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PubMed1995

[Adoption of health promotion behaviors in first-year baccalaureate nursing students: pilot study].

The goal of this pilot study was to test the usefulness of Pender's (1987) theoretical model in predicting the adoption of health-promotion behaviours in 176 first-year undergraduate nursing students. Hierarchical regression analysis indicated that the perception of self-efficacy, perception of one's state of health, the influence of professors, and place of birth are predictive variables of health-promoting behaviours in this group. The results of this study suggest, among other things, that it is important for professors to use strategies that foster and support students' confidence in their ability to commit to health-promoting behaviours. A longitudinal study currently in progress will examine whether a health-oriented program significantly influences the adoption of health-promotion behaviours in nursing students during their university education.

Adolescent↗
PubMed1996

Measuring the adoption of consistent use of condoms using the stages of change model. AIDS Community Demonstration Projects.

The stages of behavior change model has been used to understand a variety of health behaviors. Since consistent condom use has been promoted as a risk-reduction behavior for prevention of human immunodeficiency virus (HIV) infection, an algorithm for staging the adoption of consistent condom use during vaginal sex was empirically developed using three considerations: HIV prevention efficacy, analogy with work on staging other health-related behaviors, and condom use data from groups at high risk for HIV infection. This algorithm suggests that the adoption of consistent condom use among persons at high risk can be meaningfully measured with the model. However, variations in the algorithm details affect both the interpretation of stages and apportionment of persons across stages.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Constraints to adoption of appropriate breast feeding practices in a squatter settlement in Karachi, Pakistan.

Appropriate breast feeding practices (ABFP) are important for successful lactation. Constraints to adoption of ABFP by mothers in a squatter settlement in Karachi, Pakistan are reported. One hundred and two mother-infant pairs were followed from birth to 16 weeks of age. Eighty-seven infants received prelacteal feeds of honey as a quasi-religious ritual, 16 received ghutti for "cleansing of stomach", other prelacteal feeds were given as substitutes for breast feeding. Twenty nine mothers initiated breast feeding within 4 hours of birth. Supplemental water was given to 53 infants; major reasons being mothers' perception of thirst and diarrhoea in the infant. Supplemental milk was given to 24 infants. Insufficient milk and work load of mothers were main reasons for supplementation. Home remedies were given in 36 instances for prevention/treatment of indigestion or colds. Quasi-religious ritual of giving honey, perception that child birth was a major stress and early initiation of breast feeding adds to that stress, fear of dehydration and perception of insufficient breast milk were the major constraints to adoption of appropriate breast feeding practices.

Adult↗
PubMed1997

Structural incentives and adoption of medical technologies in HMO and fee-for-service health insurance plans.

Recent literature has argued that conventional fee-for-service (FFS) health insurance, as compared to managed care (HMO) insurance, may lead to the adoption of new technology that raises costs and reduces patient welfare. In this paper, we show that this result depends on an increasingly unrealistic key assumption-that FFS insurers cannot refuse to reimburse new technology. We also show that, when the assumption is changed, HMO insurers may adopt costly technologies that FFS insurers do not.

Decision Making, Organizational↗
PubMed1998

Adoption of hospital policies for prevention of perinatal group B streptococcal disease--United States, 1997.

Group B streptococcal (GBS) infections are the leading bacterial cause of disease and deaths among newborns in the United States. In 1993, the annual cost of caring for newborns with sepsis caused by group B Streptococcus was an estimated $294 million. A survey of hospital GBS disease prevention practices in 1994 indicated that those hospitals with a prenatal screening policy had fewer neonatal GBS disease cases. In 1996, to promote a coordinated approach to prevention, CDC issued consensus guidelines about GBS disease prevention that were endorsed by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. These consensus guidelines recommend using either a screening-based strategy or a risk-based strategy for identifying women who should receive intrapartum antimicrobial prophylaxis. To evaluate adoption of the consensus guidelines, in 1997, hospitals in eight surveillance areas were surveyed, and the results were compared with findings of a similar survey conducted in 1994. The proportion of hospitals with prevention policies in each site was compared with the site's rate of early-onset disease to assess the impact of the prevention policies. This report presents the survey findings, which indicate that more hospitals have adopted GBS disease prevention policies since issuance of the consensus guidelines.

