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PubMed1996

Caregivers' appraisals of efficacy in coping with dementia.

This study investigated the types, prevalence, and stability of appraisals of coping efficacy made by 87 family caregivers of persons with dementia. With the use of content analysis, 12 efficacy appraisals were identified that reflected caregivers' perceptions of progress in problem-solving, regulating emotional distress, protecting self-esteem, managing social interactions, and self-development. Most appraisal types showed variability across 2 time points, which suggests that appraisals reflect changing person-environment transactions. Five of the appraisals-namely, nonefficacious coping outcomes, no coping options, no control, an improved ability to cope, and means/ends insights-were prospectively related to distress and well-being. The findings suggest that a broad set of goals guides coping efforts in the context of chronic stress.

Adaptation, Psychological↗
PubMed1998

Neuroticism, coping and change in MCMI-II clinical syndromes: test of a mediator model.

The aim of the study was to examine prospectively whether coping mediated the relation between Neuroticism and change in different clinical mental syndromes. Assessments were conducted with 154 former psychiatric outpatients six and seven years after their initial contact with an outpatient clinic. Dispositional coping mediated the relation between Neuroticism and change in four of the nine clinical scales of the Millon Clinical Multiaxial Inventory (MCMI-II) (Millon, 1987). High Neuroticism led to coping strategies of disengagement and the venting of emotions and to a lack of problem-focused coping, which in turn translated into a relative increase on the MCMI-II scales. The mediator model of coping was found to apply to the MCMI-II scales 'somatoform disorder', 'dysthymia', 'alcohol dependence' and 'thought disorder'. Results are discussed under the perspective of an integration of the positions of the transactional theory of stress and personality psychology.

Adaptation, Psychological↗
PubMed2005

The development and psychometric analyses of ADEPT: an instrument for assessing the interactions between doctors and their elderly patients.

BACKGROUND: The lack of instruments and methodologies designed specifically for assessing doctor-elderly patient interactions has constricted research on effective communication in the medical care of older adults. PURPOSE: This article reports on the development, qualitative analyses, and psychometric testing of the Assessment of Doctor-Elderly Patient Transactions (ADEPT), an instrument for assessing interactions between doctors and their elderly patients. METHODS: The ADEPT was based on the recommendations of an expert panel and designed around the three-function model of the medical interview. The ADEPT is meant to operationalize the research findings of interactional analysis studies of doctor-patient interaction. Following preliminary testing with standardized patients, the ADEPT was applied to videotaped visits of 433 patients 65 years of age and older to the doctor (n = 40) identified as their primary source of care. RESULTS: Four final scales derived from exploratory and confirmatory factor analyses were scored: Supporting, comprised of the 12 items from the first factor; Eliciting Needs, containing the 5 items from the second factor; and Informing, based on the final 6-item factor. Individual Cronbach's alphas across raters for this sample ranged from .71 to .79 for the first scale, from .83 to .88 for the second scale, and from .64 to .81 for the third scale. The reliability estimates for the total scale (23 items) ranged from .80 to .86 across raters. A fifth summed index composed of 46 binary checklist items also was computed. CONCLUSIONS: The findings indicate that credible scales can be developed for assessing communication behaviors.

Adult↗
PubMed1994

Induction of heat-stable enterotoxin receptor activity by a human Alu repeat.

The heat-stable enterotoxins (ST) elaborated by enterotoxigenic Escherichia coli are a family of small cysteine-rich peptides that bind to specific epithelial receptors in the mammalian intestine, causing a secretory diarrhea. The expression of ST receptors is tightly regulated; they are found primarily in intestine, and their expression is developmentally modulated. One receptor for ST has been cloned, and its cDNA encodes a approximately 120-kDa particulate guanylyl cyclase (guanylyl cyclase-C). Recent studies suggest that there are additional ST receptors that are not homologous to guanylyl cyclase-C. We used an expression cloning strategy to identify intestinal mRNAs that lead to expression of ST receptor activity in transfected cells. Using an ST-specific affinity panning system, we identified a novel 1891-base pair cDNA that does not encode a receptor protein, but instead, consists primarily of untranslated sequence. This cDNA induced receptor activity in both COS and 293 embryonic kidney cells. Northern analysis of the T84 human intestinal cell line, from which this cDNA was cloned, suggests that it is part of a 7.8-kilobase mRNA transcript. This transcript was also identified in human small intestine and colon, as well as in several extra-intestinal tissues. Functional analysis of subcloned fragments reveals that ST binding activity is induced by a 457-base pair human Alu repetitive sequence within the cDNA and that the phenotype is independent of orientation. These findings suggest that a human Alu element induces expression of a unique ST receptor by a transacting mechanism. An unrelated Alu-rich genomic clone did not confer ST binding, suggesting that there may be structural and functional specificity within individual Alu sequences.

