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PubMed2000

A nurse-coordinated educational initiative addressing primary care professionals' attitudes to and problem-solving in depression in older people--a pilot study.

This study assessed the feasibility and efficacy of an intervention focusing on primary care professionals' attitudes to, problem-solving in and practice relating to depression in old age before and after a nurse-implemented educational intervention. One hundred and twenty-one practices were approached, in which 297 doctors worked. Most practices did not want to be involved in this study. Evidence from previous studies and this one suggests that GPs are more amenable to interventions which are implemented by doctors rather than other health personnel. In addition, the lack of interest in this intervention may be a reflection of the therapeutic nihilism of primary care physicians regarding depression in older people. Sixteen surgeries expressed an interest in the study, of whom 14 participated in the study comprising 40 GPs. Thirty-one GPs and 24 nurses completed the baseline questionnaires. Only six GPs and no nurses returned completed questionnaires post-intervention. The only statistically significant before versus after change in the attitude questionnaire was found in 'I need more training to be able to deal effectively with depression in the elderly'. Mean scores were 0.73 and 0.47 respectively (p<0.05; 95%CI 3.2-47.1). Significant improvements post-intervention were, however, found in the answers to three questions (all p<0.05) addressing whether patients with depression complicated by or presenting with physical illness were referred appropriately and/or followed up. The results of our study do not indicate that the evaluation of nurse-led educational interventions in primary care is feasible in the field of depression in old age. The belief that all that is needed is the provision of accessible education of professionals by experts in the field to change attitudes and practice has not been reinforced. The high refusal rate suggests that such interventions are unlikely in any case to be generally acceptable.

Aged↗

PubMed1998

Chemoselectively addressable HCan building blocks in peptide synthesis: L-homocanaline derivatives.

(S-2-amino-5-(aminooxy)pentanoic acid (L-homocanaline, HCan), a structural analogue of lysine, contains a reactive alkyloxyamine side chain and is therefore considered to react chemoselectively with carbonyl compounds by forming a kinetically stable oxime bond. The chemical synthesis of L-homocanaline starting from protected glutamic acid derivatives is described. Two orthogonally protected homocanaline derivatives were synthesized and their use in standard SPPS procedures was exemplified for the synthesis of a chemoselectively addressable cyclic peptide for use in TASP design. Moreover, the wide range of applications of this unique building block was demonstrated for the chemoselective ligation of an unprotected disaccharide to a HCan containing model peptide resulting in a chimeric glycopeptide structure.

Aminobutyrates↗

PubMed1984

Presidential address. Fatti Maschii Parole Femine.

The current role of the Society of Surgical Oncology has demonstrated leadership in the field of surgical oncology in both word and deed, as exemplified by the motto of the State of Maryland, adopted from the 1632 family seal of Lord Baltimore, "Fatti Maschii Parole Femine." The current emphasis on the need for clinical research on human cancers, and the education of surgeons in all aspects of various cancers is well founded in the writings and the addresses of Dr. James Ewing, the Society's founder. Our goals as a society for the next decade have been precisely defined and, as in all important national programs, made current and interfaced with corresponding priorities of the American Cancer Society and the National Cancer Institute. The Society, in three project areas, is: (1) assessing current progress in surgical oncology, as well as future manpower needs; (2) studying on a comprehensive basis the surgical practices in cancer patient management; and (3) surveying academic centers concerning the nature of current education and training of academic surgeons in clinical research. The Training Committee currently reviews and recognizes 2-year postresidency multidisciplinary training at several institutions, and the James Ewing Foundation has expanded its fiscal support of educational activities. This annual meeting marks an historic first signified by the conjoint sessions being held with other international surgical oncology societies.

Education, Medical, Graduate↗

PubMed2000

Recommended minimal requirements and development guidelines for exposure setups of bio-experiments addressing the health risk concern of wireless communications.

