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PubMed1982

[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↗
PubMed1993

An economic analysis of heart-lung transplantation. Costs, insurance coverage, and reimbursement.

Rarely has the cost of heart-lung transplantation received attention. Although the procedure is still largely regarded as experimental, this does not diminish the significance of costs. The National Cooperative Transplantation Study was undertaken to better understand the costs of all transplants, including heart-lung transplantation. Data on transplantation charges from date of procedure to discharge were obtained from more than 65% of all heart-lung transplantation programs active in 1988. These programs accounted for 61% of all transplantations performed in 1988. Valid sample survey data (no more than 25 procedures per center) were obtained for 42 patients, or approximately 58% of all procedures done in the United States. Detailed data were also collected on sources of payment and amount reimbursed. Because of outlier data, we report statistical medians, rather than means, as our measure of central tendency. The median charge for heart-lung transplantation was $134,881, with an average hospital stay of 31 days. Total charges fell between $99,535 and $216,639 for 50% of the cases studied. Half of the patients spent between 23 and 49 days in the hospital. Because of the small number of cases available for analysis, it was not meaningful to cross-classify the data according to various prognostic variables. More than 78% of the procedures studied were paid for by private insurers. Reimbursement exceeded 90% of billed charges for 84.6% of the cases analyzed. Despite the experimental status of heart-lung transplantation, insurance reimbursement has been favorable for those heart-lung transplantations that insurers have covered. Nevertheless, the future of heart-lung transplantation is unclear. The availability of donors remains a serious constraint, as is seen in the decrease of procedures performed annually. In fact, lung transplantation now appears to be the preferred approach to the treatment of pulmonary disease.

Fees and Charges↗
PubMed1997

The acquisition of life skills through adventure-based activities and programs: a review of the literature.

This paper discusses the definition of at-risk elementary and secondary school students and identifies incidence and prevalence of various related stressors and behaviors. Assessment issues for at-risk students are highlighted. Theoretical issues that pertain to early adolescence and educational adventure-based program approaches that have been used to intervene or assist in risk remediation for the identified student are addressed. A comparison between the adventure-based programs and the more traditional life skills approach is presented. Empirical evaluations and limitations of adventure programming and adventure-based counseling as well as practice implications and suggestions for further research are reviewed.

Adolescent↗
PubMedDate not supplied

International student enrollment in US dental hygiene schools.

PURPOSE: The purpose of this study was to determine the international student enrollment in US dental hygiene programs, identify methods used to recruit and retain international students, and describe accommodations used for them. METHOD: A 27-item, closed-ended questionnaire was mailed to all dental hygiene program directors (n = 216) in the US. Data were analyzed using descriptive statistics. RESULTS: Responses were received from 154 dental hygiene program directors for a response rate of 71%. Of the 154 returned questionnaires, 70 (45%) dental hygiene program directors indicated that international students were enrolled in their programs, totalling 4% of the total student population, with female students outnumbering males. The highest international student population came from Canada (42%) followed by Asia (32%), Europe (10%), Central America (9%), South America (3%), and Africa and the Caribbean (2%). Six percent of dental hygiene programs actively recruited international students, 3% had an articulation agreement with institutions outside the US, and 96% did not offer special orientation for incoming international students. CONCLUSION: Research showed a need for professional oral health services in other countries. US dental hygiene programs do not actively recruit nor retain international students. The benefits of US dental hygiene programs actively recruiting and retaining international students would be: 1) international students would be equipped to provide comprehensive, preventive oral health services upon returning to their native country 2) international students would foster a better understanding of cultural diversity, which could transfer to social and professional settings among students in US dental hygiene programs.

Dental Hygienists↗
PubMed1979

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↗
PubMed2000

Salmonella pathogenicity island 1-independent induction of apoptosis in infected macrophages by Salmonella enterica serotype typhimurium.

The enteric pathogen Salmonella enterica serotype Typhimurium induces apoptosis in infected macrophages. This process is rapid, specific, and depends on the type III protein secretion system encoded within Salmonella pathogenicity island 1 (SPI1). Here, we demonstrate that serotype Typhimurium can activate programmed macrophage cell death independently of SPI1. SPI1 independent induction of apoptosis in infected macrophages is observed as early as 12 to 13 h postinfection, even in the absence of intracellular bacterial replication. Delayed activation of programmed macrophage cell death is not observed with serotype Typhimurium strains mutated in ompR or SPI2. Even though SPI2 mutants have a defect in intracellular proliferation, our results indicate that long-term intracellular survival and growth are not required for delayed macrophage killing per se, since Salmonella mutants that are severely defective in intracellular growth still induce delayed apoptosis. Inactivation of genes required for either rapid or delayed induction of apoptosis results in a conditional noncytotoxic phenotype, whereas simultaneous inactivation of genes required for both rapid and delayed induction of apoptosis renders serotype Typhimurium noncytotoxic under all conditions tested. Our hypothesis is that differential activation of programmed macrophage cell death by serotype Typhimurium occurs under discrete physiological conditions at distinct locations within an infected host.

