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PubMed2003

Psychosocial evaluation interview protocol for living related and living unrelated kidney donors.

This article is intended to help mental health clinicians who work with kidney transplant teams enhance their understanding, abilities and skills to determine the best possible psychosocially stable living donor candidates who present for evaluation. Additionally, this article is intended to help the clinician gain a better understanding of the donor ability and willingness to give informed consent, and determine those who present for donorship which may be at high risk due to either historic or current mental health, substance use and current lifestyle issues. Finally, this article considers the rationale and goals of pretransplant psychosocial evaluation of potential kidney donors as well as the net effects on the families. The intent is to provide a clinical protocol useful in both private and public hospitals. The current protocol is currently being used at HCA: Henrico Doctors' Hospital, Virginia Transplant Center in Richmond, Virginia. Early post-transplant psychosocial problems and their management and the long-term adaptation for the donors are discussed. Additionally, ethical considerations are addressed.

Decision Making↗
PubMedDate not supplied

A training apartment with electronic aids to daily living: lived experiences of persons with brain damage.

OBJECTIVE: The objective of this study was to investigate how persons with acquired brain damage experienced their 1-week stay in an apartment fitted with electronic aids to daily living (EADL). The study focused on how the individuals adapted to this artificial environment in their performance of daily activities and how their occupational experiences influenced their view of the future. METHODS: The 11 participants were interviewed on the last day of their rehabilitation period in an EADL-equipped training apartment. The data were collected and analyzed using the Empirical Phenomenological Psychological (EPP) method. FINDINGS: The findings revealed four main characteristics that described an adaptation process that occurred during the week in the EADL-equipped training apartment: plunging into an EADL-equipped environment, "landing" and feeling comfortable with the new environment, incorporating the "new" in daily activities, and "taking-off" for the future. CONCLUSION: In a short time, the combination of the EADL and the aesthetically attractive environment gave the participants experiences that contributed to a "taking off" for their future life. Findings from this study suggest that, in clinical practice, clients may need initial guidance from the therapists to "land" and feel comfortable in a new environment, like a training apartment, before they can learn how to incorporate new electronic aids in their every day activities.

Acclimatization↗
PubMed2004

Living and dying with dignity: reflections on lived experience.

Considerations of human dignity figure prominently in discussions of health care, and are central in the debate with regard to end-of-life care and the issue of physician-assisted suicide. In this paper I reflect on my experience as a person living with multiple sclerosis in order to explore ways in which prevailing cultural values contribute to the loss of dignity that accompanies incurable illness and disability. I suggest that authentic Christian community may offer an alternative culture with a radically different value system, one that enhances human dignity.

Activities of Daily Living↗
PubMed1993

[Difference in impact of social support on morale and medical utilization between elderly with low activity of daily living and elderly with high activity of daily living].

The impact of social support on morale and medical utilization among elderly with low activity of daily living (ADL) were compared to those of elderly with high ADL. Social support was measured from three aspects--receiving emotional support, receiving instrumental support, and providing emotional support, all based on the individual perception of the elderly person. Subjects were 125 persons with low ADL obtained from a national random survey of 3,288 people aged 60 and over. They were matched with 125 high ADL people with the same age categories and sex. 1. Persons with low ADL had lower PGC-Morale Scale Score than persons with high ADL. In the low ADL group, the percentage who went to a physician less than 3 times during the past three months was 30.6%. 2. In the low ADL group, people who perceived receiving high emotional support to others also scored high in PCG-Morale Scale. People who perceived being able to provide emotional support to others also scored high in PCG-Morale Scale. In the high ADL group, only perception for receiving emotional support had an impact on the score. 3. Social support of any kind did not have an impact on medical utilization in either group.

Activities of Daily Living↗
PubMed1995

Detection of short-lived free radicals by low-frequency electron paramagnetic resonance spin trapping in whole living animals.

We report the direct observation of sulfur trioxide anion free radical (SO3.-) from the body of live mice by using a low-frequency (1.2 GHz, L-band) EPR spin trapping method. Intraperitoneal injection of 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) (15 mmol/kg) used as trapping agent was followed by sequential iv injections of sodium sulfate (2-5 mmol/kg) and sodium dichromate (0.3 mmol/kg). The mouse was placed in an L-band loop gap resonator. The observed spectra consisted of two superposed components: DMPO/SO3.- (alpha N = 14.0, alpha H = 16.0) and Cr(V) (g = 1.9798). The time course for the generation and reduction of DMPO/SO3.- was followed. The signal intensity reached a maximum at about 7 min. In vitro experiments carried out at 9.15 GHz confirmed the production of SO3.- under the conditions used for in vivo studies; the hyperfine splittings of DMPO/SO3.- produced in the in vitro experiments were the same as those produced in the in vivo studies. The production of SO.-3 is supported by oxygen uptake studies, which show that the prior addition of 300 mM DMPO inhibits oxygen consumption by SO3.-.