The evidence currently available on the potential health effects from electromagnetic field (EMF) exposure has been largely judged as being too tentative and inadequate to meet criteria for assessing health risks. Some of the main reasons for these shortcomings lie in the incomplete description of the exposure and poorly characterized dosimetry. Well-defined exposure conditions are essential to obtain reproducible and scientifically valuable results. To facilitate the development of optimized setups for specific bio-experiments, this paper lists basic requirements and provides development guidelines for evaluation, optimization, construction, and verification of exposure. In addition, definitions of minimum performance requirements for setups addressing the health risk concern of wireless communications are suggested.

Electromagnetic Fields↗

PubMed2004

Guidance for exposure design of human studies addressing health risk evaluations of mobile phones.

Conflicting results have recently emerged from human provocation studies that addressed the possible health hazards of radio frequency (RF) field exposure from mobile phones. Different findings may have resulted from exposures that are poorly defined and difficult to compare. The aim of this study was to develop guidelines to facilitate the development of exposure systems for human volunteer studies which lead to reproducible results and which provide maximum relevance with respect to the assessment of the safety of mobile technology. The most important exposure parameters are discussed such as the signal, field distribution, and field strength, as well as the minimum requirements for the setup and dosimetry.

Absorption↗

PubMed2003

A small issue addressed.

Cell size is an important determinant of body size. While the genetic mechanisms of cell size regulation have been well studied in yeast, this process has only recently been addressed in multicellular organisms. One recent report by Wang et al. (2002) shows that in the nematode C. elegans, the TGFbeta-like pathway acts in the hypodermis to regulate cell size and consequently body size.1 This finding is an exciting step in discovering the molecular mechanisms that control cell and body size.

Animals↗

PubMed2005

Locally Addressable Electrochemical Patterning Technique (LAEPT) applied to poly(L-lysine)-graft-poly(ethylene glycol) adlayers on titanium and silicon oxide surfaces.

The protein-resistant polycationic graft polymer, poly(L-lysine)-g-poly(ethylene glycol) (PLL-g-PEG), was uniformly adsorbed onto a homogenous titanium surface and subsequently subjected to a direct current (dc) voltage. Under the influence of an ascending cathodic and anodic potential, there was a steady and gradual loss of PLL-g-PEG from the conductive titanium surface while no desorption was observed on the insulating silicon oxide substrates. We have implemented this difference in the electrochemical response of PLL-g-PEG on conductive titanium and insulating silicon oxide regions as a biosensing platform for the controlled surface functionalization of the titanium areas while maintaining a protein-resistant background on the silicon oxide regions. A silicon-based substrate was micropatterned into alternating stripes of conductive titanium and insulating silicon oxide with subsequent PLL-g-PEG adsorption onto its surfaces. The surface modified substrate was then subjected to +1800 mV (referenced to the silver electrode). It was observed that the potentiostatic action removed the PLL-g-PEG from the titanium stripes without inducing any polyelectrolyte loss from the silicon oxide regions. Time-of-flight secondary ions mass spectroscopy and fluorescence microscopy qualitatively confirmed the PLL-g-PEG retention on the silicon oxide stripes and its absence on the titanium region. This method, known as "Locally Addressable Electrochemical Patterning Technique" (LAEPT), offers great prospects for biomedical and biosensing applications. In an attempt to elucidate the desorption mechanism of PLL-g-PEG in the presence of an electric field on titanium surface, we have conducted electrochemical impedance spectroscopy experiments on bare titanium substrates. The results showed that electrochemical transformations occurred within the titanium oxide layer; its impedance and polarization resistance were found to decrease steadily upon both cathodic and anodic polarization resulting in the polyelectrolyte desorption from the titanium surface.

Biosensing Techniques↗

PubMed2000

Mixed group validation: a method to address the limitations of criterion group validation in research on malingering detection.