Adult↗
PubMed2000

Dendritic cells armed with anti-CD3 mAbs reduce pulmonary metastases, prolong survival, and engender antitumor effector cells demonstrable by adoptive transfer.

BACKGROUND: Dendritic cells (DCs) pulsed with tumor cells or peptides are effective antitumor agents in a number of tumor models. In light of our earlier demonstration that T-cell signaling via the CD3 proteins induces cytolytic activity and constrains tumor progression, we equipped DCs pulsed with tumor cells with anti-CD3 mAbs and tested their antitumor efficacy in a murine renal cell cancer pulmonary metastasis model. METHODS: We investigated the antitumor efficacy of DCs pulsed with whole irradiated tumor cells (DC/R) or DCs pulsed with irradiated tumor cells and armed with anti-CD3 mAbs (DC/R/anti-CD3 mAbs). Experimental end points included the number of pulmonary metastases and survival of tumor-inoculated mice. RESULTS: Our studies demonstrate that arming tumor-pulsed DCs with anti-CD3 mAbs results in a superior outcome compared to that from tumor-pulsed DCs alone in terms of reduction in the number of pulmonary metastases and survival times. Furthermore, adoptive transfer experiments revealed that the splenocytes from DC/R/anti-CD3 mAbs-treated mice are superior to splenocytes from DC/R-treated mice in reducing renal cancer pulmonary metastases in severe combined immunodeficient (SCID) beige mice. CONCLUSION: Our data suggest that the therapeutic efficacy of DCs pulsed with tumor cells can be augmented by arming them with anti-CD3 mAbs. DC-based treatment regimens that currently are being pursued in clinical trials might be improved by equipping such cells with anti-CD3 mAbs.

Adoptive Transfer↗
PubMed2006

Adoptive cell therapy using in vitro generated human CD4+ CD25+ regulatory t cells with indirect allospecificity to promote donor-specific transplantation tolerance.

The holy grail in clinical transplantation is the establishment of long-term donor-specific transplantation tolerance with the minimum use of immunosuppressive agents. CD4+ CD25+ regulatory T cells (Tregs) play a crucial role in the prevention of autoimmunity, and appear to mediate transplantation tolerance. Harnessing Tregs for potential adoptive cell therapy to promote donor-specific transplantation tolerance is promising. Here we show that human CD4+ CD25+ Tregs with indirect allospecificity for an HLA-A2 (103-120) peptide can be generated from purified peripheral blood CD4+ CD25+ by priming with HLA-DR0101+ A2- autologous dendritic cells (DCs) pulsed with the A2 peptide in vitro. The antigen specificity for the A2 peptide was demonstrated in functional assays and flow cytometric analysis using a fluorescent tetramer composed of HLA-DR0101 and the A2 peptide. The CD4+ CD25+ Tregs with indirect allospecificity for the A2 peptide showed potent suppression of an indirect alloresponse by effector CD4+ CD25- T-helper cells. Importantly, the selected CD4+ CD25+ Tregs can be expanded substantially to meet a therapeutic end after T-cell receptor (TCR) stimulation by CD3/CD28 antibody-coated beads in the presence of high doses of interleukin-2 (IL-2). The expanded CD4+ CD25+ Tregs highly expressed Foxp3, and retained their suppressive properties and maintained expression of lymphoid homing receptor CD62L. Taken together, these data pave the way for clinical studies using in vitro generated and expanded human CD4+ CD25+ Tregs with indirect allospecificity as therapeutic reagents to promote donor-specific transplantation tolerance.

Adoptive Transfer↗
PubMed2003

Adoptive cellular therapy for early cytomegalovirus infection after allogeneic stem-cell transplantation with virus-specific T-cell lines.

Adoptive transfer of CMV-specific T cells offers the potential for reconstitution of viral immunity after allogeneic transplantation. However, the logistics of producing virus-specific T-cell clones has limited the application of cellular therapies. We treated 16 patients for CMV infection with polyclonal CMV-specific T-cell lines generated by short-term culture. Massive in-vivo expansions of CMV-specific cytotoxic T lymphocytes were observed, resulting in reconstitution of viral immunity. In eight cases antiviral drugs were not required, and subsequent episodes of reactivation occurred in only two patients. Our findings indicate that application of CMV-specific cell lines is both feasible and effective in a clinical environment.

