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This article is the fourth in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, important considerations relating to liability insurance and pension plans, and both the phasing in and phasing out of shareholders are discussed.
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RATIONALE, AIMS AND OBJECTIVES: This paper presents selected results from a study investigating the impact of small group processes on the development of clinical practice guidelines by multidisciplinary panels. Observations of one panel developing a guideline for primary care over several months are reported here. METHODS: Non-participant observation with content analy-sis of transcripts aided by field notes. RESULTS: Bales's interaction process analysis was used to categorize interactions in terms of their task-oriented or socioemotional qualities. This revealed a well-functioning, task-oriented group characterized by predominantly positive social behaviours. However, a breakdown of dialogue by speaker indicated a marked effect of professional role and status on the level of contribution to group discussions. This, and marked changes in panel composition across meetings, has implications for the multidisciplinarity of decision-making in such groups and hence for the acceptance and implementation of their outputs. CONCLUSIONS: These findings are likely to generalize to other health care settings in view of the growing emphasis on multidisciplinary decision-making and the clear status hierarchies inherent within the medical and allied fields.
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During a 17-month study at the Lokoué clearing in Odzala National Park, Republic of Congo, we identified 377 western lowland gorillas. This population included 31 solitary males, 37 breeding groups, and eight nonbreeding groups. Its age- and sex-class structure was similar to those observed at two other clearings in the same forest block. However, the size of breeding groups varied with site (either clearing or forest sites). At Lokoué, breeding groups (mean size: 8.2 gorillas; range: 3-15) included a single silverback male and, on average, 3.2 adult females. Nonbreeding groups (mean size: 5.5; range: 2-15) were devoid of adult females. Five of the nonbreeding groups were composed predominantly of blackbacks, subadult males, and juveniles, and thus fit the definition of all-male groups previously observed in mountain gorillas. Our study confirms that 1) one-male breeding groups are the norm in western gorillas, and 2) all-male groups occur in this species. Despite frequent changes in members due to migrations of the males, the persistence of these all-male groups indicates that they may play an important role in the life of migrating males. Variations in population structure, and group composition and type among gorilla populations are discussed. However, a further understanding of the evolution of group-living in gorillas requires detailed ecological studies conducted in parallel with studies of the population structure and dynamics of these groups.
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Two mouse monoclonal antibodies with specificity for the Lea blood group determinant of human red cells have been produced by immunising mice with soluble Lewis substance. Both antibodies were of the IgM class and agglutinated only trypsinised or papainised Lea-positive red cells. The precise antigenic conformations recognised by these antibodies have been defined by inhibition studies with monosaccharides, disaccharides and synthetic blood group oligosaccharides. These studies have suggested that the alpha-side of a 1-substituted D-galactosyl residue is a central part of the determinants recognised by the antibodies. Preliminary studies have shown these antibodies to be superior to many of the presently available human and animal polyclonal reagents for routine Lea typing of red cells.
The ability to infer relationships between groups of sequences, either by searching for their evolutionary history or by comparing their sequence similarity, can be a crucial step in hypothesis testing. Interpreting relationships of human immunodeficiency virus type 1 (HIV-1) sequences can be challenging because of their rapidly evolving genomes, but it may also lead to a better understanding of the underlying biology. Several studies have focused on the evolution of HIV-1, but there is little information to link sequence similarities and evolutionary histories of HIV-1 to the epidemiological information of the infected individual. Our goal was to correlate patterns of HIV-1 genetic diversity with epidemiological information, including risk and demographic factors. These correlations were then used to predict epidemiological information through analyzing short stretches of HIV-1 sequence. Using standard phylogenetic and phenetic techniques on 100 HIV-1 subtype B sequences, we were able to show some correlation between the viral sequences and the geographic area of infection and the risk of men who engage in sex with men. To help identify more subtle relationships between the viral sequences, the method of multidimensional scaling (MDS) was performed. That method identified statistically significant correlations between the viral sequences and the risk factors of men who engage in sex with men and individuals who engage in sex with injection drug users or use injection drugs themselves. Using tree construction, MDS, and newly developed likelihood assignment methods on the original 100 samples we sequenced, and also on a set of blinded samples, we were able to predict demographic/risk group membership at a rate statistically better than by chance alone. Such methods may make it possible to identify viral variants belonging to specific demographic groups by examining only a small portion of the HIV-1 genome. Such predictions of demographic epidemiology based on sequence information may become valuable in assigning different treatment regimens to infected individuals.
Total neutral glycolipid fractions were isolated from kidney and ureter tissue obtained at autopsy of an individual of the rare blood group A1 Le(a-b+) p. The amount of glycolipids isolated were 3.7 and 2.5 mg g-1 dry tissue weight for the kidney and ureter tissue, which is in the range of reference blood group P kidneys. Part of the kidney glycolipid fraction was subfractionated by HPLC. Glycolipid compounds were structurally characterized by thin-layer chromatography (chemical detection and immunostaining with monoclonal antibodies), proton NMR spectroscopy and mass spectrometry. Globotriaosyl- and globotetraosyl-ceramides, which are the major compounds in kidneys of P individuals, were absent in the p kidney, and a comparatively increased amount of monoglycosyl- and lactosylceramides was found. A shift to longer fatty acyl chains in the ceramide part of lactosylceramides was noted. Elongated globoseries compounds with five to seven sugar residues, including the blood group A type 4 chain structure, were lacking. A slight increase in neolactotetraosyl- and blood group X pentaglycosyl-ceramides was noticed. The study confirms an enzymatic block in the conversion of lactosylceramide to elongated globoseries compounds in the kidney tissue similar to that of erythrocytes of p individuals.
