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Mutants of Arabidopsis reveal many roles for membrane lipids.

Polyunsaturated acyl lipids constitute approximately 50% of the hydrophobic membrane barriers that delineate the compartments of cells. The composition of these lipids is critically important for many membrane functions and, thus, for proper growth and development of all living organisms. In the model plant Arabidopsis, the isolation of mutants with altered lipid compositions has facilitated biochemical and molecular approaches to understanding lipid metabolism and membrane biogenesis. Just as importantly, the availability of a series of plant lines with specific changes in membrane lipids have provided a new resource to study the structural and adaptive roles of lipids. Now, the sequencing of the Arabidopsis genome, and the development of reverse-genetics approaches provide the tools needed to make additional discoveries about the relationships between lipid structure and membrane function in plant cells.

Arabidopsis↗

Caring for caregivers: experiences and evaluation of interventions for a palliative care team.

Palliative care is a fairly recent development in The Netherlands. The first palliative unit in a hospital setting was the Palliative Care Unit (PCU) in the Dr Daniel den Hoed Clinic, a specialized oncology hospital, now part of the Academic Hospital Rotterdam (AZR-Daniel). This PCU was designed to function as an academic laboratory, where palliative care concepts are being developed, put into practice, and evaluated. It's mission was to put the patient first in mind, heart and soul. Right from the start, special attention was paid to the implementation a system of 'care for caregivers' in order to support the staff of the PCU in caring for the terminally ill and to prevent burnout. A process evaluation has been carried out with a special focus on the effects of the implementation of the new unit on the wellbeing of the interdisciplinary team of caregivers during the first year of its existence and on the experiences with a residential training preceding the start of patient care activities and the weekly staff support meetings. In the second half of the first year, the PCU staff experienced increased levels of job-related stress. Most stress was attributed to organizational factors, related to management issues but also to lack of institutional support. Teamwork also contributed to stress within the interdisciplinary team. Direct patient care activities also had some impact on experienced stress levels, through a heavy work-load of complex care, a shortage of staff and an experienced lack of competence. While the staff support activities were designed to give emotional support and deal with death and bereavement, these issues did not arise as major problems. As a consequence, the staff support in the PCU was perhaps less successful than it could have been. However, the high stress levels of this innovative palliative team warrant attention. We discuss how support meetings could be a more effective way of caring for staff. They should be accompanied by adequate resources, a supportive management structure, and an extensive educational program.

Adult↗

Women in Arab countries: challenging the patriarchal system?

Progress in the empowerment of Arab women was found to be low in a 2002 report. Yet Arab women's status is not reflected in continuing high fertility, which in 2000 had dropped sharply in one generation to 3.4. This paper discusses why fertility decline could nevertheless have taken place in the Arab countries. Islam has not stood in the way of fertility decline, as Iran and Algeria show. From the mid- 1970s to 1980s, subsidised consumption through oil wealth redistribution reduced the cost of children, and social conservatism kept married women out of the labour force, both of which promoted higher fertility. The early stages of fertility decline were mainly due to longer length of education of girls, rising female age at first marriage, e.g. 28 in urban Morocco and 29 in Libya, and entry into the labour force of young, single women. There is also a growing population sub-group of never-married young women. Collapsing oil prices and structural adjustment reduced household resources and became an effective fertility regulation factor. Girls born since the 1950s have not only been educated longer than their mothers, but also their fathers, which increases their authority. These factors, and women's activism and civil and political lobbying for the reform of personal status now underway in a number of Arab countries, could all challenge the patriarchal system.

Adult↗

Soluble expression in Escherichia coli, purification and characterization of a human TF-1 cell apoptosis-related protein TFAR19.