Adoptive Transfer↗
PubMed2005

Restoration of immunity in lymphopenic individuals with cancer by vaccination and adoptive T-cell transfer.

Immunodeficiency is a barrier to successful vaccination in individuals with cancer and chronic infection. We performed a randomized phase 1/2 study in lymphopenic individuals after high-dose chemotherapy and autologous hematopoietic stem cell transplantation for myeloma. Combination immunotherapy consisting of a single early post-transplant infusion of in vivo vaccine-primed and ex vivo costimulated autologous T cells followed by post-transplant booster immunizations improved the severe immunodeficiency associated with high-dose chemotherapy and led to the induction of clinically relevant immunity in adults within a month after transplantation. Immune assays showed accelerated restoration of CD4 T-cell numbers and function. Early T-cell infusions also resulted in significantly improved T-cell proliferation in response to antigens that were not contained in the vaccine, as assessed by responses to staphylococcal enterotoxin B and cytomegalovirus antigens (P < 0.05). In the setting of lymphopenia, combined vaccine therapy and adoptive T-cell transfer fosters the development of enhanced memory T-cell responses.

Adoptive Transfer↗
PubMed2004

Horse antilymphocytic globulin in hepatitis B exacerbation after bone marrow transplantation adoptive immunity transfer.

We describe the case of a HBsAg+, HBeAg+ carrier, treated with lamivudine, who experienced exacerbation of hepatitis after BMT from an anti-HBs+, anti-HBc+, anti-HBe+ donor. The serological profile of the donor and the timing of exacerbation suggested that the adoptive immunity transfer played a major pathogenetic role. Antilymphocyte globulin administration resulted in resolution of hepatitis and seroconversion to anti-HBs+. Therapy aimed at blocking the effector arm of liver damage could represent a novel approach to avoid the risk of progression to fulminant hepatitis without hampering the chances of recovery from hepatitis B.

Adoptive Transfer↗
PubMed2002

Effective anti-tumor adoptive immunotherapy: utilization of exogenous IL-2-independent cytotoxic T lymphocyte clones.

To attain one of the final goals for cancer immunotherapy, cytotoxic T lymphocyte (CTL) clones were selected on the basis of exogenous IL-2 independence after limiting dilution culture from mixed lymphocyte tumor cell culture cells of FBL-3 tumor-immune spleens. About 10% of the clones could be propagated up to >5 times by weekly passages in the presence of splenic feeder and stimulating tumor cells. Two of the representative FBL-3-specific CTL clones that were able to undergo the fifth passage were expanded in large numbers for adoptive transfer by two rounds of a weekly passage with medium containing IL-2. FBL-3-specific CTL clones thus obtained showed a strong ability to eliminate the established tumors when transferred into tumor-bearing nude mice. In addition, the cells were recovered from the mouse spleen even 8 months after the transfer. The most striking differences between the CTL clones used in this experiment and those maintained conventionally in the presence of IL-2 were the abilities to produce IL-2 by themselves and the high expression level of the integrin molecule, VLA-4, that disappeared when cultured completely in the continuous presence of IL-2 in vitro during 12 weeks. In addition, concomitant with the disappearance of exogenous IL-2 independence and VLA-4 expression, the CTL clones lost their capacity to eradicate the tumor in vivo. Thus, the higher capacity of CTL clones to produce IL-2 on their own seemed to be correlated with the in vivo efficacy for tumor eradication and the long-term maintenance of their physiological profiles typical of memory T cells.

Adoptive Transfer↗
PubMed1977

Alcoholism and depression in adopted-out daughters of alcoholics.

Forty-nine daughters of alcoholics were compared to 47 daughters of nonalcholics; both groups of women (average age, 35 years) had been adopted by nonrelatives early in life. Two women in each group were alcoholic or problem drinkers. Although this is above the expected rate of alcoholism among women, the numbers are too small to draw definite conclusions. Almost all were light drinkers. Daughters of alcoholics had no more depression than controls, indicating that alcoholism in the biological parents did not increase the risk of depression in daughters raised by foster parents. Environmental factors may be important in both alcoholism and depression in women, since both tended to be correlated with psychopathology in the foster parents.

