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The greater strength of arginine: carboxylate over lysine carboxylate ion pairs implications for the design of novel enzymes and drugs.

The rational design of enzyme catalysts for chiral chemistry and of drugs which bind to proteins would be facilitated if rules for the recognition of one partner by the other could be formulated. This communication suggests and tests one generalization: arginine forms a tighter ion pair with a carboxylate group than does lysine and is always used for ion-pairs which are not broken during turnover in naturally-occurring enzymes.

Amino Acid Sequence↗

Modulation of anxiety-related behaviors by mu- and kappa-opioid receptor agonists depends on the social status of mice.

This study was aimed to determine the effects of mu- and kappa-opioid receptor activation in relation to the social status of mice, being a winner with repeated experience of victories or a loser with repeated experience of social defeats. The behaviors of the animals were assessed in a social encounter test measuring the communicative behavior towards a familiar and an unfamiliar partner behind a perforated transparent partition (partition test) and in an elevated plus-maze test estimating the anxiety level of mice. Placebo and graded doses of the mu-opioid receptor agonist DAMGO (0.5 and 2 mg/kg s.c.) and the kappa-opioid receptor agonist U-50,488H (0.6, 1.25, and 2.5 mg/kg s.c.) were administered to the control mice, winners and losers in two experiments. In the partition test, the winners spent somewhat more time and the losers less time than the controls in the vicinity of their partner probably related to a lower and higher level of anxiety respectively. In the plus-maze test the losers appeared to have a somewhat higher anxiety level than the controls and winners. In both tests DAMGO produced anxiogenic-like effects in the winners and the controls, but not in the losers. Winners hardly responded to treatment with U-50,488H, while the losers responded dose dependently with an anxiolytic-like effect in both tests. It is concluded that anxiety-like responses in mice are differentially affected by stimulation of mu- and kappa-opioid receptors and that the effects depend on the social status of the animals.

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗

Common molecular mechanisms of symbiosis and pathogenesis.

Traditionally, symbiotic and pathogenic interactions were considered different manifestations of the bacteria-host interaction. However, the molecular mechanisms that mediate communication between and cellular modulation of the involved partners are quite similar. With this review we aim to contribute to a reduction of the traditional gap between symbiosis and pathogenesis research.

Animals↗

OneView strategy aligns physicians with Carilion.

Carilion's OneView strategy will ultimately integrate and link our ambulatory activities to our members, patients and community. It is our technology level to lift Carilion, our physician partners and patients to a new level of communication, cooperation, service and quality health care. It will take several years to complete the project, but by the turn of the century we will have OneView of our ambulatory world.

Ambulatory Care Information Systems↗

Forming physician organizations. Part 2: The underlying reason a PO succeeds: an offense, not defense.

How has Community Health Partners been able to move the ball down the field toward the goal of a preferred network in its community? What are the specific offensive strategies CHP has implemented to bring about its vision? Part 1 of this series explored five reasons for CHP's progress: (1) A working, knowledgeable board of respected physicians, (2) A board that moves ahead on simultaneous tracks, (3) a willingness to affiliate with any hospital or payer that really knows how to partner with physicians, (4) developing quick wins and communicating the progress, and (5) educating physicians about the new ground rules for capitation. Here are six more reasons for CHP's success in forming a PO.

Capitation Fee↗

Neuraxial infusion for pain control: when, why, and what to do after the implant.

Neuraxial infusion therapy is an excellent option for selected patients with severe pain. Both epidural and intrathecal systems can be effective for multiple pains and are titratable, nondestructive, and very safe. Intraspinal therapy requires low opioid doses, has no motor, sensory, or sympathetic effects, and may have a lower side-effect liability than systemic therapy. Although most oncologists do not refer patients for intrathecal therapy, a recent study indicated that more oncologists would if they knew more about the therapy and if patients requested it. When permanent systems are used, close follow-up is essential. To obtain the maximum benefit from intraspinal therapy, pain management physicians and oncologists must communicate with each other and work together as partners.

Analgesics, Opioid↗

[Analysis of pragmatic aspects of communication behavior of verbal and nonverbal autistic children].

