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Methods to map protein interactions in mammalian cells: different tools to address different questions.

In the post-genome era, functional annotation of the predicted gene-sets will be one of the most important upcoming challenges. So-called interactome analysis positions a protein in its subcellular environment by mapping its interaction partners. Such interaction maps are essential for an accurate insight into protein function since many cellular processes are organised to operate in protein complexes. These assemblies have dynamic structures and can interact with each other, two properties which are often controlled by regulated protein expression and modification. Various methods exist to unravel protein interaction circuitries, which can be roughly divided into biochemical and genetic strategies. In this review we focus on the different strategies to study protein-protein interactions in living mammalian cells. Recently developed analytical and screening methods are also addressed.

Animals↗

Expanding the avenues for addressing patient safety.

The Safety Case Management Committee, initiated in 1999, is a core component of the safety program at the Department of Veterans Affairs Medical Center in Ann Arbor. It is one of several approaches the facility uses to address error prevention or to contain its damaging effects.

Hospitals, Veterans↗

[Continuous challenges in Japanese forensic toxicology practice: strategy to address specific goals].

In this paper, the status quo of forensic toxicology in Japan and the West is surveyed and a strategy to address future goals of Japanese forensic toxicology is proposed. Forensic toxicology in the West consists of three main areas--post-mortem forensic toxicology, human-performance forensic toxicology and forensic urine drug testing. In Japan, post-mortem forensic toxicology is practiced in university forensic medicine departments while most of the human-performance forensic toxicology is carried out in police laboratories. However, at least at present, strictly controlled workplace urine drug testing is not being performed, despite the abuse of drugs even by uniformed members of the National Defence Forces and police. For several years, the author has been introducing Western forensic toxicology guidelines and recommendations, translated into Japanese with the help of Western forensic toxicologists, to Japanese forensic toxicologists. Western forensic toxicology practice is at an advanced stage, whereas Japanese practice is in a critical condition and holds many problems awaiting solution, as exemplified by the urine drug testing in police laboratories. There is never any sample left for re-examination by the defence in all cases, though the initial volume of the urine sample available for examination is 30-50 ml. Only one organisation carries out everything from sampling to reporting and, in addition, the parent drug and its metabolites are not quantified. It is clear that the police laboratories do not work within good laboratory practice guidelines, nor do they have quality manuals or standard operating procedures manuals. A basic change in Japanese forensic toxicology practice is now essential. The author strongly recommends that, first of all, Japanese toxicologists should prepare forensic toxicology guidelines based on the Western models. The guidelines would progress the following objectives for forensic toxicology laboratories: 1) to have documented good laboratory practice standards; 2) to have a quality control system including a quality manual and standard operating procedures manual; 3) to have some degree of compulsion to implement quality assurance both through their own internal efforts and by appropriate remedial actions based on the results of an external proficiency testing scheme. For forensic toxicologists, the implications are that they should be: 1) responsible for ensuring that laboratory practices are performed under satisfactory conditions and 2) required to be certified as a forensic toxicology specialist in order to prove their forensic toxicology ability. For their part, governments should: 1) carry out administrative reforms related to forensic toxicology; 2) simplify the procedure for obtaining certified reference materials; 3) introduce a strict workplace urine drug testing programme for government employees, at least for those related to law enforcement. When all of these objectives have been realised, the specific goal will be achieved through which Japanese forensic toxicology is able, in practice, to fulfill its responsibility to society.

Forensic Medicine↗

Frames of reference that address the impact of physical environments on occupational performance.

A frame of reference is the mechanism for linking theory to practice. It may be the most practical and important tool a professional uses. As the practice of occupational therapy has evolved, so has the basis of information, or theories, on which it is grounded. From the theories, models have been developed that typically view occupational performance as a transaction between the person, occupation and environment. Occupational therapy practitioners use many frames of reference. Not all of them address all areas of occupational performance identified within this overarching model. Often the area of the environment does not receive attention. To do their jobs thoroughly, occupational therapy practitioners need frames of reference for thinking about the environment. The purpose of this paper is to identify and explore frames of reference that may be useful to occupational therapy practitioners when they are taking into consideration the physical environment. Included are the following frames of reference: ergonomics, industrial hygiene, environmental psychology, accessibility and feng shui. A case study is presented to illustrate the unique perspective of each frame of reference.

Journal Article↗

Addressing cardiovascular disease in patients with renal disease.

It is well-established that patients with renal disease are at increased risk of cardiovascular disease (CVD) death. Despite better understanding of CVD in endstage renal disease (ESRD) patients and more rigid guidelines addressing the major risk factors for CVD in this population, CVD continues to be the number one cause of death in patients with ESRD. Moreover, higher rates of CVD are seen in patients with moderate, and even mild, renal dysfunction and in patients with albuminuria (micro and macroscopic). Few studies with CVD endpoints have included patients with renal disease. There is sufficient evidence to support appropriate blood pressure reduction as having a beneficial effect on CVD morbidity and mortality in patients with renal disease (especially for patients with diabetes). Data supporting the benefit of modification of other CVD risk factors is not as strong, but current recommendations do stress aggressive control of lipids, smoking cessation, and maintenance of adequate nutritional status. Inclusion of patients with renal disease in studies with CVD endpoints is necessary. Until then, it is generally recommended that CVD risk stratification and modification strategies be applied to this high-risk population.

