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PubMed2000

Macrophages from inflamed but not normal glomeruli are unresponsive to anti-inflammatory cytokines.

This study examined the properties and responsiveness to cytokines of macrophages purified from normal and nephritic glomeruli to ascertain whether macrophages activated in vivo develop programmed unresponsiveness to cytokines as do bone marrow-derived macrophages in vitro when activated by interferon-gamma (IFN-gamma), tumor necrosis factor (TNF), interleukin-4 (IL-4), or transforming growth factor-beta (TGF-beta). Macrophages from normal glomeruli did not generate nitric oxide (NO) spontaneously but only after treatment with IFN-gamma and TNF-alpha. NO generation by these macrophages was abrogated by administering IL-4, TGF-beta, or TNF-alpha before but not after IFN-gamma treatment. Glomerular macrophages also expressed beta-glucuronidase, which was increased by TGF-beta and decreased by IFN-gamma and TNF. By contrast, glomerular macrophages from rats with nephrotoxic nephritis did not express beta-glucuronidase even after exposure to TGF-beta. Furthermore, they generated NO spontaneously, and this spontaneous generation of NO was not suppressed by IL-4, TGF-beta, or TNF-alpha. Systemic treatment of nephritic rats with IL-4 reduced NO generation by 40% but did not prevent activation, which is similar to the effect of IL-4 on bone marrow-derived macrophages in vitro when given simultaneously with IFN-gamma. We conclude that macrophages infiltrating inflamed glomeruli have developed programmed unresponsiveness to activating cytokines. This may enable them to function appropriately in the complex conditions within an inflammatory focus.

Animals↗
PubMed2004

Assessing the reliability and validity of anti-tobacco attitudes/beliefs in the context of a campaign strategy.

OBJECTIVES: To identify multi-item attitude/belief scales associated with the theoretical foundations of an anti-tobacco counter-marketing campaign and assess their reliability and validity. METHODS: The data analyzed are from two state-wide, random, cross-sectional telephone surveys [n(S1)=1,079, n(S2)=1,150]. Items forming attitude/belief scales are identified using factor analysis. Reliability is assessed with Chronbach's alpha. Relationships among scales are explored using Pearson correlation. Validity is assessed by testing associations derived from the Centers for Disease Control and Prevention's (CDC) logic model for tobacco control program development and evaluation linking media exposure to attitudes/beliefs, and attitudes/beliefs to smoking-related behaviors. Adjusted odds ratios are employed for these analyses. RESULTS: Three factors emerged: traditional attitudes/beliefs about tobacco and tobacco use, tobacco industry manipulation and anti-tobacco empowerment. Reliability coefficients are in the range of 0.70 and vary little between age groups. The factors are correlated with one-another as hypothesized. Associations between media exposure and the attitude/belief scales and between these scales and behaviors are consistent with the CDC logic model. CONCLUSIONS: Using reliable, valid multi-item scales is theoretically and methodologically more sound than employing single-item measures of attitudes/beliefs. Methodological, theoretical and practical implications are discussed.

Adolescent↗
PubMed1997

Rural health network development: public policy issues and state initiatives.

Rural health networks are a potential way for rural health care systems to improve access to care, reduce costs, and enhance quality of care. Networks provide a means for rural providers to contract with managed care organizations, develop their own managed care entities, share resources, and structure practice opportunities to support recruitment and retention of rural physicians and other health care professionals. The results of early network development initiatives indicate a need for state officials and others interested in encouraging network development to agree on common rural health network definitions, to identify clearly the goals of network development programs, and to document and analyze program outcomes. Future network development efforts need to be much more comprehensive if they are to have a significant impact on rural health care. This article analyzes public policy issues related to integrated rural health network development, discusses current efforts to encourage network development in rural areas, and suggests actions that states may take if they desire to support rural health network development. These actions include adopting a formal rural health network definition, providing networks with alternatives to certain regulatory requirements, and providing incentives such as matching grants, loans, or technical assistance. Without public sector support for networks, managed care options may continue to be unavailable in many less densely populated rural areas of the country, and locally controlled rural health networks are unlikely to develop as an alternative to the dominant pattern of managed care expansion by large urban entities. Implementation of Medicare reform legislation could provide significant incentives for the development of rural health networks, depending on the reimbursement provisions, financial solvency standards, and antitrust exemptions for provider-sponsored networks in the final legislation and federal regulations.

Antitrust Laws↗
PubMed1995

Ciliogenesis in sea urchin embryos--a subroutine in the program of development.