A novel human TF-1 cell apoptosis-related protein, TFAR19, cloned from a human leukemia cell line, TF-1, was first overexpressed in Escherichia coli with the sequence Met-Gly-His(6)-Gly-Thr-Asn-Gly, a hexahistidine sequence followed by a hydroxylamine cleavage site attached to its amino terminus. The resulting protein was soluble and single-step purified to homogeneity by metal chelating affinity chromatography. After cleavage of the purified His(6)-tagged TFAR19 sample with hydroxylamine, highly purified untagged TFAR19 protein was then obtained through an FPLC Resource Q column. The structural characteristics and function of the His(6)-tagged and untagged TFAR19 proteins were studied using circular dichroism, intrinsic fluorescence, and ANS-binding fluorescence spectra and apoptosis activity assay. The results show that alpha-helix is the main secondary structure of the proteins and the two forms of TFAR19 protein fold properly, which correspond well to their apoptosis activity expression. The results also indicate that the extra sequence including the His(6)-tag fused to the N-terminus of TFAR19 protein has a minimal effect on its structure and function, suggesting that the His(6)-tagged TFAR19 protein could be further used as an immobilized target for finding potential proteins which interact with TFAR19 from a cDNA library using in vitro ribosome display technique.

Amino Acid Sequence↗

Metalloantimalarials: targeting of P. falciparum strains with novel iron(III) and gallium(III) complexes of an amine phenol ligand.

Emergence of chloroquine (CQ)-resistant Plasmodium falciparum strains necessitates discovery of potent and inexpensive antimalarial drugs. The high cost of new drugs negatively impacts their access and distribution in the regions of the world with scarce economic resources. While exploring structure-activity relationships, using gallium(III) as a surrogate marker for iron(III), we found cationic, and moderately hydrophobic, compounds, [[1,12-bis(2-hydroxy-3-ethyl-benzyl)-1,5,8,12-tetraazadodecane]metal(III)](+) (metal = Fe(III) and Ga(III); [Fe-3-Eadd](+), 3; [Ga-3-Eadd](+), 4), that possessed antimalarial activity. Crystal structure analyses revealed octahedral geometry for these complexes. The RP-HPLC analysis, after incubation in PBS or HEPES buffer (pH 7.4) at 37 degrees C for 3 days, detected only parental compounds thereby providing evidence for stability under physiological conditions. Both 3 and 4 demonstrated promising half-maximum inhibitory concentration (IC(50)) values of approximately 80 and 86 nM in the CQ-sensitive HB-3 line, respectively. However, both 3 and 4 were found to possess elevated IC(50) values of 2.5 and 0.8 microM, respectively, in the CQ-resistant Dd2 line, thus displaying preferential cytotoxicity toward the CQ-sensitive HB3 line. In cultured parasites, 3 and 4 targeted hemozoin formation. Thus, these compounds acted similarly to chloroquine with regard to action and resistance, despite the lack of structural similarity to quinolines. Finally, similarity in coordination chemistry, stability, and antimalarial cytotoxicity profiles indicated that gallium(III) ion can serve as a template for iron(III) in structure elucidation of active molecules in solution.

Amines↗

Client as colleague. Therapeutic contracting with the seriously mentally ill.

This article introduces the therapeutic contracting program as a comprehensive treatment system for persons with serious mental illness. Therapeutic contracting offers a promising framework for integrating medical, psychological, and social therapies in a manner that fosters clients' active involvement in treatment. This article outlines a multistage therapy program that mobilizes clients' adaptational resources through experimental interventions, structured goal-setting exercises, and skills-building experiences. Data illustrate the effectiveness of therapeutic contracting for (a) securing clients' treatment compliance, (b) promoting positive clinical outcomes, (c) reducing overall treatment costs. The therapeutic contracting model is discussed as a potential vehicle for expanding the professional role of psychologists in psychiatric settings, particularly in areas of clinical and administrative decision making.

Chronic Disease↗

One year's experience with a clinical skills resource centre.

OBJECTIVES: To describe our experience of teaching clinical skills to first-year medical students in a new problem-based curriculum. DESIGN: Prospective evaluation of clinical skills acquisition using objective measures. SETTING: Students were taught in a purpose-designed clinical skills resource centre in weekly structured sessions. SUBJECTS: All 210 first year medical undergraduates in the first year of a new problem-based and clinically oriented course. RESULTS: Student performance in structured objective examinations improved over 1 year. In all but one of nine matched stations, involving history, examination and procedural skills, improvements were significant. Ninety-three per cent thought that the appropriateness of the skills training course to other course elements was 'good' or 'very good'. CONCLUSIONS: First-year medical students can learn a wide range of clinical skills. Integrated teaching of clinical skills improves satisfaction with undergraduate studies.

