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PubMed1992

CD4+ T cell-mediated killing of major histocompatibility complex class II-positive antigen-presenting cells (APC). III. CD4+ cytotoxic T cells induce apoptosis of APC.

A subset of CD4+ T cells, belonging to the T helper type 1 (Th1) cells, kills antigen-presenting cells (APC) in an antigen-specific and major histocompatibility (MHC) class II-restricted way. Evidence is presented that CD4+ cytotoxic T lymphocytes (CTL) induce apoptosis or programmed cell death within susceptible APC as witnessed by quantitative DNA fragmentation. Apoptosis is more reliable to determine cell death than the 51Cr-release assay, because some cells demonstrate resistance to CD4-mediated lysis in the 51Cr-release assay. Apoptosis becomes manifest after 2 to 4 h of incubation preceding the disintegration of the target cells which is detectable between 12 and 24 h as measured by the 51Cr-release assay. Unstimulated B cells, which are not killed, but function as APC, do not undergo apoptosis, whereas lipopolysaccharide or anti-mu-activated B cell blasts show apoptosis and are efficiently lysed. Several CD4+ Th2-type cells tested, which did not demonstrate killing of APC as measured by the 51Cr-release assay, are unable to mediate programmed cell death of appropriate APC. Actinomycin D or cycloheximide, inhibitors of transcription and translation, respectively, fail to prevent apoptosis of APC excluding the involvement of newly synthesized soluble products as mediators of killing. Pretreatment of CD4+ CTL, but not of APC with 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid, a specific inhibitor of the anion transport, efficiently prevents apoptosis of APC, although the secretion of interleukins is not affected. We propose, that upon contact of the CD4+ CTL with APC, molecules of yet undefined nature are activated and released in a polar fashion at the contact site and induce the endogenous pathway of programmed cell death.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed1999

From randomized trial to community-focused practice.

PURPOSE: To describe the use of findings from a randomized trial--a nursing intervention using telephone contacts to reduce the incidence of low-birth-weight and preterm births--in four community settings in North Carolina, to show that implementing research into practice is important. Low-birth-weight and preterm births are the major cause of high infant mortality in the United States. Rates are highest among African-American women. Telephone intervention as a strategy for preventive health care can be cost effective, reduce low-birth-weight and preterm births in African-American women, and provide a means of health consultation for parents of children age five and under. ORGANIZING FRAMEWORK: Four community programs are discussed in relation to five phases of implementing and sustaining research in communities: research, transfer, transition, regeneration, and empowerment. Modification from the original research, bonuses, and barriers are described for each program. METHODS: The randomized trial was conducted from 1990-1995. Randomized trial data and data for subsequent projects were collected from telephone interviews and health care records from 1994-1998. A successful adaptation was made from the original randomized trial to the four programs by (a) educating the staff for each program about the methods and findings in the original research, and (b) working with program staff to make appropriate modifications for each site. CONCLUSIONS: Findings from a randomized trial can be used in a variety of settings. By working together, researchers and community-health nurses can integrate research findings into community-health nursing practice.

Black People↗
PubMed1991

Guidelines for developing and managing an environmental enrichment program for nonhuman primates.

Before implementing an environmental enrichment program for nonhuman primates, several issues should be considered. The assignment of enrichment tasks can be made to caretakers, a dedicated "enrichment technician," volunteers, students or individuals with training in behavioral science. Determining the enrichment techniques to be used must take into account personnel time available; the species, age, sex, and individual histories of the nonhuman primates; and experimental protocols for which animals are being maintained. Identifying the most beneficial way to use the available personnel time must be tailored for each institution. To meet federal regulations, records must be kept of the environmental enhancements available to each nonhuman primate. Good record-keeping will allow appropriate evaluation of the program. This evaluation should involve the animals' responses to the enrichment opportunity, cost and durability of enrichment items, human and nonhuman safety considerations, and personnel required. The well-being of captive nonhuman primates will be most improved if well-informed decisions are made in developing and managing environmental enrichment programs.

Animal Husbandry↗
PubMed1986

Parental preferences regarding sex education topics for sixth graders.