One major milestone in the development of the sea urchin embryo is the assembly of a single cilium on each blastomere just before hatching. These cilia are constructed both from pre-existing protein building blocks, such as tubulin and dynein, and from a number of 9 + 2 architectural elements that are synthesized de novo at ciliogenesis. The finite or quantal synthesis of certain key architectural proteins is coincident with ciliary elongation and proportional to ciliary length. Upon deciliation, the synthesis of architectural proteins occurs anew, a new cilium grows, and the stores of various building blocks are replenished. This routine of coordinated ciliary gene expression may be replayed experimentally many times without delaying normal development. The ability to regenerate cilia has allowed elucidation of these various protein synthetic relationships and has led to the discovery of the pathways by which membrane-associated tubulin and axoneme-associated architectural proteins are conveyed into the highly compartmentalized growing cilium. The sea urchin embryo thus provides a very convenient model system for studies of ciliary assembly and maintenance, coordinate gene expression and membrane dynamics.

Animals↗
PubMed1985

A systems model of health behavior change.

The modeling in this paper is at the level of the individual, in relation to the subsystem of health behavior. It integrates social, environmental, psychological, and physiological factors to describe the health behavior change process. It is not intended to be quantitatively predictive of behavior change, since further development of this model is needed to determine the mathematical form of the relationships between variables. The model is innovative in several ways. First, it includes health-related variables and a rich feedback structure. In contrast, attitude behavior change models often cannot explain health behavior adequately, because they do not incorporate physiological variables. Second, the model can be easily used by educators to help identify important variables for developing health education curricula. Consequently, program developers are helped in determining program intents, teaching strategies, and learning activities, and evaluative strategies which are congruent with the attitude behavior change process.

Attitude to Health↗
PubMed1993

Progress in developing improved programs for pulsed field agarose gel electrophoresis of DNA.

Details are described here for using a rotating gel to perform pulsed field agarose gel electrophoresis (PFGE) with programmable control of the following variables: magnitude of the electrical field, polarity of the electrical field, temperature of the gel and position of the rotating disk upon which the agarose gel rests. By use of this procedure for programmable control, modes of PFGE have been explored that have the following characteristics: (i) resolution by DNA length is completely lost for DNA shorter than a critical length that increases as the pulse times increase, and (ii) resolution by DNA length is enhanced for longer DNAs that are shorter than a second critical length. This window of resolution can be moved to the position of the 2-6 Mb chromosomes of Schizosaccharomyces pombe.

DNA↗
PubMed1978

The psychologist in the community mental health center: an analysis of activities and training needs.

Professional activities and expressed needs for additional training were examined in the case of 211 psychologists employed in 51 community mental health centers in western United States. Two-thirds of the work week is taken up directly or indirectly with traditional clinical services, 19% with community mental health activities; and the balance in program development, administration, research, and program evaluation. In contrast to the common assertion linking psychologists and research activity, the current results indicate that psychologists in community mental health centers devote very little time to research or program evaluation. Expressed training needs parallel reported activity patterns - highest for clinical functions and moderately high for community mental health functions. The significant impact of the community mental health movement is seen in both the distribution of professional activities and in expressed needs for additional competence.

Adult↗
PubMed2001

[Education, graduate and continuing education in geriatrics and geriatric rehabilitation].

Education and training in geriatric medicine for family doctors and medical specialists, nurses, physio- and ergotherapists, social workers becomes more important. A curriculum in high quality geriatric medicine can help solve the problems coming up with the increasing life-expectancy and with the increasing proportion of elderly depending on care and social services. The development of curricula and programs in high quality geriatric medicine demonstrates that the geriatrician has a special approach to the elderly patient different from traditional medicine. Describing and teaching this special approach to the elderly patient shows the special view of the geriatrician working with elderly patients. A number of barriers to program development must be considered. To successfully implement geriatrics training, geriatric faculties need to have adequate protected time to plan, administer and teach the curriculum. It is very important to implement geriatrics training in universities and medical institutes.

Aged↗
PubMed1997

A species-specific recognition system directs haustorium development in the parasitic plant Triphysaria (Scrophulariaceae).

