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[Relationships between programmed physical activity and risk factors in atherosclerosis].

The lipidemic pattern has been evaluated in 40 systematically trained subjects and in 43 subjects of same age and BMI sedentary ones. The mean CT concentration of active subjects was not different from that of the sedentary group, whereas HDL-C was significantly higher and TG significantly lower, CT/HDL-C was significantly lower in active subjects. The obtained results show that systematic physical activity, even if not at agonistic level, can induce antiatherogenic modifications of the lipidemic pattern.

Adult

A behaviorally-oriented activities therapy for program for adolescents.

A behaviorally-oriented activities therapy program was designed and implemented with adolescents who manifested problems in school, at home, and with peers. Baseline measures for target behaviors were taken within the activities therapy program and, after a behavioral analysis, specific techniques were chosen to remediate problems. Techniques employed included: contingency contracting, assertiveness training, relaxation training, and cognitive restructuring. Evaluation of the effectiveness of each program was performed through daily measurement of the frequency of the occurrence of the target behaviors. Three case studies are presented which are illustrative of the range of programs which can be successfully implemented with this population.

Acting Out

Genetics-Informed Mapping Identifies a CRIM1-Associated Endocardial Inflammatory Remodeling State in Acute Myocardial Infarction.

BACKGROUND Acute myocardial infarction (AMI) reflects inherited susceptibility and inflammatory remodeling, but the cellular contexts linking genetic risk to disease remain unclear. MATERIAL AND METHODS We integrated a meta-transcriptome-wide association study (TWAS) with a human cardiac single-nucleus RNA-sequencing atlas contained 11 individuals (5 AMI and 6 donor) to identify genetics-informed cellular programs. Composite program states were defined by global score quartiles. A fixed 5-gene panel was evaluated for nucleus-level endocardial low-transcriptional-state (Endo_LTS) vs endocardial high-transcriptional-state (Endo_HTS) discrimination within the AMI endocardium using 5-fold leave-1-patient-out cross-validation. Functional follow-up used CRIM1 silencing in hypoxia-treated human induced pluripotent stem cell (hiPSC)-derived endocardial endothelial-like cells and complementary peripheral blood analyses. RESULTS The endocardium exhibited the most prominent infarction-associated increase in TWAS-anchored program activity, with expansion of program-high states and higher CytoTRACE scores. A consensus 5-gene panel (RPS8, PLEC, CFDP1, CRIM1, TNS2) was identified. Among 2163 AMI endocardial nuclei from 5 patients, the state classifier included 364 Endo_LTS and 751 Endo_HTS nuclei; 1048 Endo_MTS nuclei were excluded. Pooled out-of-fold ROC-AUCs ranged from 0.665 to 0.831. The panel also showed discriminatory value in an independent peripheral-blood AMI-vs-control cohort. CRIM1 was prioritized as a candidate linked to the remodeling program. CRIM1 silencing attenuated ACTA2/alpha-SMA, vimentin, LDHA, CCL2, and VEGFA and partially restored CD31, whereas TGF-ß remained elevated. CONCLUSIONS These findings identify a genetics-informed endocardial inflammatory remodeling state in AMI and define a 5-gene surrogate of its activated state. CRIM1 is prioritized as a candidate linked to selected inflammatory, metabolic, and structural outputs. Persistent TGF-b elevation after CRIM1 silencing argues against a simple linear regulatory model and indicates that further mechanistic validation is required.

Humans

Dog interaction with persons receiving institutional geriatric care.

A prospective study of 66 geriatric residents in 2 facilities was conducted to quantitate people-dog interactions. Residents were assigned randomly to sessions with dog activity and to sessions with other activity in a crossover design. This study involved a 12-week prestudy activity period and two 12-week activity periods, one before crossover and one after crossover. Systolic and diastolic blood pressures, psychologic evaluation of case histories, and other health and social variables were measured on all residents for dog activity and other combinations of programmed activity sessions. Frequence of attendance in both facilities was higher at dog activity sessions than at other activity sessions (P less than 0.01). Resident systolic blood pressures were lower in one facility during dog activity (P less than 0.02). Combined pre- and postactivity systolic and diastolic blood pressures at the same facility were lower when residents had 12 weeks of dog activity before 12 weeks of other activity (P less than 0.04). There were no significant differences in residents' blood pressures between measurements before and after dog activity (treatment mode) or between measurements before and after other activity. Psychologic scores of residents in both facilities were not significantly different between periods of the study. Of the 9 types of interaction between the residents and the dog, grooming and touching were the 2 most commonly used by residents.

Aged

Surgical oncology in university departments of surgery in the United States.

