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Social disparities in cancer: lessons from a multidisciplinary workshop.

The problem of social disparities in cancer continues to challenge health care researchers. This article summarizes the themes and lessons emerging from a 2004 workshop that convened researchers from academic and government venues to review and discuss the extant literature, and to develop new conceptual frameworks for future investigations. Workshop participants explored the factors that contribute to social inequalities in cancer in the U.S. including the relative contributions of race and racism, the independent contributions of socioeconomic position, insurance, and access to care. Noting the heterogeneous patterns of inequality across cancer types, the multiple underlying causes of disparities, and the role of the health care system itself, the authors call for an organized program of multidisciplinary research.

Delivery of Health Care↗

Linking water science to policy: results from a series of national workshops on water.

To ensure science better informs the decision-making process, researchers and policy/program managers need to understand and respect each other's way of working, culture and operational timelines. However, there is little practical guidance on how this should be done and even less documented experience with specific mechanisms that better link these two groups. The published literature on information transfer has largely emphasized the dissemination of standard packages of information to ill-defined constituencies whose needs for scientific information are not well understood. Environment Canada's National Water Research Institute, on behalf of the Canadian Council of Ministers of the Environment, led a series of "Linking Water Science to Policy Workshops" as one such mechanism by which recent science could be delivered to practitioners, and practitioners could identify their research needs to scientists and research managers. There is a pressing need to explore and share experiences using creative mechanisms for sustained dialogue and networking between scientists and policy and program managers. The lessons learned from the workshop series and the need for science to continually inform the decision-making process has particular relevance for Canada's Ecosystem Initiatives given their integrated, place-based focus on long-term restoration and protection, and the challenge of continually changing ecosystems.

Canada↗

Pregnancy-maintaining antibodies: workshop report (Giessen, 1988).

To analyse the nature of antibodies which are purported to be essential for the maintenance of normal human pregnancy, six centers participated in a workshop of "blind" tests on 19 allosera. Fc-receptor dependent assays detected antibodies with specificity only for HLA. In addition to cytotoxic antibodies, the Fc-receptor dependent immune phagocytosis inhibition test revealed two non-cytotoxic alloantibodies with HLA specificity. These antibodies had high titers and may, therefore, be essentially non-cytotoxic. Murine monoclonal antibodies to HLA-A, B, C or DR (W6/32 and 2MC3) were used to evaluate the methods. These antibodies inhibited immune rosette formation as well as immune phagocytosis. Diluted to concentrations below the threshold of complement-dependent cytotoxicity, the monoclonal antibodies still inhibited the mixed lymphocyte reaction and the immune phagocytosis. A human monoclonal immunoglobulin M with specificity for monomorphic non-HLA lymphocyte antigens inhibited the mixed lymphocyte reaction. The immune rosette inhibition test exhibited several false positive reactions, e.g. three out of four with a serum that did not contain alloantibodies to blood cells. Non-cytotoxic antibodies were therefore rare in the selected sera of the workshop and they exhibited HLA specificity only. No participant was able to identify pregnancy-maintaining non-HLA-antibodies.

Abortion, Habitual↗

Characterisation of lymphocyte populations in African buffalo (Syncerus caffer) and waterbuck (Kobus defassa) with workshop monoclonal antibodies.

