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PubMed2002

Girls in the juvenile justice system: leave no girl's health un-addressed.

Despite an increase in middle to older aged adolescent females' early contact with the juvenile justice system, inadequate health care remains a concern. This descriptive study surveyed the physical and mental health needs of 130 self-selected, nonrandomized girls aged 12 to 18 years, with a mean age of 15.42 years (SD, 1.24), who were involved with a juvenile justice diversional program located in a southeastern region of the United States. Findings revealed early initiation of sexual-related activities (mean age, 13.9 years; SD, 1.49) and substance use (mean age, 12.9 years; SD, 1.53). The data suggest an increasing need for pediatric nurses, and in particular advanced practice nurses, to provide gender-responsive health care and health promotion services to early middle-childhood females in the juvenile justice system.

Adolescent↗
PubMed2004

[The patient, an (un-)known being--the subjective view of users].

After a long time medicine has rediscovered the patient and his subjective view. The changing doctor-patient-relationship, the growing influence of user groups and consumer associations, the new model of patients as responsible partners and last not least the increasing financial pressure have resulted in patients being more often and more intensively involved in treatment decisions. This development has influenced psychiatry in general and psychiatric research. Concepts like quality of life and consumer satisfaction were taken up in Germany as well and have stimulated a lot of empirical studies. In addition to traditionally used outcome criteria like severity of disease and symptomatology so called subjective outcome criteria are more and more often applied. Using seven simple questions - why, what for, who, what, in what way, where, when - some general aspects concerning surveys of patient surveys are discussed. Some relevant results are outlined and the actual situation is evaluated. In general the described results of patient surveys refer to patients in hospitals. This can be explained by the structure of our health care system and by the fact that substantial research resources are generally linked to the inpatient sector. Results of inpatient surveys cannot be generalized to outpatients and users of complementary services. In the next years social psychiatric research should bring stronger focus to the subjective perspectives of these patients.

Community Participation↗
PubMed1982

Use of un-derivatized thyroid hormones for photoaffinity labeling of binding proteins.

Irradiation of the thyroid hormones thyroxine and 3,5,3'-triiodothyronine in the near UV (greater than 300 nm) causes homolytic fission of C--I bonds in both rings. In the presence of hormone-binding proteins, the phenyl radical thus formed, and possibly also the iodine radical, can establish a covalent bond with certain amino acid residues in the binding site. Most if not all of the iodine radicals, however, appear to be reduced to iodide. Incubation of purified carrier proteins for the thyroid hormones in human serum as well as of an extract of rat liver nuclei or of whole nuclei with trace amounts of 125I- or 14C-labeled hormone, followed by irradiation, resulted in covalent binding. This was proven by gel filtration after boiling with guanidine:HCl and by sodium dodecyl sulfate/polyacrylamide gel electrophoresis of the irradiated solutions or of the excluded-peak material obtained after gel filtration. Sodium dodecyl sulfate/polyacrylamide gel electrophoresis of 125I-labeled irradiated nuclear extracts showed a prominent peak (Mr approximately equal to 45,000), sometimes with a shoulder or small peak at Mr approximately equal to 56,000, and a fast-moving peak (Mr approximately equal to 12,000). Similar patterns were obtained with N-bromoacetylthyroxine or N-bromoacetyltriiodothyronine without irradiation. When a suspension of whole nuclei was irradiated instead of nuclear extracts, the shoulder also became a prominent peak.

Affinity Labels↗
PubMed2004

Bacteriophage T4Dam DNA-(adenine-N(6))-methyltransferase. Comparison of pre-steady state and single turnover methylation of 40-mer duplexes containing two (un)modified target sites.

We analyzed pre-steady state and single turnover kinetics of bacteriophage T4Dam DNA-(adenine-N(6))-methyltransferase-mediated methyl group transfer from S-adenosyl-l-methionine (AdoMet) to 40-mer duplexes containing native recognition sites (5'-GATC/5'-GATC) or some modified variant(s). The results extend a model from studies with single-site 20-mer duplexes. Under pre-steady state conditions, monomeric T4Dam methyltransferase-AdoMet complexes were capable of rapid methylation of adenine residues in 40-mer duplexes containing two sites. During processive movement of T4Dam to the next site, the rate-limiting step was the exchange of the product S-adenosyl-l-homocysteine (AdoHcy) for AdoMet without T4Dam dissociating from the duplex. Consequently, instead of a single exponential rate dependence, complex methylation curves were obtained with at least two pre-steady state steps. With 40-mer duplexes containing a single target site, the kinetics were simpler, fitting a single exponential followed by a linear steady state phase. Single turnover methylation of 40-mer duplexes also proceeded in two stages. First, two dimeric T4Dam-AdoMet molecules bound, and each catalyzed a two-step methylation. Instead of processive movement of T4Dam, a conformational adaptation occurred. We propose that following methyl transfer to one strand, dimeric (T4Dam-AdoMet)-(T4Dam-AdoHcy) was capable of rapidly reorienting itself and catalyzing methyl transfer to the target adenine on the complementary, unmethylated strand. This second stage methyl transfer occurred at a rate about 25-fold slower than in the first step; it was rate-limited by Dam-AdoHcy dissociation or its clearance from the methylated complementary strand. Under single turnover conditions, there was complete methylation of all target adenine residues with each of the two-site 40-mer duplexes.

