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PubMed2006

Education needs for integrated care: a literature review.

AIM: This paper reports a systematic review to identify the education needs of the workforce within primary care to promote the effective delivery of integrated health and social care services. BACKGROUND: The need for different professionals to work more closely dominates global health policy. The drive to develop a workforce prepared for the future is crucial to the success of integrated services. However, some have argued that nurses are ill-equipped to meet the challenges of integrated service provision. The ability to work interprofessionally is an important skill which needs to be developed to support integrated working. METHODS: Structured searches were undertaken on organizational websites and the Caredata, CINAHL, Cochrane Library, MEDLINE, Sociofile databases between December 2002 and April 2004 to identify policy documents and primary research studies. The robustness of identified research studies were appraised using recognized appraisal tools. FINDINGS: Six themes were identified which indicate essential elements needed for integrated care. The need for effective communication between professional groups within teams and an emphasis on role awareness are central to the success of integrated services. In addition, education about the importance of partnership working and the need for professionals to develop skills in relation to practice development and leadership through professional and personal development is needed to support integrated working. CONCLUSION: Education which embeds essential attributes to integrated working is needed to advance nursing practice for interprofessional working. Further research exploring this and its impact on integrated provision is essential to ensure that evidence-based services are provided. The reinforcement of partnerships between higher education institutions and health and social care organizations should ensure that the workforce is educated to manage continuous change in service delivery. Innovative ways of teaching and learning which promote inter-professional working need to be explored.

Attitude of Health Personnel↗
PubMed1988

Control of yeast gene expression by transposable elements: maximum expression requires a functional Ty activator sequence and a defective Ty promoter.

Integration of a transposable element adjacent to a gene frequently results in an alteration in expression of the nearby gene. The purpose of our experiments was to identify cis-acting sequences within a yeast transposon (Ty) that are important for expression of the adjacent gene. The role of these sequences in Ty transcription was also analyzed in order to examine the relationship between Ty and adjacent gene expression. Three naturally occurring Ty elements located at the HIS4 locus were examined. These Ty elements differed by multiple sequence changes and had different effects on HIS4 expression. To determine which sequences were important to Ty and HIS4 expression, Ty::lacZ and Ty::HIS4::lacZ fusion genes were constructed and analyzed. Results of these experiments indicated that a sequence element is present in the Ty epsilon region that is necessary for HIS4 expression but which has only a modest effect on Ty transcription. Additionally, a mutation in the Ty promoter region decreased Ty transcription and increased HIS4 expression. The opposite effects of this mutation on Ty and adjacent gene expression were probably caused by promoter competition.

Cell Cycle↗
PubMed1999

Sensorimotor Integration at the Dorsal Column Nuclei.

Interaction among primary afferents, corticofugal fibers, and intrinsic elements allows for sensorimotor integration at the dorsal column nuclei. The interneurons permit the spatial localization, the recurrent collaterals synchronize the activity of projecting cells with overlapping receptive fields, and the corticofugal fibers induce a central zone of activity surrounded by a peripheral zone of inhibition.

Journal Article↗
PubMed1983

A proposed neural network for the integrator of the oculomotor system.

Single-unit recordings, stimulation studies, and eye movement measurements all indicate that the firing patterns of many oculomotor neurons in the brain stem encode eye-velocity commands in premotor circuits while the firing patterns of extraocular motoneurons contain both eye-velocity and eye-position components. It is necessary to propose that the eye-position component is generated from the eye-velocity signal by a leaky hold element or temporal integrator. Prior models of this integrator suffer from two important problems. Since cells appear to have a steady, background signal when eye position and velocity are zero, how does the integrator avoid integrating this background rate? Most models employ some form of lumped, positive feedback the gain of which must be kept within totally unreasonable limits for proper operation. We propose a lateral inhibitory network of homogeneous neurons as a model for the neural integrator that solves both problems. Parameter sensitivity studies and lesion simulations are presented to demonstrate robustness of the model with respect to both the choice of parameter values and the consequences of pathological changes in a portion of the neural integrator pool.

