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PubMed1995

Maternal influence on the decision to adopt Norplant.

PURPOSE: To examine maternal influence and related variables on adolescents' decision to adopt Norplant. METHODS: A prospective study of 121 adolescent females who received Norplant through a hospital-based outpatient adolescent gynecology service. Each patient completed self-report questionnaires about her decision process, sexual behaviors and standardized measures of depression and anxiety at their insertion appointment or first-follow-up appointment. RESULTS: Almost 40% of the sample reported that their mother significantly influenced their decision to use Norplant and 61% of all patients stated that they had informed their mother of their choice of this contraceptive method. Through logistic regression, six variables were found to be significantly associated with mother as the most important decision source. These included: obtaining information about Norplant from a parent, maintaining the same sexual partner, past pill use, and not knowing other adolescents who boast about using the Norplant system. CONCLUSION: These data suggest that when parental consent is not required, adolescent females disclose sensitive information regarding choice-making to their mothers when they decided to adopt Norplant.

Adolescent↗
PubMed1998

Marketing innovations to nurses, Part 1: How people adopt innovations.

This article is the first in a two-part series that explores marketing techniques to enhance nurse's adoption of innovations in practice. Introducing new policies and procedures and persuading colleagues to implement them constitute an important part of the WOC nurse role. Nursing research reveals a lag of 8 to 30 years between the time new ideas are generated and nurses use them in practice. This article presents a theoretic grounding based on the Everett Rogers Diffusion of innovation Theory and uses the author's experiences introducing a research-based practice innovation to illustrate concrete and practice-relevant examples of innovation adoption theory and marketing principles in action.

Decision Support Techniques↗
PubMed2003

An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians.

Physicians' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine. Confirmatory factor analysis (CFA) was performed to assess the measurement model and structural equation modelling (SEM) was applied to test the theoretical model. The adapted theoretical model explained 81% (P<0.001) of variance in physicians' intention to use telehealth. The main predictors of intentions were a composite normative factor, comprising personal as well as social norms (beta=1.08; P<0.001) and self identity (beta=-0.33; P<0.001). Thus, physicians who perceived professional and social responsibilities regarding adoption of telehealth in their clinical practice had stronger intention to use this technology. However, it is likely that personal identity had a suppression effect in the regression equation, indicating that physicians' intention to use telemedicine was better predicted if their self-perception as telemedicine users was considered. These results have several implications at the theoretical and practical levels that are discussed in this paper.

Adult↗
PubMed2004

Physician-perceived barriers to adopting a critical pathway for unity-acquired pneumonia.

BACKGROUND: A proven efficacious and evidence-based critical pathway for community-acquired pneumonia (CAP) was implemented in six hospitals across a health service region (Edmonton, Canada). After one year (November 2000-November 2001), the pathway had reduced average length of stay by 1 day (from 10.8 to 9.8 days, p < .001). However, great variation was observed in physician adherence to the pathway. METHODS: Physician-perceived barriers to adoption of the CAP pathway were identified through in-depth interviews. Data saturation was reached after 10 physicians, representing a convenience sample of those willing to participate, were interviewed. RESULTS: Self-reported adherence to the CAP pathway was 75% (range 50%-100%). Qualitative analysis of the interview data indicated that comments could be grouped into five themes: (1) limited applicability, (2) lack of flexibility to accommodate atypical clinical presentations, (3) perception of insufficient evidence to support recommendations, (4) local organizational barriers, and (5) need for local adaptation. For example, one physician remarked that his community hospital had insufficient staff to support collection of lab samples for all patients. DISCUSSION: Interventions to increase pathway adoption and further improve quality of CAP care should address the identified barriers. For example, local audit and feedback of outcomes data to persuade physicians of the benefits of CAP pathways will need to be instituted.

Alberta↗
PubMed2004

Short sequences of non-proline residues can adopt the polyproline II helical conformation.

The left-handed polyproline II (P(II)) helix is a structure that has been given a great deal of attention lately because of its role in a wide variety of physiologically important processes and potential significance in protein unfolded states. Recent work by several authors has shown that residues besides proline can adopt this structure. A scale of relative P(II)-helix-forming propensities has been generated but only for single guest residues in a proline-based host system. Here, we present multiple guest residues in a proline-based host system. Using circular dichroism spectroscopy, we have shown that not only single residues, but also short sequences of non-proline residues can adopt the P(II) conformation.

Alanine↗
PubMed1998

2'-Deoxyisoguanosine adopts more than one tautomer to form base pairs with thymidine observed by high-resolution crystal structure analysis.