The purpose of this study was to ascertain which sex education topics parents of preadolescents regarded as appropriate for their children. The sample was comprised of 146 respondents randomly selected from a class list of sixth graders in a suburban school district. A mailed, self-administered questionnaire listing 48 possible topics was used to elicit parental response. Pretesting found the questionnaire to be highly reliable (Cronbach's alpha = .95). Overall, parents strongly supported the inclusion of a broad range of sex education topics regardless of parental age, sex, marital status, income, education, or child's sex. Moreover, parents were largely in agreement with the inclusion of sensitive topics in addition to those which were more physiological or behavioral. Catholics more often than Protestants agreed with the inclusion of birth control, abortion, and sterilization even after controlling for income and education. Thus, the findings suggest that parents of sixth graders find a broad sex education program in the school appropriate. To this end, school officials and sex educators should not overlook the needs of preadolescents for sex education solely on the basis of perceived parental opposition.

Adolescent↗
PubMed1995

Elder abuse policy: considerations in research and legislation.

Elder abuse has become the most recently "discovered" form of intrafamilial violence. Most states have enacted elder abuse statutes or have amended their adult protection acts to specify the elderly. A majority of jurisdictions have included mandatory reporting requirements within their statutes. Commentary has been fiercely opposed to mandatory reporting for a variety of reasons. Compelled reporting does not appear to increase the number of reports filed, while enforcement of the schemes depletes much of the funds devoted to elder abuse. Definitions of elder abuse are contradictory and vague. Mandatory reporting requirements suggest that legislators believe elders are unable to determine whether reporting is in their own best interests and thus is an ageist response to the problem of elder abuse. Finally, few services are available to families in which elder abuse has been verified and even fewer program evaluations have been performed to assess these services. Mandatory reporting to identify elder abuse is not appropriate in the absence of programs found to be helpful.

Aged↗
PubMed1979

Programmed control of aimed movements revisited the role of target visibility and symmetry.

Reaction time prior to starting a 2-mm amplitude aimed movement was studied as a function to target size and experimental procedure. Consistent with a report by Klapp, choice reaction time increased as target size decreased when the visual signal that initiated the reaction time interval also indicated which of two targets was to be hit. This result implies response programming during the reaction time interval, with more programming time for slower movements to smaller targets. By contrast, in a simple reaction time procedure, there was no effect of target size on reaction time, suggesting that the response can be programmed in advance when the appropriate target is precued. This provided a control for speed-accuracy trade-off, supporting the programming interpretation of the choice reaction time result. In another condition in which both targets could be viewed while waiting for the auditory signal that initiated the reaction time interval and indicated which target to hit, choice reaction time was independent of target size provided that both possible targets on each trial were of the same size. The overall results suggest that response programs include both spatial and temporal information, and that parallel programming of different spatial goals is possible provided that the responses are of the same duration.

Acoustic Stimulation↗
PubMed2003

Toxicity characterization of environmental chemicals by the US National Toxicology Program: an overview.

The US National Toxicology Program (NTP) is an interagency program whose mission is to evaluate agents of public health concern by developing and applying the tools of modern toxicology and molecular biology. Chemicals substances or physical agents selected for toxicology and carcinogenesis evaluations by the NTP are usually studied in a series of subacute (14-day exposure), subchronic (90-day exposure) and chronic (2-year exposure) studies in rodents. The NTP has published more than 500 reports of the findings and conclusions from its toxicology and carcinogenesis studies. In more specialized studies, the NTP also evaluates adverse effects on the structure and function of the immune, reproductive, nervous, and respiratory systems. The program attempts to evaluate and appropriately incorporate new technologies to improve the way we study the toxicity of chemicals. For example, the program has extensively evaluated several transgenic mouse models for their potential use as short-term cancer screens and has been a full participant in an international effort to examine their usefulness in pharmaceutical registration. Toxicogenomics, an emerging scientific field that examines the expression of thousands of genes simultaneously in response to chemical exposure, holds promise for future application to better understand the underlying mechanisms of chemical toxicity. A number of public health issues being addressed by the NTP are not only of national importance but also have global impact, such as the potential for endocrine disruptors to influence development and carcinogenesis and the safety of herbal medicines and dietary supplements. The program participates in the preparation of national and international toxicity testing guidelines and the findings from NTP studies are widely used for risk assessments by international organizations and federal agencies. The NTP maintains databases that contain toxicity, and health and safety information on a large number of chemicals. These databases are available from the NTP web site (http://ntp-server.niehs.nih.gov) and are accessed over 100000 times a month from around the world.

