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PubMed1988

The USA-USSR collaborative cross-cultural comparison of autogenic training and thermal biofeedback in the treatment of mild hypertension.

We have conducted a cross-cultural (USA and USSR) comparison of thermal biofeedback (TBF) and autogenic training (AT) to a self-relaxation control condition in 59 unmedicated males with mild hypertension. Identical assessment and treatment protocols were carried out in both settings (Albany, New York, and Moscow). Treatments were delivered in small groups on an outpatient basis twice per week for 10 weeks. Results showed comparable, significant (p less than .05), short-term decreases (M = 8.5 mm Hg) in diastolic blood pressure (DBP) for both treatments at both sites. However, the Soviet patients, starting with significantly (p less than .01) higher systolic blood pressures (SBPs), showed significant decreases (M = 12.8 mm Hg) in SBP, whereas the American patients did not change appreciably (M = 4.6 mm Hg). During follow-up, the treated Soviet patients showed significantly (p less than .05) better maintenance of treatment effects, from 3 months to 1 year, than did the American patients. At 1 year, 75% of the treated Soviet patients had DBPs less than 90 mm Hg, whereas only 24% of the American patients had comparable DBPs.

Adult↗
PubMed2025

Cathepsin Z is a conserved susceptibility factor underlying tuberculosis severity.

Tuberculosis (TB) outcomes vary widely, from asymptomatic infection to mortality, yet most animal models do not recapitulate human phenotypic and genotypic variation. The genetically diverse Collaborative Cross mouse panel models distinct facets of TB disease that occur in humans and allows identification of genomic loci underlying clinical outcomes. We previously mapped a TB susceptibility locus on mouse chromosome 2. Here, we identify cathepsin Z (Ctsz) as a lead candidate underlying this TB susceptibility and show that Ctsz ablation leads to increased bacterial burden, pulmonary inflammation and decreased survival in mice. Ctsz disturbance within murine macrophages enhances production of chemokine (C-X-C motif) ligand 1 (CXCL1), a known biomarker of TB severity. From a Ugandan household contact study, we identify significant associations between CTSZ variants and TB disease severity. Finally, we examine patient-derived TB granulomas and report CTSZ localization within granuloma-associated macrophages, placing human CTSZ at the host-pathogen interface. These findings implicate a conserved CTSZ-CXCL1 axis in humans and genetically diverse mice that mediates TB disease severity.

Animals↗
PubMed2000

Mycobacterium bovis as a significant cause of tuberculosis in children residing along the United States-Mexico border in the Baja California region.

OBJECTIVE: To determine the role of Mycobacterium bovis in active pediatric tuberculosis (TB) in a United States-Mexico border region. METHOD: We reviewed all new cases of pediatric (<15 years old) TB presenting to San Diego hospitals and clinics from 1980 to 1997. Patients were categorized by age, ethnicity, country of origin, culture results, and disease manifestations. Case definitions were similar to those used by the Centers for Disease Control and Prevention. M bovis was distinguished from Mycobacterium tuberculosis by standard biochemical tests. RESULTS: The median age of the 563 identified patients was 4.1 years old. The yearly incidence began rising in 1989 and peaked in the mid-1990s. Hispanics constituted 78.9% of the patients, but they were less likely to be foreign-born (21.6%) than were black children and Asian/Pacific Islanders. Overall, M bovis caused 10.8% of all TB during this period. Of the 180 patients with positive culture results, however, M bovis accounted for 33.9% and M tuberculosis 66. 1%. This high percentage of M bovis infections was largely attributable to its contribution to extrapulmonary TB (55.2% of all culture-positive specimens). M bovis patients were also even more likely to be Hispanic (90.2%), to present with extrapulmonary disease (95.1%), and to be older than 12 months (96.8%). CONCLUSION: These data demonstrate the dramatic impact of this underappreciated cause of zoonotic TB on US children at the Mexican border and underscore the need for cross-collaboration to enforce existing Mexican pasteurization laws.

Adolescent↗
PubMedDate not supplied

Attitudes toward physician-nurse collaboration: a cross-cultural study of male and female physicians and nurses in the United States and Mexico.

