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PubMedDate not supplied

Exploring help-seeking for ADHD symptoms: a mixed-methods approach.

OBJECTIVE: Gender and race differences in treatment rates for attention-deficit/hyperactivity disorder (ADHD) are well documented but poorly understood. Using a mixed-methods approach, this study examines parental help-seeking steps for elementary school students at high risk for ADHD. METHODS: Parents of 259 students (male/female, African American/Caucasian) identified as being at high risk for ADHD completed diagnostic interviews and provided detailed accounts of help-seeking activities since they first became concerned about their child. Help-seeking steps (n=1,590) were analyzed using two methods: inductive analysis based on grounded theory, and deductive quantitative analysis of coded data derived from application of the network-episode model, merged subsequently with demographic and other characteristics. RESULTS: The inductive analysis revealed unique parental perceptions of their children's sick role and of the agents of identification and intervention for each of the four groups. Deductive analysis showed significant variations by race and gender in consultation experiences, in the person or entity being consulted and in the transactions occurring in the consultation, and in illness careers. CONCLUSION: ADHD symptoms are interpreted as having different implications for the sick role and the intervention, dependent on a child's gender and race. Educational interventions need to address cultural stereotypes contributing to inequitable access to treatment.

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

Shyness-environment interaction: a view from the shy side through auto-photography.

It is proposed that shyness both induces and is induced by the perception of the environment. This study of person-situation transaction used photographic images taken by shy and less shy subjects in response to the question, "Who are you?" A content analysis of the photographs showed that shy persons were less person-oriented, more aesthetically oriented, and showed a reduced range of orientations when compared to less shy persons. The hierarchy of orientations for shy persons was aesthetic, people, self, and school; whereas for less shy persons it was people, self, aesthetic, and other persons. Thus, the difference between shy and less shy persons is in the pattern of orientations rather than in orientations in and of themselves. Moreover, one single difference between the groups, such as the lesser orientation toward people, does not justify the interpretation of shyness as a "people phobia."

Adult↗
PubMed1997

Kinetic study of irreversible inhibition of an enzyme consumed in the reaction it catalyses. Application to the inhibition of the puromycin reaction by spiramycin and hydroxylamine.

A systematic procedure for the kinetic study of irreversible inhibition when the enzyme is consumed in the reaction which it catalyses, has been developed and analysed. Whereas in most reactions the enzymes are regenerated after each catalytic event and serve as reusable transacting effectors, in the consumed enzymes each catalytic center participates only once and there is no enzyme turnover. A systematic kinetic analysis of irreversible inhibition of these enzyme reactions is presented. Based on the algebraic criteria proposed in this work, it should be possible to evaluate either the mechanism of inhibition (complexing or non-complexing), or the type of inhibition (competitive, non-competitive, uncompetitive, mixed non-competitive). In addition, all kinetic constants involved in each case could be calculated. An experimental application of this analysis is also presented, concerning peptide bond formation in vitro. Using the puromycin reaction, which is a model reaction for the study of peptide bond formation in vitro and which follows the same kinetic law as the enzymes under study, we have found that: (i) the antibiotic spiramycin inhibits the puromycin reaction as a competitive irreversible inhibitor in a one step mechanism with an association rate constant equal to 1.3 x 10(4) M-1 s-1 and, (ii) hydroxylamine inhibits the same reaction as an irreversible non-competitive inhibitor also in a one step mechanism with a rate constant equal to 1.6 x 10(-3) M-1 s-1.

Acyltransferases↗
PubMed1989

A non-deletion hereditary persistence of fetal hemoglobin (HPFH) determinant not linked to the beta-globin gene complex.

We describe an Asian Indian family with a non-deletion form of hereditary persistence of fetal hemoglobin (HPFH) and beta zero thalassemia. The propositus who has homozygous beta zero thalassemia has an unusually mild form of the disease which is ascribed to the co-inheritance of HPFH. The interaction of HPFH and beta thalassemia was studied in five generations of this family. Linkage analysis showed that the genetic determinant for the HPFH segregates independently from the gamma delta beta globin gene complex. Analysis of HPFH linkage to a panel of genetic markers in such a large family offers the possibility of defining a transacting locus (or loci) involved in the expression of the gamma globin gene.

Adolescent↗
PubMedDate not supplied

Evaluation of pharmacist-managed nonprescription drug benefit for Canadian military personnel.

