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At least 73 records · Page 4Linked to original sources

Managed care, technology adoption, and health care: the adoption of neonatal intensive care.

Managed care may influence technology diffusion in health care. This article empirically examines the relationship between HMO market share and the diffusion of neonatal intensive care units. Higher HMO market share is associated with slower adoption of mid-level units, but not with adoption of the most advanced high-level units. Opposite the common supposition that slowing technology growth will harm patients, results suggest that health outcomes for seriously ill newborns are better in higher-level units and that reduced availability of mid-level units may increase their chance of receiving care in a high-level center, so that slower mid-level growth could have benefitted patients.

California↗

Cellular interactions in the adoptive transfer of contact sensitivity: characterization of an antigen-nonspecific Vicia villosa-adherent T cell needed for adoptive transfer into naive recipients.

The adoptive transfer of delayed-type hypersensitivity (DTH) into naive recipients requires the interaction of two functionally distinct Ly-1+ T cells: and I-J- cell effector cell for DTH which transfers antigen-specific DTH only into animals whose suppressive mechanisms have been compromised, and and I-J+ cell which alone never transfers DTH but allows the transfer of DTH by the I-J- DTH effector cell into naive animals. We investigated the phenotypic and functional characteristics of the cell which "protects" the I-J- DTH effector cell from host suppressive mechanisms and allows the transfer of DTH into naive recipients. This cell was found to express the cell surface phenotype Lyt-1+,2-, L3T4+, and I-J+, and, in contrast to the I-J- DTH effector cell, was found to be adherent to the lectin Vicia villosa (VV). These cells routinely are found in the spleens of both immune or naive animals, and regardless of their origin are antigen-nonspecific in their functional activity in that they complement VV-nonadherent cells to transfer DTH responses of both TNP and oxazolone-primed cells. Treatment of recipient mice with cyclophosphamide (to remove host suppressor mechanisms) or Bordetella pertussis vaccine (which stimulates splenic T cells to circulate) abrogates the need for these cells in the transfer population, whereas treatment of donor mice with B. pertussis functionally depletes these cells from splenic T cell populations. Therefore, it appears that in the adoptive transfer of DTH responses, the antigen-specific I-J- VV-nonadherent cell requires an I-J+ VV-adherent cell in the circulation to overcome host suppressive mechanisms. The importance of these I-J+ cells in DTH responses is discussed.

Animals↗

Psychiatric disorders in the biological and adoptive families of adopted individuals with affective disorders.

To investigate the contribution of genetic and environmental factors in the etiology of mood disorders, a study was initiated to examine the frequency of psychiatric disorders in the biological and adoptive relatives of adult adoptees with mood disorders and in matched normal adoptees. Psychiatric evaluations of the relatives were made on the basis of independent blind diagnoses based on mental hospital and other official records. Analysis of the data showed an eightfold increase in unipolar depression among the biological relatives of the index cases and a 15-fold increase in suicide among the biological relatives of the index cases. These data demonstrate a significant genetic contribution to unipolar depression and suicide. They fail to disclose a significant contribution of family-associated transmission in the genesis of the mood disorders.

Adjustment Disorders↗

Quantitative genetic analysis of longitudinal trends in adoption designs with application to IQ in the Colorado Adoption Project.

A factor model is presented that provides for either multivariate or developmental specification of longitudinal genetic and environmental effects in the presence of assortative mating and cultural transmission. Delta path methods are employed for the treatment of assortative mating and selective placement effects. The proportions of genetic and environmental variance and covariance attributable to assortative mating and cultural transmission are modeled explicitly. The model was applied to cognitive ability data on 493 families in the Colorado Adoption Project by means of maximum-likelihood pedigree analysis. A test of the assumption of multivariate normality of error provided an additional model criterion beyond the log-likelihood ratio statistic. No significant effects were found for cultural transmission, genetic-environmental covariance, or selective placement. The results suggest that the phenotypic stability of IQ during early childhood is largely, if not entirely, genetic in origin and that these longitudinal genetic effects can be represented most parsimoniously in the form of developmental transmission.

Adoption↗

Allogeneic H-2d leads to H-2b irradiation bone marrow chimeras: a) failure to transfer chimerism adoptively and b) immune reactivity of immunocompetent lymphocytes adoptively transferred to chimeras.

Long-lived, GVHD-free, H-2 incompatible haemopoietic chimeras (P1 leads to P2) were constructed transfusing unmanipulated bone marrow cells together with recently identified marrow-regulating factors (MRF) in lethally irradiated recipients. The chimeric tolerance of P1 leads to P2 chimeras proved to be adoptively untransferable. Another peculiar property of established P1 leads to P2 allochimeras was their ability to "suppress" or reject passively transfused immunocompetent P1 or P2 lymphocytes. Even this "suppression" appeared to be untransferable and to operate in the chimera only in a fashion dependent upon the age of the established chimeras. This chimeric "unidentified suppressive principle" seems not to follow familiar immunologic lines. A relationship with the mechanism of chimeric tolerance is suggested.

Animals↗

Cyclophosphamide (Cy)-facilitated adoptive immunotherapy of a Cy-resistant tumour. Evidence that Cy permits the expression of adoptive T-cell mediated immunity by removing suppressor T cells rather than by reducing tumour burden.

A cyclophosphamide (Cy)-resistant immunogenic tumour, the L5178Y lymphoma, was used to demonstrate that Cy-treatment of a host bearing this tumour enables passively transferred tumour-sensitized T cells to cause complete tumour regression without any need for Cy to cause a reduction in tumour burden. It was shown that whereas infusion of tumour-sensitized T cells from immune donors had very little effect on growth of the tumour, and whereas treatment with 150 mg/kg of Cy caused appreciable enhancement of tumour growth, combination therapy with Cy plus immune T cells caused complete tumour regression and resulted in long-term survival. Evidence that Cy treatment facilitated the expression of adoptive immunity against the L5178Y lymphoma by eliminating tumour-induced suppressor T cells consisted of the demonstration that tumour regression caused by combination treatment with Cy and immune T cells could be inhibited by infusing the recipient with Cy-sensitive, L3T4+ T cells from tumour-bearing but not from normal donors.

Animals↗