In order to measure different lymphocyte populations in buffalo (Syncerus caffer) and waterbuck (Kobus defassa), we analysed the monoclonal antibodies from the 1st International Workshop on Leukocyte Antigens in Cattle, Sheep and Goats for suitable cross-reactive reagents. Peripheral blood mononuclear cells from three buffalo and three waterbuck were tested with the whole panel of monoclonal antibodies (mAbs) together with some additional antibodies against MHC and Ig. In some clusters almost all antibodies cross-reacted (CD2, CD8), in others almost none cross-reacted (CD4, CD5) and in cluster CD6, mAbs only reacted with buffalo but not waterbuck. Double staining experiments were performed on buffalo PBM with the cross-reacting antibodies, to confirm that they detected similar cell populations as in bovine PBM. This was shown with reagents against CD2, CD4, CD6, CD8, CD11, WC1, WC3 and Ig. The molecular weights of the buffalo antigens correlated well with those of the homologous cattle antigens. In the CD5 cluster, only one mAb reacted with the two wild species, and defined an unusual CD2+ CD5- cell population in buffalo. Also mAbs cross-reacting with buffalo MHC class II detected unusual expression on resting T cells. From the results presented, it is clear that the workshop panel contains mAbs against the most important T and B cell antigens of buffalo and probably waterbuck, which will allow us to compare functional lymphocyte populations in cattle and wild ruminants.

Animals↗

Reactivity of workshop monoclonal antibodies with normal and pathological ovine lymph nodes.

The monoclonal antibodies (82 mAbs) included in the Second Workshop that belonged to agreed named bovine CD and workshop clusters were tested for their reactivity and tissue distribution on (1) normal sheep lymph nodes and (2) pathological sheep lymph nodes. Pathological lymph nodes were induced following experimental infection with Corynebacterium pseudotuberculosis and were characterized by the presence of typical pyogranulomas. Amongst the 82 mAbs tested, 38 reacted with sheep lymph nodes. The results of these tests are presented and discussed.

Animals↗

Summary of workshop findings for porcine T-lymphocyte antigens.

Fifty-four mAb preselected in the first round of the first porcine CD workshop for their possible reactivity with T-lymphocyte specific antigens and/or activation antigens were further analysed in a second round. PBMC, thymocytes and nylon-wool purified T lymphocytes derived from peripheral blood, mesenteric lymph nodes and spleen served as target cells for flow cytometric analyses. For the classification of activation antigens several experiments were performed with activated, mitogen-stimulated T lymphocytes and long-term T-lymphocyte cultures. Out of the 54 mAb, 35 mAb could be distributed to six different CD clusters and two swine workshop clusters (SWC). Five mAb could be distributed to the porcine CD2, four mAb to the CD4. Six mAb seemed to recognize the porcine CD5 and two mAb the porcine CD6 analogue. Six mAb were directed against the porcine CD8, whereas two different epitopes could be defined. One mAb was directed against the porcine CD25 analogue. Nine mAb could be clustered to the SWC1, defining an antigen on T lymphocytes and cells of the myeloic linage. Two mAb with high T-cell specificity were clustered to the SWC2.

Animals↗

Report on the behaviour of monoclonal antibodies in the First International Pig CD Workshop identifying the Null cell families.

Clustering analyses were carried out on data from five independent laboratories testing 22 monoclonal antibodies (mAbs) reacting with CD2-sIg-lymphocytes on 14 pig blood and/or tissue lymphoid target cells using cytofluorometry. This was coupled with extensive further studies on blood lymphocytes from normal and thymectomised SLAb/b inbred pigs. These mAbs formed two groups: those mainly identifying the large blood-borne thymus-dependent Null T cells (N) and those reacting with tissue and a small number of blood-borne thymus-independent lymphocytes (N'). Based on their tissue cell reaction patterns, the 10 N' mAbs formed three main groups: N'1A and B; N'2A and B; and N'3. The 12N mAbs fell into four groups N4-N7; N6 was divided into subgroups A-D. One N' (032) and two N mAbs (010 and 063) were unclustered. Based on these data, swine workshop cluster numbers were designated to groups N5 (021, 022 and 059) as SWC4, N6 (061 and 117) as SWC5 and N7 (020 and 141) as SWC6, the latter exceptionally as a single antibody, MAC320, since it is the 'type' mAb identifying effectively all blood Null T lymphocytes. Future research and workshops will have to define with a wider range of techniques the relationships, molecular properties and functional roles of the several new, perhaps novel, antigens identified by this family of fascinating, as yet still poorly defined, mAbs.