Animals↗
PubMed1981

Comment: a schema for the interactions between motor programs and sensory input.

In this overview we utilize and extend a model, originally developed for "command interneuron" control of the generation of motor programs, to discuss the roles sensory inputs play in movement control. To provide a conceptual framework, we present a modular schematic of the motor control and sensory processing apparatus of an hypothetical nervous system. In the schematic, "subroutines" (basic units of motor programs) are seen as "playing out" through switching and sequencing networks to "driver neurons." The "driver neurons" then activate motoneurons to execute the programmed movements. Five modes of interaction between motor programs and sensory input are considered using examples from invertebrate and vertebrate neuronal circuitry. These modes of interaction occur at the following locations: (1) the "program selector," to initiate a motor program; (2) the "motor subroutine directory," advancing the program to the next subroutine; (3) the "driver neurons" and motoneurons, where the "gain" of subroutine instructions can be modulated; (4) the "motor programmer," which monitors programs in progress and provides for program development and updating; and (5) the "driver neurons" themselves, which control sensory processing by "selecting" the appropriate sensory inputs for the program in progress. Mode 5 is illustrated in more detail through a consideration of the modification of stretch receptor input by "extensor" and "flexor" command interneurones in the circuitry controlling postural movements of the crayfish abdomen.

Humans↗
PubMed1999

Cooperative agreement with Policy Research, Inc., to continue the National GAINS Center for People with Co-Occurring Disorders in the Justice System. Center for Substance Abuse Treatment (CSAT) and Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), HHS.

This notice is to inform the public of a planned $1,100,000 cooperative agreement award to Policy Research, Inc., to support the National GAINS Center for People with Co-occurring Disorders in the Justice System. CSAT and CMHS will make this award if the application is recommended for approval by the initial review group and the CSAT and CMHS National Advisory Councils. This is not a formal request for applications; assistance will be provided only to Policy Research, Inc. The purpose of the award is to support developing knowledge, conducting analyses of state-of-the-art practices, and disseminating and transferring information related to treating and managing persons in the justice system who are dually diagnosed with substance abuse and mental disorders. The GAINS Center promotes effective solutions by gathering information, assessing what works, interpreting the facts, networking with key stakeholders, and stimulating change. Eligibility for this program is limited to Policy Research, Inc., a non-profit corporation which operates the National GAINS Center. The GAINS Center has been federally funded by SAMHSA through the National Institute of Corrections/Department of Justice. This resource center has established, on a national level, a locus for the collection and dissemination of information about effective mental health and substance abuse services for people with co-occurring disorders in the justice system. The Center gathers information designed to influence the range and scope of mental health and substance abuse services provided in the justice system, tailors these materials to the specific needs of localities, and provides technical assistance to help them plan, implement, and operate appropriate, cost-effective programs. SAMHSA, for administrative reasons, can no longer fund the Center in this fashion because the former funding mechanism is no longer available. Therefore, SAMHSA will fund the project directly to complete the originally approved term of 5 years. An award to Policy Research, Inc., will enable the GAINS Center to build upon prior work and current activities underway in its work plan. This conversion to direct SAMHSA (CSAT and CMHS) funding will permit several important projects to be completed.

Diagnosis, Dual (Psychiatry)↗
PubMed2004

The novel yeast PAS kinase Rim 15 orchestrates G0-associated antioxidant defense mechanisms.