The questions of whether different tautomeric forms of nucleic acid bases exist to any significant extent in DNA, or what their possible roles in mutation may be, are under intense scrutiny. 2'-Deoxyisoguanosine (iG) has been suggested to have a propensity to adopt the enol form. Isoguanine (also called 2-hydroxyadenine) can be found in oxidatively damaged DNA generated from treating DNA with a Fenton-type reactive oxygen-generating system and is known to cause mutation. We have analyzed the three-dimensional structure of the DNA dodecamer d(CGC[iG]AATTTGCG) (denoted iG-DODE) by X-ray crystallography and NMR. The crystal structure of the iG-DODE complexed with the minor groove binder Hoechst 33342, refined to 1.4 A resolution, showed that the two independent iG.T base pairs in the dodecamer duplex adopt different (one in Watson-Crick and the other in wobble) conformations. The high-resolution nature of the structure also affords unprecedented clear information about the conformation and interactions of the Hoechst drug. The Hoechst 33342 binds in the narrow minor groove at the iGAATT site, with the N-methylpiperazine ring near the iG4.T21 base pair. Three hydrogen bonds are found between the NH of the Hoechst ligand and T-O2 DNA atoms. In solution, the two iG.T base pairs in iG-DODE predominantly are in the wobble form at 2 degreesC. At higher temperatures, another duplex form (likely involving the enol form of iG) is in slow exchange with the keto form and becomes significantly populated, reaching approximately 40% at 40 degreesC. Our data support the conclusion that iG pairs with T in a Watson-Crick configuration to a significant extent at physiological temperature (37 degreesC), which may explain the facile incorporation rate of T across from an iG during in vitro DNA replication.

Adenosine↗
PubMed1999

Do the structures of big ET-1 and big ET-3 adopt a similar overall fold? Consequences for endothelin converting enzyme specificity.

Big ET-1 and big ET-3 are precursor peptides which render endothelin-1 (ET-1) and endothelin-3 (ET-3) relatively unreactive and resistant to proteolytic cleavage. Big ET-1 is cleaved in vivo by ECE-1 (endothelin-converting enzyme), and big ET-3 is also cleaved but apparently to a significantly lesser extent by this enzyme. To shed light on the relation between structure and function, circular dichroism (CD) spectroscopy and homology modeling were used to determine whether big ET-1 and big ET-3 adopt similar secondary and tertiary structures. Analyses of the CD spectra and thermal denaturation indicate they have similar secondary structures and thermal stabilities. Superposition of the modeled coordinates of both peptides indicates that they can adopt the same overall fold except in the C-terminal residues, 34-38 in big ET-1 and 34-41 in big ET-3. This region corresponds to an area of complete sequence heterogeneity between the two peptides. A model has been developed which has a loop for residues 27-30 (HVVP in big ET-1), which have previously been demonstrated to be essential for eliciting efficient hydrolysis of the W21-V22 bond in big ET-1 and which have the sequence QTVP in big ET-3. Differences in affinity between big ET-1 and big ET-3 for ECE-1 thus appear to be due solely to sequence variations in the local region of the cleavage site.

Amino Acid Sequence↗
PubMed1993

NMR and computational evidence that high-affinity bradykinin receptor antagonists adopt C-terminal beta-turns.

Three tetrapeptides were prepared, each corresponding to the four C-terminal amino acid residues of highly potent, second-generation bradykinin receptor antagonists. The tetrapeptides are (IA) Ser-D-Phe-Oic-Arg, (IIA) Ser-D-Tic-Oic-Arg, and (IIIA) Ser-D-Hype(trans-propyl)-Oic-Arg. Solution conformations for each were determined by incorporating interproton distance restraints, determined by 2D NMR experiments performed in water at neutral pH, into a series of distance geometry/simulated annealing model building calculations. Similarly, systematic conformational analyses were performed for each using molecular mechanics calculations. Both the NMR-derived structures, as well as the calculated structures, are shown to adopt a beta-turn as the primary conformation. Excellent agreement between the predicted structures and the NMR-derived structures is demonstrated. Aside from being the first examples of linear tetrapeptides reported to be ordered in aqueous solvent, the results presented support the hypothesis that high-affinity bradykinin receptor antagonists must adopt C-terminal beta-turn conformations.

Amino Acid Sequence↗
PubMed2001

Adopting innovations--lessons learned from a peer-based hospital diversion program.