The analysis and intervention of communication is an important focus of autism research. The present study is a microanalysis of the communicative behaviour of 10 autistic children with their parents and a therapist. Protests, appropriate initiation and responses of the children were analysed in relation to demands and the specific feedback of the adults. After 20 months of structured therapy changes in the communicative behaviour of the participants were demonstrated. Autistic children showed different communicative pattern with their parents compared to a therapist. The non-verbal group exhibited significantly more protests and decreased responsivity with their parents compared to the therapist. The verbal group interacted with their parents predominantly by echolalia. After 20 months a significant reduction in protests, increased compliance and responsivity were obvious in the non-verbal group. The verbal group showed a reduction in echolalia as well as increased responsive and spontaneous communication. The results demonstrate that even non-verbal autistic children are sensitive towards different interaction partners. Over the observation period participants showed a reduction in behaviour problems and positive developments of communicative behaviour.

Adult↗

[A survey on contraceptive knowledge, attitude and behavior among never-married young women who are seeking pregnancy termination in Beijing].

OBJECTIVE: To identify contraceptive knowledge, attitude, behavior and its determinants among never-married young women who have unwanted pregnancy in Beijing. METHODS: A cross-sectional study under adoption of Lawrence "Procede-Proceed" model, was conducted in China in 1999. Three hundred and six unmarried young women aged 18 to 24, requesting for pregnancy termination were interviewed in person. RESULTS: Findings of this study indicated that only one-eighth (13%) of the young women insisted on contraceptive use every time, and almost an equal proportion (26.4%, 26.8% respectively) occasionally or never using contraceptives. Among 224 women who ever used contraceptives during the past 12 months, condom (49%) ranked the first place followed by withdrawal (27.7%) and the rhythm method (15.6%). One of the most important reasons, cited by 73 percent of women who had never used contraceptives, was that they were not aware of the risk of pregnancy when engaging in sexual activities. The results of logistic regression analysis revealed that knowledge about contraception, boyfriend's approval of contraceptive use, perceived the risk of getting pregnancy, perceived availability of contraceptive service and discussion of contraception with boyfriend were important indicators of young women's behavior on contraceptive use. CONCLUSION: These results indicated an urgent need to develop sex education about contraception among young women and men, through enhancing perception about risk of unwanted pregnancy and complications of induced abortion among young women, and to promote men's co-operation and participation in contraceptive use as well as strengthening communication on contraception between young women and their partners.

Abortion, Induced↗

Female sexual dysfunction.

Happiness is an attitude, not an event! The glass is either half-full or half-empty; it simply depends on the viewer. Some rich people are miserable...some poor people are ecstatic. You cannot change the world but you can change yourself. You, and you alone, control your destiny. With very little practice, you can learn to think positively. Postmenopausal estrogen deficiency leads to urogenital atrophy. Sexual dysfunction and urinary dysfunction are the most inevitable but least publicized consequences of estrogen deficiency, and these represent important quality-of-life issues that patients and health care providers are often reluctant to discuss. In addition to estrogen deficiency, oophorectomized women may be subject to androgen deficiency and problems with libido. While the relationship with one's partner is the quintessential factor in female sexuality, hormone deficiency remains important, especially in reference to genital atrophy. Humans are the products of learned behavior. We literally become what we think. "I am sick and tired" becomes a self-fulfilling prophecy. Self-esteem represents learned behavior just as ego does...but there is a world of difference between the two. Sexuality is enhanced by good self-esteem and hindered by ego: two partners working together can reach far greater heights than either alone ever imagined...one and one can equal three! There are good data to substantiate that happy people have more sex and that people who have more sex are happier. Partners need to learn to honor one another, communicate in a positive manner, develop touching salutations, be a spouse at home, and make their bedroom a sacred sanctuary. With a little behavior modification and hormone therapy, sexuality can remain a priority ad infinitum.

Atrophy↗

Contraceptive use behavior among never married young women who are seeking pregnancy termination in Beijing.