The highly conserved PKA and TOR proteins define key signaling pathways that control cell proliferation in response to growth factors and/or nutrients. In yeast, inactivation of PKA and/or TOR causes cells to arrest growth early G1 and induces a program that is characteristic of G0 cells. We have recently shown that the protein kinase Rim15 integrates both PKA- and TOR-mediated signals. In this work, we demonstrate that the Rim15-activated genomic expression program following glucose limitation at the diauxic shift is mediated by the three transcription factors Gis1, Msn2, and Msn4. The Rim15 regulon comprises several gene clusters implicated in the adaptation to respiratory growth, including classical oxidative stress genes such as SOD1 and SOD2, suggesting that the reduced life span of rim15delta cells may be due to their deficiency in oxidative damage prevention. Interestingly, we found that the primary amino acid sequence of Rim15 includes in its amino-terminal part a conserved PAS domain, known to act as a sensor for a variety of stimuli, We propose that Rim15 has evolved to integrate nutrient signals (transduced via TOR and PKA) and redox and/or oxidative stress signals to appropriately induce a transcriptional program that ensures survival in G0.

Amino Acid Sequence↗
PubMed1996

Hazardous materials. Disaster medical planning and response.

Hazardous materials offer a variety of unique challenges to emergency personnel. These agents have immense economic impact, but when mishandled, they become notorious for turning contained accidents into disasters involving the entire community. During a hazmat accident, the victims often ignore the rules of the disaster plan by seeking out the nearest hospital for medical care, regardless of that institution's capabilities. Health care workers rushing to the aid of contaminated individuals, without taking appropriate precautions (i.e., donning PPE), potentially make themselves victims. Disaster preparedness requires planning, policy, and procedure development, hazard analysis, training, and the availability of personal protective equipment for all responding personnel. Presently, the level of hazmat preparedness varies greatly among different hospitals, EMS and fire services, and disaster response teams. These differences in hazmat preparedness can be linked to a variety of factors (lack of awareness, funding, and support) and controversies (types of PPE and level of training required) which have prevented the establishment of a national hazmat policy for most of these organizations. Despite these difficulties, emergency departments continue to be the primary provider of care to contaminated individuals. As a result, emergency physicians must work with their hospital to implement a hazmat decontamination program in order to appropriately care for these individuals. The appendix to this article presents a list of recommendations for hospital hazmat preparedness. It is modeled after existing CDC and OSHA guidelines.

Decontamination↗
PubMedDate not supplied

Partnerships in neonatal care: a model in reverse neonatal transport.

An agreement between a pediatric tertiary-care center and a community hospital provides a model of a program that has facilitated appropriate, cost-effective, high-quality care for high-risk neonates through reverse transport. This agreement has established trust between the professionals at both hospitals, increased communications to ensure continuity of care and psychosocial support for families, and obtained supplemental financial resources for families of high-risk neonates.

Communication↗
PubMed2003

Optimizing lipid management in patients with acute coronary syndromes.

According to the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), patients with low-density lipoprotein (LDL) cholesterol > or = 130 mg/dL should be discharged on lipid-lowering therapy. When LDL cholesterol levels are between 100 and 129 mg/dL, evaluation of ratios of LDL cholesterol/high-density lipoprotein (HDL) cholesterol or total cholesterol/HDL cholesterol may provide additional insight into a patient's risk status. Patients who were using statin therapy before admission for an acute coronary syndrome should be continued on lipid-lowering therapy. The American College of Cardiology/American Heart Association (ACC/AHA) 2002 guideline update for management of patients with unstable angina and non-ST-segment elevation myocardial infarction recommends statin therapy at discharge as a class I indication, level of evidence A. Furthermore, studies confirm that statin therapy begun early during hospitalization can prevent ischemic events in patients who are treated by an invasive strategy and those who are treated only by a medical strategy. However, studies suggest that patient compliance with a statin regimen after discharge is far from optimal. There are 2 programs available to help ensure that appropriate patients receive and continue taking lipid-lowering therapy. These programs are the Cardiac Hospitalization Atherosclerosis Management Program (CHAMP) and the Guidelines Applied in Practice (GAP).

Acute Disease↗
PubMed2003

Behavioral forms of stress management for individuals with Asperger syndrome.

