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PubMed2006

Constructing 'expertness': a novice pharmacist's development of interactional competence in patient consultations.

It has been argued that being able to utilize expertise in discourse is as important as having expertise (C. Candlin and S. Candlin 2002). From a constructivist perspective, knowledgeability does not exist outside of social interaction: being expert involves performing knowledge and skills effectively in social practices (cf. Butler 1990; Lave and Wenger 1991). It is, then, crucial that novice professionals develop the interactional competence to construct themselves as experts in interaction. This study brings together perspectives from research on expert-lay communication, social interaction, and situated learning to examine how a pharmacy intern performed his professional knowledge in the practice of patient consultation over time. Using conversation analysis complemented by the interactional competence framework (Hall 1995; Young 2002), I demonstrate that as the novice pharmacist gained more experience over the course of one internship, he was able to employ professional knowledge in ways that were sensitive to the sequential organization of talk, and to share the patients' lifeworld perspectives (Mishler 1984) more effectively, thus successfully managing the transactional and interpersonal functions of the consultations. This study contributes to research on expert-lay interaction, particularly in pharmacy, and to the under-studied area of interactional competence development in the professions.

Community Pharmacy Services↗
PubMed1990

Transacting transcriptional activation of human spumaretrovirus LTR in infected cells.

The long terminal repeat (LTR) of the human spumaretrovirus (HSRV) was examined with respect to its ability to function as transcriptional promotor in virus-infected and uninfected cells. Transient transfections using a plasmid in which the 3' LTR of HSRV was coupled to the bacterial chloramphenicol acetyltransferase (cat) gene revealed that the level of HSRV LTR-directed cat gene expression was markedly increased in HSRV-infected cells compared to uninfected cells. Northern blot analysis of cat mRNA from transfected cultures suggests that transactivation of HSRV-directed gene expression occurs at the transcriptional level.

Animals↗
PubMed1998

Doing it all in the public eye: a comparative analysis of California district hospital affiliations.

California contains 74 hospital districts, which are local governmental entities with publicly elected boards. Historically, they have been responsible for operating hospitals in remote areas to provide for the health care needs of their communities. Because the health care market has become increasingly competitive and because some of these once rural areas have grown into large cities, these districts are seeking partners for their hospitals in hopes of preserving their long-term financial viability. The terms reached in these transactions are discussed in the article.

California↗
PubMed2006

Mapping the dimer interface in the C-terminal domains of the yeast MLH1-PMS1 heterodimer.

Yeast MutLalpha is a heterodimer of MLH1 and PMS1 that participates in a variety of DNA transactions, including DNA mismatch repair. Formation of the MutLalpha heterodimer requires that the C-terminal domains of MLH1 and PMS1 interact in a manner that is not yet fully understood. Here we investigate the interactions involved in heterodimerization. Using protein surface modification and mass spectrometry, we identify numerous lysine residues that are exposed to solvent in monomeric MLH1. A corresponding analysis of the MLH1-PMS1 heterodimer reveals that three of these exposed residues, K665, K675, and K704, are no longer solvent accessible in the heterodimer, suggesting that they are within the dimer interface. We refine secondary structure predictions and sequence alignments of C-terminal residues of seven eukaryotic MutL homologues and then develop homology models for the N- and C-terminal domains of MLH1. On the basis of this information, we present a model for interaction of the C-terminal domains of MLH1 and PMS1.

Adaptor Proteins, Signal Transducing↗
PubMed2005

[Evaluation of stress tolerance in the neurological patients].