Clinical Competence↗

Inhibiting bacterial fatty acid synthesis.

The type II fatty acid synthase consists of a series of individual enzymes, each encoded by a separate gene, that catalyze discrete steps in chain elongation. The formation of fatty acids is vital to bacteria, and each of the essential enzymes and their acyl group carriers represent a potential target for the development of novel antibacterial therapeutics. High resolution x-ray and/or NMR structures of representative members of every enzyme in the type II pathway are now available, and these structures are a valuable resource to guide antibacterial drug discovery. The role of each enzyme in regulating pathway activity and the diversity in the components of the pathway in the major human pathogens are important considerations in deciding the most suitable targets for future drug development.

Acetyltransferases↗

A comparative study of referral patterns and management of patients with malignant brain tumours in Birmingham, UK, and Toronto, Canada.

The management of malignant brain tumours comprises a huge financial burden to any health care system. The referral pattern and initial management of this condition has not been widely investigated. Our main aim was to investigate and compare the referral patterns between two tertiary referral centres in Birmingham, UK, and Toronto, Canada, which have similar health care provision structures, but different financial resources, in order to examine whether there are any significant delays in the pathway of either system. The investigation consisted of a retrospective analysis of case records of patients identified as having malignant brain tumours who had been operated on at the two centres during the period 1997-1998. Data were collected on patient demographics, symptomatology at presentation, referral pattern, and time intervals between presentation, investigations, neurosurgical consultation and operation. Mann-Whitney U-tests of statistical significance were used to compare the two centres. Sixty-eight and 100 patients in Birmingham and Toronto, respectively, were identified from the registers following exclusion of patients with benign or low-grade tumours. Both centres were found to be similar with respect to sociodemographic factors of patients with malignant brain tumours. Referral patterns were analysed for presenting symptoms of neurological deficit and seizure, and found to be similar for both centres. Time intervals from presentation to investigation and from investigation to neurosurgical consultation were not significantly different between the two centres. Significant differences were found from neurosurgical consultation to operation (Birmingham, 3 days, and Toronto, 6 days, p = 0.006), and the duration of stay in hospital (Birmingham, 11 days, and Toronto, 2 days, p < 0.001). Although there are differences in the financial resources of the two tertiary centres our study reveals no significant differences in the referral pathway to operation.

Adult↗

Perceptions of African American faculty in kinesiology-based programs at predominantly White American institutions of higher education.

The purpose of this study was to examine the perceptions of African American faculty on their organizational socialization in kinesiology-based (i.e., sport pedagogy, exercise physiology, motor behavior, sport management/history) programs at predominantly White American institutions of higher education (PW-IHE). Participants were 9 African American tenure-track faculty members from various kinesiology-based programs at PW-IHE. Data were gathered via interviewing and analyzed within the framework of critical race theory (Ladson-Billings, 2000). Findings are presented using storytelling and thematic narratives. Interviews with the participants revealed four major recurring themes with regard to: (a) resources, opportunities, and power structures; (b) programmatic neglects and faculty mentoring needs; (c) social isolation, disengagement, and intellectual inferiority issues; and (d) double standards, marginalization, and scholarship biases. This study suggests that faculty and administrators at PW-IHE should develop sensitivity toward organizational socialization issues relevant to faculty of color.

Black or African American↗

Genetic disorders in a paediatric hospital in Cambodia.

Cambodia is an extremely underdeveloped country in Southeast Asia with a childhood mortality rate of 105/1000 live births. Angkor Hospital for Children is a paediatric teaching hospital in Siem Reap, northwest Cambodia, which serves as the provincial paediatric department but also sees children from provinces throughout northern Cambodia, and with training provided for health workers from all parts of the country. The impact of genetic disease on this paediatric population is discussed, addressing the areas of haematology (including thalassaemia and other haemoglobinopathies, glucose-6-phosphate deficiency and bleeding disorders), multifactorial disorders (cleft palate, congenital heart disease and neural tube defects), and uncommon genetic disorders and chromosomal syndromes. In the future, as low-income countries develop and their burden of infectious disease begins to subside, the contribution of these disorders to paediatric morbidity and mortality will become increasingly apparent. This transition needs to be considered in the allocation of health resources and in the structuring of undergraduate and postgraduate medical education.