Animals↗
PubMed2004

Emotional and behavioral problems of children living with drug-abusing fathers: comparisons with children living with alcohol-abusing and non-substance-abusing fathers.

Although the effects of paternal alcoholism on the psychosocial adjustment of children are well documented, the impact of fathers' illicit drug abuse on their children is poorly understood. The purpose of this study was to compare the adjustment of children living in families with drug-abusing fathers (n = 40) with that of children with fathers who abused alcohol (n = 40) and children with non-substance-abusing fathers (n = 40). Children with drug-abusing fathers experienced more internalizing and externalizing symptoms than children with alcoholic or non-substance-abusing fathers. Interparental conflict and parenting behavior mediated the relationship between family type and children's adjustment. Interventions to improve fathers' parenting behavior and reduce partner conflict may lead to better adjustment among custodial children of drug-abusing fathers.

Adult↗
PubMed2000

Short-lived green fluorescent proteins for quantifying ubiquitin/proteasome-dependent proteolysis in living cells.

The ubiquitin/proteasome-dependent proteolytic pathway is an attractive target for therapeutics because of its critical involvement in cell cycle progression and antigen presentation. However, dissection of the pathway and development of modulators are hampered by the complexity of the system and the lack of easily detectable authentic substrates. We have developed a convenient reporter system by producing N-end rule and ubiquitin fusion degradation (UFD)-targeted green fluorescent proteins that allow quantification of ubiquitin/proteasome-dependent proteolysis in living cells. Accumulation of these reporters serves as an early predictor of G2/M arrest and apoptosis in cells treated with proteasome inhibitors. Comparison of reporter accumulation and cleavage of fluorogenic substrates demonstrates that the rate-limiting chymotrypsin-like activity of the proteasome can be substantially curtailed without significant effect on ubiquitin-dependent proteolysis. These reporters provide a new powerful tool for elucidation of the ubiquitin/proteasome pathway and for high throughput screening of compounds that selectively modify proteolysis in vivo.

Cysteine Endopeptidases↗
PubMed1999

The hemodialysis catheter conundrum: hate living with them, but can't live without them.

BACKGROUND: Hemodialysis requires reliable recurrent access to the circulation. On a chronic basis, this has been best provided by the use of arteriovenous fistulae and arteriovenous grafts. In recent years, hemodialysis catheters have come to play an increasingly important role in the delivery of hemodialysis. The use of both temporary as well as cuffed hemodialysis catheters has emerged as a significant boon for both patients and practicing nephrologists. The complications, however, associated with each of these hemodialysis catheters, both in terms of anatomic, thrombotic, and infectious issues, have emerged as a major problem with their continued use. This significant morbidity and complication rate has forced many nephrologists to face a basic conundrum: they have come to hate having to deal with the problems inherent in catheter usage, but the enormous utility of these devices have forced physicians to accept the fact they cannot live without them in their current practice. METHODS: We used a comprehensive literature review to describe the types, use and dilemmas of hemodialysis catheters. RESULTS: This article provides a comprehensive review of both the benefits inherent with the use of these hemodialysis catheters while cataloging their complications and offering some possible solutions. CONCLUSION: Hemodialysis vascular access catheters are essential in the maintenance of hemodialysis vascular access. However, they have a significant infectious, thrombotic, anatomic complication rate that are detailed with proposed problem-solving guidelines.

Catheters, Indwelling↗
PubMed2006

"Live and Let Live": an analysis of HIV/AIDS-related stigma and discrimination in international campaign posters.

As a corollary to The Declaration of Commitment adopted by the United Nations General Assembly Special Session on HIV/AIDS in June 2001, UNAIDS developed a World AIDS Campaign that sought to eradicate HIV/AIDS-related stigma and discrimination. The campaign incorporated several educational strategies, including a poster campaign that advocated the just and equal treatment of people living with HIV/AIDS. In an effort to develop an understanding of these educational efforts, this study deconstructs the 2002-2003 World AIDS Campaign posters. While the overall results suggest that the campaign has been successful in redefining images of HIV/AIDS, they also show that certain aspects of these posters may actually serve to reinforce stigma and discrimination. Using a visual studies approach to textual analysis, this study explores the underlying ideological and cultural assumptions that exist within the posters and provides a method for evaluating such materials.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Asporogenic Bacillus megaterium mutant 27-36 degrades intrinsically short-lived proteins but fails to convert most of other proteins to a short-lived fraction.