Animals↗

Assessment of three methods of evaluating soluble class I HLA molecules in cell culture supernatants and serum samples from the second international workshop on soluble human leukocyte antigens.

Three methodologies were compared in assessing sHLA specificities in cell culture supernatants and serum specimens from the Second International Workshop on sHLA: CDC inhibition, FC inhibition, and cellular ELISA inhibition. Initially, the CDC inhibition assay used polyclonal antisera in commercial HLA-phenotyping trays to confirm known specificities and screen for unknown specificities in 31 specimens. Although partly successful, critical limits were imposed by the variable antiserum titers. Thus, using pools of these same antisera and renal transplant recipient antisera, the FC inhibition assay was employed to determine the endpoint serum titers before confirming the known sHLA specificities. Of 25 specimens, four were not confirmed and five gave weak inhibitory reactions. The cellular ELISA inhibition assay, incorporating patient sera and mAbs toward three HLA, successfully confirmed all three known specificities in eight selected workshop specimens. Each methodology had advantages and disadvantages, but all three methods were successful in detecting and identifying sHLA class I specificities. Success, however, was dependent on the initial characterization (specificity and titer) and titration to end point (appropriate for each method's sensitivity) of each antibody preparation.

Cells, Cultured↗

Proceedings of the Workshop on the Acceptability and Interpretation of Dermal Developmental Toxicity Studies.

The workshop on The Acceptability and Interpretation of Dermal Developmental Toxicity Studies, held April 13-14, 1988, was organized by the U.S. EPA's Office of Research and Development and Office of Toxic Substances and was supported by the Agency's Risk Assessment Forum. The purpose of the workshop was to review the current state of knowledge on the use of the dermal route of exposure in developmental toxicity studies. In evaluating this area, three major issues were considered by the participants: (1) the evaluation of maternal toxicity in dermal developmental toxicity studies, (2) what types of pharmacokinetic data are necessary or desirable for the appropriate design and interpretation of these studies, and (3) what factors are important to consider in the design of dermal developmental toxicity studies. The participants concluded: (1) dermal developmental toxicity studies without any indication of maternal or developmental toxicity are inadequate for risk assessment unless accompanied by absorption data, (2) absorption data and limited pharmacokinetic data should be collected in every dermal developmental toxicity study, and (3) dermal developmental toxicity studies in which skin irritation is too marked should be considered inadequate for risk assessment. General recommendations made for all developmental toxicity studies regardless of the route of exposure were: signs of local irritation should be examined, and absorption/pharmacokinetic data should be developed. Areas in which additional research is needed to permit more complete assessment of dermal developmental toxicity studies were also identified.

Absorption↗

Workshop on risk assessment in reproductive and developmental toxicology: addressing the assumptions and identifying the research needs.

The risk assessment process is an imprecise procedure aimed at determining a toxicant exposure level with an acceptable risk to the human population. The lack of precision is due to the uncertainties in the assumptions that must be made due to the lack of specific scientific information or knowledge of how to use certain types of data. Unfortunately, every necessary piece of information cannot be obtained for every chemical requiring a risk assessment. In order to better identify and understand some of the assumptions that are made in the risk assessment of reproductive and developmental toxicants, a workshop was organized to specifically define the assumptions underlying the risk assessments for seven specific toxicants (dibromochloropropane, dioxin, glycol ethers, heptachlor, lead, tetrahydrocannabinol, and vitamin A) and to determine the potential research which would reduce the uncertainty associated with making those assumptions. The major assumptions discussed centered around the topics of heterogeneous populations, thresholds, safety factors, exposure assessment, quantitative structure-activity relationships, and mechanisms. This report is the summary of the workshop discussions.

Animals↗

Workshop on the health effects of HCl in ambient air.