Although many children and youth with AS exhibit anxiety that may lead to challenging behaviors, stress and subsequent behaviors should be viewed as an integral part of the disorder [36]. As such, it is important to understand the cycle of behaviors to prevent seemingly minor events from escalating. Although understanding the cycle of tantrums, rage, and meltdowns is important, behavior changes will not occur unless the function of the behavior is understood and the student is provided instruction and support in using (1) strategies that increase social understanding and problem solving, (2) techniques that facilitate self-understanding, and (3) methods of self-calming. Because little research exists on the cycle of behaviors exhibited by students with AS and interventions appropriate at each stage, a systematic program of research is required to identify which techniques are most appropriate for children and youth, the context in which they can be used, and methods to ensure that individuals with AS generalize these skills to home, school, and community.

Adolescent↗
PubMed1993

An ecological approach to evaluating a special education program.

This study provides further evidence of the value of ecobehavioral measurements in program evaluations, especially since past evaluations have focused on individual-level factors rather than ecological factors. Static (e.g., classroom materials) and dynamic (e.g., group interactions) features of the classroom environment were used to describe the impact of a special education program on 84 behaviorally disturbed adolescent males. The program outcomes assessed included increases in appropriate and decreases in inappropriate behaviors. The findings reveal that the program apparently accomplished its objectives. However, the ecobehavioral data also suggest that these students were mostly involved in busywork; that is, they were working by themselves with instructional materials rather than participating in interactive activities with the teacher or peers. Ecological issues related to increasing student motivation are addressed.

Achievement↗
PubMed1999

Delivering prevention: the role of public programs in delivering care to high-risk populations.

A successful program of prevention or early detection should have a high level of population coverage and should ensure that high-risk populations are targeted. In practice, relatively little attention has been paid to the tendency toward greater use of preventive care by populations at lower risk, in other words, for higher use by the wealthy than by the poor. Current delivery patterns of preventive care raise questions as to how to organize these services more effectively. Physician-based delivery of preventive care in a fee-for-service system seems to result in Canadian patterns of use that are fairly similar to those found in the United States. Universal free insurance alone does not appear to be enough to counteract the failure to target preventive care toward the least-healthy groups. Appropriately-run Canadian provincial programs may be able both to expand coverage and to target high-risk populations. The population coverage for three measures directed toward prevention or early detection--childhood immunization (which in Manitoba has been offered through a long-standing provincial program), screening mammography (a new provincial program), and cervical cancer screening (no provincial program)-are compared using longitudinal administrative data from Manitoba. The discussion emphasizes the role of provincial programs and the possibilities for using population-based data to help provide cost-effective care to high-risk populations.

Adolescent↗
PubMed1997

A family medicine teaching program for obstetrics-gynecology residents.

BACKGROUND AND OBJECTIVES: The Harbor-UCLA Family Practice Residency Program has offered a year-long primary care continuity clinic experience to first-year obstetrics-gynecology (OB-GYN) residents since July 1994. This paper describes the teaching programs and compares the experience of the OB-GYN residents to that of family practice (FP) residents in the same clinic site. METHODS: OB-GYN residents worked in the family medicine teaching clinic for a half day each week for the entire year. The teaching program was evaluated with a questionnaire and interviews of OB-GYN residents to obtain their opinions on the value of this teaching modality. A review of clinic schedules and medical records compared the practice profiles of six OB-GYN residents with six matched FP residents. RESULTS: Five out of six OB-GYN residents felt that the educational objective of improving primary care skills was achieved. Half of them were pleased about their relationships with the family medicine faculty; the remainder reported being treated as second-class citizens. Patient volume and the diagnosis encountered were similar between the OB-GYN residents and the FP residents. CONCLUSIONS: Evaluation of the primary care continuity clinic experience for OB-GYN residents through questionnaires, interviews, and medical records analysis revealed the acceptability, feasibility, and appropriateness of this teaching program for OB-GYN residents. However, not all OB-GYN residents were happy about their relationships with the family medicine faculty. The long-term effectiveness of the experience needs further study.

Adult↗