Asporogenic mutant blocked in the 0-II sporulation stage degraded pulse-labelled proteins in the sporulation medium at the same rate as the parental strain for the first two hours. The degraded fraction was mostly composed of intrinsically short-lived proteins which were degraded even after enriching the medium with amino acids and growth resumption. Proteins accessible to degradation because of nutritional shift down formed a lesser proportion of this fraction. The acceleration of protein turnover in the parent strain during the irreversible sporulation phase was not developed in the mutant. A first order kinetic model of protein degradation was used for parameter estimation. Ca(2+)-dependent intracellular serine proteinase was synthesized in an inactive form, which was activated by increasing Ca2+ concentration to 30 mM.

Bacillus megaterium↗
PubMed2006

Insights into the kinetics of siRNA-mediated gene silencing from live-cell and live-animal bioluminescent imaging.

Small interfering RNA (siRNA) molecules are potent effectors of post-transcriptional gene silencing. Using noninvasive bioluminescent imaging and a mathematical model of siRNA delivery and function, the effects of target-specific and treatment-specific parameters on siRNA-mediated gene silencing are monitored in cells stably expressing the firefly luciferase protein. In vitro, luciferase protein levels recover to pre-treatment values within <1 week in rapidly dividing cell lines, but take longer than 3 weeks to return to steady-state levels in nondividing fibroblasts. Similar results are observed in vivo, with knockdown lasting approximately 10 days in subcutaneous tumors in A/J mice and 3-4 weeks in the nondividing hepatocytes of BALB/c mice. These data indicate that dilution due to cell division, and not intracellular siRNA half-life, governs the duration of gene silencing under these conditions. To demonstrate the practical use of the model in treatment design, model calculations are used to predict the dosing schedule required to maintain persistent silencing of target proteins with different half-lives in rapidly dividing or nondividing cells. The approach of bioluminescent imaging combined with mathematical modeling provides useful insights into siRNA function and may help expedite the translation of siRNA into clinically relevant therapeutics for disease treatment and management.

Animals↗
PubMed2007

Compatibility of a bivalent modified-live vaccine against Bordetella bronchiseptica and CPiV, and a trivalent modified-live vaccine against CPV, CDV and CAV-2.

Eight puppies (group 1) were vaccinated once with a bivalent modified-live vaccine against infectious tracheobronchitis by the intranasal route and at the same time with an injectable trivalent vaccine against canine parvovirus, canine distemper virus and canine adenovirus; a second group of eight puppies (group 2) was vaccinated only with the intranasal bivalent vaccine, and a further eight puppies (group 3) were vaccinated only with the injectable trivalent vaccine. Three weeks later they were all challenged with wildtype Bordetella bronchiseptica and canine parainfluenza virus by the aerosol route, and their antibody responses to the five vaccine organisms were determined. Oronasal swabs were taken regularly before and after the challenge for the isolation of bacteria and viruses, and the puppies were observed for clinical signs for three weeks after the challenge. There were no significant differences in the puppies' titres against canine parvovirus, canine distemper virus and canine adenovirus type 2 between the groups vaccinated with or without the bivalent intranasal vaccine. After the challenge the mean clinical scores of the two groups vaccinated with the intranasal vaccine were nearly 90 per cent lower (P=0.001) than the mean score of the group vaccinated with only the trivalent injectable vaccine, and the puppies in this group all became culture-positive for B bronchiseptica and canine parainfluenza virus. There were only small differences between the rates of isolation of B bronchiseptica from groups 1, 2 and 3, but significantly lower yields of canine parainfluenza virus were isolated from groups 1 and 2 than from group 3.

Adenoviridae Infections↗
PubMed1995

Living in two different worlds or living in the world differently: a qualitative study with American Indian nurses.

Nurses of American Indian heritage address unique challenges in their professional and personal lives. A qualitative study is described that investigates how such nurses bring unique qualities to nursing based on their spiritual beliefs, which stem from tradition and ritual, belief in the family, and harmony and oneness with the earth and with all creatures. The imperative to do cross-cultural research as well as the difficulties encountered in doing such research are discussed.

Acculturation↗
PubMed1978

[Immunological Tests By Anti-Free-Living Amoebas Serum Produced In Experimental Animals: I. Immobilization Of Free-Living Amoebas In Vitro By Rabbit Antiserum]