Animals↗
PubMed2003

Genomic structure and transcriptional regulation of the human NAD+-dependent 15-hydroxyprostaglandin dehydrogenase gene.

The NAD(+)-dependent 15-hydroxyprostaglandin dehydrogenase (PGDH) is a catabolic enzyme that controls the biological activities of prostaglandins by converting them into inactive keto-metabolites. Here we report the genomic organisation of the complete human PGDH gene and characterise its transcriptional regulation. The PGDH gene spans about 31 kb on chromosome 4 and contains 7 exons. Within 2.4 kb of the 5'-flanking sequence we identified two regions with clustered putative transcription factor binding sites. The distal promoter element PGDH-DE (positions-2152/-1944 relative to the start codon) contains binding sites for Ets and activating protein-1 (AP-1) flanked by two cAMP-responsive element-binding protein binding sites (CREB1, CREB2), whereas the proximal element PGDH-PE (-235/-153) includes an Ets and an AP-1 binding sequence. By electrophoretic mobility shift assay, no high affinity binding of Ets or AP-1 factors was observed with PGDH-PE, whereas we confirmed interaction of members of the Ets, AP-1 and CREB families of transcription factors with PGDH-DE. Transcriptional control of the PGDH promoter was assessed by transiently transfecting JEG-3 choriocarcinoma cells. A luciferase reporter gene construct containing the PGDH-PE was not induced by c-jun/c-fos in the absence or presence of co-expressed Ets-1. A construct carrying the PGDH-DE in front of the minimal homologous promoter was activated by co-transfection of expression vectors for AP-1 proteins. Mutation of the AP-1 or CREB2 site reduced the response to c-jun/c-fos, whereas mutation of the Ets site of the distal element reduced basal promoter activity. CREB activated the PGDH-DE construct through the CREB1 site. These results defined the distal element as an integrator of transcriptional regulation by AP-1, Ets and CREB proteins.

Base Sequence↗
PubMed1995

Sequence diversity and chromosomal distribution of "young" Alu repeats.

Members of the recently inserted human-specific (HS)/predicted variant (PV) subfamily of Alu elements were sequenced. A number of these Alu elements share greater than 98% sequence identity with the subfamily consensus sequence, and they are flanked by perfect 5' and 3' direct repeats ranging in size from 6 to 15 nucleotides (nt). Based on the low number of random mutations, the estimated average age of these elements was calculated to be 1.5 million years (Myr). All the young Alu subfamily members were restricted to the human genome, as judged by polymerase chain reaction (PCR) amplification of human and non-human primate DNA samples using the unique flanking sequences specific for each Alu element. The chromosomal locations of several Alu elements belonging to the young subfamilies, designated as HS/PV and Sb2, were determined by PCR amplification of DNA samples from human/rodent somatic cell hybrid panels. A statistical analysis of the chromosomal distribution pattern showed that the recently inserted Alu elements appear to integrate randomly in the human genome.

Animals↗
PubMed2003

Genome-wide targeted search for human specific and polymorphic L1 integrations.

Retroelements (REs) occupy up to 40% of the human genome. Newly integrated REs can change the pattern of expression of pre-existing host genes and therefore might play a significant role in evolution. In particular, human- and primate-specific REs could affect the divergence of the Hominoidea superfamily. A comparative genome-wide analysis of RE sites of integration, neighboring genes, and their regulatory interplay in human and ape genomes would be of help in understanding the impact of REs on evolution and genome regulation. We have developed a technique for the genome-wide comparison of the integrations of transposable elements in genomic DNAs of closely related species. The technique called targeted genome differences analysis (TGDA) is also useful for the detection of deletion/insertion polymorphisms of REs. The technique is based on an enhanced version of subtractive hybridization and does not require preliminary knowledge of the genome sequences under comparison. In this report, we describe its application to the detection and analysis of human specific L1 integrations and their polymorphisms. We obtained a library highly enriched in human-specific L1 insertions and identified 24 such new insertions. Many of these insertions are polymorphic in human populations. The total number of human-specific L1 inserts was estimated to be approximately 4000. The results suggest that TGDA is a universal method that can be successfully used for the detection of evolutionary and polymorphic markers in any closely related genomes.