OBJECTIVES: To determine whether (1) desirable health outcomes (e.g., symptom resolution) would be achieved with a new national drug-management program implemented by the Canadian Forces (CF); (2) CF members would be satisfied with the services offered by the civilian pharmacists; and (3) cost implications of the new program would be favorable. DESIGN: Open, nonrandomized, longitudinal program evaluation and cost analysis study. SETTING: Canada. PARTICIPANTS: 583 CF members who did not have access to a military pharmacy in selected geographic areas of Canada and 65 community pharmacy providers. INTERVENTION: A new drug-management program, which allowed members to obtain nonprescription medications from civilian pharmacies without first obtaining a prescription from a physician at no additional cost, was evaluated in a pilot study. MAIN OUTCOME MEASURES: A cost-analysis model conducted from the CF Health Services and Department of National Defense perspectives and telephone survey assessing health outcomes and members' satisfaction with the program. RESULTS: Based on 563 transactions that occurred during the pilot study period, 96% of the CF members reported being very to somewhat satisfied with the service received under the new drug-management program, and a majority stated that desirable health outcomes were achieved. The one area of concern cited about the new program was the low percentage of members who recalled being instructed by civilian pharmacists to see a physician if their symptoms did not abate. The cost analysis showed the new program was more economical than previous physician-based system. CONCLUSION: The provision of nonprescription medications by civilian pharmacists to members who had no access to a base pharmacy was both cost-efficient and associated with a high level of satisfaction. Future evaluations should include prospective monitoring of drug use patterns as well as assessments of the quality of care.

Affective Symptoms↗
PubMed1997

Transected thoracic aorta: age-specific differences in incidence and possible reasons.

The objective of this study was to determine the incidence of aortic transaction in relation to age, and to examine possible reasons for the observed differences. Data from the North Carolina Medical Database over a 7-year period were examined for the total number of motor vehicle accident victims and for the subset with aortic rupture, based on age at presentation. Data were then divided into 10-year intervals and the differences analyzed using chi-square analysis. Differences among various age groups were statistically significant (P = 0.0001). The highest rate was in the 21-30-year-old age group and average incidence for all ages was 0.7%. High incidence of aortic transaction in the 21-30-year-old group may be due to an increase in high-risk behaviors in such persons, to an improved survival compared with other age ranges, or to an inherent susceptibility of the aorta at this stage of life. These data have important implications for the diagnosis and treatment of aortic transaction and should be taken into account when developing practice guidelines for its management.

Accidents, Traffic↗
PubMed2004

PratA, a periplasmic tetratricopeptide repeat protein involved in biogenesis of photosystem II in Synechocystis sp. PCC 6803.

The light reactions of oxygenic photosynthesis are mediated by multisubunit pigment-protein complexes situated within the specialized thylakoid membrane system. The biogenesis of these complexes is regulated by transacting factors that affect the expression of the respective subunit genes and/or the assembly of their products. Here we report on the analysis of the PratA gene from the cyanobacterium Synechocystis sp. PCC 6803 that encodes a periplasmic tetratricopeptide repeat protein of formerly unknown function. Targeted inactivation of PratA resulted in drastically reduced photosystem II (PSII) content. Protein pulse labeling experiments of PSII subunits indicated that the C-terminal processing of the precursor of the reaction center protein D1 is compromised in the pratA mutant. Moreover, a direct interaction of PratA and precursor D1 was demonstrated by applying yeast two-hybrid analyses. This suggests that PratA represents a factor facilitating D1 maturation via the endoprotease CtpA. The periplasmic localization of PratA supports a model that predicts the initial steps of PSII biogenesis to occur at the plasma membrane of cyanobacterial cells.

Amino Acid Motifs↗
PubMed1989

Combined immunodeficiency with defective expression in MHC class II genes.

MHC class II deficiency is an inherited immunodeficiency disease characterized by the presence of a normal number of T and B lymphocytes and profound anomaly of cellular and humoral responses to foreign antigens. All bone-marrow-derived cells (including B lymphocytes, monocytes and activated T lymphocytes) and also enterocytes and endothelial cells do not express all HLA class II (DR, DQ and DP) molecules on their membrane. It is known that the proper recognition of foreign antigens depends on their presentation, together with HLA class II molecules, on the membrane of antigen-presenting cells. MHC class II deficient combined immunodeficiency confirms the important role of MHC gene products in immune-defence mechanisms. Patients suffer from repeated and severe infections that are frequently the cause of death. The defect in HLA class II expression is the consequence of a lack of synthesis of HLA class II alpha and beta chains in patients' cells. Studies performed at DNA and RNA levels showed that there was no gross abnormality of MHC class II genes and that mRNA for all HLA molecules was not detected in patients' cells. These results, together with segregation studies performed in several families, suggested that the defect in HLA class II gene expression involves a transacting regulatory factor. Direct transcription assays showed that the disease is characterized by an absence of HLA class II gene transcription. An analysis of the specific binding of nuclear proteins from patients' cell lines to HLA class II promotor showed that a specific protein, RF-X, which normally binds to a regulatory sequence common to HLA class II promotors, is affected in MHC class II combined immunodeficiency.