Rabbits were immunized with free-living amoebas by intravenous injections. The amoebas were Acanthamoeba culbertsoni and Naegleria fowleri and obtained by axenic cultivation in CGVS medium. Each rabbit received 10(6) of Acanthamoeba culbertsoni and 10(5) of Naegleria fowleri trophozoites respectively every other day in three doses and finally one booster dose at 1 week later. Antiserum was collected from thc following day of the booster injection up to 2 months period, and stored at -30 degrees C until use. The immobilization test was performed. One drop of amoeba suspension was mixed with the test serum on slide and observed the mobile state under microscope. 1. Maximal immobilizing phenomenon observed in 30 minutes and, then gradually recovered to normal state. 2. Inactivation of antiserum at 56 degrees C for 30 minutes did not affect the immobilization phenomenon. 3. The immobilization rates decreased by the serial dilution of antiserum. At dilution more than 1:8, the immobilization was almost the same as in the normal serum. 4. The immobilizing antibody in anti-Acanthamoeba culbertsoni rabbit serum showed highest titre in 3rd day after booster immunization and from first to 6th week in anti-Naegleria fowleri rabbit serum. 5. Cross matching of Acanthamoeba culbertsoni and Naegleria fowleri showed antigenic difference of the two species. It is suggested that the immobilization reaction may be of value as a supplementary test in the diagnosis of primary amoebic meningoencephalitis.

Journal Article↗
PubMed1993

Physicians attitudes toward living non-related renal transplantation (LNRRT). The Living non-Related Renal Transplant Study Group.

Renal transplantation is considered now the definitive treatment for patients with end-stage renal disease (ESRD). Unfortunately, the worldwide shortage of kidneys remains the most important obstacle to transplantation. In developing countries, including those of the Middle East, the shortage is even more dramatic. Despite great efforts to establish and maintain successful transplant centers, the number of kidneys that have been transplanted in the last few years has actually declined. The lack of a dependable kidney source played well into the hands of unscrupulous entrepreneurs who started brokerage of organs for profit. In this practice, patients with ESRD travel to India and other countries to purchase kidneys from living genetically non-related poor donors. Patient care was therefore relegated to the laws of the marketplace and both patients and donors were exploited to maximize profit. Additionally, reported results of this type of transplantation were inferior to those of other types of transplantation. Not unexpectedly, these issues have created intense controversy among transplant physicians and the general public in which moral, ethical and medical issues were debated. To investigate these issues, we conducted a large multicenter study in Saudi Arabia, Bahrain and Egypt. In the first phase of this study, we surveyed 50 institutions regarding their attitude toward LNRRT, of which 22 responded. The results of our survey clearly show that patients with ESRD take the initiative in seeking LNRRT despite physician discouragement and significant financial burden.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMedDate not supplied

100,000 Lives campaign exceeds goals and saves lives.

U.S. hospitals taking part in an unprecedented 18-month effort to prevent 100,000 unnecessary deaths by improving patient care have exceeded their goal, the Institute for Healthcare Improvement (IHI) announced in June. Hospitals that participated in the 100,000 Lives campaign have collectively prevented an estimated 122,300 avoidable deaths.

Hospital Mortality↗
PubMed1977

The role of macrophages in the generation of T helper cells. V. Evidence for differential activation of short-lived T1 and long-lived T2 lymphocytes by the macrophage factors GRF and NMF.

The generation of T helper cells in vitro requires macrophages or macrophage-derived factors such as genetically related macrophage factor (GRF) or nonspecific macrophage factor (NMF). However, there is a basic difference of T helper cell induction when using particulate antigens. The present study demonstrates that this difference is based on the activation of two different T cell subsets. GRF activates short-lived 'T1' cells which amplify the induction of T2 cells, which are the helper cell precursors. Thus, the genetic restriction of T helper cell induction seen with soluble antigen or GRF lies on the level of macrophage or GRF interaction with T1 cells. NMF (or macrophages) and particulate antigens directly activate the helper cell precursor (T2) indicating no requirement for T1-T2 cooperation. The direct activation of the helper cell precursor with particulate antigens does not require histocompatible macrophages or NMF from histocompatible macrophages. The present results may explain some of the discrepancies reported in the literature concerning the genetic requirements and specificity of T cell activation.

Animals↗
PubMed1984

Trials of live attenuated influenza virus vaccine in patients with chronic obstructive airways disease. (MRC Advisory Group on Pulmonary Function Tests in relation to live influenza vaccines).

Three controlled trials of attenuated live influenza vaccines in patients with chronic bronchitis with airways obstruction are described. A recombinant virus with parentage from PR8/34 (H1N1) and A/Alaska/77 (H3N2) was present in the vaccine (RIT 4199) used in the first two trials. In the third trial a cold-adapted recombinant virus vaccine (A/Washington/80, H3N2) was used. No adverse effects were noted in the first two trials in which half of the patients responded serologically to the vaccine. In the third trial increases in upper respiratory symptoms occurred in the first week after vaccine was inoculated. One patient, who did not respond serologically to the vaccine, developed a temporary sharp decline in FEV1.0 and FVC. We have no explanation other than the preinoculation HI serum antibodies for the low rate of serological response (9 of 29) in the vaccinated patients in the third trial.

Bronchitis↗