OBJECTIVE: To identify contraceptive use behavior and its determinants among never married young women with an unwanted pregnancy and seeking pregnancy termination in Beijing. METHODS: A cross sectional study, adopting the Lawrence' PRECEDE-PROCEED model was conducted in 1999 in Beijing, China. A total of 306 unmarried young women, aged 18 to 24 years and requesting pregnancy termination, were face to face interviewed. RESULTS: Only 13% of the young women insisted on contraceptive use, and almost an equal proportion occasionally or never used contraceptives (26% and 27%, respectively). Among 224 women who had contraceptive use during the past 12 months, the methods used most often were condom (49%), withdrawal (28%) and the rhythm method (16%). One of the most important reasons cited by 73 percent of women who had never used contraceptives was that they did not realize the risk of getting pregnant. The results of logistic regression analysis revealed that knowledge on contraception, boyfriend's approval of contraceptive use, perceived risk of getting pregnant, perceived availability of contraceptive services and discussion of contraception with boyfriend were important indicators of a young woman's contraceptive use behavior. CONCLUSION: These results indicate an urgent need to develop sex education on conception and contraception among young women and men. It is equally important to enhance young women's perception about the risk of unwanted pregnancy and the complications of induced abortion. Promotinga men's cooperation and participation in contraceptive use as well as strengthening communication on contraception between young women and their partners is essential.

Abortion, Induced↗

The role of the urologist in barren marriages.

This paper is addressed to the gynecologist, who is generally the first to be consulted by the patient because of her failure to conceive. Early in the study there arises the problem of assigning individual factors. Is the patient involved solely, or is there also a male factor? Excluding the female's role to bear and nurture the fertilized cell until maturity, the frequency of subfertility in the male is just as great as it is in the female. Evaluation of the male should be done early in the study of the childless couple because it is less complex and less time consuming. Assignment of the relative fertility of husband and wife depends on the correlation of the findings in each. For that reason, also, treatment of the subfertile husband should not be undertaken until it is definitely determined that his wife is either reproductively normal or has remediable abnormalities. On the other hand, improvement of the fertility of one partner may be sufficient to induce pregnancy. Frequent communication between gynecologist and urologist is of utmost importance. An attempt is made to clarify for the gynecologist the abnormalities that may be encountered, the treatment to be employed and the prognosis. The mere fact that hormone administration is generally not effective in the male should not lead to the conclusion that treatment of the male is useless and that nothing can be done to improve his semen quality.

Cryptorchidism↗

Collaborative practice: the nurse practitioner's role in its success or failure.

This study critically analyzes the underlying values, beliefs and behaviors of 18 family nurse practitioners and physicians who identified themselves as being in a joint practice relationship. Participants in the study were interviewed separately and in pairs around issues related to their reasons for joint practice, their interactional patterns, and how these patterns could be different. Transcribed interviews and data summaries for each practice were returned to the participants for review, discussion and validation. Results of the study suggested that the language, values and behaviors of the nurses continued to support, to varying degrees, the authoritarian and dominant position of the physician. In addition, nurses tended to demonstrate distorted communication and non-meaningful interactions. The possibility for nurses to create conditions in the practice relationship oriented toward mutual understanding and effective collaboration was clearly apparent in a few of these practices. Steps essential in achieving these conditions include the following: 1) self reflection; 2) clarification of goals; 3) examination of interactional patterns; 4) analysis of the level of commitment to mutual understanding; 5) willingness to risk calling issues into question; 6) conscious commitment to maintaining this level of communication over time; and 7) facilitating the physician partner's commitment to these goals.

Attitude of Health Personnel↗

Nursing care of children with developmental disabilities having surgery.

Children with developmental disabilities (CWDD) who undergo surgery have special needs. The nurse is required to make accurate assessments of the intellectual, psychosocial, and physical state of the child as well as the emotional functioning of the family. The nurse must be aware of the legal implications and his/her own attitudes regarding CWDD. Parents must be accepted as partners with the health care team and open communication should be established. Special concerns for the health care team are latex allergy and malignant hyperthermia. Nursing Care Plans specific to the child with pain, epilepsy, hydrocephalus, myopathy, Down syndrome, myelomeningocele, and cerebral palsy are provided. The material presented here should serve as a basis for nurses to deliver family-centered compassionate care to children and their families who are living with the burdens and enduring the hardships brought about by developmental disabilities.

Child↗

First coitus for adolescents: understanding why and when.

