Theory and simulation of Ostwald ripening.
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Biomedical subjects
Publications and source records attributed to M Grant.
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A school-based social influences approach to alcohol education was tested among Norwegian 8th grade lower secondary school students. The goal of the programme was to delay onset and minimize involvement in use of alcohol among the participants. 15 schools were randomly assigned to peer-led education, teacher-led education or a control condition. The programme focused on the social and environmental influences to drink alcohol, and skills to resist those influences. It consisted of five lessons over two months. Baseline and post-test data measured alcohol-use, knowledge, attitudes, skills, friends' drinking, and intentions to drink alcohol in the future. Data were collected immediately prior to and following the educational programme. The data indicate that peer-led education appears to be efficacious in reducing alcohol use and intention to use alcohol. There was no intervention effect of the peer-led programme for knowledge, attitudes or skills. There was no intervention effect for the teacher-led education.
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The contribution of autoimmune phenomena to the development of AIDS is not fully understood. In this paper we provide new evidence that idiotypic network interactions are operative in the development of AIDS. We furthermore present a model that involves two groups of antibodies and other molecules that are related to each other by a network of specific complementarities. We define Group I molecules to include antibodies and other molecules that have direct or indirect similarities with class I MHC molecules, and Group II substances that have similarities with class II MHC. We observe an inverse relationship between Group I antibodies (including anti-Fab) and Group II antibodies (including anti-anti-gp120, anti-anti-CD8 and anti-rCD4). The potential roles of members of these two groups in AIDS pathogenesis and/or protection are discussed.
This chapter describes the polymerase chain reaction (PCR) detection of methylation changes at specific CpG sites in DNA isolated from minute quantities of biological material, such as single preimplantation mouse embryos or small numbers of stem cells, or germ cells. We have concentrated on refining these techniques to monitor specific sites in X-linked genes for methylation changes associated with X-chromosome inactivation. The general principles of the HpaII-sensitive PCR assay described here should be applicable and adaptable to specific CpG sites in other genes of interest.
Adequate pain management is a 24 hr a day responsibility for health-care professionals working with cancer patients. Because nurses spend more time with patients in pain than any other member of the health-care team, they play a central role in pain assessment and pain management. The City of Hope National Medical Center, a clinical cancer center, developed a pain management course for staff nurses entitled "The Pain Resource Nurse (PRN) Training Program." The purpose of this innovative course was to prepare staff nurses to assume an active role in pain management. Twenty-six registered nurses participated in the 40-hr didactic and clinical course. The curriculum included information on pain assessment, pharmacology, nondrug interventions, and cultural, ethical, and psychosocial issues related to pain. After completion of the course, program staff have remained available to the PRNs to provide current information on pain management, and to assist with role implementation and guidance on interfacing with staff. This paper reports on the development, implementation, and 3-mo evaluation of this unique program.
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This WHO collaborative project is the first phase of a programme of work aimed at developing techniques for early identification and treatment of persons with hazardous and harmful alcohol consumption. The aim of the present study was to determine the prevalence of hazardous and harmful alcohol use among patients attending primary health care facilities in several countries, and to examine the correlates of drinking behaviour and alcohol-related problems in these culturally diverse populations. The broader purpose was to determine whether there was justification for developing alcohol screening instruments for cross-national use. One thousand, eight hundred and eighty-eight subjects in Australia, Bulgaria, Kenya, Mexico, Norway and the USA underwent a comprehensive assessment of their medical history, alcohol intake, drinking practices, and any physical or psychosocial problems related to alcohol. After non-drinkers and known alcoholics had been excluded, 18% of subjects had a hazardous level of alcohol intake and 23% had experienced at least one alcohol-related problem in the previous year. Intrascale reliability coefficients were uniformly high for the drinking behaviour (dependence) and adverse psychological reactions scales, and moderately high for the alcohol-related problems scales. There were strong correlations between the various alcohol-specific scales, and between these scales and measures of alcohol intake. Although the prevalence of hazardous and harmful alcohol consumption varied from country to country, there was a high degree of commonality in the structure and correlates of drinking behaviour and alcohol-related problems. These findings strengthen the case for developing international screening instruments for hazardous and harmful alcohol consumption.
The cross-cultural validity of the Alcohol Dependence Syndrome was tested on 13 symptoms of alcohol dependence which were assessed as part of a WHO collaborative study of the early detection of harmful drinking. The subjects were drinking patients in health care settings in Australia, Bulgaria, Kenya, Mexico, Norway, and the US. Principal Components Analyses were performed on the symptoms in each centre, and the degree of agreement between the results was assessed by calculating coefficients of congruence between the item loadings on the first principal component. In all six centres the first Principal Component accounted for at least half of the total variance and all symptoms had positive loadings greater than 0.40 on the first Principal Component. The coefficients of congruence were all 0.98 or more, and the 13 symptoms had internal consistency coefficients of 0.94 or more. An alcohol dependence score defined by the sum of positive responses to the 13 alcohol dependence symptoms was positively correlated with self-reported alcohol consumption, alcohol-related problems, serum gamma glutamyltransferase and a clinical examination assessment of alcoholism in all six samples.
The Alcohol Use Disorders Identification Test (AUDIT) has been developed from a six-country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10-item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol-related problems. Questions were selected from a 150-item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non-hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross-national study.
Two hundred and forty female clients attending primary health care centers in Montego Bay and the Kingston Metropolitan Area were interviewed to obtain information about their beliefs with regard to hypertension. This study revealed that the variables-perceived susceptibility, perceived severity and 'cue to action'-identified in the Health Belief Model need to be strengthened if patient compliance and adoption of health-promoting behaviours are to be realized. This study also pointed out the pressing need for health care providers to enhance health promotion programmes relative to hypertension. These programmes should be aimed at increasing clients' knowledge base and self-care abilities in order to to help prevent and/or control this disorder.
This article presents findings from an exploratory, descriptive study that investigated the experiences of pain in the home from the perspective of the patient, the primary family caregiver, and the home care nurse. The following research questions are addressed: What are the special problems associated with pain management at home as identified by patients, caregivers, and nurses? What are the similarities and differences among patients, caregivers, and nurses regarding issues of managing pain at home? Qualitative techniques were used to collect and analyze data. The sample included 10 cancer patients with pain and their respective caregivers and nurses. After the in-depth interviews were transcribed, a multidisciplinary research team performed content analysis on the data. Overall, the findings suggest that patients approach pain management with a struggle for control, whereas self-denying caregivers seek to provide comfort, and nurses attempt to fulfill an urgent mission to eradicate pain.
The purpose of this paper is to present findings from an exploratory, descriptive study that investigated the experience of managing pain in the home from the perspectives of the patient, the primary family caregiver, and the homecare nurse. In particular, the decisions and ethical conflicts encountered by members of 10 patient-caregiver-nurse triads were studied. Data were collected through in-depth semistructured interviews, and the transcribed interviews were content-analyzed by a multidisciplinary research team. Subjects reported that the use of medications prompted the majority of the decisions and provoked most of the conflicts; however, decisions related to assessment, the future, and how to live with pain were identified as well. Subjects also identified other areas that created conflict, such as spiritual/theological issues, when to tell the truth, and interpersonal relationships. Findings illustrate the importance of understanding the beliefs and values that influence individuals' decisions and conflicts, because discrepant perceptions of the pain experience among patients, caregivers, and nurses can interfere with satisfactory management of pain.
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