Gene Expression Regulation↗
PubMed1993

Analysis of the c-FOS gene on chromosome 14 and the promoter of the amyloid precursor protein gene in familial Alzheimer's disease.

The c-FOS gene product, a putative transacting transcriptional regulator of the amyloid precursor protein (APP) gene, is a candidate locus for the familial Alzheimer's disease (FAD) mutation on chromosome 14 (FAD14). In light of this functional relationship, we investigated the nucleotide sequence and segregation of c-FOS and the nucleotide sequence of the 5' APP promoter. Single-stranded conformational polymorphisms (SSCPs) in the c-FOS gene revealed that c-FOS closely cosegregates with the FAD14 gene but does not show allelic association with FAD. A conservative third-position T-->C mutation was demonstrated in exon 2 (codon 84) of c-FOS, and a C-->G substitution was detected at -209 bp in the 5' promoter of APP. Neither were unique to FAD and are unlikely to be pathogenic or secondary modifiers of the FAD phenotype. We conclude that the c-FOS open reading frame is probably not the site of the FAD14 locus, but we cannot exclude the existence of modifier loci on chromosome 21.

Adult↗
PubMed2006

cis-regulatory region analysis using BEARR.

Genome-wide studies are fast becoming the norm, partly fueled by the availability of genome sequences and the feasibility of high-throughput experimental platforms, e.g., microarrays. An important aspect in any genome-wide studies is determination of regulatory relationships, believed to be primarily transacted through transcription factor binding to DNA. Identification of specific transcription factor binding sites in the cis-regulatory regions of genes makes it possible to list direct targets of transcription factors, model transcriptional regulatory networks, and mine other associated datasets for relevant targets for experimental and clinical manipulation. We have developed a web-based tool to assist biologists in efficiently carrying out the analysis of genes from studies of specific transcription factors or otherwise. The batch extraction and analysis of cis-regulatory regions (BEARR) facilitates identification, extraction, and analysis of regulatory regions from the large amount of data that is typically generated in genome-wide studies. This chapter highlights features and serves as a tutorial for using this publicly available software. The URL is http://giscompute.gis.a-star.edu.sg/~vega/BEARR1.0/.

Binding Sites↗
PubMed1991

[Community intervention during economic disasters].

A political conflict forced banks to close down in Panama during March 1988. Thus, thousand of families were unable to meet their most basic needs during that lapse of time. This paper describes a community intervention program that was set up in the midst of such an economic disaster. That program emphasized mental health consultation techniques to help devising an effective organizational action as well as developing standards to determine needs, and a clear-cut two-way communication with the affected families. The incidence of emotional disorder was assessed with the Self Report Questionnaire, and crisis intervention was offered to any people who should apply for it. Cognitive responses, coping behaviors, and social supports were also assessed. Results showed that those individuals excluded from a full participation in their culture were much more likely to develop emotional disorders. Finding that affected people showed a scarce self-help behavior was interpreted as a feature of the transcultural transaction between affected people, and professionals.

Adaptation, Psychological↗
PubMed1990

[Structural analysis of social behavior in training and research. A contribution to the "functional histology" of the psychotherapy process].

To be able to identify qualitative differences in the results of psychotherapeutic activity and to establish a relationship between those results and the particularities of the treatment process involved, the problems of the patient, the relevant events during therapy, and therapeutic results must be interrelatable both terminologically and theoretically (P-T-O congruence; Strupp et al., 1989). If, therefore, the relevant qualities of the relationships involved in interpersonal transactions during the therapeutic process are to be represented adequately and independently of schools, an appropriate instrument is required for both clinical and research use. This instrument is introduced here in the form of the Structural Analysis of Social Behavior (SASB) after Lorna Smith Benjamin by means of the key question: Who acts how toward whom and how does the latter react to this?

Follow-Up Studies↗
PubMed1994

Transcultural nursing ethics: a framework and model for transcultural ethical analysis.

Increased awareness of cultural diversity in contemporary society and nursing mandates the need for transcultural nursing ethics. The core of this ethics assumes that all discourse and interaction is transcultural because of strengths and differences in values and beliefs of individuals and groups within global society. Transcultural ethics addresses how people ought to live when subjectively sharing a common world. This article presents a framework and model with four parts: Transcultural Caring Dynamics, Principles, Transcultural Context, and Universal Source. These incorporate the ethics of virtue, principle, values, and belief, respectively. Interactive parts of the holistic process provide the foundation for assessing and analyzing transactions to facilitate understanding and direction toward culturally based ethical decision making.

Beneficence↗
PubMedDate not supplied

Leadership styles across hierarchical levels in nursing departments.