BACKGROUND: Inter-professional collaboration between physicians and nurses, within and between cultures, can help contain cost and insure better patient outcomes. Attitude toward such collaboration is a function of the roles prescribed in the culture that guide professional behavior. OBJECTIVES: The purpose of the study was to test three research hypotheses concerning attitudes toward physician-nurse collaboration across genders, disciplines, and cultures. METHOD: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was administered to 639 physicians and nurses in the United States (n = 267) and Mexico (n = 372). Attitude scores were compared by gender (men, women), discipline (physicians, nurses), and culture (United States, Mexico) by using a three-way factorial analysis of variance design. RESULTS: Findings confirmed the first research hypothesis by demonstrating that both physicians and nurses in the United States would express more positive attitudes toward physician-nurse collaboration than their counterparts in Mexico. The second research hypothesis, positing that nurses as compared to physicians in both countries would express more positive attitudes toward physician-nurse collaboration, was also supported. The third research hypothesis that female physicians would express more positive attitudes toward physician-nurse collaboration than their male counterparts was not confirmed. CONCLUSIONS: Collaborative education for medical and nursing students, particularly in cultures with a hierarchical model of inter-professional relationship, is needed to promote positive attitudes toward complementary roles of physicians and nurses. Faculty preparation for collaboration is necessary in such cultures before implementing collaborative education.

Analysis of Variance↗
PubMed1998

Health informatics and the humanities.

Researchers and professionals from the Humanities are new within the science of health informatics, where researchers and professionals from the natural sciences have so far de-fined the problems and their solutions. A cross-disciplinary collaboration can be difficult due to factors such as status and competition, to insufficient co-operation qualifications, and due to different definitions of problems. This paper presents examples of differently formulated health informatics problems. Cross-disciplinary collaboration is necessary but collaboration demands openness, curiosity, and readiness from researchers and professionals as well as it demands know-edge of the processes in cross-disciplinary cooperation. Considerations for cross-disciplines were actualized with the foundation in Denmark of the cross-disciplinary institution: The Virtual Centre for Health Informatics.

Cooperative Behavior↗
PubMed1993

Discontinuation reactions to alprazolam in panic disorder.

Panic disorder is a chronic illness with only some degree of spontaneous recovery. It is not surprising therefore that discontinuation of an effective medical treatment may be followed by relapse. Therefore the timing and methodology of discontinuing that treatment are now recognized as essential facets of optimal clinical management. In addition to relapse, rebound and the withdrawal syndrome have been reported with many psychotropic agents, particularly with the benzodiazepines. This paper discusses data from three discontinuation studies with alprazolam i.e. the Phase I Cross-National Collaborative Panic discontinuation study after short-term treatment, the Phase I discontinuation study after long-term treatment, and data from the Montreal site of the Alprazolam SR discontinuation study. Phase I of the Cross-National Collaborative Study of Panic Disorder investigated the discontinuation of alprazolam in two populations. There was an intensive, placebo-controlled, time-limited study of discontinuation after short-term treatment (8 weeks) in the first population. For the second, there was a less rigorous open follow-up of patients who had been treated for 5-12 months with alprazolam. The dose-reduction regimen of alprazolam in both studies was approximately the same--a 1 mg decrease every 3-7 days. In the short-term treatment study, 109 patients were treated for 8 weeks, tapered for 4 weeks and observed for another 2 weeks post discontinuation. Significant relapse in the alprazolam-treated group occurred during discontinuation. Rebound of panic attacks occurred in 27% of patients given alprazolam, and distinct transient withdrawal syndrome occurred in 35%. Indicative of the withdrawal syndrome were confusion, clouded sensorium, heightened sensory perception, dysosmia, paresthesias, muscle cramps, muscle twitch, blurred vision, diarrhea, decreased appetite, and weight loss. The clinical course in the alprazolam-treated patients revealed a marked exacerbation of symptoms during the end of the tapering period and the first week without medication, which was followed by improvement during the second post-taper week. In the long-term treatment study, 142 patients were treated with alprazolam for periods ranging from 5 months to 1 year (mean, 27.5 weeks). In this naturalistic study, 76% of the patients reported improvement, 6.3% reported no change, and 10.6% reported that they were worse. During discontinuation, 12.8% of the 128 patients whose dosage was tapered reported some kind of nonspecified withdrawal symptoms. Of the 142 patients, 47.2% were able to taper their medication dosage and to discontinue treatment; 19.7% tapered but restarted alprazolam shortly after discontinuation; 33.1% were unable or unwilling to taper or discontinue alprazolam.(ABSTRACT TRUNCATED AT 400 WORDS)

Agoraphobia↗
PubMed1999

Virtual network computing: cross-platform remote display and collaboration software.