BACKGROUND: Correlates of initiation of coitus for teenagers were examined, and participants were asked their reasons for initiating or postponing the onset of coitus. METHODS: Questionnaires were completed privately by 218 patients aged 13 to 18 years. Questions explored the reasons adolescents cite for their sexual decisions and the role of peer influence in these decisions. RESULTS: Correlation was noted in young teenagers between perception of peer sexual behavior and participant's initiation of coitus. Reasons stated for engaging in first intercourse reflect both active choices and loss of control. Reasons for refraining included fear of pregnancy and sexually transmitted diseases, lack of developmental readiness and opportunity, and social sanctions. Morality was cited infrequently as a reason for postponing sexual behavior. CONCLUSIONS: Results suggest that sexuality education should address the direct and curious questions of younger teenagers about sexuality, help youth define strategies that they can use to evaluate and resist peer pressure, and give more generalized attention to ways of helping youth feel competent. Physicians and other health educators might focus on helping older youth define how and when they know they are ready to have intercourse, consider ways of expressing sexuality that do not jeopardize health, and improve communication skills when talking with friends and potential partners about sexual issues.

Adolescent↗

Multiple partners, risky partners and HIV risk among low-income urban women.

A sample of 671 predominantly single, young black women living in 10 low-income housing developments in five cities completed an anonymous questionnaire assessing factors related to their risk of contracting the human immunodeficiency virus, including their sexual behavior and condom use, and their partners' risk-related behaviors. In the two months before the 1994 survey, 17% of the women had sex with multiple partners and 22% had an exclusive partner who either had had other sexual partners in the past year or had a history of injection drug use; 40% had an exclusive partner who they believed had not engaged in these risky behaviors. During the same interval, 26% of women who had multiple partners received treatment for a sexually transmitted disease, compared with 9-11% of those who had an exclusive relationship. Condom use at last intercourse and communications about condom use were less frequent among women with an exclusive, risky partner than among those with multiple partners; attitudinal barriers to condom use did not vary, however, by the characteristics of women's relationships.

Adult↗

Sex pheromone communication and its regulation by the sex determination pathway in cockroaches.

Sexual communication in animals orchestrates a series of interactive behaviors from locating and recognizing potential partners to courtship and final mating decisions and is thus critical for sexual reproduction and population fitness. Highly efficient communication between the sexes requires not only the production and emission of species-specific signals but also their precise detection and interpretation by the receiving individuals. Cockroaches, as one of the most evolutionarily ancient and successful group of insects, are quintessential chemical communicators that rely heavily on sex pheromones for sexual communication. They have long served as excellent model organisms in studies of chemical ecology. Although the biochemical characterization of sex pheromones in several species was largely accomplished during the last century, the past two decades have witnessed remarkable progress in understanding the molecular genetics of sex pheromone communication and its regulation, particularly driven by functional genomics. This review first provides an updated comparative survey of the pheromone components identified across distinct taxa. We then synthesize, but not limited to, recent advances in identification of key molecules controlling sex pheromone production, characterization of candidate chemosensory receptors and their neural processing pathways, and the regulatory roles of the sex determination cascade in shaping sexually dimorphic traits in both pheromone production and perception. Finally, we highlight key scientific questions that remain unsolved and propose future directions aimed at extending our mechanistic understanding of cockroach pheromone communication, as well as at developing behavior-based pest management strategies.

biosynthetic pathway↗

Nonverbal communication and play correlates of language development in autistic children.

The aim of this study was to determine the social and cognitive correlates of language acquisition in autistic children. Functional and symbolic play skills were shown to be associated with language abilities in a sample of young autistic children (mean CA 54.5 months), thereby replicating previous findings. Certain types of nonverbal communication skills were also shown to be significant correlates of language development in this group of autistic children. These involved the ability to use gestures to coordinate visual attention between social partners with respect to objects or events. The play and nonverbal communication variables were not significantly correlated, suggesting that these variables reflect independent psychological factors associated with language development in young autistic children.

Autistic Disorder↗

Communication technologies in health care environments.

A successful implementation of hierarchical health care networks is dependent on a number of different technical and non technical factors. This paper investigates how the networking technologies, both 'traditional' and broadband, can support the communication requirements of medical environments. The general purpose is to implement communication infrastructures and services, which will improve the collaboration between the different partners in the health sector in offering better healthcare services at affordable costs.

Computer Communication Networks↗