The structural relation of YOP-1 of "european" and "american" Yersinia enterocolitica serotypes O:3, O:9, O:5,27, and O:8 and O:20, respectively, and Y. pseudotuberculosis serotypes I, II, and III was compared by sodium dodecyl sulfate polyacrylamide gel electrophoresis and peptide mapping using Staphylococcus aureus protease V8. Apparent molecular weights of YOP-1 ranged from 206,000 (O:3) to approx. 180,000 (O:8). According to their respective peptide maps YOP-1 of the "european" and "american" Y. enterocolitica serotypes and Y. pseudotuberculosis serotypes could be assigned to three different groups. Evaluation of several isolates of Y. enterocolitica serotypes O:3, O:9, and O:8 by peptide mapping indicated that YOP-1 is conserved within a serotype. However, one serotype O:8 isolate differed from the consensus peptide pattern of the other serotype O:8 and O:20 isolates. The similarity of the peptide patterns of Yersinia serotypes which predominate in certain geographical locations, i.e., "european" and "american" Y. enterocolitica serotypes, suggest common evolution of YOP-1 of these serotypes independent of the evolution of the other serotypes.
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A structured programme was organized to address the high rate of legal conflicts among our in-patient population, the personal problems (e.g., denial) and practical problems (e.g. trying to find a job with a criminal record) which complicate their resolution. Active conflicts involved criminal mischief, breach of peace, fraud, burglary, larceny, assault, drug-related offenses, civil suits, etc. Common aspects of conflicts which were identified for discussion by members included authority issues, family reactions, employment, guilt, social rejection, etc. Well-described dynamics of deviant ("psychiatric") behaviour were seen applicable to legally-conflicted behaviour: blaming the victim; stereotyping; issues of accepting and escaping a label. Observation of interpersonal relationships in groups have potential application to forensic situations.
A new macrocyclic ligand with a pendant naphthalene group, N-[2-(1-naphthyl)ethyl]-1-aza-4,8-dithiacyclodecane (L), has been synthesized and characterized. The copper(I)-acetonitrile complex [LCu(CH(3)CN)](PF(6)) (1) was synthesized from L and [Cu(CH(3)CN)(4)](PF(6)). The acetonitrile ligand from 1 was easily removed to give [LCu](PF(6)) (2). Complexes 1 and 2 have been crystallographically characterized. 1: C(21)H(28)N(2)CuF(6)PS(2), triclinic, P&onemacr;, a = 11.1901(10) Å, b = 11.2735(12) Å, c = 12.1350(10) Å, alpha = 98.996(8) degrees, beta = 117.188(6) degrees, gamma = 105.354(7) degrees, Z = 2, R1 = 0.0505 (wR2 = 0.1418). 2.0.5hexane: C(22)H(31)NCuF(6)PS(2), monoclinic, P2(1)/c, a = 15.7318(15) Å, b = 8.9164(10) Å, c = 17.205(5) Å, beta = 102.431(6) degrees, Z = 4, R1 = 0.0587 (wR2 = 0.1545). In addition, a cocrystallized mixture of both complexes was crystallographically characterized. 1&2.hexane: C(46)H(61)N(3)Cu(2)F(12)P(2)S(4), triclinic, P&onemacr;, a = 10.8308(9) Å, b = 12.6320(8) Å, c = 19.9412(13) Å, alpha = 80.445(5) degrees, beta = 76.405(6) degrees, gamma = 78.825(5) degrees, Z = 2, R1 = 0.0661 (wR2 = 0.1871). The solid-state structure of 2 features the pendant naphthalene group bound in an eta(2)-fashion, which is highly unusual for copper complexes. In CDCl(3), 2 exhibits fluxional behavior with the barrier to the process estimated, DeltaG() = 12-13 kcal. Variable temperature NMR spectroscopy gave compelling evidence for solution binding of the naphthalene group in 2, apparently the first example for copper(I). The fluxional process seen for 1 is best described as interconversion of the two enantiomers via a species with an unbound naphthalene group. Consistent with the weak binding of the naphthalene group, it is readily replaced with other ligands, such as triphenylphosphine to form [LCu(PPh(3))](PF(6)) (3). Complex 3 has also been structurally characterized: C(37)H(40)NCuF(6)P(2)S(2), monoclinic, P2(1)/c, a = 11.462(2) Å, b = 15.972(2) Å, c = 19.835(9) Å, beta = 94.50(3) degrees, Z = 4, R1 = 0.0906 (wR2 = 0.1889).
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Modification of nucleosomal particles from chicken erythrocytes with the reagents for protein amino groups acetic and dimethylmaleic anhydrides causes a rearrangement of nucleosomal components. Treatment with both reagents is accompanied by liberation of free DNA and formation of residual particles with anomalous histone composition. The residual particles obtained with acetic anhydride contain an excess of histones corresponding to the free DNA produced. In contrast, dimethylmaleic anhydride causes release of histones H1, H5, H2A and H2B and formation of residual particles deficient in these histones but containing an excess of H3 and H4 corresponding to the liberated DNA. Regeneration of the modified amino groups of nucleosomal preparations treated with dimethylmaleic anhydride is accompanied by reconstitution of nucleosomal particles with the sedimentation coefficient and composition of core histones of the original nucleosomes. This reconstitution does not occur when the released fraction containing histones H2A and H2B and free DNA is separated from the residual particles. The studied disassembly of nucleosomal particles obtained by specifically blocking lysine-DNA interactions with these reagents appears to indicate that lysine residues are essential for the binding of DNA to histones with formation of nucleosomal particles.
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