Animals↗
PubMed2003

Public and private sector responses to essential drugs policies: a multilevel analysis of drug prescription and selling practices in Mali.

Many African countries have introduced cost recovery mechanisms based on the sale of drugs and measures aimed at improving drug supply. This study compares prescribing and selling practices in Mali, in 3 cities where the public sector contributes differentially to the supply of drugs on the market. Multilevel models are used to analyse the content and cost of 700 medication transactions observed in 14 private and public legal points of sale. Results show that the objective of improving access to drugs seems to have been achieved in the sites studied. Costs of prescriptions were lower where public health services had been revitalized. Affordable generic drugs were accessible and widely used, even in the private sector. However, measures intended to rationalize the prescription and delivery of drugs did not always have the desired effect. While agents in the public sector tended to prescribe fewer antibiotics, injectables, or brand-name drugs, the data confirm the virtual absence of advice concerning the use or the side effects of the drugs in both public and private sectors. In addition, data supported the notion that the public and private sectors are closely intertwined. Notably, availability of drugs in the public sector contributed to diminishing the prices charged in the private sector. Similarly, the use that agents in the public sector made of the opportunities afforded by the presence of the private pharmaceutical sector provided another illustration of interrelatedness. Finally, the data showed that the presence of a private sector, which has not been affected by measures aimed at rationalizing prescription and sales practices, limits the effects of measures implemented in the public sector. More assertive policies, based on strategies encompassing actors in the private sector, are needed to increase the safety and effectiveness of prescription and sales practices.

Community Health Centers↗
PubMed1997

Sensitivity and attachment: a meta-analysis on parental antecedents of infant attachment.

This meta-analysis included 66 studies (N = 4,176) on parental antecedents of attachment security. The question addressed was whether maternal sensitivity is associated with infant attachment security, and what the strength of this relation is. It was hypothesized that studies more similar to Ainsworth's Baltimore study (Ainsworth, Blehar, Waters, & Wall, 1978) would show stronger associations than studies diverging from this pioneering study. To create conceptually homogeneous sets of studies, experts divided the studies into 9 groups with similar constructs and measures of parenting. For each domain, a meta-analysis was performed to describe the central tendency, variability, and relevant moderators. After correction for attenuation, the 21 studies (N = 1,099) in which the Strange Situation procedure in nonclinical samples was used, as well as preceding or concurrent observational sensitivity measures, showed a combined effect size of r(1,097) = .24. According to Cohen's (1988) conventional criteria, the association is moderately strong. It is concluded that in normal settings sensitivity is an important but not exclusive condition of attachment security. Several other dimensions of parenting are identified as playing an equally important role. In attachment theory, a move to the contextual level is required to interpret the complex transactions between context and sensitivity in less stable and more stressful settings, and to pay more attention to nonshared environmental influences.

Adult↗
PubMed2000

The use of information technology in improving medical performance. Part III. Patient-support tools.

