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Biomedical subjects

M West

Publications and source records attributed to M West.

At least 145 records · Page 8Linked to original sources
PubMed1990

National supported employment initiative: a preliminary analysis.

A survey of 27 states receiving federal supported employment grants was conducted. Results indicated that the number of participating individuals increased 157% during the 3-year study period. Further, over 1,400 programs of supported employment were authorized by state agencies during this time. Individual placement options remained prevalent and employment outcomes associated with this approach appeared to be superior to outcomes associated with other models. Persons with mental retardation were the most frequent participants; individuals experiencing other handicapping conditions or those considered severely handicapped were not well represented. Implications of these results for the continued implementation of this new service alternative were discussed.

Disability Evaluation↗
PubMed1989

A formalin-inactivated whole SIV vaccine confers protection in macaques.

A vaccine against human immunodeficiency virus (HIV) would be highly effective in stopping the acquired immunodeficiency syndrome (AIDS) epidemic. A comprehensive evaluation of potential vaccine methodologies can be made by means of the simian model for AIDS, which takes advantage of the similarities in viral composition and disease potential between simian immunodeficiency virus (SIV) infection of rhesus macaques and HIV infection in humans. Immunization with a formalin-inactivated whole SIV vaccine potentiated with either alum and the Syntex adjuvant threonyl muramyl dipeptide (MDP) or MDP alone resulted in the protection of eight of nine rhesus monkeys challenged with ten animal-infectious doses of pathogenic virus. These results demonstrate that a whole virus vaccine is highly effective in inducing immune responses that can protect against lentivirus infection and AIDS-like disease.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1989

Attachment theory and brief psychotherapy: applying current research to clinical interventions.

Recent advances in attachment research provide a framework for defining the content and process of brief psychotherapy with adults. Attachment theory emphasizes a number of issues crucial to therapeutic work. Specifically, attachment relationships are enduring components of a individual's pattern of interpersonal behaviours. Functionally, attachment relationships address security needs. Insecure attachment arises from a representational model based on feared loss of the attachment figure, which predisposes the individual to have little confidence in the attachment figure's availability, responsiveness, and permanence. Behavioural responses to insecure attachment can lead to specific patterns of interpersonal relationships which, in turn, strengthen the representational model. Thus, a relatively stable, self-reinforcing system evolves and results in a consistent inability to experience security within attachment relationships. In this article, the authors describe the current framework for understanding adult attachment relationships and present clinical vignettes illustrating the saliency of attachment theory to common clinical presentations. The goal of the clinical intervention is defined as increasing the "permeability" of the individual's working model of attachment through affective and cognitive re-assessment of attachment experiences and expectations. Finally, the utility of this approach in evaluating the outcome and effectiveness of psychotherapy is highlighted.

Adult↗
PubMed1989

The functional discrimination of attachment and affiliation. Theory and empirical demonstration.

Volunteer college students completed a categorisation task designed to test the hypothesis that adults organise their expectations of relationships in a manner that reflects a functional distinction between attachment and affiliation. Terms associated with the provision of security and with characteristics theoretically identified as definitive of attachment relationships were significantly more likely to be associated with the relationship identified as 'lover'. There was substantial overlap between attachment and affiliation relationships in functions relating to intimacy and disclosure. These results highlight the need to differentiate close relationships by functional rather than structural characteristics.

Adult↗
PubMed1989

Elevated expression of basic fibroblast growth factor messenger ribonucleic acid in acoustic neuromas.

Human tumors were analyzed for the presence of mRNA coding for basic fibroblast growth factor (basic FGF). Basic FGF transcript levels were consistently elevated in schwannoma samples (five acoustic neuromas and two spinal schwannomas) ranging from 9- to 22-fold higher than the average level of expression in four benign meningioma samples. Acidic extracts of acoustic neuromas contained a potent mitogen which bound to heparin-Sepharose, eluted at 2 M NaCl, and cross-reacted with an N-terminal specific anti-basic FGF antiserum. The present findings indicate that basic FGF appears to be the major heparin-binding endothelial cell mitogen in acoustic neuromas. Southern restriction analysis revealed no evidence of amplification or rearrangement of the gene for basic FGF in schwannomas or in the astrocytoma cell line U87-MG. These findings demonstrate a tumor-specific elevation in basic FGF transcript levels in tumors of Schwann cell origin and suggest that increased transcription or stabilization of basic FGF mRNA may play an autocrine role in the development and progression of these tumors.

Blotting, Southern↗
PubMed1989

Effect of supported employment on the vocational outcomes of persons with traumatic brain injury.

This paper reports the job placement of 5 males with severe traumatic brain injury. An individual placement model of supported employment was used. All individuals were placed in competitive employment and received staggered intervention over time by trained employment specialists. A multiple baseline design across persons was used to evaluate results. All individuals had been unable to work consistently or at all in competitive work environments. The range of wages was $4.25 to $5.00 per hour with an average of 339 hours of employment specialist intervention time required per case. The major problems experienced by employment specialists were insubordinate and disruptive behaviors as well as other inappropriate social behaviors displayed at the job site.