This article presents a summary of the proceedings of the Workshop on the Health Effects of HCl in Ambient Air, held in Detroit, Michigan, on October 15, 1990. Participants addressed three topic areas: sources, levels, and chemistry of HCl in ambient air; toxicity of atmospheric HCI to humans and animals; and the need for future research on toxicity and exposure. Consensus conclusions related to each of these topic areas, arising form the deliberations of the workshop participants, are presented. These include: (1) atmospheric HCl will most commonly exist in the gaseous form; (2) long-range transport of HCl is probably of limited importance; (3) ambient HCI levels are in the low parts per billion range; (4) irritation of the upper airways appears to be the most sensitive indicator of exposure; (5) such effects are likely to occur only at exposure levels much greater than those measured in ambient air; and (6) future health research should focus on occupationally exposed populations and potentially sensitive subgroups, e.g., asthmatics.

Air↗

Menopause research: the Korpilampi workshop.

A workshop on menopause research focused on three topics: (1) problems and issues in the definition of menopausal status: (2) problems and issues in cross-cultural research: (3) the contributions which research in the behavioural sciences can make to clinical research and practice. Among the conclusions reached by the workshop was the recommendation that researchers should adopt a standard definition of menopause based on the cessation on menses. Yet, while standard definitions are essential to scientific comparison, it is also important to determine how women decide on their own status, particularly when working cross-culturally.

Adult↗

A multidisciplinary patient education workshop to integrate staff training with program development.

A four session multidisciplinary workshop was held to teach Veterans Administration (VA) Medical Center staff basic patient education design principles. During the sessions, staff, working in teams, designed patient education programs on a wide variety of health care topics. Guidance to teams was provided at each step of program development so that at the end of the workshop, programs were ready for implementation. Medical Center standards for patient education and documentation were integrated into program designs.

California↗

Breast cancer workshop for nurses: innovative approach to staff development.

Breast cancer is a major health problem today. Mastectomy and adjuvant therapy are standard treatments available in most acute care hospitals. Nurses who care for mastectomy patients have primary responsibility for patient education. This article describes use of a breast cancer workshop to strengthen teaching capabilities of staff nurses. The workshop addresses facts regarding breast cancer and the educational needs of breast cancer patients. It also provides opportunity for nurses to develop patient education standards for patients who have had a mastectomy.

Breast Neoplasms↗

Workshop on DNA repair.

A workshop on DNA repair with emphasis on eukaryotic systems was held, under the auspices of the EC Concerted Action on DNA Repair and Cancer, at Noordwijkerhout (The Netherlands) 14-19 April 1991. The local organization of the meeting was done under the auspices of the Medical Genetic Centre South-West, The Netherlands (MGC), c/o Department of Radiation Genetics and Chemical Mutagenesis, University of Leiden (The Netherlands). Local organizers were: D. Bootsma (chairman), W. Ferro, J.H.J. Hoeijmakers, A.R. Lehmann, P.H.M. Lohman, L. Mullenders, and A.A. van Zeeland (secretarial assistance: Mrs. C. Escher-van Heerden and Mrs. R. Bontre). Over 190 scientists participated, and the format of the meeting followed that of the 1987 workshop on the 'Molecular Aspects of DNA Repair' (Friedberg et al., 1987). Plenary review talks in the mornings were followed, in the afternoon, by poster viewing in three or four parallel sessions. Groups of 15-20 posters were discussed in detail, and later on, in plenary sessions, chairpersons of the poster discussions reviewed the afternoons' posters. The principal themes of the meeting were the isolation and characterisation of repair genes and proteins, repair in specific sequences, consequences of defective DNA repair, and new methods for detecting DNA damage and repair. Remarkable progress has been made recently in all of these areas, and many exciting new results were presented. It is impossible to summarize all contributions to this (intensive) one-week meeting. Therefore, and for the sake of coherence, presentations that did not fit easily into any of the general themes of the meetings have not been included.

Animals↗

X-linked myotubular myopathy. 33rd ENMC International Workshop Soest. The Netherlands, 9-11 June 1995.