Data on surgical oncology and multidisciplinary cancer program activity were obtained from 124 of 126 university surgery departments in the United States. Most of these institutions have American College of Surgeons-approved cancer programs (84%) as well as divisions of medical (95%), radiation (94%), pediatric (76%), and gynecologic (79%) oncology. Only 47 departments (38%) have formal divisions of surgical oncology. There are no major staffing or activity differences in surgical departments with or without such divisions, but multidisciplinary cancer program activity is greater in those institutions with a surgical oncology focus. Peer-reviewed cancer research grants are more frequent in departments of surgery with a surgical oncology division (68% vs 47%). The activities of the existing 47 divisions of surgical oncology are mainly operative, with breast cancer, melanoma, and soft-tissue sarcomas being the major clinical responsibilities. Chemotherapy is also frequent (81%). Cancer education for undergraduate and postgraduate surgical trainees is a major responsibility of most divisions, but only a small proportion (28%) have postresidency surgical oncology training programs. In contrast to the growth of some oncologic specialties, the establishment of surgical oncology within university departments has been slow, and the manpower needs appear modest.

Academic Medical Centers

Selected chronic disease 'risk factors' in two elementary school populations. A pilot study.

Ninety-five first-grade elementary school students (aged 5 to 6 years) in two New York City area schools participated in a pilot test of a chronic disease primary prevention program stressing nutrition, antismoking, and physical activity. Program components included a health knowledge questionnaire; measurement of height, weight, skin-fold thickness, total serum cholesterol level, and blood pressure; and a modified Harvard step test of pulse rate recovery after exercise and subsequent classroom health education. The proportion of students with test values higher than specified critical levels was much greater in school M compared with school S. These measures will be repeated after one year to determine the feasibility and potential effectiveness of certain classroom health education activities.

Blood Pressure

Trends in rehabilitation after cochlear implantation.

Although postimplant rehabilitation is generally considered to be an important aspect of a cochlear implant program, the literature reports widely varying practices in the implementation of such programs. The National Institutes of Health consensus statement on cochlear implantation (May 1988), while recognizing that aural rehabilitation facilitates maximal use of the implant, offers no specific guidelines or recommendations. A questionnaire survey was made of over 200 otolaryngologists to determine current practices in a variety of aspects of their cochlear implant programs. Results were obtained from a total of more than 1400 patients, including adults, adolescents, and children. Rehabilitation is an integral part of the cochlear implant program in the vast majority of active programs surveyed. General aspects of cochlear implant programs, as well as those of rehabilitation programs in particular, are discussed.

Adolescent

Cancer Program Administrators' survey results.

In summary, cancer programs across the country have been developing since 1975. A more formal organizational structure has been adopted to program activities since 1980. The full-time Cancer Program Administrator position exists in about one-third of the programs reporting. Persons occupying the position are at least bachelors degreed with many also having a masters degree. Strengths, weaknesses, and obstacles to program development are basically the same items across the country. It appears that programs that have one problem resolved are still working towards the solution of another problem and vice versa among programs. All programs are struggling for identity within the hospital and are in developmental stages with a lot of activity focused on clarifying the position of an organized cancer program within the hospital organization.

Cancer Care Facilities

Using concept mapping to develop a conceptual framework of staff's views of a supported employment program for individuals with severe mental illness.

This article describes the use of concept mapping to develop a pictorial multivariate conceptual framework of staff views of a program of supported employment (SE) for individuals with severe mental illness. The SE program involves extended individualized supported employment for clients through a mobile job support worker (MJSW) who maintains contact with the client after job placement and supports the client in various ways. All 14 staff members of a psychiatric rehabilitation agency with assignments associated with the SE program. They brainstormed a large number of specific program activity statements (N = 96), sorted and rated the statements, and interpreted the map that was produced through multidimensional scaling and hierarchical cluster analysis. The resulting map enabled identification of 4 issues that should be included in any theory of SE programs--the specific activity sequences that characterize the program itself; the pattern of local program evolution; the definition of program staff roles; and the influence of key contextual factors such as the client's family or the program's administrative structure. The implications of concept mapping methodology for theory development and program evaluation are considered.

Community Mental Health Services

The impact of service delivery frequency on family planning program output and efficiency.

Operations research is the study of factors that can be controlled by program administrators. Among such factors is the frequency of performing program activities. The present experiment, conducted in Lima, Peru during 1985-86, tested the impact of holding family planning post sessions once per month, twice per month, and weekly. Frequency was shown to have a major impact on program outputs, costs, and cost-effectiveness. Depending on the indicator, sessions held twice per month produced between 1.5 and 2.1 times the output of those conducted once per month. Weekly sessions produced between 1.3 and 1.6 times the output of those held twice per month. At an output level of nearly 11,200 visits per year, twice-per-month sessions were estimated to be 7-38 percent more cost-effective, depending on the indicator, than once-per-month sessions, and 6-28 percent more cost-effective than weekly sessions.