Achievement↗
PubMed1981

Inheritance of alcohol abuse. Cross-fostering analysis of adopted men.

The inheritance of alcoholism was studied in 862 Swedish men adopted by nonrelatives at an early age. Both the congenital and postnatal backgrounds of the adoptees modify their risk for alcohol abuse. We distinguish two forms of alcoholism that have distinct genetic and environmental causes and differ in their association with criminality, severity of alcohol abuse, and the frequency of expression in biological mothers. Postnatal milieu determines the frequency and severity of expression of the common type of susceptibility in both men and women. In contrast, the less common type is highly heritable in men but is seldom expressed in mothers of affected men.

Adoption↗
PubMed1981

An independent analysis of the copenhagen sample of the Danish adoption study of schizophrenia. I. The relationship between anxiety disorder and schizophrenia.

Familial factors have been shown to be important in the transmission of both anxiety disorder and schizophrenia. The familial relationship between these two disorders, however, has received little attention. This study examines the relationship between anxiety disorder and schizophrenia by a blind independent analysis of the interviews from the Danish Adoption Study of Schizophrenia using DSM-III criteria. The results show neither a genetic nor a familial-environmental link between the two disorders. These results are not consistent with the unitary hypothesis of mental illness. From a genetic and familial-environmental perspective, anxiety disorder and schizophrenia appear to be distinct, unrelated psychiatric illnesses.

Adoption↗
PubMed1981

An independent analysis of the Copenhagen sample of the Danish adoption study of schizophrenia. III. The relationship between paranoid psychosis (delusional disorder) and the schizophrenia spectrum disorders.

To genetic relationship between paranoid psychosis (delusional disorder) and schizophrenia spectrum disorders (schizophrenia and schizotypal personality disorder) is examined by a blind independent diagnostic evaluation of the interviews of relatives from the greater Copenhagen sample of the Danish Adoption Study of Schizophrenia. While cases of schizophrenia spectrum disorders are strongly concentrated in the biologic relatives of the schizophrenic adoptees, this pattern is not found for delusional disorder. These results suggest that from a genetic perspective, delusional disorder is not part of the schizophrenia spectrum.

Adoption↗
PubMed1984

An independent analysis of the Danish Adoption Study of Schizophrenia. VI. The relationship between psychiatric disorders as defined by DSM-III in the relatives and adoptees.

In this report, modified DSM-III criteria were applied to all the available interviews with adoptees from the greater Copenhagen sample of the Danish Adoption Study of Schizophrenia. In the adoptees, reasonable agreement was found between our DSM-III diagnoses and the original diagnoses using global DSM-II-based criteria by Kety et al for their categories of chronic and acute, but not borderline, schizophrenia. Comparing DSM-III-based diagnoses in adoptees and relatives, schizophrenia, schizotypal personality disorder, and paranoid personality disorder were all significantly more common in the biologic relatives of schizophrenic v screened control adoptees. These three diagnoses, which together form a tentative "schizophrenia spectrum," were also significantly concentrated in the biologic relatives of adoptees with schizoaffective disorder, mainly schizophrenic subtype, and schizotypal personality disorder, but not in biologic relatives of adoptees with schizophreniform disorder or atypical psychosis.

Adoption↗
PubMed1984

An adoption study of somatoform disorders. II. Identification of two discrete somatoform disorders.

linical heterogeneity among women with prominent somatization was studied in a population of 859 adopted women in Sweden. We distinguished two groups of "somatizers" who differ in both the diversity of their somatic complaints and the frequency of their periods of disability. Type 1 or high-frequency somatizers have a high frequency of psychiatric, abdominal, and back complaints. Type 2 or diversiform somatizers have less frequent disability, but a greater diversity of complaints per occasion than do other somatizers. Diversiform somatizers have psychiatric chief complaints or backache in a lower proportion of their sick periods than either high-frequency somatizers or nonsomatizers. Quantitative measures of frequency and diversity were derived in a series of discriminant analyses. The distribution of scores on these measures indicated that high-frequency somatization and diversiform somatization were discrete disorders with little clinical overlap and rare intermediate cases. This demonstration of two discrete types of somatizers was confirmed in a replication sample.

Adolescent↗