The research work presented at this the 2nd Workshop of the International Consortium on X-linked Myotubular Myopathy has clearly shown the benefits to be gained from a multinational research consortium with a common interest in identifying and cloning the MTM1 gene. The clinicians have rapid access to knowledge about the current state of the detailed physical map encompassing the disease gene, which is of particular importance when asked to carry out a linkage-based carrier risk assessment in such families, and the molecular geneticists benefit by having access to a large panel of samples from clinically well-documented XMTM patients, and their families, for the rapid testing of any new potential candidate genes. Strategies for the rapid exchange of information and material between members of the consortium to facilitate the cloning of the MTM gene were generated in the hope that the next Workshop will see the consortium discussing the clinical and histological implications of the mutations found. To this end it was decided to set up a Register, based in Cardiff, of all XMTM patients from whom tissue and DNA samples had been made available to the consortium. A decision was also made to collect samples from the very rare families with possible autosomal MTM for future study.

Genetic Linkage↗

Workshop on Alcohol Use and Health Disparities 2002: a call to arms.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH) sponsored a "Workshop on Alcohol Use and Health Disparities 2002: A Call to Arms," on December 5, 2002, in Bethesda, Maryland, USA. This workshop was part of the NIAAA/NIH comprehensive strategic plan to reduce, and ultimately eliminate, health disparities. Eleven topics were addressed: (1). biomedical risk factors that may contribute to disparities in the toxic effects of alcohol; (2). alcohol and gene-environment interactions that affect the health of diverse groups; (3). alcohol pharmacogenetics in Mexican-Americans; (4). determinants of risk for alcoholism in minority populations; (5). consideration of population groups in linkage-disequilibrium studies to identify genes associated with alcohol dependence; (6). interaction between alcohol dependence and African-American ethnicity in disordered sleep, nocturnal cytokines, and immunity; (7). disparities of brain functional reserve capacity affecting brain morbidity related to substance abuse; (8). alcohol and pregnancy disparities; (9). role of alcohol in cancer risk disparities; (10). ethnic diversity in alcoholic cardiomyopathy; and (11). postmenopausal health disparities. On the basis of these presentations, seven conclusions emerged: (1). Genetic variations in alcohol-metabolizing enzymes exist in various populations. (2). These enzymes play a role in the variation in health effect outcomes seen in different populations, owing to alcohol consumption. (3). Differences between and among population groups can be critically important for the design and interpretation of studies in genetics. These include differences in expression of phenotype, in locus heterogeneity, in risk alleles, and in population structure. (4). Incidence rates for fetal alcohol syndrome and fetal alcohol spectrum disorders are greater in African-Americans and Native-Americans than in Caucasians. Genetic polymorphisms, nutrition, and other factors may account for these differences. (5). The highest mortality rate for cirrhosis has been found in white Hispanic men. (6). Mexican-Americans have a low frequency of the protective alleles ADH1B(*)2 and ALDH2(*)2 and a relatively high frequency of CYP2E1 c2, which is associated with early onset alcoholism. (7). The incidence rate for cancer is greater for African-Americans than for Caucasians, and part of the higher risk may be attributed to heavier drinking.

Alcohol Drinking↗

The Eighth Human Leucocyte Differentiation Antigen (HLDA8) Workshop: natural killer cell section report.

Monoclonal antibodies submitted to the natural killer (NK) cell section of the Eighth International Workshop on Human Leucocyte Differentiation Antigens (HLDA8) comprised those to known clusters of differentiation (CD), those to well-characterised molecules without a CD nomenclature, and those to unknown molecules. From the HLDA8 workshop, the seven well-characterised molecules in the NK cell panel were assigned a CD classification. These were NKG2D (CD314), LAIR-1 (CD305), NKp46 (CD335), NKp44 (CD336), NKp30 (CD337), CRACC (CD319), and NKG2C (CD159c).

Antibodies, Monoclonal↗