive and avenacin-resistant fungi were isolated from the roots of the non-saponin-producing cereal, wheat. The majority of the avenacin-resistant fungi were able to degrade avenacin A-1. These experiments suggest that avenacin A-1 is likely to influence the development of fungal communities within (and possibly also around) oat roots.

Antifungal Agents↗
PubMed1999

Development of a consumer survey for behavioral health services.

A consumer survey was designed to assess the quality of mental health and substance abuse services and evaluate insurance plans that provide such services. This paper describes the development of the Consumer Assessment of Behavioral Health Services instrument, which began with a review of existing consumer satisfaction surveys and input from several groups working toward development of nationally standardized satisfaction instruments. Consumer focus groups were used to ensure that all the important domains of quality were included, and group members were interviewed to ensure that all items on the instrument were understandable. Results of a pilot test conducted with 160 consumers, 82 enrolled in Medicaid plans and 78 in commercial plans, suggested that the survey was able to distinguish between the two groups in terms of evaluations of their care and insurance plans. Future efforts will focus on further testing of larger, more diverse samples and on developing scoring and reporting formats for the survey that will be useful to consumers and purchasers in choosing behavioral health services and plans.

Consumer Behavior↗
PubMed1998

Cytokine regulation of inducible nitric oxide synthase in vascular smooth muscle cells.

NO is an important mediator in sepsis. It has been unequivocally established that it is the major determinant in the vasodilatation and consequent hypotension in experimental animals following the administration of LPS. It is cytotoxic, particularly in combination with superoxide anions, and exerts negative inotropic and chronotropic effects on the heart. The exact role that these functions play in sepsis, however, remain unclear. Similarly, its immunomodulatory and cerebral effects, although potentially important, remain of uncertain significance in sepsis. Regulation of such a pivotal molecule is clearly extremely important: the data described here show that not only is this regulation extremely complex, but it appears to vary in different cell types. The implication of this finding for future clinical work is clear. NO production is not all bad: in some circumstances, it may be desirable to differentially regulate iNOS activity such that production is restricted in some cell types but not in others. The work described here begins to offer the possibility of identifying new molecular targets which allow this kind of differential regulation.

Animals↗
PubMed1997

Binding of the transcription factor interferon regulatory factor-1 to the inducible nitric-oxide synthase promoter.

Nitric oxide production in a variety of inflammatory conditions is dependent on the synthesis of the enzyme, inducible nitric-oxide synthase (iNOS). The gene for this enzyme is regulated by a number of inflammatory cytokines, including interferon-gamma. Transcriptional activation of the gene is dependent on the interferon-gamma-induced transcription factor, interferon regulatory factor-1 (IRF-1). Using a 99-base pair segment of the iNOS gene promoter encompassing nucleotides -979 to -881, a region essential for gene activation by cytokines, we show that with increasing concentrations of added IRF-1, a monomeric then a dimeric complex form. Molecular footprinting analysis shows that the factor binds initially to a canonical IRF-1 site as a monomer. The region of binding is then extended both in a 5' and 3' direction on formation of the dimeric complex, with additional contacts in the minor groove of DNA. Binding of the second molecule of IRF-1 is dependent on the presence of the initial bound protein. Sequential binding of IRF-1 to form a dimeric complex has not been described previously, and we show that formation of this dimeric complex is essential for full activation of the iNOS gene by cytokines in vascular smooth muscle cells.

Animals↗
PubMed1997

Synergy and specificity in induction of gene activity by proinflammatory cytokines: potential therapeutic targets.

This review focuses on two important routes of gene activation mediated by proinflammatory cytokines, which serve as a paradigm for mechanisms of specificity and synergy in cytokine regulated gene activity: STAT (signal transducers and activators of transcription)-related gene activation and the pathways initiated by proinflammatory cytokines leading to the activation of the NF-kappa B family of transcriptional activators. The proinflammatory cytokine cascade is involved in both the normal immune response and in the pathogenesis of several disease states. An understanding of specificity and synergism in these pathways offers an opportunity to develop novel therapeutic drugs for the selective manipulation of these disease processes. Such potential targets are examined in this review.

Animals↗
PubMed1995

The cytokine responsive vascular smooth muscle cell enhancer of inducible nitric oxide synthase. Activation by nuclear factor-kappa B.

The production of inducible nitric oxide synthase (iNOS) within vascular smooth muscle (VSM) cells following exposure to proinflammatory cytokines is a major cause of the vasorelaxation and hypotension of septic shock. We have defined the cytokine-responsive element of the murine iNOS promoter, transfected into a VSM cell line, and the role of the NF-kappa B/Rel family of proteins in iNOS gene activation in these cells. The combination of interleukin-1, interferon-gamma, and tumor necrosis factor-alpha stimulates promoter activity by a factor of 8.1-fold; single cytokines show little activity, while pairs of cytokines produce an intermediate effect. Using a series of promoter deletion mutants, we have defined the cytokine-responsive element from position -890 to -1002; this region contains an NF-kappa B-binding site as well as a number of interferon response elements. Nuclear proteins from cytokine-stimulated VSM cells which bind to an oligonucleotide containing this kappa B site are composed of p65 together with an unidentified protein of 50 kDa, which is not a known Rel family member. A promoter mutant with a 2-base pair change within this kappa B site, which abolishes NF-kappa B binding, has an activity of only approximately 34% (S.E. +/- 1.5) of the wild-type promoter. In addition, protein binding to this site is abolished by a specific inhibitor of NF-kappa B activation, which also abrogates iNOS activity. Residual inducibility in such mutant promoters is attributable to the presence of an independently functioning downstream kappa B site (-85 to -75). The mechanism by which NF-kappa B activates the iNOS promoter in VSM cells in response to cytokines appears to be markedly different to that operative in macrophages in response to lipopolysaccharide.

Animals↗
PubMed1991

Functional myocardial impairment in children treated with anthracyclines for cancer.

A non-invasive exercise method was used to look for myocardial damage in apparently normal children who had received moderate doses of anthracyclines for treatment of cancer. 19 children (mean [SD] age 10.6 [4.3] years) who had received anthracyclines (mean total dose 230 [119] mg/m2) and 10 who had received other cytotoxic drugs (mean age 13.3 [4.9] years) were selected from 263 children attending routine follow-up examinations. They underwent measurement of heart rate, blood pressure, and left ventricular dimensions by echocardiography before and after exercise on a bicycle for a maximum of 10 min. All 29 were in remission. All the subjects showed normal fractional shortening (FS = left ventricular end-diastolic minus end-systolic diameter as a percentage of the end-diastolic diameter) at rest, but the increase in FS on exercise was significantly lower in the children who had received anthracyclines than in those who had not (3 [16]% vs 23 [17]%; p less than 0.05). This difference remained significant after adjustment for age and drug exposure. However, there were no significant differences between the groups in the adjusted mean percentage changes on exercise in heart rate or systolic or diastolic blood pressure. Disease type had no effect on the cardiological indices. Thus, many children who have received anthracyclines may have suffered subclinical myocardial damage. Post-exercise echocardiography seems a useful non-invasive method for detecting such damage. Long-term cardiological follow-up of these patients is needed.

Adolescent↗