Animals↗
PubMed2026

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↗
PubMed1987

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↗
PubMedDate not supplied

Community pharmacy residency programs, 1997-1998.

OBJECTIVE: To obtain a descriptive "snapshot" of community pharmacy residency programs active in 1997-1998. DESIGN: Survey (telephone interview) of community pharmacy residency program directors. METHODS: An advance letter to residency directors stated the purpose of the study and requested written information on their residency program. Using a scripted questionnaire, telephone interviews were conducted with each residency director. RESULTS: Descriptive statistics were used to portray the data. There were 13 active community pharmacy residency programs with 20 filled residency sites nationwide at the time of the study. Results revealed that 9 (69%) programs were funded by multiple sources, 3 programs were funded solely by the affiliated college, and 1 program was funded solely by the affiliated pharmacy. Of the 10 residency programs that had been in existence for longer than 1 year, 7 (70%) had the same funding source as they did the first year. Respondents provided descriptions of the residency programs, along with insight into the challenges of creating such programs. At the time of publication (November 1999), there were 50 active community residency sites within the 21 active community pharmacy residency programs. Several other programs are planned for implementation in July 2000. CONCLUSION: In general, community pharmacy residency programs continue to grow in number, and funding has been sustained due to the programs' successful outcomes. The results of this study provide a framework for the improvement of existing community pharmacy residency programs and the development of additional ones.

Community Pharmacy Services↗
PubMed1993

Drug-use evaluation programs in short-term-care general hospitals.

The results of a survey to assess drug-use evaluation (DUE) programs in short-term-care general U.S. hospitals are reported. During February 1992, questionnaires were mailed to pharmacy directors at 491 randomly selected short-term-care general hospitals with 100 or more beds. The questionnaire was designed to collect information on the characteristics of surveyed hospitals and their pharmacies, DUE program characteristics, and the perceptions of pharmacists about the DUE programs. The net response rate was 66.6% (327 usable replies). Pharmacists involvement in DUE program activities was found to be very high, with two thirds of respondents indicating they participated in all five ASHP-recommended activities. Pharmacists rated the effectiveness of current DUE programs as moderate, while the importance of pharmacist participation was perceived to be very high. Pharmacists were members of 97.9% of the respondents' DUE committees, but only 65.5% of the pharmacist members held voting privileges. Pharmacists reported devoting an average of 11.27 hours weekly to DUE-related tasks. Reasons used to select drugs for DUEs, interventions employed, uses of DUE results, and methods of evaluating the effectiveness of DUE programs all varied widely. In short-term-care general hospitals with 100 or more beds, pharmacists assigned to DUE activities were highly involved in DUE committees and programs. The effectiveness of these activities needs to be assessed in more detail.

Data Collection↗
PubMed2000

Kainic acid-induced seizures produce necrotic, not apoptotic, neurons with internucleosomal DNA cleavage: implications for programmed cell death mechanisms.

Prolonged seizures (status epilepticus) induced by kainic acid activate programmed cell death mechanisms, and it is believed that kainic acid-induced status epilepticus induces neuronal apoptosis. In order to test this hypothesis, adult rats were subjected to 3-h kainic acid-induced seizures, with 24- or 72-h recovery periods. Neuronal death was assessed by light microscopy with the Hematoxylin and Eosin stain and with in situ terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL stain), by electron microscopy, and by agarose gel electrophoresis of DNA extracted from five vulnerable brain regions. Spontaneous and MK-801-induced apoptotic neurons from retrosplenial cortex of neonatal rats, evaluated by light and electron microscopy, were used as positive controls for apoptosis. Surprisingly, the large chromatin clumps of apoptotic neurons were TUNEL negative, whereas the cytoplasm showed light-to-moderate TUNEL staining, consistent with a lack of identifiable nuclear membranes ultrastructurally, and with intermingling of nuclear and cytoplasmic contents. Ultrastructurally, the acidophilic neurons produced by kainic acid-induced status epilepticus, identified with Hematoxylin and Eosin stain, were dark, shrunken and necrotic, with pyknotic nuclei containing small, dispersed chromatin clumps, and with cytoplasmic vacuoles, some of which were swollen, disrupted mitochondria. No apoptotic cells were seen. Acidophilic neurons were found in up to 20 of 23 brain regions examined and comprised 10-25% of the total number of neurons examined. A subset of these neurons (<10% of the total number of neurons in five of 23 regions) had TUNEL-positive nuclei 72h but not 24h after status epilepticus. Internucleosomal DNA cleavage (DNA "laddering") occurred in the four most damaged brain regions examined by electron microscopy 24h after SE and the three most damaged regions 72h after status epilepticus. Our results demonstrate that kainic acid-induced status epilepticus produces neuronal necrosis and not apoptosis in adult rats. The necrotic neurons show nuclear pyknosis, chromatin condensation and DNA laddering. Programmed cell death mechanisms activated by kainic acid-induced status epilepticus occur in neurons which become necrotic and could contribute to necrotic, as well as apoptotic, neuronal death.

Animals↗
PubMed1986

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↗