Albuminuria↗

Technical implementation of an Internet address database with online maintenance module.

The article describes the technical implementation and management of the Internet address database of the center for ZMK (University of Münster, Dental School) Münster, which is integrated in the "ZMK-Web" website. The editorially maintained system guarantees its topicality primarily due to the electronically organized division of work with the aid of an online maintenance module programmed in JavaScript/PHP, as well as a database-related feedback function for the visitor to the website through configuration-independent direct mail windows programmed in JavaScript/PHP.

Database Management Systems↗

A Cohort Study to Address the Natural History of HPV and Cervical Dysplasia in Trivandrum, South India: Methodological Issues and Initial Results.

Epidemiological studies, especially cohort studies have many limitations in countries like India. The present population based molecular epidemiolohgical cohort study was planned to address the prevalence, risk factors and natural history of uterine cervical HPV infection in women in an area of suburban dwellings in South India. Epidemiological data, blood samples and cervical scrape smears were collected from women after obtaining an informed consent. A compliance rate of 38% for the first round of screening was noted. More than 70% of women demonstrated evidence of inflammation in their smears.

Journal Article↗

Prosthetic systems for addressing problems with initiation: guidelines for selection, training, and measuring efficacy.

In this paper we address the practical considerations for rehabilitation of problems with initiation. A variety of rehabilitation strategies for clients who have problems with initiation are discussed, as are our recommendations for the use of an external cueing system with these clients. Available external cueing systems are reviewed, including those that have been shown to be effective for prospective memory deficits. We identify important factors involved in selecting a particular external cueing device, and we provide guidelines for training to both respond to and program external cues. Finally, we discuss ways to monitor the efficacy of rehabilitation of problems with initiation. Throughout we provide an illustrative case example describing implementation of an external cueing system with a client who has difficulties with initiation, other aspects of executive function, and anterograde amnesia.

Humans↗

Address risks of staff who get smallpox vaccine.

You'll need a policy to reduce risks of inadvertent transmission of the smallpox virus to address staff participation in the military's vaccination program. Vaccinated staff must wash hands, especially after touching the vaccination site or bandages. Implement Centers for Disease Control and Prevention guidelines to avoid transmission to staff, patients, and visitors. Have newly vaccinated staff avoid contact with immunocompromised patients if possible.

Centers for Disease Control and Prevention, U.S.↗

Hepatitis B vaccination: addressing a drug-related problem in hemodialysis outpatients with a collaborative initiative.

UNLABELLED: The CDC recommends that all hemodialysis (HD) patients be vaccinated against hepatitis B virus (HBV). In 1999, only 39 of our 134 (29%) HD patients had received HBV vaccine. Since the vaccine is indicated for all HD patients, this presented a drug-related problem (DRP): indication without treatment. In response, nurses and pharmacists initiated a proactive HBV vaccination program. METHODS: An immunization protocol based on then current CDC recommendations was developed. HBV vaccine (40 mcg i.m.; at 0, 1 and 6 months) was administered to consenting HD patients. Anti-hepatitis B surface antibody (anti-HBs) titers were monitored and booster doses were given per the protocol. RESULTS: By August 2001, all consenting HD patients (n = 110) had received > or = 1 dose of HBV vaccine and 90 (81.8%) had either received a full course (> or = 3 doses) or had received > or = 1 dose and developed a positive anti-HBs titer (> or = 10 mIU/mL). Of these 90 patients, 52 (58%) developed a positive anti-HBs titer, 33 (37%) responded to < or = 3 doses, and 19 (21%) following a booster. The DRP was significantly improved. CONCLUSION: Given CDC guidelines, HBV vaccine should be offered to all HD patients. This initiative demonstrates that with concerted effort all consenting HD patients can receive HBV vaccination, thereby addressing an important DRP.

Algorithms↗

[Conformational aspects of biological activity of functional fragments of the p21ras oncoproteins. 4. Address fragments of the receptor oncoproteins].

Decapeptide fragments of the scr, fgr, fps, and yes oncoproteins were studied by theoretical conformational analysis, and the arrangement of ionized residues in these fragments was found to be complementary to the binding site of p21. The results demonstrated a similarity in conformational properties of these peptides and their structural complementarity to the address fragment of p21. On the basis of this computation, a model of interaction of the p21ras family of oncoproteins with their cellular receptors was suggested.

Binding Sites↗

Addressing disparities through dental-medical collaborations, part 1. The role of cultural competency in health disparities: training of primary care medical practitioners in children's oral health.