Blood Coagulation Disorders, Inherited↗

Process evaluation of an on-site water testing program in remote Aboriginal communities in Western Australia.

A unique public health intervention introduced on-site water test kits into 19 communities in Western Australia in order to improve the frequency of water testing in remote Aboriginal communities. Resources, training and support were provided by the Health Department of Western Australia to enable the communities to conduct fortnightly water testing over a 12-month period. This study assesses how effective and appropriate the training and support strategies were, and the extent of acceptance of the program by the community 'water samplers'. A written survey of the participants (community water samplers), enabled their knowledge of the principles and the application of the test regime, and their satisfaction with both the training strategies and the resources to be evaluated. A structured phone survey was conducted mid-trial to re-assess participant knowledge, to ascertain the use of training resources and to identify barriers to regular testing. Details of the support that was provided, was documented systematically during the trial by the Health Department. The participants were satisfied with the format and content of the training workshops. Support services documentation disclosed that contact with the participants throughout the trial was limited. The acceptance of the program by the water samplers varied. Those who participated in the trial expressed the need for more feedback and support. A major reason for not participating in the trial was due to the water sampler leaving the community. The specific outcomes of the program and directions for future programs are discussed.

Adult↗

Sense of coherence and its determinants: a comparative study of the Finnish-speaking majority and the Swedish-speaking minority in Finland.

BACKGROUND: Despite similar living conditions among the Finnish-speaking majority and the Swedish-speaking minority in Finland, the latter is a more advantaged group e.g. in terms of socioeconomic status and health. This study investigated (1) the level of sense of coherence (SOC), (2) the structure of generalized resistance resources (GRRs), and (3) associations of GRRs with SOC among Finnish- and Swedish-speaking Finns. METHODS: The data derived from the Health and Social Support (HeSSup) Study. The sample comprised 22,937 Finnish men and women aged 20-54, including an additional sample from the Swedish-speaking population (n = 2,967). The response rate was 40%. Ordinary regression analysis was used. RESULTS: Swedish-speaking women scored 0.9 (p = 0.005) and men 0.6 (p = 0.05) points higher on SOC scale compared with Finnish-speaking respondents. The minor difference in the SOC level between the language groups was explained by Finnish speakers' worse psychosocial living conditions in childhood and working conditions in adulthood. Only one interaction was found: parents' divorce during childhood was associated with a significant decrease of SOC scores only for Finnish speakers. Otherwise the same GRRs had similar effects on both Finnish- and Swedish-speaking men's and women's SOC. CONCLUSION: The only key difference between Finnish- and Swedish-speaking Finns concerned the unequal distribution of GRRs. An increase in GRRs among Finnish speakers would probably strengthen their SOC. However, the slightly stronger level of SOC among Swedish-speaking compared with Finnish-speaking Finns is unlikely to explain the possible differences in well-being between the two language groups.

Adult↗

Theory of network planning for laboratory research and development.

Critical Path Method (CPM) and Program Evaluation and Review Technique (PERT) are quantitative network planning strategies that facilitate management of projects with many interrelated activities. They determine the minimum time necessary to complete a project and identify which activities are critical to achieving the minimum. PERT also incorporates probabilistic estimates of activity durations. This statistical approach is useful when planning a project entailing some uncertainty and allows one to calculate chances of finishing on time. CPM and PERT encourage participation of all key personnel in the planning process, effective fit between project variables and organizational structure, and optimization of resource allocation. Availability of several levels of sophistication make network planning flexible enough to be applied easily in laboratory research and development. Iterative refinement of network plans and time estimates in progressive steps of involvement with clinical colleagues augments the effectiveness of these technics in hospital settings.

Laboratories↗

IMGT, the international ImMunoGeneTics database.