Community Health Services

Locked posterior dislocation of the shoulder: treatment using rotational osteotomy of the humerus.

This study reports the use of rotational osteotomy in 10 patients with locked posterior dislocation of the shoulder. The average interval between injury and diagnosis was 155 days (range, 21-400 days). Patients were aged 40-78 years old, with an average age of 53 years. Articular impaction fracture of the humeral head involved 20-40% of the articular surface as determined by CT analysis. There were no postoperative complications except a transient axillary nerve palsy. Patients were started on immediate passive motion followed by an active program at 2-3 weeks. Using the Rowe/Zarins scale, six patients had good-excellent results, two fair results, and two poor results. The poor results were seen in cases where articular cartilage damage was advanced. Rotational osteotomy is an effective procedure at restoring glenohumeral congruity and early functional activity in the patient with locked posterior shoulder dislocation given the following criteria: (a) healthy articular cartilage, (b) a humeral head defect involving less than 40% of the articular surface, and (c) a patient who is able to participate in an active rehabilitation program.

Adult

Home health cardiac rehabilitation.

The Cardiac Rehabilitation Home Program provides the structural framework for patient access to cardiac recovery in the home setting. Using an interdisciplinary team approach, the program standardizes patient education, establishes a personalized activity program, and provides psychosocial support to the patient and family during the recovery process. The Cardiac Rehabilitation Home Program reduces the cost of delivering healthcare to the cardiac population while improving customer satisfaction, strategically positioning home health agencies for managed care contracts.

Aged

Acetylcholinesterase in murine erythroleukemia (Friend) cells: evidence for megakaryocyte-like expression and potential growth-regulatory role of enzyme activity.

Features of true acetylcholinesterase (AChE) regulation during growth and differentiation of Friend murine erythroleukemia cells (MELC) have been investigated with respect to other erythroid and nonerythroid murine elements. Enzyme levels of uninduced MELC were in between the very low AChE contents of erythroid cells and the huge amounts of activity exhibited by megakaryocytes and platelets. After MELC commitment to terminal division, the enzyme-specific activity increased largely, approaching values that were much closer to those of thrombocytic than of normal erythroid elements. The bulk of AChE activity in MELC, megakaryocytes, and platelets was found to be located in the cytosol as a free-soluble form. Moreover, during incubation, MELC actively released large amounts of AChE into the medium, like it occurs in murine thrombocytes. Conversely, the enzyme of the erythroid elements was mainly associated with the membranes and was not released extracellularly. Experiments with inducers showed that changes in AChE-specific activity of MELC correlated directly with the arrest of cell proliferation rather than with the activation of differentiated erythroid functions. The inverse relationship existing between MELC growth rates and AChE levels was further supported by the relative enzyme activities of the slow- and fast-growing subclones. We conclude that uninduced MELC potentially share properties of both the erythroid and megakaryoblastic phenotype. The latter might be revealed by typical regulation of AChE activity according to a thrombocytic-like program activated upon MELC commitment to terminal division. Eventually, the inhibition of MELC growth by exogenous pure bovine AChE suggested that the secreted murine enzyme might serve as a potential negative signal of cellular replication.

Acetylcholinesterase

Induction of apoptosis in catecholaminergic PC12 cells by L-DOPA. Implications for the treatment of Parkinson's disease.

The hypothesis that L-DOPA therapy in Parkinson's disease may augment neuronal damage and thus accelerate the progression of the disease remains controversial. In this study, we demonstrate that L-DOPA induces death of catecholaminergic cells in vitro via an active program of apoptosis. Treatment of PC12 cells with clinically applicable concentrations of L-DOPA (25-100 microM) induced cell death via a mechanism which exhibited morphological and biochemical characteristics of apoptosis, including chromatin condensation, membrane blebbing, and internucleosomal DNA fragmentation. L-DOPA-induced apoptosis was cell and drug-type specific. Toxicity is an intrinsic property of the drug molecule since it was not suppressed by inhibiting conversion of L-DOPA to dopamine. However, L-DOPA toxicity was inhibited by antioxidants, suggesting that activation of apoptosis is mediated by oxygen radicals. Our finding that L-DOPA-induced cell death in vitro occurs via apoptosis explains the lack of evidence supporting its toxicity in vivo, since apoptotic neurons are rapidly phagocytosed in vivo without causing damage to surrounding tissue. Furthermore, since apoptosis is an active cellular program which can be modulated, we suggest clinical approaches for decreasing L-DOPA toxicity, thus preventing acceleration of neuronal damage in Parkinson's disease.

Animals