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PubMed1992

Role played by vasopressin (and of an adrenalpostpituitary imbalance) in the development of cancerous diseases.

Several authors have demonstrated that vasopressin (VP) plays a role in the metabolism of various cell lines, cancerous or not, and in particular acts upon the growth and the multiplication of cell cultures. Less known are the data concerning the existence of an adrenal-postpituitary imbalance in favour of VP in cancerous patients. Seeing that adreno-cortical hormones (ACH) are able to exert an inhibiting action on cell multiplication in vitor, a similar effect being very moderate or even absent in vivo, one can see the advantage of taking such effects into account. They allowed us to explain the discrepancy between the in vivo and in vitro effects of ACH, since VP is able to counteract the expected effects of ACH. A model, first empirical, then mathematical, of the so-called adrenal-postpituitary system, was proposed for this purpose. It enables us to propose some hypotheses in the fight to escape the action of ACH in cancer. Paradoxically, it seems that a bipolar therapy, using ACH and VP, would be useful in reaching this goal.

Animals↗
PubMedDate not supplied

Leiomyosarcoma of the larynx: critical analysis of the diagnostic role played by immunohistochemistry.

Laryngeal leiomyosarcoma (LMS) is definitely considered a rare occurrence: our exhaustive literature review disclosed to date only 45 cases (including the new case we have reported). The morphological diagnosis of laryngeal LMS may be problematic on conventional light microscopy especially in small laryngeal specimens. In the past, LMSs of the larynx were frequently confused with other spindle-cell malignant tumors. Nowadays, immunohistochemical investigations are considered necessary to distinguishing LMS from other spindle-cell tumors. On immunostaining, LMS is usually positive for muscle-specific actin and negative for cytokeratins and epithelial membrane antigen. In most cases, immunohistochemical study allows reliable diagnosis of LMS, but it can produce ambiguous or inconclusive results when the tumor cells lack specific immunohistochemical reactivity. In these controversial cases, LMS diagnosis has to be substantiated by electron microscopy. Distinguishing laryngeal LMS from other spindle-cell malignancies plays a role not only in academic interest. Confusion in the diagnosis of a spindle-cell laryngeal malignancy could result in inappropriate clinical management and inadequate treatment.

Humans↗
PubMed1994

Role play in X-inactivation.

Initiation of X-inactivation is known to depend on the presence of a unique region or locus known as the X-inactivation center, or Xic, defined by the study of chromosomal rearrangements. Its mode of action is currently unknown but is the scene of much research effort. This review explores the recent literature concerning the definition of Xic and its relationship both to Xist and to another genetic entity thought to play a role in the initiation of X-inactivation, the X-controlling element, or Xce.

Animals↗
PubMed2001

Role played by the response regulator Ris in Bordetella bronchiseptica resistance to macrophage killing.

Previous studies suggested that the persistence in eukaryotic cells of a Bordetella bronchiseptica mutant carrying an insertion in the locus encoding the response regulator RisAS is impaired. This suggested that ris-dependent products are required for the intracellular survival of bacteria. In this study we demonstrate that ris-regulated products play a role in B. bronchiseptica resistance against both phagosomal acidification and reactive oxygen intermediates.

Adenosine Triphosphatases↗
PubMed2002

Role played by purinergic receptors on muscle afferents in evoking the exercise pressor reflex.

The exercise pressor reflex is believed to be evoked, in part, by multiple metabolic stimuli that are generated when blood supply to exercising muscles is inadequate to meet metabolic demand. Recently, ATP, which is a P2 receptor agonist, has been suggested to be one of the metabolic stimuli evoking this reflex. We therefore tested the hypothesis that blockade of P2 receptors within contracting skeletal muscle attenuated the exercise pressor reflex in decerebrate cats. We found that popliteal arterial injection of pyridoxal phosphate-6-azophenyl-2',4'-disulfonic acid (PPADS; 10 mg/kg), a P2 receptor antagonist, attenuated the pressor response to static contraction of the triceps surae muscles. Specifically, the pressor response to contraction before PPADS averaged 36 +/- 3 mmHg, whereas afterward it averaged 14 +/- 3 mmHg (P < 0.001; n = 19). In addition, PPADS attenuated the pressor response to postcontraction circulatory occlusion (P < 0.01; n = 11). In contrast, popliteal arterial injection of CGS-15943 (250 micro g/kg), a P1 receptor antagonist, had no effect on the pressor response to static contraction of the triceps surae muscles. In addition, popliteal arterial injection of PPADS but not CGS-15943 attenuated the pressor response to stretch of the calcaneal (Achilles) tendon. We conclude that P2 receptors on the endings of thin fiber muscle afferents play a role in evoking both the metabolic and mechanoreceptor components of the exercise pressor reflex.