Parasitic plants use host molecules to trigger development programs essential for parasitism. One such program governs the initiation, development, and function of haustoria, parasite-specific organs responsible for attachment and invasion of host tissues. Haustoria development can be initiated by several different molecules produced by appropriate host species. We are interested in understanding how these signals are interpreted by two related facultative parasites, Triphysaria eriantha (Benth). Chuang and Heckard, and T. versicolor Fischer and C. Meyer, to distinguish their own roots from those of potential hosts. We used an in vitro bioassay to determine what proportion of different Triphysaria populations formed haustoria in the presence and absence of closely related and unrelated host species. We found that the proportion of plants with haustoria was the same whether the plants were grown in isolation or with a conspecific host. In contrast, a significantly higher proportion of plants made haustoria when the host was a congeneric Triphysaria. Plants with haustoria neither enhanced nor inhibited other plants' propensity to form haustoria. Together these results indicate that qualitative differences exist in haustorium-inducing factors exuded by closely related species. The highest proportion of Triphysaria had haustoria when growth with Arabidopsis thaliana (L.) Heynh. Even in this case, however, some Triphysaria failed to develop haustoria. Interestingly, the percentage of haustoria that had vessel elements was higher when connections were made with Arabidopsis than with another Triphysaria. These results demonstrate that host recognition can be manifested at multiple points in haustorium development.

Arabidopsis↗
PubMed1983

Employee health and fitness: the state of the art.

Health care and health promotion measures currently are undergoing critical cost/benefit or cost/effectiveness scrutiny. An employee fitness program offers a convenient means for realizing community goals of lifestyle change but also has the potential to augment worker productivity. The costs of exercise testing and program development for an employee program ($100-$350 per participant year, measured in 1982 U.S. dollars) compare favorably with nonoccupational approaches to the promotion of fitness and a healthy lifestyle. The combined savings from a reduction of appraised age, improvement in lifestyle, decreased use of hospital and physician services, decrease in absenteeism and employee turnover, improved productivity, and decreased need for geriatric care substantially exceed the likely outlay. Given a 20% participation rate, the order of benefit from these factors is over $700 per year for each member of the labor force. In a company employing 1,000 people, a cost of perhaps $40,000 for 200 participants would yield a dividend of $650-$700,000 per year. Arguments continue on the specificity of exercise-induced gains in health and performance, but the burden of proof rests with those who maintain that equal benefits could be obtained from other tactics.

Absenteeism↗
PubMed1989

Radiation therapy technology: manpower survey 1987.

A chronic shortage of radiation therapy technologists exists in the United States. This report presents the data obtained in a 1987 survey of all radiation oncology facilities identified by the Patterns of Care master list. Of the 1,142 questionnaires mailed, 52% were returned. The survey identified 2,328 credentialed (ARRT) and 554 non-credentialed technologists employed in radiation therapy. Of this total of 2,882, 2,141 were identified as staff technologists. A total of 1,186 megavoltage units were identified, giving a ratio of 1.8 technologist/megavoltage unit. Two hundred sixty open funded positions and 230 unfunded positions for radiation therapy technologists were identified. The report compares the results of this 1987 Radiation Therapy Technology Manpower Survey with the results of the three previous surveys conducted in 1975, 1977, and 1981. Whereas this comparison demonstrates that progress has been made, current trends in allied health education are expected to have a negative impact on recruitment into radiation therapy technology. Program directors report that the number and quality of applicants to all allied health education programs is declining, and this trend in radiation therapy technology is substantiated by a drop in the number of students enrolled in programs, from 970 in 1986-87 to 777 in 1987-88. Our discussion addresses the areas of new program development, recruitment, retention, innovative programs, and overseas recruitment.

Allied Health Personnel↗
PubMed2006

Blimp-1 is an essential component of the genetic program controlling development of the pectoral limb bud.

Formation of paired limbs in vertebrate embryos has long been a particularly useful paradigm for the study of pattern formation. Here, we show that Blimp-1, a SET domain and zinc finger-containing transcriptional factor, plays an important role in the development of the pectoral fins of the zebrafish structures that are homologous to forelimbs of amniotes. The blimp-1 gene is expressed dynamically in the mesenchyme as well as the ectodermal cells of the early fin bud, and later, in the cells of the apical ectodermal ridge (AER) of the outgrowing fin. Consistent with this expression profile, loss of Blimp-1 activity severely impairs fin outgrowth and patterning. We present evidence that blimp-1 functions downstream of tbx5 and fgf24 and therefore is not required for the initial specification of the fin bud primordia. Subsequently, however, its function is necessary for the induction of fgf10 and sonic hedgehog in the mesenchyme. In addition, Blimp-1 activity is absolutely critical for the proper induction of gene expression in the ectoderm and establishment of the AER. Taken together, these results identify an additional layer of control in the genetic pathway that operates in the developing limb and provides novel insights into regulatory mechanisms that organize its pattern.

Animals↗