Gene Library↗
PubMed1980

Terminal repeats of the Drosophila transposable element copia: nucleotide sequence and genomic organization.

We have determined the nucleotide sequence of the terminal regions of two members of the copia sequence family of D. melanogaster. The first 276 bp at one end of a copia element are repeated in direct orientation at its other end. The direct repeats on a single copia element are identical to each other, but they differ by two nucleotide substitutions between the two elements which were examined; this suggests that during transposition only one direct repeat of the parent element is used as a template for both direct repeats of the transposed element. Each direct repeat itself contain a 17 bp imperfectly matched inveted terminal repetition. The ends of copia show significant sequence homology both to the yeast Ty1 element and to the integrated provirus of avian spleen necrosis virus, two other eucaryotic elements known to insert at many different chromosomal locations. Analysis of the genomic organization of the direct repeat sequence demonstrates that it seldom, if ever, occurs unlinked to an entire copia element.

Animals↗
PubMed1997

Relationship between specific types of communication deviance and attentional performance in patients with schizophrenia.

Communication Deviance (CD) characterizes the speech of schizophrenic patients and their relatives. The relationship between specific types of CD as measured from verbatim transcripts of Thematic Apperception Test protocols and attentional performance was investigated in 27 patients with schizophrenia. Assessments were conducted just prior to hospital discharge. Results revealed that a continuous performance attentional test with visually presented stimuli was most highly related to the CD factor indicating that the respondent had misperceived elements of the card. A continuous performance attentional test with auditory stimuli was found to be associated with the factor reflecting odd language use in the speaker. A measure of selective attention/executive control, from the Stroop Color-Word test, was found to be most highly related to the CD factors which involve higher level functions such as abstraction and integration of various elements of the card into a coherent story. Results suggest that CD may be a behavioral consequence of deficits in attention and executive control, and add to the growing literature suggesting that specific types of neuropsychological deficits can be linked to specific overt behaviors.

Adult↗
PubMed2006

RNA from the 5' end of the R2 retrotransposon controls R2 protein binding to and cleavage of its DNA target site.

Non-LTR retrotransposons insert into eukaryotic genomes by target-primed reverse transcription (TPRT), a process in which cleaved DNA targets are used to prime reverse transcription of the element's RNA transcript. Many of the steps in the integration pathway of these elements can be characterized in vitro for the R2 element because of the rigid sequence specificity of R2 for both its DNA target and its RNA template. R2 retrotransposition involves identical subunits of the R2 protein bound to different DNA sequences upstream and downstream of the insertion site. The key determinant regulating which DNA-binding conformation the protein adopts was found to be a 320-nt RNA sequence from near the 5' end of the R2 element. In the absence of this 5' RNA the R2 protein binds DNA sequences upstream of the insertion site, cleaves the first DNA strand, and conducts TPRT when RNA containing the 3' untranslated region of the R2 transcript is present. In the presence of the 320-nt 5' RNA, the R2 protein binds DNA sequences downstream of the insertion site. Cleavage of the second DNA strand by the downstream subunit does not appear to occur until after the 5' RNA is removed from this subunit. We postulate that the removal of the 5' RNA normally occurs during reverse transcription, and thus provides a critical temporal link to first- and second-strand DNA cleavage in the R2 retrotransposition reaction.

5' Untranslated Regions↗
PubMed1990

Normalization and integration: a look at the Swedish experience.