Adenine↗
PubMed1997

Types of hypnotically (un)susceptible individuals as a function of phenomenological experience: towards a typology of hypnotic types.

Subjects were 194 nursing students who experienced the HGSHS A (Shor & Orne, 1962) in which was embedded a 2-minute sitting quietly interval subsequent to the eye catalepsy item, but prior to the "counting out" sequence. After the HGSHS:A, subjects completed the Phenomenology of Consciousness Inventory (PCI) (Pekala, 1982, 1991c) in reference to the sitting quietly interval embedded in the hypnotic induction ceremony. Subjects were divided into low and high susceptible groups. K-means cluster analysis of the subjects' responses to the PCI revealed nine different cluster groups. These groups had different patterns of phenomenological experiences that cut across individual subjects' actual HGSHS:A scores. Implications of the above for (a) working with clients who may not score that high on standard behavioral measures of hypnotizability (such as the HGSHS:A), or (b) understanding how hypnosis "works," are discussed.

Adult↗
PubMed1996

Ensenanzas en un gimnasio: an investigation of modeling and verbal rehearsal on the motor performance of Hispanic limited English proficient children.

This study investigated the effects of modeling and verbal rehearsal on the motor performance of English-speaking and limited English proficient (LEP) children. Children (N = 64) in 4th-grade classes were randomly assigned to conditions in a 2 x 2 x 2 x 2 (Gender x Primary Language x Model Type x Rehearsal) factorial design. Boys and girls whose primary language was English or Spanish were assigned to either a verbal model or no-model condition as well as to a verbal rehearsal or no-rehearsal condition of the motor skills required to be performed. Analysis of variance revealed a significant Model Type x Primary Language interaction as well as a significant Rehearsal x Primary Language interaction. Follow-up analyses revealed that English-speaking children provided with a verbal rehearsal strategy recalled significantly more skills than English-speaking children in the no-rehearsal condition; for LEP children, there were no differences due to rehearsal. Moreover, LEP children presented with a verbal model recalled significantly more skills than LEP children in the no-model condition; for English-speaking children, there were no differences attributed to model type. These results indicate that effective modeling conditions that are provided with verbal cues in English are related to children's primary language.

Child↗
PubMed2000

Social determinants of (un)healthy behaviors.

Medical education has historically relied on the rational choice model as a vehicle for promoting health behavior change, and has largely overlooked the powerful relationships between social class and health behaviors. The rational choice model, which assumes that people can choose to pursue behaviors that are needed for their health, has some clinical utility, especially in some circumstances, but it runs the risk of missing key sources of influence and of blaming the victim. The biopsychosocial model provides an alternative basis for teaching about health behavior change. Health behavior needs to be understood in a broad social context, in which social class is recognized as playing a large part in shaping many people's health behaviors through multiple pathways, including limited opportunities for self-fulfillment, financial constraints, health beliefs, self-efficacy, stress, and social support. In addition to highlighting the limitations of the rational choice model, we illustrate how to integrate the socio-cultural context into teaching about behavior change. Specific curricular suggestions include exercises for: (1) increasing students' awareness of their own biases regarding unhealthy behaviors and individual responsibility for change; (2) enhancing knowledge of social factors that impact health; (3) building advocacy skills; (4) learning from patients; and (5) practicing counseling skills through role-plays.

Journal Article↗
PubMed2006

Elevated urine arsenic: un-speciated results lead to unnecessary concern and further evaluations.

The consumption of seafood within two to three days of testing can increase total urine arsenic concentrations. Few clinicians are familiar with this fact and often misinterpret elevated results. A retrospective chart review of all cases with arsenic testing seen between 1991 and 2004 at an occupational and environmental medicine referral clinic was performed. Urine arsenic results were classified as follows: total arsenic levels; speciated results (inorganic, ionic arsenic); and whether the patient abstained from seafood prior to the collection. Laboratory detection limits for total and for ionic arsenic were < or = 2 microg/L. Fifty-four patients with urine arsenic testing were identified. The total urine arsenic concentration exceeded 40 microg/L for 28 patients. On paired, speciated testing (n = 21), mean total arsenic was 122 +/- 227 microg/L, and ionic arsenic was not detected in any of these same samples (p = 0.023). On paired testing, before and after seafood abstention (n = 12), total urine arsenic without abstention was 291 +/- 267 microg/L, and it was only 9 +/- 12 microg/L after seafood abstention (p = 0.004). The total urine arsenic elevations observed in our series were due to benign organic arsenic compounds commonly found in seafood. Laboratories should reflexively perform speciation on most samples with elevated total arsenic concentrations prior to reporting the results. Reflexive speciation could reduce unnecessary referrals, further testing, and patient anxiety.

Adolescent↗