VNC (Virtual Network Computing) is a computer program written to address the problem of cross-platform remote desktop/application display. VNC uses a client/server model in which an image of the desktop of the server is transmitted to the client and displayed. The client collects mouse and keyboard input from the user and transmits them back to the server. The VNC client and server can run on Windows 95/98/NT, MacOS, and Unix (including Linux) operating systems. VNC is multi-user on Unix machines (any number of servers can be run are unrelated to the primary display of the computer), while it is effectively single-user on Macintosh and Windows machines (only one server can be run, displaying the contents of the primary display of the server). The VNC servers can be configured to allow more than one client to connect at one time, effectively allowing collaboration through the shared desktop. I describe the function of VNC, provide details of installation, describe how it achieves its goal, and evaluate the use of VNC for molecular modelling. VNC is an extremely useful tool for collaboration, instruction, software development, and debugging of graphical programs with remote users.

Chemistry↗
PubMed1995

Cross-linguistic study of lateral misarticulation using electropalatography.

This paper reports on some preliminary aspects of a collaborative cross-linguistic study of normal and disordered Japanese and British English speech. The investigation compares lateralised productions of parallel s which are abnormal in the two languages. EPG and acoustic recordings were made of four Japanese and four British subjects. The EPG patterns were classified according to certain criteria, such as the presence or absence of complete constriction between the tongue and the hard palate, and the area and location of this contact. Findings revealed that lateralised articulations varied between individual speakers, but that Japanese and English productions were broadly similar. Acoustically, misarticulations in both languages were characterised by a lower frequency of peak energy than would be expected in normal productions.

Adolescent↗
PubMed2000

The governance and management of effective community health partnerships: a typology for research, policy, and practice.

Community health partnerships (CHPs) are voluntary collaborations of diverse community organizations that have joined forces in order to pursue a shared interest in improving community health. Although these cross-sectoral collaborations represent a way to address social determinants of health and disease in society, they suffer from governance and management problems associated with interorganizational relationships in general and health care challenges specifically. A typology of effective governance and management characteristics provides a systematic, theoretically based way of addressing dimensions of governance and management and serves as a guide in constructing, maintaining, and measuring successful partnerships. It offers a multidisciplinary perspective for classifying important organizational issues, identifying barriers to successful development and sustainability, and facilitating the attainment of goals.

Community Health Planning↗
PubMed1991

Transmission of human T-lymphotropic virus types I and II by blood transfusion. A retrospective study of recipients of blood components (1983 through 1988). The American Red Cross HTLV-I/II Collaborative Study Group.

We studied results of a "lookback" program involving laboratory testing and interviews of 133 recipients of prior donations from blood donors seropositive for human T-lymphotropic virus types I and II (HTLV-I/II) identified at 28 American Red Cross blood centers. The study was designed to explore the natural course of posttransfusion HTLV-I/II infection among individuals who received blood components from donors subsequently identified as being HTLV-I/II seropositive. Seventeen recipients were seropositive, an apparent transmission rate of 12.8%. Red blood cells and platelets were the implicated components, and red blood cells that were less than 6 days old had a transmission efficiency of 80%. Virus typing enabled documentation of primary and secondary transfusion transmission of HTLV-I and HTLV-II, including the direct transmission of HTLV-II by a donor with a history of intravenous drug use. We conclude that transfusion transmission of HTLV-I/II to approximately 700 recipients per year occurred in the United States before routine donor testing began in 1988.

Adolescent↗
PubMed1998

Improving the quality of decision-making in health care management: a project report from the Nevada/Bohemia health management education partnership.

Health care is a data-sensitive and data-rich industry. Designers of health administration curricula recognize that future health care providers and managers must be trained to use available analytical and database information technology (IT) to transform these data into information helpful to the decision-maker. However, as the data available to administrators and clinicians proliferates, additional skills are needed to select data that is pertinent and useful. This paper presents the results of the collaboration of partners from Bohemia and University of Nevada and focuses on three areas: threats to the effective use of data to support health care decision-making;. health care decision support research and training strategies; future cross-disciplinary collaboration in health care decision support. Advanced IT methods have the potential to assist clinical and managerial decision-making. If further discussion is stimulated about the introduction of advanced IT methods into the health care management curriculum and research agenda, this paper will achieve its goal.

Curriculum↗
PubMed2024

A research synthesis of humans, animals, and environmental compartments exposed to PFAS: A systematic evidence map and bibliometric analysis of secondary literature.

