Biomedical subjects

S McNary

Publications and source records attributed to S McNary.

8 recordsLinked to original sources

PubMed2006

Molecular mechanisms of spider silk.

Spiders spin high-performance silks through the expression and assembly of tissue-restricted fibroin proteins. Spider silks are composite protein biopolymers that have complex microstructures. Retrieval of cDNAs and genomic DNAs encoding silk fibroins has revealed an association between the protein sequences and structure-property relationships. However, before spider silks can be subject to genetic engineering for commercial applications, the complete protein sequences and their functions, as well as the details of the spinning mechanism, will require additional progress and collaborative efforts in the areas of biochemistry, molecular biology and material science. Novel approaches to reveal additional molecular constituents embedded in the spider fibers, as well as cloning strategies to manipulate the genes for expression, will continue to be important aspects of spider biology research. Here we summarize the molecular characteristics of the different spider fibroins, the mechanical properties and assembly process of spidroins and the advances in protein expression systems used for recombinant silk production. We also highlight different technical approaches being used to elucidate the molecular constituents of silk fibers.

Amino Acid Motifs↗

PubMed2001

The impact of health status on work, symptoms, and functional outcomes in severe mental illness.

This study evaluated the relationships between self-ratings of physical role functioning and general health, two components of the MOS SF-36, and a variety of demographic, quality of life, clinical, functional, and attitudinal variables in a cohort of adults living with severe and persistent mental illness (SPMI). We hypothesized that poorer self-perceptions of physical functioning and general health would be significantly related to more severe symptoms and poorer functioning and quality of life. Study subjects were 218 adults with SPMI enrolled in a randomized controlled trial comparing two vocational interventions for persons who were unemployed. Hierarchical regression analysis was used to determine whether psychiatric symptoms, poorer self-perceptions of role limitations due to physical health problems and overall general health independently contributed to more severe symptoms and poorer functioning and quality of life. Psychiatric symptoms were inversely related to size of social network and satisfaction with safety. Increased role limitations were associated with reduced medication compliance, general life satisfaction, and satisfaction with health, daily activities, and safety. Reduced general health was significantly associated with reduced work motivation, self-esteem, current inability to work, self-report of functioning, and almost all subjective life satisfaction domains. Within this group of people with severe mental illness, psychiatric symptoms were minimally associated with outcomes. Physical role limitations contributed more, and an integrated global measure of overall health perception was most important. If we are to help persons with severe mental illness maximize their quality of life and functioning, our clinical interventions should employ an approach that appreciates and recognizes the importance of the patients' experience of a holistic and integrated experience of health.

Adult↗

PubMed2001

Correlates of long-term unemployment among inner-city adults with serious and persistent mental illness.

This study identified demographic, clinical, and vocational rehabilitation-related correlates of long-term unemployment among 219 adults with severe mental illness. Fifty-one percent of the sample had been unemployed five or more years before enrollment. Older age, a diagnosis of psychosis, severity of negative symptoms, and more previous hospitalizations were all significantly related to long-term unemployment. Gender, race, education, substance disorder diagnosis, severity of negative symptoms, and vocational training experience were not. The findings underscore the relevance of clinical and neurocognitive impairments to long-term unemployment and point to the need to critically reevaluate the effectiveness of traditional vocational rehabilitation services.

Adult↗

PubMed2001

Predictors of dissemination of family psychoeducation in community mental health centers in Maine and Illinois.

OBJECTIVE: The aim of this study was to determine whether it is possible at the time of staff training to predict whether a mental health center will succeed in implementing family psychoeducation services. METHODS: Fifteen mental health agencies in Maine and 51 in Illinois in which clinicians and administrators were trained in multifamily psychoeducation were studied. Participants were surveyed immediately after their initial training sessions and nine months later. Participants' demographic characteristics, agency characteristics, and principal components derived from the survey data were analyzed to identify factors associated with implementation of family psychoeducation services. RESULTS: The regression model successfully predicted which sites would succeed. Success was more likely at sites where the treatment model was viewed more positively at the outset, where real and perceived resource limitations were addressed, where inducements to implementation were seen as less important, and where attention was paid to the difference between new and existing treatment methods. Nearly all the Maine sites (14, or 93 percent) implemented multifamily psychoeducation services, whereas only five of the Illinois sites (10 percent) implemented this form of treatment. The Maine trainees were less skeptical about family psychoeducation and more interested in receiving supervision and consultation. In Maine there was wide-ranging and local consensus before and during implementation, and more federal funding was available than in Illinois. CONCLUSIONS: Surveys of clinicians allowed prediction of which sites would successfully implement family psychoeducation services. Consensus building and funding appeared to be critical to successful outcomes.