Mixed group validation (MGV) is offered as an alternative to criterion group validation (CGV) to estimate the true positive and false positive rates of tests and other diagnostic signs. CGV requires perfect confidence about each research participant's status with respect to the presence or absence of pathology. MGV determines diagnostic efficiencies based on group data; knowing an individual's status with respect to pathology is not required. MGV can use relatively weak indicators to validate better diagnostic signs, whereas CGV requires perfect diagnostic signs to avoid error in computing true positive and false positive rates. The process of MGV is explained, and a computer simulation demonstrates the soundness of the procedure. MGV of the Rey 15-Item Memory Test (Rey, 1958) for 723 pre-trial criminal defendants resulted in higher estimates of true positive rates and lower estimates of false positive rates as compared with prior research conducted with CGV. The author demonstrates how MGV addresses all the criticisms Rogers (1997b) outlined for differential prevalence designs in malingering detection research.

Adolescent↗

PubMed2004

Addressing the challenge of changing the specificity of RNase T1 with rational and evolutionary approaches.

Although ribonuclease T1 (RNase T1) is one of the best-characterized proteins with respect to structure and enzymatic action, numerous attempts at altering the specificity of the enzyme to cleave single-stranded RNA at the 3'-side of adenylic instead of guanylic residues by rational approaches have failed so far. Recently we generated and characterized the RNase T1 variant RV with a 7200-fold increase in adenylyl-3',5'-cytidine (ApC)/guanylyl-3',5'-cytidine (GpC) preference, with the guanine-binding loop changed from 41-KYNNYE-46 (wt) to 41-EFRNWN-46. Now we have introduced the asparagine residue at position 46 of the wild-type enzyme as a single-point mutation in variant E46N and in combination with the Y45W exchange also occurring in RV. Both variants show an improved ApC/GpC preference with a 1450-fold increase for E46N and a 2100-fold increase for Y45W/E46N in comparison to wild-type activity. We also addressed the challenge of altering enzyme specificity with an evolutionary approach. We have randomly introduced point mutations into the RNase T1 wild-type gene and into the gene of the variant RV with different mutation rates. Altogether we have screened about 100,000 individual clones for activity on RNase indicator plates; 533 of these clones were active. A significant change in substrate specificity towards an ApC preference could not be observed for any of these active variants; this demonstrated the magnitude of the challenge to alter the specificity of this evolutionary perfected enzyme.

Amino Acids↗

PubMed2001

Hierarchical modeling of the relation between sequence variants and a quantitative trait: addressing multiple comparison and population stratification issues.

When analyzing the relation between genetic sequence information and disease traits, false-positive associations can arise due to multiple comparisons and population stratification. In an attempt to address these issues, we incorporate into a conventional analytic model higher-level--or "prior"--models that use additional information to improve estimates while allowing for differing population structures. We apply this hierarchical model to simulated data from the Genetic Analysis Workshop 12. We focus on the effects of common candidate gene sequence variants on quantitative risk factor 5 (Q5) levels. In particular, we compare the regression coefficients (and 95% confidence intervals) obtained from conventional (one-stage) analyses versus the corresponding results from the hierarchical analyses. When examining either the marry-ins or all subjects in the general and isolate populations, the conventional model detected numerous sites in candidate genes 1-5 and 7 that had statistically significant regression coefficients (alpha level = 0.05). In contrast, our hierarchical model primarily only detected associations for variants in candidate gene 2, which is the casual gene for Q5.

Chromosome Mapping↗

PubMed1998

Zonal and regional differences identified from precision mapping of vitamin A-storing lipid droplets of the hepatic stellate cells in pig liver: a novel concept of addressing the intralobular area of heterogeneity.