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are a class of widely used anthropogenic chemicals. Concerns regarding their persistence and potential adverse effects have led to multiple secondary research publications. Here, we aim to assess the resulting evidence base in the systematic secondary literature by examining research gaps, evaluating the quality of reviews, and exploring interdisciplinary connections. METHODS: This study employed a systematic evidence-mapping approach to assess the secondary literature on the biological, environmental, and medical aspects of exposure to 35 fluorinated compounds. The inclusion criteria encompassed systematic reviews published in peer-reviewed journals, pre-prints, and theses. Comprehensive searches across electronic databases and grey literature identified relevant reviews. Data extraction and synthesis involved mapping literature content and narrative descriptions. We employed a modified version of the AMSTAR2 checklist to evaluate the methodological rigour of the reviews. A bibliometric data analysis uncovered patterns and trends in the academic literature. A research protocol for this study was previously pre-registered (osf.io/2tpn8) and published (Vendl et al., Environment International 158 (2022) 106973). The database is freely accessible through the interactive and user-friendly web application of this systematic evidence map at https://hi-this-is-lorenzo.shinyapps.io/PFAS_SEM_Shiny_App/. RESULTS: Our map includes a total of 175 systematic reviews. Over the years, there has been a steady increase in the annual number of publications, with a notable surge in 2021. Most reviews focused on human exposure, whereas environmental and animal-related reviews were fewer and often lacked a rigorous systematic approach to literature search and screening. Review outcomes were predominantly associated with human health, particularly with reproductive and children's developmental health. Animal reviews primarily focused on studies conducted in controlled laboratory settings, and wildlife reviews were characterised by an over-representation of birds and fish species. Recent reviews increasingly incorporated quantitative synthesis methodologies. The methodological strengths of the reviews included detailed descriptions of study selection processes and disclosure of potential conflicts of interest. However, weaknesses were observed in the critical lack of detail in reporting methods. A bibliometric analysis revealed that the most productive authors collaborate within their own country, leading to limited and clustered international collaborations. CONCLUSIONS: In this overview of the available systematic secondary literature, we map literature content, assess reviews' methodological quality, highlight data gaps, and draw research network clusters. We aim to facilitate literature reviews, guide future research initiatives, and enhance opportunities for cross-country collaboration. Furthermore, we discuss how this systematic evidence map and its publicly available database benefit scientists, regulatory agencies, and other stakeholders by providing access to current systematic secondary literature on PFAS exposure.

Bibliometrics↗
PubMedDate not supplied

Partnerships for research among managed care organizations.

Researchers within health maintenance organizations (HMOs) need to create greater opportunities for collaborative research within their organizations. Multisite research will yield high-quality information for improving care. This paper describes situations in which competition as well as collaboration are possible across HMOs in the current environment. The paper considers the following questions: (1) What criteria determine if a project can be conducted as a multisite study; and (2) what population and organizational features should be considered when designing cross-site collaboration? The paper also discusses two important trends in the larger health care environment: cost containment, which is both a challenge and an opportunity for health services researchers working within managed care; and mergers and acquisitions, which are changing the face of the larger health care industry.

Cost Control↗
PubMed1998

A prospective view on European pharmaceutical research and development. Policy options to reduce fragmentation and increase competitiveness.

This article analyses 3 areas of policy that could reduce the fragmentation and improve the competitiveness of the European pharmaceutical sector. It argues that a potential solution to the issue of fragmentation of pharmaceutical research, development and innovation may be the development of policies at the European level, in those areas that European institutions have a competence. These areas may not necessarily rely exclusively on solving the issue of pricing and reimbursing pharmaceuticals as European Union (EU) Member States invoke the subsidiarity principle to claim policy exclusivity in this area. By contrast, policy areas where European institutions have a competence may include: i) a more intensified collaboration in science and technology policy (supporting the science base, identifying education needs for the future, collaborating in the development of new technologies and fostering university-industry collaboration); ii) support of research and development (R&D) by means of directly channelling funds into basic pharmaceutical research, avoiding duplication of the research effort, developing a set of research priorities, tackling the issue of technology transfer, promoting university-industry and cross-border collaborations or providing incentives that would induce private R&D activities in areas with large socioeconomic impact; and iii) an improvement in the environment for the financing of innovation in the EU, by means of selective use of tax policy at the national level (and where applicable, at the EU level), institutional reform in order to widen the pool of available funds for private investment, and the introduction of schemes that would encourage individuals and institutions to hold equity in innovative companies. The article identifies specific research, regulatory, medical and financing needs that require policy intervention, evaluates the possible dynamic implications of such interventions and highlights the benefits that may accrue from their implementation.

Drug Approval↗
PubMed1983

The WHO collaborative study on strategies for extending mental health care, II: The development of new research methods.

Teams in seven developing countries under sponsorship of the World Health Organization have been carrying out collaborative operational research on providing mental health care through primary health care services. New techniques of identifying mental disorders in children and adults have been developed and tested. Methods of assessing the skills and attitudes of health workers toward mental health work and of gauging community attitudes toward mental illness have also been developed. Results have been directly applied in planning better mental health care. The authors conclude that cross-cultural collaborative research is effective in improving mental health care for those in greatest need.

Attitude of Health Personnel↗