Despite the proliferation of computer-based resources for patients, usefulness has been limited to date. Already, 17,000 biomedical Internet sites exist, and patients are increasingly finding support and knowledge on the Internet, but the accuracy of the information found is highly variable and difficult for patients to assess. Patients have also found value in electronic communication with physicians, although relatively few physicians routinely use email to communicate with patients on a regular basis. Nonetheless, patient-focused information technologies potentially will have profound effects on medical care. With advancing sophistication of technology, patients will increasingly be able to compare and choose doctors using the Internet and to access information that allows them to monitor and regulate the quality of their own care. Further, technologies will likely be developed to allow patients to increasingly manage their own care -- whether they are patients with chronic illnesses such as diabetes or congestive heart failure who use customized software to adjust drug dosages and other treatments or patients with such common illnesses as headache or gastrointestinal infection who access self-management programs that may even write prescriptions for them. Thoughtful analysis and policy development will be critical for ensuring that the benefits are maximized and potential harm minimized. Specific areas include assessing the effects on outcomes and the characteristics of patients and technologies that succeed with self-management, and developing policies regarding liability for Web-based medical transactions and the privacy of information provided to physicians by email and via interactive Web sites.

Biomedical Technology↗
PubMed1992

Genomic structure and strain-specific expression of the natural killer cell receptor NKR-P1.

NK cells are able to lyse a variety of virally infected and neoplastic cells in an MHC-unrestricted manner. The cell-surface protein NKR-P1 is thought to play a key role in this process. NKR-P1, initially identified in rat IL-2 activated NK cells, is encoded in the mouse by at least three similar, but not identical, genes. We previously reported the isolation and characterization of three different NKR-P1 cDNA, termed cDNA 2, 34, and 40, from IL-2 activated mouse NK cells. This report describes the structure of the gene encoding NKR-P1 cDNA 2, the smallest of these three cDNA. Gene 2 is composed of six exons spanning approximately 14 kb of genomic DNA. The first exon encodes the N-terminal intracellular domain, and exons 4, 5, and 6 contain the sequences coding for the CRD. This organization is similar to that of other genes that encode C-type animal lectins. The expression of the NKR-P1 genes in A-LAK cells from 13 mouse strains was examined by Northern blot analysis. NKR-P1 expression appears to coincide with that of the NK1.1 Ag. This observation further supports the hypothesis that the NK1.1 Ag is encoded by one of the NKR-P1 genes. Nucleotide sequence analysis of the promoter region of the three NKR-P1 genes in BALB/c and C57BL/6 mice suggests that differences in the level of expression probably do not result from alterations in the upstream regions of these genes, but may be caused by the expression of strain-specific transacting factors.

Animals↗
PubMed1987

Health and hassles in older and younger men.

This study compared hassles and uplifts in older and younger chronically ill men in regard to whether they perceived their health as good or poor (N = 50). Hassles are irritating and frustrating demands (minor stress) that characterize everyday transaction with the environment, such as losing things or being in traffic jams. Uplifts are positive events that could help counteract the effects of stress. Men in the study rated 40 potential hassles and 40 uplifts on 1 to 4 scales for the preceding month. These were compared by multivariate analysis of variance between older (age 65 and over) and younger (ages 45 through 64) men and between good vs. poor perceptions of health. Uplifts did not discriminate significantly between ages or health perceptions. In addition, hassles were similar between old and young; however, they differed significantly by good and poor assessments of health. Those who viewed their health as poor reported more hassles, mostly from events that were related to their physical health care. Because of the confounding effects with health in individuals who are already ill, hassles may not be good predictors of future health status, but they can help health professionals understand the kinds of demands that produce stress in management of diseases.

Age Factors↗
PubMed1992

Hepatitis B virus C gene promoter is under negative regulation.

The regulation of the core promoter of Hepatitis B virus (HBV) was investigated using the chloramphenicol acetyltransferase (CAT) reporter system. Deletional analysis of sequences 5' to the HBV core promoter indicated the presence of a negative regulatory element (NRE) located within a 282-bp BamHI-HincII DNA fragment. The NRE was functional in hepatic as well as nonhepatic cells. Results of in vivo competition experiments suggest a role for cellular transacting repressor protein(s) in the functioning of the NRE. The HBV NRE, positioned 5' to the SV40 early promoter, inhibited the activity of the heterologous promoter in an orientation-independent, but position-dependent manner. These data indicate that the HBV NRE is a silencer element, which functions to downregulate the activity of the core promoter.

Animals↗
PubMed1999

The economics of moral hazard revisited.