Knowledge of hepatic heterogeneity has been strikingly increased, while an accurate means for addressing intralobular positions is still lacking. We examined pig liver preparations of the gold impregnation method for vitamin A-storing lipid droplets in hepatic stellate cells. Droplet morphometry was performed under oil immersion, and the calculated volumes plotted on computerized maps. The heterogeneous results were assessed with five concentric zones and five radial regions; the latter were determined based on midseptum visualized by portal injection. Zonation and regionation thus subdivided lobules into 5-zone/5-region (5Z/5R) compartmentalization. Distribution of values exhibited a distinct zonal gradient, heightened at peripheral zones 1 and 2, decreased over intermediate zone 3 toward centrilobular zones 4 and 5; peak was always found at zone 2. Within a single zone, variations were obvious, forming a regional gradient. Values were significantly higher at periportal than midseptal regions. Digitized mapping showed that low values filled up centrilobular zones, whereas high values concentrated in periportal regions. Along the periphery, inlet venules were quantified, revealing an occurrence rate of 60% at periportal, and 5% at midseptal regions, closely compatible with the regional gradient of vitamin A-storing capacity. The interweaving between zonal and regional gradients results in a vitamin A-low territory, a compound area composed of centrilobular zones plus extensions into midseptal regions. Because the results could account for physiological and pathological events, we regard the 5Z/5R compartmentalization a model worth routine adoption for a precise description of any morphofunctionally demonstrable heterogeneity of the liver lobules.

Adipocytes↗

PubMed1995

Presidential address. American College of Clinical Pharmacology has provided a variety of educational opportunities.

At the current time, the College is in an excellent position to support the educational needs of its growing membership. The fund balance has increased over the past few years and is continuing to increase during the current year. The unprecedented speed of changes in the health care environment in which all clinical pharmacologists are now working necessitates that the American College of Clinical Pharmacology continually examine and update its Strategic Plan and Long Range Goals to allow all of its members to keep abreast of these changes. As hospitals, medical schools, and other allied health colleges address the need for economic accountability, as educators in medical and pharmacy and other schools encounter state and federal reductions in financial assistance to students, and as new roles are developed for the clinical pharmacologists working within the professions of medicine, pharmacy and allied health specialties, the College must maintain its role as a leader for all clinical pharmacologists. The success of the College will be directly related to the effort invested by all of the committee members and chairpersons, the Board of Regents, the Officers of the College, and most of all, the membership. During the next two years, I look forward to working with the entire membership to encourage growth of the College.

Humans↗

PubMedDate not supplied

A model of practice to address cultural competence in rehabilitation nursing.

A position statement developed by the Association of Rehabilitation Nurses (ARN), Appropriate Inclusion of Rehabilitation Nurses Wherever Rehabilitation is Provided, stated that nurses are an essential part of a client's rehabilitation because they provide holistic care and "attend to the full range of human experiences and responses to health and illness" (Association of Rehabilitation Nurses, 1996, p.1). Rehabilitation nurses must become strongly aware of the role that culture plays in this process. This article presents a conceptual model of practice with which to address cultural competence in rehabilitation nursing. The model's constructs of cultural awareness, cultural knowledge, cultural encounters, cultural skill, and cultural desire are discussed. Examples from the field of rehabilitation nursing are presented in the discussion of these constructs.

Clinical Competence↗

PubMedDate not supplied

Assessing and addressing inappropriate sexual behavior in brain-injured clients.

Inappropriate sexual comments and behaviors from clients with brain injuries can be frustrating, awkward, and time consuming for the nurses who are caring for them. Understanding the meaning of these comments and behaviors, as well as receiving direction concerning ways to handle the situation can help nurses overcome their frustration and improve the quality of nursing care. This article examines potential underlying causes of inappropriate sexual behavior, explains the behaviors from client, family, staff, and organizational perspectives, and begins to look at ways to respectfully and sensitively address the behaviors using a model and framework developed by the Sexual Health Service (SHS) at Vancouver Hospital and Health Sciences Centre (VHHSC), in British Columbia, Canada.

Behavior Therapy↗

PubMed2003

Addressing the metabolic activation potential of new leads in drug discovery: a case study using ion trap mass spectrometry and tritium labeling techniques.