Moves to bridge the gap between research and practice have heightened interest in how service innovations are adopted. This paper reports on a peer-based hospital diversion program that provided short-term respite care, clinical monitoring, connection or re-connection to other mental health services, and peer support. The program was successful in providing services to the target population and was viewed as highly desirable by service recipients and clinical agencies. However, full adoption of this innovation was not realized and it closed barely a year after opening. Lessons learned from both the "life" and "death" of this program are offered.

Community Mental Health Services↗
PubMed2004

Sequence-altered peptide adopts optimum conformation for modification-dependent binding of the yeast tRNAPhe anticodon domain.

Amino acid contributions to protein recognition of naturally modified RNAs are not understood. Circular dichroism spectra and predictive software suggested that peptide tF2 (S1ISPW5GFSGL10 LRWSY15), selected from a phage display library to bind the modified anticodon domain of yeast tRNAPhe (ASL), adopted a beta-sheet structure. Ala residues incorporated at positions Pro4 and Gly6, both predicted to be involved in a turn, did not alter the peptide binding affinity for the ASLPhe, although major changes in the peptide's CD spectra were observed. Substitutions at three positions Pro4, Gly6, and Gly9, the latter not predicted to be in a turn, reduced the peptide's binding affinity to 4% of that of the unsubstituted tF2 and strongly influenced the peptide's secondary structure. The results suggest that peptides with different conformations, but similar affinities, adopt the optimal binding conformation, indicative of a structurally adaptive model of binding in which the modified RNA serves as a scaffold.

Anticodon↗
PubMed1992

A model of the precaution adoption process: evidence from home radon testing.

We present the precaution adoption process model--a stage theory consisting of seven distinct states between ignorance and completed preventive action. The stages are "unaware of the issue," "aware of the issue but not personally engaged," "engaged and deciding what to do," "planning to act but not yet having acted," "having decided not to act," "acting," and "maintenance." The theory asserts that these stages represent qualitatively different patterns of behavior, beliefs, and experience and that the factors that produce transitions between stages vary depending on the specific transition being considered. Data from seven studies of home radon testing are examined to test some of the claims made by this model. Stage theories of protective behavior are contrasted with theories that see precaution adoption in terms of movement along a single continuum of action likelihood.

Air↗
PubMed1988

The precaution adoption process.

This article presents a critique of current models of preventive behavior. It discusses a variety of factors that are usually overlooked-including the appearance of costs and benefits over time, the role of cues to action, the problem of competing life demands, and the ways that actual decision behavior differs from the rational ideal implicit in expectancy-value and utility theories. Such considerations suggest that the adoption of new precautions should be viewed as a dynamic process with many determinants. The framework of a model that is able to accommodate these additional factors is described. This alternative model portrays the precaution adoption process as an orderly sequence of qualitatively different cognitive stages. Data illustrating a few of the suggestions made in the article are presented, and implications for prevention programs are discussed.

Accident Prevention↗
PubMed2003

Task interest and actual performance: the moderating effects of assigned and adopted purpose goals.

This research examined whether and which purpose goals moderate the relationship between task interest and actual performance and whether assigned goals have different effects (Study 1) than adopted goals (Study 2). Two studies were conducted using a full 2 X 2 design of the performance-mastery and approach-avoidance distinctions, plus control conditions. In the control conditions, that is, in a neutral purpose goal context, the expected positive relationship between initial task interest and actual performance was found. In a purpose goal context, this link held only for a congruent mastery-approach goal (either assigned or adopted). The gain in task interest found in a neutral purpose context was observed in the purpose goal conditions only when participants attained their purpose goals. It was concluded that having an incongruent purpose goal may undermine the positive effect of prior task interest on actual performance as well as on subsequent task interest.

Adolescent↗
PubMed2000

Physical activity behavior change: issues in adoption and maintenance.

The many benefits of participation in regular moderate- or vigorous-intensity physical activity are well established, yet more than 60% of the population is sedentary or insufficiently active. Published studies have revealed that behavior modification and cognitive-behavior modification can be successfully used to assist patients, healthy adults, and youth in the adoption of physically active lifestyles. However, few studies with adults and youth have examined the maintenance of physical activity behavior beyond 6 months of adoption of this behavior. Maintenance of physical activity is critically important because ongoing participation in the behavior is necessary to sustain health benefits. Knowledge of effective intervention strategies for long-term maintenance of physical activity is at an early stage. The authors provide a summary of what is known about the maintenance of physical activity behavior in adults and youth and how physical activity behavior relates to other health behaviors such as smoking, as well as recommendations for research on physical activity behavior change and maintenance.