Achilles Tendon↗
PubMed1980

Evaluation of role played by mediators of immediate hypersensitivity in exercise-induced asthma.

To determine whether mediators of immediate hypersensitivity played a role in the pathogenesis of exercise-induced asthma, we measured the concentration of histamine and neutrophil-chemotactic activity present in systemic arterial blood during thermal challenges in five asymptomatic asthmatics. Because exercise-induced asthma has been shown to be a result of respiratory heat loss and because respiratory heat loss during isocapnic hyperventilation has been shown to give identical responses, we chose the latter provocational method in order to minimize increases in cardiac output that might interfere with the interpretation of mediator concentrations in arterial blood. Multiple aspects of pulmonary mechanics were also recorded before and after provocation. The results of these studies were then compared with the effects observed when the same subjects inhaled aerosols of specific antigens on the same day. Each challenge produced identical alterations in lung function, and neither was associated with consistent changes in arterial histamine. However, antigen provocation evoked a sustained and prolonged release of neutrophil chemotactic activity in each subject, whereas isocapnic hyperventilation with cold air was without effect. These data strongly suggest that mast-cell derived mediators are not involved in the development or maintenance of the bronchial obstruction that follows exercise in asthmatics.

Adult↗
PubMed1988

Role-playing techniques: locus of control and the attraction to behavior simulation interventions.

This study investigated the relationship between internal-external locus of control and preferences to enact conflict situations designed as spontaneous, mimetic-replication or a combination of these two behavior simulation (role playing) conditions. Four groups of females, high-school students (N = 10 each), indicated their portrayal preferences on a Role Playing Situation Questionnaire. Two of these, an internal and an external group, participated in a task designed to create feelings of failure (lack of success) prior to taking the questionnaire. Spontaneous portrayals were preferred by internals, and portrayals that involved mimetic-replication were favored by externals. Unsuccessful internals preferred the combined spontaneous/mimetic-replication alternative more than did the other internals. The relationship between personality and role playing, as well as the implications for clinical uses of behavior simulation conditions, is discussed.

Adolescent↗
PubMed1975

A role-play Rorschach procedure.

Rorschach responses of three subjects were used to stimulate the type of role-playing popularized by Fritz Perls' Gestalt therapy. The standard Rorschachs were given first. Afterwards, each subject was presented with certain of his or her own images as a stimulus for the role-playing. The subjects consisted of a 19-year-old female with severe anxiety attacks, an 11-year-old lad diagnosed as having minimal cerebral dysfunction, and a 46-year-old man who had undergone two years of successful psychotherapy. It is proposed that the resulting data are valuable in expanding and clarifying the psychological meaning of the Rorschach images. Further, the procedure can be utilized, if desired, as a spur to therapeutic involvement.

Adult↗
PubMed1992

The effect of two kinds of role playing on self-evaluation of improved assertiveness.

The study investigated the "differential effect of role-playing enactments" hypothesis through self-evaluations of improvement in assertiveness by participants in an assertive training program. Twenty-two nonassertive Israeli students were trained in two groups: mimetic-replications (action modeling, n = 12) and spontaneous (self-produced action, n = 10) role-playing interventions. Comparisons of their scores on the Self-Expression College Scale (CSES) before and after the training showed that both groups significantly improved their self-evaluations, but the mimetic-replication group did better. In particular, this group scored significantly higher on the CSES first factor (the willingness to take risks in situations that involved other, significant persons).

Adult↗
PubMed1992

Assertiveness training for disabled adults in wheelchairs: self-report, role-play, and activity pattern outcomes.