Adult↗
PubMed1989

Neuropeptide Y in the sympathetic control of blood pressure in hypertensive subjects.

Neuropeptide Y (NPY) coexists with noradrenaline in postganglionic sympathetic neurons and with noradrenaline and adrenaline in the central nervous system. The possibility that NPY is released into the circulation during activation of the sympathoadrenal system was investigated in ten moderately hypertensive volunteers using three different stimuli. In healthy moderately hypertensive volunteers cold pressor test, head up tilt and graded bicycle exercise resulted in increased blood pressure, heart rate and plasma catecholamine concentrations. While there was a trend for plasma NPY-like immunoreactivity (NPY-LI) to increase during cold pressor test and head up tilt, NPY-LI concentration only increased significantly during bicycle exercise, the stimulus of greatest duration. These results suggest that plasma NPY-LI can be released into the circulation on sympathoadrenal activation in moderately hypertensive subjects and demonstrate that the pattern of release is similar to that previously observed in normotensive subjects.

Adrenal Glands↗
PubMed1989

Prescriptions for health visiting.

Building on studies of the experience of health visiting, this article makes recommendations about staffing levels, clerical assistance, role definition, counselling, supervision groups, home/work management, job appraisal, career development, training, quality circles, liaison, communication, senior nurse roles and organizational structure and ethos. It calls for more participative management styles and greater involvement of health visitors in human resource management and administrative decision-making. Previous research on the health visitor's role 1, 2, 3, 4, 5, 6 have provided insights into the experience of health visiting. Drawing on these insights and the theory and practice of occupational psychology, a number of recommendations are offered for improving well-being and effectiveness among health visitors. These recommendations are aimed at promoting discussion of issues which emerged as contentious in the research. They are based on studies conducted in three separate and distinct areas of the country which may not be entirely representative. Furthermore, the suggested practices may already be implemented in other areas.

Career Mobility↗
PubMed1989

[Creep of amalgam fillings under clasp rests].

A clinically realistic experiment was set up to obtain information on the amount of vertical settling of clasp rests in amalgam restorations under functional loading. Mesioocclusal cavities were prepared in 16 lower molar specimens cast in brass. The cavities were filled with amalgam and provided with a mesial rest seat. A constant load of 100 N was applied via a simplified (experimental) saddle to a cobalt-chromium E-clasp cast to the saddle. The duration of the load corresponded to 160 days of clinical function. The chronological course of vertical displacement was analyzed mathematically. According to this result the process can be divided into three components: settling immediately upon load initiation (mean value 96 microns, transition creep (mean value 25 microns) and creep ata constant rate (mean value 15 microns). The mean overall vertical displacement of the rests was 136 microns, the maximum value 287 microns. These findings suggest that vertical settling of a clasp rest into its seat in an amalgam restoration may eventually result in significant changes in occlusion and may almost completely exhaust gingival resilience.

Dental Amalgam↗
PubMed1989

Hepatic dysfunction in multiple systems organ failure as a manifestation of altered cell-cell interaction.

Multiple organ failure continues to be the primary cause of death after trauma and sepsis. This clinical syndrome follows shock and resusitation and the transition from a hypermetabolic response to a syndrome of progressive organ failures and death. Risk factors include: perfusion deficits, persistent foci of dead or injured tissue, an uncontrolled focus of infection, the presence of the respiratory distress syndrome, and preexisting fibrotic liver disease. The imitation of the syndrome represents the clinical manifestation of hepatic failure. It is hypothesized that this hepatic failure results from paracrine amplification with Kupffer cell induced hepatocyte cytotoxicity. The best treatment remains prevention and rapid control of risk factors including restoration of oxygen transport and aggressive nutrition support. There seems to be no treatment "magic bullet" either experimentally or clinically once the syndrome has occurred.

Animals↗
PubMed1989

Innovation in health visiting.

Innovation in health visiting practice is compared to that in the steel and wool industries. The health visiting role is seen as one demanding change and innovation, while health visitors apparently do not see themselves as innovative. Examples of innovation and barriers to innovation are described.

Community Health Nursing↗
PubMed1988

Antigenic mapping of the envelope proteins of equine infectious anemia virus: identification of a neutralization domain and a conserved region on glycoprotein 90.

Monoclonal antibodies (MCAbs) were used to dissect the antigenic sites of the surface glycoproteins of the prototype cell-adapted Wyoming strain of equine infectious anemia virus (EIAV). Serologic reactivities of these MCAbs were determined by ELISA, additive ELISA, competitive ELISA, and Western blot assays. The results indicated that antigenic reactivity of gp90 was localized on at least four distinct epitopes, two of which were important in neutralization. Our studies also revealed that these epitopes were localized on overlapping antigenic sites on gp90. On the other hand, only two distinct non-overlapping epitopes were identified on gp45. Competitive binding studies of neutralizing MCAbs and reference EIA-positive horse serum delineated the presence of a neutralization domain on gp90 that appears to be immunodominant both in naturally infected horses and in mice immunized with EIAV. Limited proteolytic fragmentation of the gp90 component of several serologically distinct EIAV isolates produced common 12K immunoreactive fragments that contained a conserved epitope. These results indicate the occurrence of conserved antigenic regions on EIAV glycoproteins as well as a neutralization domain on gp90, which can be used as potential targets for vaccine development.