This paper introduces a series of articles examining specific dental-medical educational collaborations intended to decrease oral health disparities. The first article discusses cultural competency and its relationship to oral health disparities. The next two articles present pediatric oral health educational programs for medical practitioners, one targeting primary care practitioners and the other training family practice residents. This introductory article reviews the national public health agenda for oral health, explains the rationale for targeting dental-medical educational collaborations to address health disparities, and identifies important gaps in dental as well as medical education, especially in the area of infant oral health. Key findings of the two projects are reviewed as well as lessons learned. We call for leadership in dental education in three critical areas: cultural competency, infant oral health, and ethical and professional values. Given the historical isolation of dentistry, strong leadership at the level of the dean's office is needed to advance the agenda of eliminating oral health disparities through collaborations among dentistry, medicine, and the other health professions. Finally, an appreciation of the professional obligations of dental educators, practitioners, and the profession of dentistry can add resolve to this new prioritization.

Child↗

Addressing infrequent cancer screening among women.

National health policies must be revised to support basic health services for all Americans, a breadth of cost-effective health practitioners, and a system that provides comprehensive, coordinated care in decentralized locations. State and local advocacy groups should increase consumers and policy-makers awareness about inadequate cancer screening. Educational institutions should address cancer prevention for practitioners in training. Practice institutions should employ nurses and nurse practitioners more effectively, as well as institute computerized feed-back and reminder systems. More rigorous research on the effect of educational messages on client beliefs, affect, and screening behavior are needed to guide interventions for cancer control.

Female↗

In the right words: addressing language and culture in providing health care.

As part of its continuing mission to serve trustees, executives, and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a group of experts from philanthropy, research, health care practice, and policy on April 4, 2003, to discuss the roles of language and culture in providing effective health care. During this Issue Dialogue, In the Right Words: Addressing Language and Culture in Providing Health Care, health grantmakers and experts from policy and practice participated in an open exchange of ideas and perspectives on language access and heard from fellow grantmakers who are funding innovative programs in this area. Together they explored ways to effectively support comprehensive language services, including the use of interpreters and translation of written materials. This Issue Brief synthesizes key points from the day's discussion with a background paper previously prepared for Issue Dialogue participants. It focuses on the challenges and opportunities involved with ensuring language access for the growing number of people who require it. Sections include: recent immigration trends and demographic changes; the effect of language barriers on health outcomes and health care processes; laws and policies regarding the provision of language services to patients, including an overview of public financing mechanisms; strategies for improving language access, including enhancing access in delivery settings, promoting advocacy and policy change, improving interpreter training, and advancing research; and roles for foundations in supporting improved language access, including examples of current activities. The Issue Dialogue focused mainly on activities and programs that ensure linguistic access to health care for all patients. Although language and culture are clearly inseparable, a full exploration of the field of cultural competence and initiatives that promote its application to the health care setting are beyond the scope of this Issue Brief. The day's discussion did, however, raise provocative issues of culture that are reflected throughout this report.

Civil Rights↗

A bereavement care service to address multicultural user needs.

A bereavement care service was set up in a large, acute NHS trust to understand and address the multicultural and multifaith needs of all its users. The service has not only facilitated support and guidance for friends and relatives at a time of great need and vulnerability, it has also made professionals throughout the trust aware of the importance of death with dignity.

Coroners and Medical Examiners↗

National Academy of Neuropsychology Distinguished Neuropsychologists Award address. Slouching toward the milennium: some survival prescriptions for neuropsychology.

The following address was given as the Distinguished Neuropsychologist Award Presentation and Acceptance Speech at the 15th annual conference of the National Academy of Neuropsychology, San Francisco, November 2, 1995. Substantive issues discussed include: (a) the threatened loss of the clinical in clinical neuropsychology; (b) post-doctoral training and job market dilemmas in 1995; (c) proficiency versus specialty status for neuropsychology; (d) the Battle of the Boards (ABCN, APBN); and (e) forensic neuropsychology, a cautionary note.

Journal Article↗

A collaborative effort between nurse leaders to address the hospital nursing shortage.

The current nursing shortage is not a routine swinging of the supply pendulum. Indeed, this shortage is determined to be quantitatively and qualitatively different from those of the past (Kimball & O'Neil, 2002). In Cincinnati, Ohio, nurse leaders decided that the uniqueness of this shortage necessitated new strategies. Hospital nurse executives proposed the creation of a community leadership group, and other Cincinnati nurse leaders enthusiastically embraced the idea. A collaborative effort was initiated in the spring of 2000 between a representative group of hospital chief nursing officers, school of nursing deans and faculty, staff nurses, hospital nurse recruiters, and professional nursing organizations to address concerns related to the nursing shortage. This article describes the process and outcomes of this collaborative effort with a focus on the retention of hospital nurses.

Adult↗

Addressing the shortage. Strategies for building the nursing workforce.

For more than two decades, nursing educators and administrators have grappled with issues of declining student enrollments and the concurrent "defection" of nurses from the labor market. This article describes both short- and long-term strategies for addressing the nursing shortage and identifies new opportunities for collaboration in building the nursing workforce of the future.

Attitude of Health Personnel↗