A purpose of the study was to develop the Stress Tolerance Scale (STS) and to assess its diagnostic efficacy in neurological clinical practice. The theoretical ground for stress tolerance measurement is the concept of personal environmental interaction as a process including phases of the subjective stress event appraisal, active reaction and subjective result appraisal. The STS encompasses the response items of the descriptions of the accomplished and unaccomplished person-environment and self-personal relations that result in stress overcoming or in stress maintenance, respectively. Within each group, the additional variants of the transactions were specified according to their space-temporal characteristics. Data sets from 112 healthy people and 247 patients (60 with chronic tension headache, 72 with chronic low back pain, 51 with myasthenia gravis, 14 with progressive muscular dystrophy, 27 with hereditary polyneuropathy and 23 with torticollis) have been analyzed. The validity and quiantitation of the STS were determined by Rasch analysis and comparison of the results with those of total STS score and subscale scores of the Hospital Anxiety and Depression Scale and Russian brief version of MMPI. All correlations were at a level of significance. A decrease of stress tolerance was found in patients with chronic pain syndromes and torticollis. The results indicate that the STS allows assessing stress tolerance and a structure of person-environment interactions used by a patient. It can be utilized for optimization of short-term psychotherapy of neurological patients.

Adaptation, Psychological↗
PubMed1987

Human steroid receptors and erb-A gene products form a superfamily of enhancer-binding proteins.

Steroid hormones exert potent effects on development and differentiation, and their actions are mediated as a consequence of their interaction with specific, high-affinity binding proteins referred to as receptors. To initiate the analysis of the molecular mechanisms by which steroid receptor molecules regulate transcription, we have recently cloned the human glucocorticoid receptor cDNA. The structural analysis of receptor clones reveals 2 protein forms termed 'alpha' and 'beta' which differentiate their carboxy termini. The alpha-receptor is equivalent to the major form of the human glucocorticoid receptor and appears to be the molecule that confers transcriptional control. This protein contains a cysteine-rich region which we believe defines the DNA-binding domain. Structural analysis reveals the receptor to be related to a novel family of proto-oncogenes termed 'erb-A'. To examine this relationship, we have cloned certain members of the erb proto-oncogene family which reveals strong relatedness to the DNA-binding domain of the glucocorticoid receptor. Based on these homologies, we proposed that erb-A protooncogenes are transacting factors that may be candidates for enhancer sequence binding proteins. The unexpected indication from this study is that the steroid receptors and the erb-A proto-oncogenes share a common primordial archetype and therefore appear to be members of new super family of regulatory proteins.

Amino Acid Sequence↗
PubMed2005

Commercial agencies and surrogate motherhood: a transaction cost approach.

In this paper we investigate the legal arrangements involved in UK surrogate motherhood from a transaction-cost perspective. We outline the specific forms the transaction costs take and critically comment on the way in which the UK institutional and organisational arrangements at present adversely influence transaction costs. We then focus specifically on the potential role of surrogacy agencies and look at UK and US evidence on commercial and voluntary agencies. Policy implications follow.

Commerce↗
PubMed1993

Reducing the risks from radon.

The U.S. Environmental Protection Agency estimates that residential radon levels in the United States lead to approximately 13,600 lung cancer deaths per year. To address this problem, the Agency has identified three program initiatives that can provide substantial reductions in the public's risks: (1) public information activities that urge the public to test for radon and reduce elevated concentrations in existing homes, (2) new construction standards to reduce radon entry, and (3) radon testing and mitigation during real estate transactions. This paper analyzes the costs and risk reductions that could result from the implementation of these major initiatives, showing how all three elements cost-effectively protect the public's health.

Construction Materials↗
PubMed1993

Pituitary specific transcription factor messenger ribonucleic expression in adenomatous and nontumorous human pituitary tissues.