Thirty-four physically disabled adults participated in an 11-week assertiveness training (AT) program. Ss were randomly assigned to either AT or a waiting-list (WL) condition. Each was asked to complete three self-report measures, a role-play test, and a social and recreational activity diary. The AT Ss showed significant improvements on both self-reported assertiveness and role-play performance from pre- to posttreatment, whereas WL controls showed no changes on these measures. No significant changes in frequency of social or recreational activities were found at posttest for either AT or control Ss. A mixed pattern of results was shown at 6-month follow-up. Posttest gains were maintained across all self-report measures of assertiveness and acceptance of disability, whereas role-play performance approached baseline levels at 6-month follow-up. Overall results support the use of AT in enhancing perceived social efficacy and interpersonal skill of physically disabled adults in wheelchairs.

Activities of Daily Living↗
PubMed1993

Refusal assertion versus conversational skill role-play competence: relevance to prevention of tobacco use.

Conversational and refusal assertion skills of 768 seventh grade youth were assessed through ratings of global (for example, effectiveness) and non-verbal (for example, eye contact) behaviour performed in two role-play scenarios. The ratings were completed after each scenario by the subjects themselves, as well as by classmate and trained adult observers. Use of the Hays and Hayashi multitrait scaling method to interpret these data revealed two results. First, the items used to measure role-play behaviour did not achieve sufficient internal consistency to create global and non-verbal composites. Second, inter-rater agreement and discriminant validity were obtained only for ratings of the global effectiveness of each of the two social skills. Next, a series of multiple regression analyses indicated that an index of the global effectiveness of refusal assertion skill, but not of conversational skill, was predictive of intention to use tobacco. Those who were relatively unskillful at refusing offers were more likely to intend to use tobacco. Analyses exploring relations of trained observer ratings of the effectiveness of both role-play types, trained observer ratings of the other global and non-verbal items, and subjects' intention to use tobacco indicated that only a hesitant voice pattern was both negatively predictive of effective refusal assertion and positively predictive of intention to use tobacco in the future. In other words, those who are hesitant when they refuse a tobacco offer are the ones most likely to report an intention to use tobacco in the future. The consistency of this last finding in the tobacco use prevention literature is discussed.

Assertiveness↗
PubMed1995

Does rational role-play enhance the outcome of exposure therapy in dysmorphophobia? A case study.

BACKGROUND: Dysmorphophobia may improve after a variety or combination of treatments, but which elements of a treatment are useful is usually not certain. METHOD: In a single out-patient case study rational role-play ('paradoxical discourse') was added to exposure plus cognitive restructuring (CR) for a dysmorphic delusion study comprised of 20-minute sessions one week apart. RESULTS: Previous exposure plus attempted CR had improved anxiety, phobias, work and social leisure, but not dysmorphic belief. Added brief rational role-play was followed by resolution of the dysmorphic belief. All measures remained much improved at 18-month follow-up. CONCLUSIONS: Rational role-play deserves a controlled trial in dysmorphophobia and other problems and exploration of its mechanism of action.

Adult↗
PubMed1978

Comparing the effectiveness of the mini-lecture technique to role-playing in a dental psychology course.

The array of instructional methods utilized in teaching behavioral sciences to dental students has included both teacher-centered and student-centered approaches. The purpose of this study was to evaluate the effectiveness of two small-group treatments, mini-lecture and role-playing, in teaching dental psychology. Freshman dental students were randomly assigned to 12 groups. Groups were then assigned to one of six dentist-pyschologist teaching teams so that each team taught one mini-lecture and one role-playing group. Teaching teams taught seven sessions in which each mini-lecture/role-playing pair of groups received parallel subject matter. Following instruction, two outcome measures were administered: (1) an achievement post-test measuring factual recall, and (2) a measure of facilitative communication. Results indicated that mini-lectures were more effective than role-playing in effecting student mastery of factual information. There were no significant differences between the instructional treatments in teaching facilitative communication skills.

Curriculum↗
PubMed2001

A randomised controlled trial of the effectiveness of combining video role play with traditional methods of delivering undergraduate medical education.