Metabolic activation of drug candidates to electrophilic reactive metabolites that can covalently modify cellular macromolecules may result in acute and/or idiosyncratic immune system-mediated toxicities in humans. This presents a significant potential liability for the future development of these compounds as safe therapeutic agents. We present here an example of an approach where sites of metabolic activation within a new drug candidate series were rapidly identified using online liquid chromatography/multi-stage mass spectrometry on an ion trap mass spectrometer. This was accomplished by trapping the reactive intermediates formed upon incubation of compounds with rat and human liver microsomes as their corresponding glutathione conjugates and mass spectral characterization of these thiol adducts. Based on the structures of the GSH adducts identified, potential sites and mechanisms of bioactivation within the chemical structure were proposed. These metabolism studies were interfaced with iterative structural modifications of the chemical series in order to block these bioactivation sites within the molecule. This strategy led to a significant reduction in the propensity of the compounds to undergo metabolic activation as evidenced by reductions in the irreversible binding of radioactivity to liver microsomal material upon incubation of tritium-labeled compounds with this in vitro system. With the efficiency and throughput achievable with such an approach, it appears feasible to identify and address the metabolic activation potential of new drug leads during routine metabolite identification studies in an early drug discovery setting.

Animals↗

PubMed2005

An exploratory survey of the practice of rheumatology nurses addressing the sexuality of patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic progressive inflammatory condition primarily affecting the joints. It is characterized by pain, stiffness and fatigue. Research has demonstrated that the symptoms of RA can negatively impact on a patient's sexuality and patients would welcome the opportunity to discuss their sexual needs with a health professional. AIMS: To identify current perceived practice, skills, and knowledge of rheumatology nurses in addressing the sexuality of patients with RA. METHODS: A postal questionnaire was sent to 132 rheumatology nurses identified from the British Health Professionals in Rheumatology Handbook. The questionnaire sought to identify the nurse's role in the assessment and management of RA patients' sexuality. RESULTS: Seventy six questionnaires were returned (response rate of 57.5%). Sixty nine respondents stated that sexuality should be included within the nursing assessment. The main factors that influenced whether sexuality was discussed was privacy, the level of knowledge and skills and time. Nurses felt that while contraceptive advice for patients treated with cytotoxic drugs was discussed in depth, the patient's sexual relationship was not discussed at all. The majority of respondents (83%) had never received any training in this area and would undergo training if they had the opportunity. CONCLUSION: While rheumatology nurses acknowledge the importance of including sexuality in the care management of patients with RA, in practice the impact of the condition on a patient's sexuality is only discussed briefly. Rheumatology nurses have identified the need for further training in this complex area.

Journal Article↗

PubMed2006

Self-assembling protein arrays on DNA chips by auto-labeling fusion proteins with a single DNA address.

The high-throughput deposition of recombinant proteins on chips, beads or biosensor devices would be greatly facilitated by the implementation of self-assembly concepts. DNA-directed immobilization via conjugation of proteins to an oligonucleotide would be preeminently suited for this purpose. Here, we present a unique method to attach a single DNA address to proteins in one step during the purification from the E. coli lysate by fusion to human O6-alkylguanine-DNA-alkyltransferase (SNAP-tag) and the Avitag. Use of the conjugates in converting a DNA chip into a protein chip by self assembly is demonstrated.

Base Sequence↗

PubMed2004

Addressing tobacco smoke exposure: passive and active.

Many smoking parents are receptive to receiving smoking counseling messages and pediatric health care providers need to increase their efforts to address ETS exposure. Efforts to prevent smoking acquisition should continue by parents, doctors, schools, and the community. Start early in childhood to promote positive family communication and role modeling. Screen for tobacco use or intention and provide counseling to teen without the parent in room. Brief tobacco-dependence interventions are effective. Every patient/parent that uses tobacco should be identified, urged to quit, and offered treatment. Those willing to quit should be provided effective treatments using the "5 A's". Those unwilling to quit should be motivated using "5 R's". Quitting smoking is a major challenge but it is one that many people successfully achieve every day. Even a small increase in smoking cessation can be significant impact from a public health perspective and pediatric providers can play a significant role.

Adolescent↗