BACKGROUND: The pituitary-specific transcription factor, Pit-1/GHF-1 (Pit-1) is a member of the POU family of homeobox genes. This transacting factor has a role in the development and expression of selected anterior pituitary cells including prolactin, growth hormone (GH), and thyrotropin, cell types in rodent pituitary. The expression of Pit-1 mRNA in human pituitaries has not been previously analyzed and the role of specific secretagogues in the regulation of Pit-1 transcripts in human pituitary adenomas has not been examined. Analysis of Pit-1 expression in normal and neoplastic human pituitaries may provide insight into the specificity of this transcription factor for pituitary cell types and the role of Pit-1 in human pituitary function. EXPERIMENTAL DESIGN: In situ and Northern hybridization analyses were used to study the expression of Pit-1 mRNA in surgically removed human pituitary adenomas and nontumorous pituitaries obtained within 6 hours postmortem. A cultured GH surgically removed adenoma was used to analyze the regulation of GH and Pit-1 in vitro. RESULTS: In situ hybridization localized Pit-1 mRNA in all pituitary adenomas, although the mRNA levels in GH and prolactin adenomas were significantly higher than those in ACTH, null cell and gonadotroph tumors. Northern hybridization analysis revealed a 2.4 and a 1.2 kb mRNA transcript for Pit-1. Although GH mRNA transcript was markedly changed by dexamethasone and phorbol 12-myristate 13-acetate in vitro, Pit-1 mRNA transcripts were not changed significantly by these secretagogues. CONCLUSIONS: Pit-1 mRNA transcripts are expressed mainly in prolactin and GH pituitary adenomas, but are also found in other adenomas and in the nontumorous adult human pituitary. Pit-1 mRNA transcript levels are not readily modulated in cultured GH adenoma cells by various secretagogues in vitro compared with the marked modulation of GH mRNA transcripts by these same secretagogues.

Adenoma↗
PubMed1992

An analysis of interpersonal manipulation.

The term 'manipulation' is frequently employed but rarely discussed or defined in psychiatric circles. This paper reviews previous conceptual analyses of the term by philosophers and psychiatrists, and examines its use in ordinary discourse. A series of characteristics which comprise the conceptual core of the term when it is unambiguously applied in interpersonal settings are proposed. Manipulation is contrasted with other behavior control methods such as rational persuasion and coercion, with emphasis on the role played by deception and the communicative context in which the manipulative transaction occurs. It is argued that manipulative behavior is fundamentally intentional, and the usefulness of the concept of 'unconscious manipulation' is questioned. Though the proposal that Manipulative Personality Disorder be formally recognized as a new diagnostic category is rejected, it is urged that the concept of manipulation receive wider attention and discussion within the mental health community.

Attitude of Health Personnel↗
PubMed2005

Technical guidelines for enhancing privacy and data protection in modern electronic medical environments.

Raising awareness and providing guidance to on-line data protection is undoubtedly a crucial issue worldwide. Equally important is the issue of applying privacy-related legislation in a coherent and coordinated way. Both these topics gain extra attention when referring to medical environments and, thus, to the protection of patients' privacy and medical data. Electronic medical transactions require the transmission of personal and medical information over insecure communication channels like the Internet. It is, therefore, a rather straightforward task to capture the electronic medical behavior of a patient, thus constructing "patient profiles," or reveal sensitive information related to a patient's medical history. The consequence is clearly a potential violation of the patient's privacy. We performed a risk analysis study for a Greek shared care environment for the treatment of patients suffering from beta-thalassemia, an empirically embedded scenario that is representative of many other electronic medical environments; we capitalized on its results to provide an assessment of the associated risks, focusing on the description of countermeasures, in the form of technical guidelines that can be employed in such medical environments for protecting the privacy of personal and medical information.

Computer Communication Networks↗
PubMed1978

On the transaction of social change processes and the perception of self in relation to others: a study of Greek preadolescents.

The purpose of this study was to investigate the relationship between perception of self and others on the one hand, and milieu complexity on the other. The basic assumption was that comparison of TAT records of two groups of preadolescents living in an urban-industrialized and rural-traditional milieu, respectively, would reveal more interpersonal and intrapersonal conflict in the first group. The TAT stories were analyzed by story sequence analysis. 16 judges rated the sequence on the basis of a number of scales referring to several variables. The criteria developed for the rating were formulated on the basis of five working hypotheses which concerned degree of syntonicity between personal goals and family expectations, perception of human relationships, possibility assumptions as well as degree of involvement in active effort, etc. All hypotheses were supported.