OBJECTIVE: To determine the effectiveness of video role play with structured feedback in improving undergraduate communication skills and application of knowledge in genitourinary medicine. DESIGN: A blind, randomised, controlled trial. SUBJECTS AND SETTING: Fourth year undergraduates attending a 5 week attachment in genitourinary medicine during 1997 at a London medical school. INTERVENTION: A randomly selected sample group of undergraduates were filmed in the role of a doctor interviewing a patient (played by an actor) presenting with a genitourinary (GU) problem. Structured feedback by a GU physician and an educational psychologist was given a week later. The control group of undergraduates did not receive this training intervention. OUTCOME MEASURES: Student performance in two stations of an objective structured clinical examination (OSCE), administered at the end of their attachment. This tested communication skills and knowledge in GU settings. RESULTS: 132 undergraduates were assessed in the OSCE. 40 of these were in the sample group who received training using video role play with feedback and 92 were in the control group. The sample group scored significantly higher marks than the control group (p<0.001). CONCLUSIONS: Video role play with structured feedback is effective in improving undergraduate communication skills and application of knowledge in GU medicine settings.

Education, Medical, Undergraduate↗
PubMed1993

Development of a behavior analytically derived alcohol-specific role-play assessment instrument.

Social learning theory postulates that chronic alcohol abusers may have deficits in ability to cope with stressful situations, and these deficits may be associated with relapse after treatment. Attempts to study the hypothesized deficits have been hampered by methodological problems. Therefore, a behavior analytic procedure was used to develop 10 categories of situations based on over 600 drinking situations elicited from alcoholics. Role plays were developed for each of these categories, and samples of alcoholics in treatment were asked to respond as if they were trying not to drink. Videotaped responses were behaviorally rated by trained judges for skill and anxiety, and subjects completed self-report ratings of urge to drink, anxiety, difficulty and skill after each role play. Good interrater reliabilities and internal consistency were found across three samples of alcoholics, with virtually no gender differences. Previous and current investigations show the validity and utility of this instrument. The Alcohol Specific Role Play Test therefore shows promise as a means of assessing alcoholics' reactions to high-risk situations.

Adaptation, Psychological↗
PubMed2006

Do students develop better motivational interviewing skills through role-play with standardised patients or with student colleagues?

OBJECTIVE: Smoking is the leading cause of preventable death in the USA and reducing the number of smokers by 50% is among the goals of the Healthy People 2010 initiative. Despite its importance, few medical students receive formal training in smoking cessation counselling. Motivational interviewing is a patient-centred, but directive, method of counselling that has been found to be more effective than giving brief advice for motivating smokers to quit. We wanted to determine whether using standardised patients to teach this skill to Year 3 medical students would be more effective than using student role-plays. METHODS: We conducted a randomised, controlled trial of 93 Year 3 family medicine clerkship students at our medical school between July 2003 and July 2004. The control group (n=46) practised motivational interviewing with one another and the intervention group (n=47) practised with standardised patients trained in motivational interviewing for smoking cessation. At the end of the study all the students conducted an interview with a different standardised patient that was videotaped. The primary outcome was analysis by a trained masked evaluator of the quality of a final videotaped interview using the motivational interviewing treatment integrity code (MITI), which assesses the quality of the interview according to 6 different criteria. RESULTS: There was no significant difference between the control and intervention groups in the final analyses of the interviews. CONCLUSIONS: According to MITI scores, standardised patient role-plays are similar in effectiveness to student role-plays when teaching basic motivational interviewing skills for smoking cessation to Year 3 medical students.

Adult↗
PubMed1991

Using role-play to teach consultation skills--the Singapore experience.

Role-play by students has been adopted as a teaching method for learning consultational skills during a primary health care posting for fourth year medical students in the National University of Singapore. This article describes the construction of the framework used, and reports on its evaluation by both the students and their teachers. The overall response to the session by the students was positive. Suggestions were then solicited to make refinements to enhance its efficacy as a teaching tool.

Communication↗
PubMed1993

Using role-plays to teach palliative medicine.

Teaching of communication skills in Palliative Medicine can be achieved using a three hour exercise involving role-plays, a time of feedback and discussion, a teaching video and a reading list. Using this teaching method self-ratings of perceived skills recorded on a questionnaire before and four weeks after the exercises showed a significant increase in both undergraduates and postgraduates. The validity of these self-ratings as a tool to measure communication skills was assessed by correlating the self-ratings with the ratings given by the participant and the observers after the clinical scenarios from the questionnaire were simulated in role-plays.

Communication↗