Adolescent↗
PubMed2003

Psychosocial variables, external barriers, and stage of mammography adoption.

Guided by H. Triandis's (1980) theory of behavior and the transtheoretical model, the study purpose was to examine differences in psychosocial variables and external conditions by stage of mammography adoption. Sampled from a statewide population, participants (N=509) were women aged 51-80. They had been contacted by telephone, screened for eligibility (e.g., no history of cancer or recent mammogram), and interviewed 3-6 months later. Higher utility beliefs, social influences, and practitioner interactions about mammography were associated with improved stage of adoption, as were lower negative affect and external barriers regarding mammography. Higher decisional balance scores, with and without negative affect toward mammography were associated with improved stage. Controlling for variables reflecting pros and cons, negative affect toward mammography further distinguished among stages. A richer set of pros and cons measures could explain screening more fully.

Aged↗
PubMed1989

Mutant Drosophila embryos in which all cells adopt a neural fate.

In the Drosophila embryo, early developmental decisions lead to all cells adopting one of several initial fates, such as those characteristic of the germ layers. The central nervous system is formed subsequently from the neurogenic region of the ectoderm, in which progenitor cells of the neuroblasts and ventral epidermis are intermingled. Two classes of genes govern the segregation of neuroblasts and peripheral sensory organs. The pro-neural class of genes, for example, the achaete-scute complex, participates in the initial decision to make each uniquely positioned neuroblast or sensory organ, but are initially expressed in groups of cells. The segregation of a neuroblast or sensory organ from an equivalent group of equipotential cells involves a mechanism of lateral inhibition whereby the future epidermal cells are prevented from engaging in the primary dominant neural fate. In the absence of this inhibitory signal, all cells of the group will become neural by default. The neurogenic class of genes is thought to mediate these cell interactions. Here we report that cells in embryos mutant for shaggy which are unable to adopt any of the early initial fates, instead develop neural characteristics.

Animals↗
PubMed1982

Non-specific factors can induce s-IgD on the intermediate, "pre-progenitor" B cells that give adoptive primary responses.

The intermediate or "pre-progenitor" B-cell subpopulation giving primary adoptive responses has been found by this laboratory to be s-IgD-, whereas other laboratories have reported the progenitors of primary adoptive responses to be s-IgD+. This difference appears to depend on the recent history of environmental stimuli received by the mice. Deliberate administration of a complex non-specific stimulus, designed to mimic the effects of infection or certain types of experimental manipulation, shifted "pre-progenitor" activity from the s-IgD- compartment to the s-IgD+ compartment within 24 h. Neither horse erythrocytes (HRC) nor lipopolysaccharide (LPS) alone produced a reproducible effect, but the combination of HRC with low doses of LPS produced a marked shift to s-IgD+ activity. Some earlier experiments from this laboratory suggesting a striking effect with HRC alone probably resulted from suspension of HRC in saline contaminated by LPS-like material. Priming with HRC alone, under conditions which did not induce s-IgD, nevertheless stimulated the "pre-progenitors" to enter cell cycle. Three conclusions are drawn: (1) The stimulus for induction of s-IgD is not identical with the non-specific stimulus which selectively induces cell division in this intermediate B-cell subset; (2) the presence of IgD on the surface per se does not prevent the non-specific activation of these cells into division; (3) the absence of s-IgD is only a useful marker of the "pre-progenitor" subset if the mice are maintained under specific pathogen-free conditions and exogenous stimuli are controlled.

Animals↗
PubMed1982

An NK-like cell limits the adoptive response from "pre-progenitor" B cells.

Evidence is presented that a dividing, Thy 1 . 2 positive and NK 1 . 2 positive cell with a suppressive effect on adoptive responses is present in the spleens of normal and athymic mice, and that its function may be enhanced by non-specific antigenic stimulation. NK cells may thus exert a controlling function on the proliferation and differentiation of B cells. The main experimental observation is that under certain assay conditions incubation of spleen cells with 3H-TdR in order to kill dividing, non-specifically activated 'pre-progenitor' B cells may actually give a marked increase rather than a decrease in a subsequent hapten-specific primary adoptive response. An activated 'suppressor' population was proposed as the reason for this effect. This anomalous effect may be avoided and the cycle state of the B cells assessed by prior elimination of cells bearing Thy 1 antigen, together with the use of a more reliable hydroxyurea incubation to kill dividing B cells.

Animals↗