Quality service provision is seen as an integral and essential element of the normalization effort in Sweden. Results of the present study suggest that Sweden's well-developed system of comprehensive services and support for individuals with mental retardation ensures a level of security and material well-being that allows these people to live and function within society-at-large. Considered in relation to Nirje's (1980) elaboration of integration as it pertains to normalizing the life conditions of persons with mental retardation, functional and physical integration are clearly evident in many community settings. At the same time, other indicators of integration, such as social relations and association with people without mental retardation, suggest that social integration continues to challenge the community living endeavors in Sweden in much the same way as it does in North America.

Adult↗
PubMed1994

Evaluation of the washing system efficiency in sugar cane mills by neutron activation analysis.

The effectiveness of industrial washing operation in minimizing soil in sugar cane delivered to mills is evaluated. Instrumental neutron activation analysis was the nuclear analytical technique chosen for this work, with Fe, Hf, Sc, and Th selected as soil tracers. On the basis of differences between elemental concentration of integral and prepared cane, that is before and after washing, the feasibility of the method for evaluation of the washing efficiency is demonstrated.

Brazil↗
PubMed2005

High-order discretization schemes for biochemical applications of boundary element solvation and variational electrostatic projection methods.

A series of high-order surface element discretization schemes for variational boundary element methods are introduced. The surface elements are chosen in accord with angular quadrature rules for integration of spherical harmonics. Surface element interactions are modeled by Coulomb integrals between spherical Gaussian functions with exponents chosen to reproduce the exact variational energy and Gauss's law for a point charge in a spherical cavity. The present work allows high-order surface element expansions to be made for variational methods such as the conductorlike screening model for solvation and the variational electrostatic projection method for generalized solvent boundary potentials in molecular simulations.

Algorithms↗
PubMed2002

Trace element contamination in benthic macroinvertebrates from a small stream near a uranium mill tailings site.

Direct measurement of the accumulation of non-radioactive trace elements in aquatic biota near uranium mining or processing sites has been relatively rare, with greater focus on the radiological activity in the adjacent soils and groundwater. To evaluate the potential ecological concern associated with trace elements at a former uranium mill site in southeastern Utah, benthic macroinvertebrates were collected and analyzed for 17 trace elements from multiple locations within a small on-site stream, Montezuma Creek, and a nearby reference stream. Key questions of this study relate to the spatial and temporal extent of contamination in aquatic biota, the potential ecological risks associated with that contamination, and the usefulness of benthic macroinvertebrates as a monitoring tool at this site. Composite samples of similar macroinvertebrate taxa and functional feeding groups were collected from each site over a two year period that was representative of normal and dry-year conditions. In both years, mean concentrations of arsenic, molybdenum, selenium, and vanadium were significantly higher (a factor of 2-4 times: P < 0.05) in macroinvertebrates collected from one or both of the two Montezuma Creek sites immediately downstream of the mill tailing site in comparison to concentrations from reference locations. Mean uranium concentrations in invertebrates immediately downstream of the mill site were more than 10 times higher than at reference sites. The site-to-site pattern of contamination in Montezuma Creek invertebrates was similar in 1995 and 1996, with mill-related trace elements showing a downstream decreasing trend. However, nine of seventeen contaminant concentrations were higher in the second year of the study, possibly due to a higher influx of deep groundwater during the drier second year of the study. A preliminary assessment of ecological risks, based on the benthic macroinvertebrate bioaccumulation data, suggests that aquatic and terrestrial population risks are low. Benthic macroinvertebrates appeared to be sensitive integrators of trace element inputs to the aquatic environment from a former uranium mill tailing site, and provided useful spatial and temporal patterns of contamination not easily obtained using conventional surface water or groundwater measures.

Animals↗
PubMed2005

A small family of sushi-class retrotransposon-derived genes in mammals and their relation to genomic imprinting.