Antibodies, Monoclonal↗
PubMed1988

Simian immunodeficiency virus/delta-induced immunodeficiency disease in rhesus monkeys: relation of antibody response and antigenemia.

Infection of the rhesus macaque (Macaca mulatta) with simian immunodeficiency virus (SIV) induces a disease similar to AIDS. We compared SIV-specific antibody and antigenemia with the progression of disease in monkeys experimentally infected with SIV/Delta isolates that varied in pathogenicity. Western blot, immunoprecipitation, and sandwich enzyme-linked immunosorbent assay of serial sera from macaques infected with attenuated virus revealed a persistent antibody response and no evidence of SIV antigenemia. Immunosuppressed macaques without central nervous system (CNS) infections responded similarly to initial infection, but antibody specific for gag or, less frequently, to gag and env determinants declined predictably before clinical disease. Monkeys with CNS infections, however, had little, if any, detectable antibody to either envelope or gag proteins, regardless of the duration of survival. SIV/Delta-specific antigenemia, evident only in immunodeficient monkeys, fluctuated reciprocally with antibody. Our data suggest that SIV/Delta-induced disease is dependent upon antigenemic episodes that, particularly in animals with CNS infection, appear coincident with diminished antibody.

Animals↗
PubMed1988

Slit ventricle syndrome with aqueduct stenosis: third ventriculostomy as definitive treatment.

Slit ventricle syndrome is a poorly understood entity characterized by features of raised intracranial pressure and small ventricles in shunt-dependent hydrocephalics. Five patients with this syndrome were treated with antisiphon devices, high pressure shunts, or subtemporal decompression, but continued to be symptomatic. Third ventriculostomy, performed as a last resort in these patients, gave encouraging results. The patient data, operative approach, and preliminary results are presented here.

Adult↗
PubMed1988

Nimodipine treatment in poor-grade aneurysm patients. Results of a multicenter double-blind placebo-controlled trial.

A multicenter, randomized placebo-controlled double-blind trial of nimodipine in poor-grade aneurysm patients was carried out in 17 Canadian hospitals. Of 188 patients enrolled in the trial, 32 were excluded for protocol violations and two were excluded due to statistical considerations, leaving 154 patients for valid outcome analysis. Nimodipine treatment was associated with a significantly better outcome (p less than 0.001): 21 (29.2%) of 72 nimodipine-treated patients had a good outcome at 3 months after subarachnoid hemorrhage (SAH) compared to eight (9.8%) of 82 placebo-treated patients. Delayed ischemic deficits from vasospasm alone were significantly less frequent in the nimodipine group (p less than 0.05) with permanent deficits occurring in five nimodipine-treated patients (6.9%) and in 22 placebo-treated patients (26.8%). Improvement in the good outcome rate and reduction in delayed ischemic deficits from vasospasm alone occurred in both Grade 3 and 4 patients, with no difference between nimodipine- and placebo-treated patients being found in Grade 5 patients. Repeat angiography after Day 4 was carried out in 124 patients. There was no significant difference in the incidence of moderate or severe diffuse spasm, which was seen in 64.3% of nimodipine-treated patients and 66.2% of placebo-treated patients. The authors conclude that nimodipine treatment in poor-grade patients with SAH results in an increase in the number of good outcomes and a reduction in the incidence of delayed neurological deterioration due to vasospasm. This effect occurs by a mechanism other than prevention of large-vessel spasm as visualized on angiography.

Adolescent↗
PubMed1988

A four-wall orbital decompression for dysthyroid orbitopathy.

A new surgical technique is described for the relief of the ocular manifestations of dysthyroid orbitopathy. Surgical decompression of the orbit was reserved for patients who failed to respond to medical treatment. Eleven patients (nine women and two men) were followed for periods from 3 to 48 months. Visual loss was the commonest presentation and the main indication for surgery. All patients had failed to respond to medical therapy, consisting of steroid and/or radiation therapy. Three patients had previously undergone orbital decompressions with limited success. Six patients had preoperative visual acuity of worse than 20/200. Preoperative exophthalmos ranged from 24 to 35 mm (normal 16 mm). The orbits were approached by a bifrontal scalp flap with exposure of the temporal and infratemporal fossae. The orbital roof was approached transcranially. The posterior wall of the frontal sinus was removed together with the mucous lining. To maximize the decompression, the periosteum surrounding the orbital contents was incised, allowing the contents to prolapse through the newly created windows into the maxillary antrum, temporal fossa, anterior cranial fossa, and nose. During the past 3 years, 22 orbits in 11 patients have been decompressed by this technique. Symptomatic relief was obtained in all but one patient who still had significant exophthalmos with keratitis, but did have a dramatic improvement in vision. The decrease in exophthalmos ranged from 1 to 13 mm (mean 7 mm). The most dramatic improvement was in vision, with postoperative acuity of 20/20 to 20/30 in all but two patients. There were no deaths and no major morbidity.

Adult↗