BACKGROUND: Some researchers have reported on the cascading effect of transformational leadership across hierarchical levels. One study examined this effect in nursing, but it was limited to a single hospital. OBJECTIVES: To examine the cascading effect of leadership styles across hierarchical levels in a sample of nursing departments and to investigate the effect of hierarchical level on the relationships between leadership styles and various work outcomes. METHODS: Based on a sample of eight hospitals, the cascading effect was tested using correlation analysis. The main sources of variation among leadership scores were determined with analyses of variance (ANOVA), and the interaction effect of hierarchical level and leadership styles on criterion variables was tested with moderated regression analysis. RESULTS: No support was found for a cascading effect of leadership across hierarchical levels. Rather, the variation of leadership scores was explained primarily by the organizational context. Transformational leadership had a stronger impact on criterion variables than transactional leadership. Interaction effects between leadership styles and hierarchical level were observed only for perceived unit effectiveness. CONCLUSIONS: The hospital's structure and culture are major determinants of leadership styles.

Adult↗
PubMed2003

Positive, accurate animal identification.

Positive, accurate identification of animals and their products would be very helpful in livestock commerce, prevention of theft and fraud and in tracing animals and products to origin. Food safety, animal health, and prevention of epidemics, would be enhanced by combining identification with location. Identification may be by electronic chips, iris or retinal scans, antibody or DNA analysis. A cross listing of one or more means in a central repository would facilitate tracing origin of animals and build confidence in transactions of all kinds.

Animal Identification Systems↗
PubMed2006

The Rc and Rd genes are involved in proanthocyanidin synthesis in rice pericarp.

Different colors, such as purple, brown, red and white, occur in the pericarp of rice. Here, two genes affecting proanthocyanidin synthesis in red- and brown-colored rice were elucidated. Genetic segregation analysis suggested that the Rd and A loci are identical, and both encode dihydroflavonol-4-reductase (DFR). The introduction of the DFR gene into an Rcrd mutant resulted in red-colored rice, which was brown in the original mutant, demonstrating that the Rd locus encodes the DFR protein. Accumulation of proanthocyanidins was observed in the transformants by the introduction of the Rd gene into the rice Rcrd line. Protein blot analysis showed that the DFR gene was translated in seeds with alternative translation initiation. A search for the Rc gene, which encodes a transacting regulatory factor, was conducted using available DNA markers and the Rice Genome Automated Annotation System program. Three candidate genes were identified and cloned from a rice RcRd line and subsequently introduced into a rice rcrd line. Brown-colored seeds were obtained from transgenic plants by the introduction of a gene containing the basic helix-loop-helix (bHLH) motif, demonstrating that the Rc gene encodes a bHLH protein. Comparison of the Rc locus among rice accessions showed that a 14-bp deletion occurred only in the rc locus.

Amino Acid Sequence↗
PubMed1997

Diagnostic certainty and hospital resource use.

OBJECTIVE: To determine whether the house staff's subjective probability estimates of their initial admitting diagnoses are independent predictors of in-hospital resource consumption. DESIGN: Descriptive correlational study. SETTING: Academic medical center inpatient setting. PATIENTS: Patients admitted to general medicine wards. MEASUREMENTS: A visual analog scale with hash marks at 0, 25, 50, 75 and 100 was used to obtain a subjective probability estimate that the house staff's initial admitting diagnosis was a correct diagnosis. This provided the measure of diagnostic "certainty" at the time of admission. Patient demographic data, prior hospital stays, distance from hospital, MedisGroups scores, outlier status and vital status at discharge were obtained from administrative systems. Length of stay, total charges, cost estimates (total departmental), and number of consultations were obtained from the hospital-based transaction master database. RESULTS: House staff evaluated 1,778 admissions, 77.2% were assigned a diagnostic certainty rating of 75% or higher. In univariate analysis, the certainty rating did not vary with the MedisGroups score, outlier status or vital status at discharge. It varied with prior stays and measures of resource use. In multivariate analysis, the certainty rating was a significant factor accounting for variation in each of the measures of resource utilization with the exception of adjusted pharmacy charges. CONCLUSIONS: Even in a teaching hospital only a small proportion of patients had an "uncertain" diagnosis (22.8%). Nonetheless, the certainty variables were significantly related to measures of resource consumption including length of stay, total costs and number of consults obtained.

Adult↗
PubMed1995

Information systems analysis approach in hospitals: a national survey.

A survey of 216 hospitals reveals that some hospitals do not conduct cost-benefit analyses or analyze possible adverse effects in feasibility studies. In determining and analyzing system requirements, external factors that initiate the transaction are not examined, and computer-aided software engineering (CASE) tools are seldom used. Some hospitals do not investigate the advantages and disadvantages of using in-house-developed software versus purchased software packages in the evaluation of alternatives. The survey finds that, overall, most hospitals follow the traditional systems development life cycle (SDLC) approach in analyzing information systems.

Cost-Benefit Analysis↗