Pauly's (1968) [Pauly, M., 1968. The economics of moral hazard, Comment, American Economic Review 58, 531-537.] analysis of the welfare loss from insurance assumes that medical care consumption is not determined by income, but recent studies suggest it is. This study argues that (1) Pauly's analysis overstates the welfare loss because it includes the effect of income on consumption, (2) the relevant income effect is derived from income transfer from the healthy to the ill that occur when the probability of illness is less than 1, and (3) the welfare loss can be considered the transaction cost of insurance.

Health Expenditures↗
PubMed2005

Poly(ADP-ribose) glycohydrolase is a component of the FMRP-associated messenger ribonucleoparticles.

PARG [poly(ADP-ribose) glycohydrolase] is the only known enzyme that catalyses the hydrolysis of poly(ADP-ribose), a branched polymer that is synthesized by the poly(ADP-ribose) polymerase family of enzymes. Poly(ADP-ribosyl)ation is a transient post-translational modification that alters the functions of the acceptor proteins. It has mostly been studied in the context of DNA-damage signalling or DNA transaction events, such as replication and transcription reactions. Growing evidence now suggests that poly(ADP-ribosyl)ation could have a much broader impact on cellular functions. To elucidate the roles that could be played by PARG, we performed a proteomic identification of PARG-interacting proteins by mass spectrometric analysis of PARG pulled-down proteins. In the present paper, we report that PARG is resident in FMRP (Fragile-X mental retardation protein)-associated messenger ribonucleoparticles complexes. The localization of PARG in these complexes, which are components of the translation machinery, was confirmed by sedimentation and microscopy analysis. A functional link between poly(ADP-ribosyl)ation modulation and FMRP-associated ribonucleoparticle complexes are discussed in a context of translational regulation.

Amino Acid Sequence↗
PubMed1992

Presence: discovering the artistry in relating.

Through the substantive practice experience of relating to patients, the author has identified provisional attributes associated with presence. Concept analysis was used to systematically illustrate the uses of presence identified by other authors and disciplines. A model case with the attributes of presence as described by the author is presented. The provisional attributes proposed by the author are (a) time with another (T), (b) unconditional positive regard (UPR), (c) transactional speaking with, being with, doing with (TR), (d) encounter that is valued (EV), (e) connectedness (essence linking) (C), and (f) sustaining memory (SM). The definition of presence as a nursing intervention is included.

Holistic Health↗
PubMed1990

Yeast Gal11 protein mediates the transcriptional activation signal of two different transacting factors, Gal4 and general regulatory factor I/repressor/activator site binding protein 1/translation upstream factor.

GAL11 was first identified as a gene required for full expression of some of the galactose-inducible genes in the yeast Saccharomyces cerevisiae. A null mutation within the GAL11 locus causes defects in mating, growth on nonfermentable carbon sources, and sporulation of gal11 homozygotes. The mating defect was observed only in MAT alpha gal11 strains. Northern hybridization analysis revealed that a gal11 mutation impaired transcription of alpha-specific genes (MF alpha 1 and STE3) but not of an a-specific gene (STE2). Furthermore, this mutation reduced expression of the MAT alpha locus, suggesting that a deficiency in MAT alpha 1 protein is responsible for the reduced expression of alpha-specific genes. Since general regulatory factor I (GRFI)/repressor/activator site binding protein 1 (RAP1)/translation upstream factor (TUF) is believed to be an activator of MAT alpha expression, we examined whether PYK1, which is known to be regulated by GRFI/RAP1/TUF, is also affected by the gal11 mutation. It was determined that the level of PYK1 message was significantly lowered by the mutation. The requirement for functional GAL11 in transcriptional activation was bypassed when either the upstream activating sequence of galactose-inducible genes or of PYK1 was placed very close to the TATA box, suggesting that one of the Gal11 protein functions is to mediate the activation signal of Gal4 and GRFI/RAP1/TUF, when the respective binding site is situated at the naturally occurring distance from the TATA box.

Blotting, Northern↗
PubMed1993

Characterization of the promoter from the single-copy gene encoding ferredoxin-NADP(+)-oxidoreductase from spinach.