Adult↗

PubMed1999

Case managers' and clients' perspectives on a representative payee program.

OBJECTIVE: Clients with severe and persistent mental illnesses often require a representative payee to help manage benefit funds. This study compared the perceptions of clients and clinical case managers about the benefits of and problems with the representative payee relationship. METHODS: Fifty-four clients receiving assertive community treatment completed an interview that assessed satisfaction with their experience of having a representative payee and the resulting impact on their substance use, budgeting, and housing. The clients' clinical case managers completed a similar questionnaire. Analyses examined associations between providers' and clients' responses and clients' gender, race, diagnosis, previous experience with a representative payee, and duration of the current representative payeeship. RESULTS: Clients and case managers recognized benefits of the representative payeeship in the areas of housing, substance use, and budgeting. Although little evidence was found that the payeeship pervasively interfered with the therapeutic relationship, 44 percent of case managers reported incidents in which clients verbally abused them over management of their funds. Clients' satisfaction with the representative payeeship was initially low but grew over time. Longer duration of the current payeeship and clients' previous experience with representative payeeship were associated with greater satisfaction and fewer problems. Case managers overestimated clients' initial satisfaction and underestimated their current satisfaction. CONCLUSIONS: Findings suggest that both mental health professionals and clients value the representative payee process as helpful in improving outcomes, although the benefits of the arrangement may be more evident with time and experience.

Case Management↗

PubMed1998

Remission of substance use disorder among psychiatric inpatients with mental illness.

OBJECTIVE: The authors assessed the nature and stability of remission of substance use disorder among persons with severe mental illness at index hospitalization and at 1-year follow-up. METHOD: Consecutively admitted inpatients with severe mental illness completed the Structured Clinical Interview for DSM-III-R, Quality of Life Interview, and Addiction Severity Index at admission and 1 year later. Of the 268 patients, 70 were classified as past substance abusers in remission at baseline. Baseline characteristics and 1-year outcomes of this group were compared with those of the 109 current substance abusers and the 89 patients who were not substance abusers. RESULTS: The past abusers were significantly more likely to be women, and they consistently differed significantly from the current abusers in variables involving frequency of drug and alcohol use at baseline. During the follow-up period, the patients with current abuse at baseline were significantly more likely to have recurrences of substance use disorders and to use substance abuse services, and they had significantly more months of alcohol use and alcohol use to excess during follow-up than did the past abusers. CONCLUSIONS: Baseline and follow-up assessments suggested that a substantial proportion of severely mentally ill patients with past substance use disorders are in stable remission.

Adult↗

PubMed1997

One-year follow-up of secondary versus primary mental disorder in persons with comorbid substance use disorders.

OBJECTIVE: Service utilization and outcomes of dually diagnosed patients with independent mental disorders and those with substance-induced mental disorders were compared. METHOD: Diagnosis, service use, and severity of substance use problems at baseline and 1 year later were assessed in consecutively admitted inpatients with independent mental disorders plus substance use disorders (N = 71), substance-induced mental disorders plus substance use disorders (N = 38), and independent mental disorders only (N = 59). RESULTS: At follow-up, patients with substance-induced mental disorders at baseline were more likely to have been rehospitalized than the other groups, were more likely to have used outpatient substance abuse services, were less likely to have an independent mental disorder, and had the most severe alcohol- and drug-related impairment. CONCLUSIONS: Treatment programs for both types of dual diagnosis patients must address mental health concerns.

Adolescent↗

PubMed1995

Substance abuse and family relationships of persons with severe mental illness.

OBJECTIVE: The authors sought to determine how substance abuse affects family relationships of persons with severe mental illness. METHOD: Patient reports of family relationships were compared between 101 psychiatric inpatients with a concurrent substance use disorder and 78 subjects with severe mental illness only. RESULTS: Patients with comorbid substance abuse reported significantly lower family satisfaction and a greater desire for family treatment. Objective indicators of frequency of family contact did not differ. CONCLUSIONS: Substance abuse is associated with low levels of satisfaction with family relationships among persons with severe mental illness. Family interventions would meet the stated needs of persons with mental illness and a comorbid substance use disorder and might help to engage them in treatment.

Adult↗