Child↗
PubMed1994

The X-gene of human hepatitis B virus transactivates the c-jun and alpha-fetoprotein genes.

The X-gene product of human hepatitis B virus is a transacting transcriptional factor which activates a variety of heterologous viral and host promoters/enhancers. We have found that the X-gene product can significantly transactivate the regulatory sequences located at the 5'-upstream of the c-jun oncogene when a reporter plasmid containing the sequences was co-transfected to HepG2 cells with an X-gene expression plasmid. The results of mutational analysis indicate that the X-gene activation requires the AP-1 sequence of the c-jun gene. Furthermore, we also found that the X-gene is capable of activating the 5'-upstream sequence of the alpha-fetoprotein gene. There are at least two elements that respond to the X-gene transactivation. One is located in the sequences between -5,100 and -2,900, and the other is at the C/EBP site. Therefore, the X-gene activates the c-jun and alpha-fetoprotein genes through different host factors, namely AP-1 and C/EBP, respectively. The results of c-jun activation by the X-gene strongly support the previous hypothesis that the X-gene may play a critical role in the development of hepatocellular carcinoma.

Base Sequence↗
PubMed2004

Psychological contract and organizational citizenship behavior in China: investigating generalizability and instrumentality.

This study examined the generalizability of psychological contract forms observed in the West (D. M. Rousseau, 2000) to China. Using 2 independent samples, results confirmed the generalizability of 3 psychological contract forms: transactional, relational, and balanced. This study also examined the nature of relationships of psychological contracts with organizational citizenship behavior (OCB). In particular, this study explored the role of instrumentality as a mediating psychological process. The authors found evidence that instrumentality mediates the relationship of relational and balanced forms with OCB; however, the transactional contract form is directly related to OCB. The authors discuss the implications of these results for the meaning of psychological contracts and OCB in China and raise issues for future research.

Adult↗
PubMed2003

Class II transactivator (CIITA) promoter methylation does not correlate with silencing of CIITA transcription in trophoblasts.

Trophoblast cells are unique because they do not express major histocompatibility complex (MHC) class II antigens, either constitutively or after exposure to interferon-gamma (IFN-gamma). The absence of MHC class II antigens on trophoblasts is thought to play a critical role in preventing rejection of the fetus by the maternal immune system. The inability of trophoblasts to express MHC class II genes is primarily due to lack of the class II transactivator (CIITA), a transacting factor that is required for constitutive and IFN-gamma-inducible MHC class II transcription. We, therefore, investigated the silencing of CIITA expression in trophoblasts. In transient transfection assays, transcription from the IFN-gamma-responsive CIITA type IV promoter was upregulated by IFN-gamma in trophoblasts, which suggests that CIITA is silenced by an epigenetic mechanism in these cells. Polymerase chain reaction analysis demonstrated that the CIITA type IV promoter is methylated in both the human choriocarcinoma cell lines JEG-3 and Jar and in 2fTGH fibrosarcoma cells, which are IFN-gamma inducible for CIITA. Conversely, methylation of the CIITA type IV promoter was not observed in human primary cytotrophoblasts isolated from term placentae or in mouse or rat trophoblast cell lines. Simultaneous treatment with IFN-gamma and the histone deacetylase inhibitor trichostatin A weakly activated CIITA transcription in mouse trophoblasts. Stable hybrids between human choriocarcinoma and fibrosarcoma cells and between mouse trophoblasts and fibroblasts expressed CIITA following treatment with IFN-gamma. These results suggest that silencing of CIITA transcription is recessive in trophoblasts and involves an epigenetic mechanism other than promoter methylation. The fact that CIITA is expressed in the stable hybrids implies that trophoblasts may be missing a factor that regulates chromatin structure at the CIITA promoter.