Ty3/gypsy retrotransposons are rare in mammalian genomes despite their abundance in invertebrate and other vertebrate classes. Here we identify a family of nine conserved mammalian genes with homology to Ty3/gypsy retrotransposons but which have lost their ability to autonomously retrotranspose. Of these, five map to the X chromosome while the remaining four are autosomal. Comparative phylogenetic analyses show them to have strongest homology to the sushi-ichi element from Fugu rubripes. Two of the autosomal gene members, Peg10 and Rtl1, are known to be imprinted, being expressed from the paternally inherited chromosome homologue. This suggests, consistent with the host-parasite response theory of the evolution of the imprinting mechanism, that parental-origin specific epigenetic control may be mediated by genomic "parasitic" elements such as these. Alternatively, these elements may preferentially integrate into regions that are differentially modified on the two homologous chromosomes such as imprinted domains and the X chromosome and acquire monoallelic expression. We assess the imprinting status of the remaining autosomal members of this family and show them to be biallelically expressed in embryo and placenta. Furthermore, the methylation status of Rtl1 was assayed throughout development and was found to resemble that of actively, silenced repetitive elements rather than imprinted sequences. This indicates that the ability to undergo genomic imprinting is not an inherent property of all members of this family of retroelements. Nonetheless, the conservation but functional divergence between the different members suggests that they have undergone positive selection and acquired distinct endogenous functions within their mammalian hosts.

Amino Acid Sequence↗
PubMed2001

On the modeling of narrow gaps using the standard boundary element method.

Numerical methods based on the Helmholtz integral equation are well suited for solving acoustic scattering and diffraction problems at relatively low frequencies. However, it is well known that the standard method becomes degenerate if the objects that disturb the sound field are very thin. This paper makes use of a standard axisymmetric Helmholtz integral equation formulation and its boundary element method (BEM) implementation to study the behavior of the method on two test cases: a thin rigid disk of variable thickness and two rigid cylinders separated by a gap of variable width. Both problems give rise to the same kind of degeneracy in the method, and modified formulations have been proposed to overcome this difficulty. However, such techniques are better suited for the so-called thin-body problem than for the reciprocal narrow-gap problem, and only the first is usually dealt with in the literature. A simple integration technique that can extend the range of thicknesses/widths tractable by the otherwise unmodified standard formulation is presented and tested. This technique is valid for both cases. The modeling of acoustic transducers like sound intensity probes and condenser microphones has motivated this work, although the proposed technique has a wider range of applications.

Journal Article↗
PubMed1993

Integration of oral habituation and gastric signals in decerebrate rat pups.

During a series of oral infusions of a sweet solution, the ingestive responses of young rat pups habituate; pups stop responding to the infusions even when their stomachs are empty and the infused diet is nonnutritive. The rate of this oral habituation is enhanced by the addition of gastric fill signals, even in decerebrate pups. In intact but not in decerebrate pups, prior deprivation gates out the influence of gastric fill on habituation. This oral habituation system, responsive to multiple ingestion-related signals, may serve as the elemental process that integrates physiological state with ongoing behavior to control ingestion.

Animal Feed↗
PubMed2004

Retrotransposition of limited deletion type of intracisternal A-particle elements in the myeloid leukemia Clls of C3H/He mice.

The murine genome has about 1,000 copies of DNA elements for the intracisternal A-particle (IAP) that resembles a retrovirus. We previously reported that the genomic DNA of the cells from radiation-induced acute myeloid leukemia (AML) lines derived from C3H/He inbred mice was frequently rearranged by the integration of the IAP element. In this study, 8 IAP elements from the characteristic integration sites in 6 cell lines of radiation-induced AML from different mice were characterized and compared in structure with 114 IAP elements isolated from the normal C3H/He genome. One of the 8 elements was a full-length type I IAP, and 7 were of type-I Delta 1 with a common deletion site. Although the type I Delta 1 form is a minor population accounting for about 6% of total genomic IAP elements, it is predominantly retrotransposed in the AML cells from different C3H/He mice. This indicates that limited populations of the IAP elements contribute to the unique retrotransposition in AML cells.

Animals↗