We describe a genomic DNA segment from spinach that bears part of the single-copy gene for ferredoxin-NADP(+)-oxidoreductase (FNR) including a 3.4 kb promoter sequence. Dissection of this DNA segment and its analysis in GUS (beta-glucuronidase) gene fusions in transgenic tobacco demonstrated that the promoter differs in structure from all other promoters for thylakoid protein genes studied to date. Two regions with light-responsive elements were identified. One is located within the first 118 bp upstream of the transcription initiation site. A second fragment covering nucleotide positions -220 to -119 is capable of conferring light-dependent GUS gene expression on two different minimal promoters. The latter fragment binds a transacting factor in gel-shift assays. None of the fragments carries cis elements known from other genes to be involved in light-controlled expression. Comparison of the light responsiveness of GUS gene fusions controlled by the -753/+231 and -118/+231 regions indicates that they respond differentially to phytochrome-dependent signals and that their expression in tobacco is not restricted to tissue with functional chloroplasts.

Amino Acid Sequence↗
PubMed2005

Adenosine kinase inhibitor attenuates the expression of inducible nitric oxide synthase in glial cells.

The present study demonstrates the anti-inflammatory effect of adenosine kinase inhibitor (ADKI) in glial cells. Treatment of glial cells with IC51, an ADKI, stimulated the extracellular adenosine release and reduced the LPS/IFNgamma-mediated production of NO, and induction of iNOS and TNF-alpha gene expression. The recovery of IC51-mediated inhibition of iNOS expression by adenosine transport inhibitor, S-(4-nitrobenzyl)-6-thioinosine (NBTI), and the inhibition of LPS/IFNgamma-induced iNOS gene expression by exogenous adenosine indicate a role for adenosine release in IC51-mediated iNOS expression. The rescue of IC51-mediated inhibition of iNOS expression by adenosine receptor antagonist for A2A, 8-(3-chlorostyryl)caffeine (CSC) and alloxazine for A2B, further supports a role for interaction of adenosine and its receptors in anti-inflammatory activity. The IC51-mediated induction of cAMP levels, downstream target of A2A and A2B, and inhibition of LPS/IFNgamma-induced expression of iNOS by forskolin, a cAMP activator, document a role for cAMP mediated pathway in anti-inflammatory activity of IC51. Taken together, these studies document that IC51-mediated inhibition of iNOS expression is through activation of adenosine receptors, which activates A2A and A2B resulting in increased cAMP levels following LPS/IFNgamma stimulation. Moreover, the lack of effect of IC51 or adenosine on NFkappaB DNA binding activity and its transactivity indicates that the inhibition of iNOS expression mediated by IC51 may be through an NFkappaB independent pathway.

Adenosine↗
PubMed1986

Thirty years of child psychology: a selective review.

A selective review of the literature in child psychology over the last 30 years reveals substantial changes in methodology, in analysis and the interpretation of findings. Evidence on the multifactorial nature of development is drawn from genetic/environmental research, longitudinal studies and a consideration of potential long-term effects of early experience, including planned intervention. It is increasingly recognized that individuals play some part in causing their own development, via ongoing transactional processes. Eight themes form the basis for discussion, including the belated emergence of Piaget's theory and the changing outlook for the mentally retarded. In addition, the explosion of research upon infancy and the growing influence of behavioural psychology are noted.

Child↗
PubMed1993

Regenerating liver-specific transacting factors of H2B histone gene are newly synthesized during liver regeneration.

We have investigated DNA synthesis and levels of H2B histone mRNA, and the binding pattern of nuclear proteins to various elements in the rat H2B histone gene upstream region with DNase I footprinting assay. Both DNA synthesis and H2B histone mRNA level were increased with maximal stimulation reached at 24 hrs and 36 hrs after partial hepatectomy, respectively. In DNase I footprinting analysis, the nuclear factors interacting with the three elements, TATA at -19 bp (site AR), site B at -29 bp, and CAAT at -69 bp (site C) were required during maximal increase of H2B histone mRNA level after partial hepatectomy. The DNase I protection pattern by nuclear extract of the cycloheximide-treated regenerating liver showed the same results with normal liver. These results suggest that transcriptional regulation of H2B histone gene during liver regeneration may be mediated by nuclear factors that are newly induced by partial hepatectomy.

Animals↗