The international ImMunoGeneTics database (IMGT) (http://imgt.cines.fr), is a high quality integrated information system specializing in Immunoglobulins (IG), T cell Receptors (TR) and Major Histocompatibility Complex (MHC) of human and other vertebrates, created in 1989, by the Laboratoire d'ImmunoGénétique Moléculaire (LIGM), at the Université Montpellier II, CNRS, Montpellier, France. IMGT provides a common access to standardized data which include nucleotide and protein sequences, oligonucleotide primers, gene maps, genetic polymorphisms, specificities, 2D and 3D structures. IMGT includes three sequence databases (IMGT/LIGM-DB, IMGT/MHC-DB, IMGT/PRIMER-DB), one genome database (IMGT/GENE-DB) with different interfaces (IMGT/GeneSearch, IMGT/GeneView, IMGT/LocusView), one 3D structure database (IMGT/3Dstructure-DB), Web resources comprising 8000 HTML pages ('IMGT Marie-Paule page') and interactive tools for sequence analysis (IMGT/V-QUEST, IMGT/JunctionAnalysis, IMGT/Allele-Align, IMGT/PhyloGene). IMGT data are expertly annotated according to the rules of the IMGT Scientific chart, based on IMGT-ONTOLOGY. IMGT tools are particularly useful for the analysis of the IG and TR repertoires in physiological normal and pathological situations. IMGT has important applications in medical research (autoimmune diseases, AIDS, leukemias, lymphomas, myelomas), biotechnology related to antibody engineering (phage displays, combinatorial libraries) and thera-peutic approaches (graft, immunotherapy). IMGT is freely available at http://imgt.cines.fr.

Animals↗

The Catalytic Site Atlas: a resource of catalytic sites and residues identified in enzymes using structural data.

The Catalytic Site Atlas (CSA) provides catalytic residue annotation for enzymes in the Protein Data Bank. It is available online at http://www.ebi.ac.uk/thornton-srv/databases/CSA. The database consists of two types of annotated site: an original hand-annotated set containing information extracted from the primary literature, using defined criteria to assign catalytic residues, and an additional homologous set, containing annotations inferred by PSI-BLAST and sequence alignment to one of the original set. The CSA can be queried via Swiss-Prot identifier and EC number, as well as by PDB code. CSA Version 1.0 contains 177 original hand- annotated entries and 2608 homologous entries, and covers approximately 30% of all EC numbers found in PDB. The CSA will be updated on a monthly basis to include homologous sites found in new PDBs, and new hand-annotated enzymes as and when their annotation is completed.

Animals↗

Prosthetic feet. State of the Art.

Familiarity with the characteristics of current prosthetic foot-ankle assemblies will enable physical therapists to participate more effectively in the management of individuals with lower limb amputation. The purpose of this article is to inform therapists of the distinctions among various prosthetic devices, including their advantages and disadvantages. All foot-ankle prosthetic, components support the wearer, absorb shock, and simulate toe extension passively. Articulated assemblies, such as the single-axis and multiple-axis feet, plantar flex easily after heel-strike; however, they have an unattractive gap at the ankle. Nonarticulated components, such as the solid-ankle cushion heel foot, have various keel designs; energy-storing variants provide springiness for walking and running. Foot selection should reflect consideration of the patient's physical and psychological attributes and financial resources. Training should be structured to enable the wearer to make use of all features of the component. More laboratory and clinical research on prosthetic feet should be conducted to provide objective data on foot function.

Amputation, Surgical↗

Collaboration in community based rehabilitation agencies.

One of the strategies which non-government organizations (NGOs) involved in Community Based Rehabilitation (CBR) use to develop their organizations and maximize their impact is through collaboration with other partners. A survey conducted by the International Centre for the Advancement of CBR identified collaboration styles, concerns, opportunities, and barriers among NGOs working in disability. Discussion focuses on differences between collaboration in industrialized and less developed countries; on resource dependency; and on structural characteristics of organizations that influence their interactions. The limited public concern for disability issues is viewed as a principal reason for the broad collaboration patterns which are seen in this field.

Ambulatory Care↗