Animals↗
PubMed2005

Quantifying fluctuations in market liquidity: analysis of the bid-ask spread.

Quantifying the statistical features of the bid-ask spread offers the possibility of understanding some aspects of market liquidity. Using quote data for the 116 most frequently traded stocks on the New York Stock Exchange over the two-year period 1994-1995, we analyze the fluctuations of the average bid-ask spread S over a time interval deltat. We find that S is characterized by a distribution that decays as a power law P[S>x] approximately x(-zeta(S) ), with an exponent zeta(S) approximately = 3 for all 116 stocks analyzed. Our analysis of the autocorrelation function of S shows long-range power-law correlations, (S(t)S(t + tau)) approximately tau(-mu(s)), similar to those previously found for the volatility. We next examine the relationship between the bid-ask spread and the volume Q, and find that S approximately ln Q; we find that a similar logarithmic relationship holds between the transaction-level bid-ask spread and the trade size. We then study the relationship between S and other indicators of market liquidity such as the frequency of trades N and the frequency of quote updates U, and find S approximately ln N and S approximately ln U. Lastly, we show that the bid-ask spread and the volatility are also related logarithmically.

Journal Article↗
PubMed1988

The organization of the human-plasminogen-activator-inhibitor-1 gene. Implications on the evolution of the serine-protease inhibitor family.

Plasminogen activator inhibitor 1 (PAI-1) is a member of the serine protease inhibitor super family (SERPINS) which is thought to play an integral role in the control of plasminogen activation. PAI-1 inhibits both tissue-type plasminogen activator and urokinase-type plasminogen activator and may therefore be implicated in the control of various physiological processes. We have isolated the PAI-1 gene including its 5'-flanking sequence. The gene was characterized by restriction enzyme analysis, Southern blotting and DNA sequencing of all the coding parts as well as the 5'-flanking region. The PAI-1 gene contains nine exons and eight introns distributed over approximately 12.3 kb of DNA. All exon/intron boundaries agree with the 'GT-AG' rule. To characterize the presumptive promoter region, 800 bp of the 5'-flanking region was sequenced and potential binding sites for transacting transcriptional factors were localized. The transcription initiation site was identified by S1 protection experiments and is located 25 base pairs downstream of a TATA consensus sequence. By aligning the gene structure of PAI-1 and four other SERPINS and extrapolating a general tertiary structure to these SERPINS, we find that most introns map between subdomain structures of the proteins. Evidence is presented supporting an intron loss model for the evolution of the SERPIN family.

Amino Acid Sequence↗
PubMed2002

Wealth happens.

The economic world is full of patterns, and one of the most controversial is the distribution of wealth. You might expect the balance between rich and poor to vary widely from country to country. But back in 1897, Vilfredo Pareto discovered a pattern of wealth distribution that appears to be universal. Whenever you double the amount of wealth within a country, the number of people in each successively higher wealth bracket falls by a constant factor. The factor varies among countries, but the pattern remains essentially the same. From a mathematical standpoint, Pareto's distribution has stubbornly defied explanation. But recently, researchers were able to replicate the curve by applying the principles of network organization. They began with two simple assumptions. First, wealth accumulates either by transfers from person to person or through investment returns, positive or negative. Second, rich people invest more money than poor people. Starting with a hypothetical group of 1,000 people of equal wealth and abilities, the model always produces Pareto's wealth distribution no matter how the links in the network are organized or how the balance between interpersonal transactions and investment returns are set. The model also indicates that the degree of wealth concentration can be influenced. Increasing the number of links in the network or the total amount of money flowing through an economy tends to decrease wealth disparities; increasing investment returns or volatility tends to increase it. Replete with public policy implications, the model is only one example of how network analysis can reshape our understanding of complex economic and social systems, which may have less to do with the behavior of individual members than with impersonal and seemingly insignificant forces.

Models, Economic↗