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1.
Horm Behav ; 127: 104878, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33148500

RESUMO

Dominance status in hamsters is driven by interactions between arginine-vasopressin V1a, oxytocin (OT), and serotonin 1A (5-HT1A) receptors. Activation of V1a and OT receptors in the anterior hypothalamus (AH) increases aggression in males, while decreasing aggression in females. In contrast, activation of 5-HT1A receptors in the AH decreases aggression in males and increases aggression in females. The mechanism underlying these differences is not known. The purpose of this study was to determine if dominance status and sex interact to regulate V1a, OT, and 5-HT1A receptor binding. Same-sex hamsters (N = 47) were paired 12 times across six days in five min sessions. Brains from paired and unpaired (non-social control) hamsters were collected immediately after the last interaction and processed for receptor binding using autoradiography. Differences in V1a, OT, and 5-HT1A receptor binding densities were observed in several brain regions as a function of social status and sex. For example, in the AH, there was an interaction between sex and social status, such that V1a binding in subordinate males was lower than in subordinate females and V1a receptor density in dominant males was higher than in dominant females. There was also an interaction in 5-HT1A receptor binding, such that social pairing increased 5-HT1A binding in the AH of males but decreased 5-HT1A binding in females compared with unpaired controls. These results indicate that dominance status and sex play important roles in shaping the binding profiles of key receptor subtypes across the neural circuitry that regulates social behavior.


Assuntos
Agressão/fisiologia , Hierarquia Social , Mesocricetus/fisiologia , Receptores Acoplados a Proteínas G/metabolismo , Animais , Arginina/metabolismo , Arginina Vasopressina/metabolismo , Cricetinae , Feminino , Hipotálamo Anterior/metabolismo , Masculino , Mesocricetus/metabolismo , Mesocricetus/psicologia , Ocitocina/metabolismo , Ligação Proteica , Receptor 5-HT1A de Serotonina/metabolismo , Receptores de Ocitocina/metabolismo , Receptores de Vasopressinas/metabolismo , Serotonina/metabolismo , Caracteres Sexuais , Comportamento Social
2.
Nature ; 494(7435): 86-9, 2013 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-23389543

RESUMO

Long-term and persistent human disturbances have simultaneously altered the stability and diversity of ecological systems, with disturbances directly reducing functional attributes such as invasion resistance, while eliminating the buffering effects of high species diversity. Theory predicts that this combination of environmental change and diversity loss increases the risk of abrupt and potentially irreversible ecosystem collapse, but long-term empirical evidence from natural systems is lacking. Here we demonstrate this relationship in a degraded but species-rich pyrogenic grassland in which the combined effects of fire suppression, invasion and trophic collapse have created a species-poor grassland that is highly productive, resilient to yearly climatic fluctuations, and resistant to invasion, but vulnerable to rapid collapse after the re-introduction of fire. We initially show how human disturbance has created a negative relationship between diversity and function, contrary to theoretical predictions. Fire prevention since the mid-nineteenth century is associated with the loss of plant species but it has stabilized high-yield annual production and invasion resistance, comparable to a managed high-yield low-diversity agricultural system. In managing for fire suppression, however, a hidden vulnerability to sudden environmental change emerges that is explained by the elimination of the buffering effects of high species diversity. With the re-introduction of fire, grasslands only persist in areas with remnant concentrations of native species, in which a range of rare and mostly functionally redundant plants proliferate after burning and prevent extensive invasion including a rapid conversion towards woodland. This research shows how biodiversity can be crucial for ecosystem stability despite appearing functionally insignificant beforehand, a relationship probably applicable to many ecosystems given the globally prevalent combination of intensive long-term land management and species loss.


Assuntos
Biodiversidade , Ecossistema , Atividades Humanas , Biomassa , Mudança Climática , Ecologia/métodos , Incêndios , Espécies Introduzidas , Poaceae/crescimento & desenvolvimento , Dinâmica Populacional , Árvores/crescimento & desenvolvimento
3.
Allergy ; 72(12): 1916-1924, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28600891

RESUMO

BACKGROUND: Food allergies are a growing health problem, and the development of therapies that prevent disease onset is limited by the lack of adjuvant-free experimental animal models. We compared allergic sensitization in patients with food allergy or Wiskott-Aldrich syndrome (WAS) and defined whether spontaneous disease in Was-/- mice recapitulates the pathology of a conventional disease model and/or human food allergy. METHODS: Comparative ImmunoCAP ISAC microarray was performed in patients with food allergy or WAS. Spontaneous food allergy in Was-/- mice was compared to an adjuvant-based model in wild-type mice (WT-OVA/alum). Intestinal and systemic anaphylaxis was assessed, and the role of the high-affinity IgE Fc receptor (FcεRI) in allergic sensitization was evaluated using Was-/- Fcer1a-/- mice. RESULTS: Polysensitization to food was detected in both WAS and food-allergic patients which was recapitulated in the Was-/- model. Oral administration of ovalbumin (OVA) in Was-/- mice induced low titers of OVA-specific IgE compared to the WT-OVA/alum model. Irrespectively, 79% of Was-/- mice developed allergic diarrhea following oral OVA challenge. Systemic anaphylaxis occurred in Was-/- mice (95%) with a mortality rate >50%. Spontaneous sensitization and intestinal allergy occurred independent of FcεRI expression on mast cells (MCs) and basophils. CONCLUSIONS: Was-/- mice provide a model of food allergy with the advantage of mimicking polysensitization and low food-antigen IgE titers as observed in humans with clinical food allergy. This model will facilitate studies on aberrant immune responses during spontaneous disease development. Our results imply that therapeutic targeting of the IgE/FcεRI activation cascade will not affect sensitization to food.


Assuntos
Hipersensibilidade Alimentar/etiologia , Hipersensibilidade Alimentar/metabolismo , Mastócitos/imunologia , Mastócitos/metabolismo , Receptores de IgE/metabolismo , Proteína da Síndrome de Wiskott-Aldrich/genética , Adulto , Alérgenos/imunologia , Anafilaxia , Animais , Modelos Animais de Doenças , Feminino , Hipersensibilidade Alimentar/diagnóstico , Expressão Gênica , Humanos , Imunização , Imunoglobulina E/imunologia , Masculino , Camundongos , Camundongos Knockout , Fenótipo , Síndrome de Wiskott-Aldrich/diagnóstico , Síndrome de Wiskott-Aldrich/imunologia , Adulto Jovem
4.
J Immunoassay Immunochem ; 38(5): 494-504, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28537469

RESUMO

The enzyme-linked immunosorbent assay (ELISA) is extensively used for measurement of proteins utilized for various research and diagnostic purposes in the biological disciplines. However, it is a labor-intensive and lengthy procedure due to a number of incubation and washing steps required for performing the assay. The ELISA procedure in the current study has been simplified through the simultaneous addition of antigen and detection antibody and elimination of washing steps. This resulted in a decreased time required to perform the procedure and without affecting assay capability. This approach offers the possibility of increasing ELISA productivity in low throughput laboratories without the need for alternative analytical platforms which would require significant assay redevelopment and capital expense.


Assuntos
Anticorpos/análise , Anticorpos/imunologia , Antígenos/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Humanos
5.
Curr Oncol ; 23(4): 280-5, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27536179

RESUMO

BACKGROUND: This guideline was prepared by the Fever Assessment Guideline Development Group, a group organized by the Program in Evidence-Based Care at the request of the Cancer Care Ontario Systemic Treatment Program. The mandate was to develop a standardized approach (in terms of definitions, information, and education) for the assessment of fever in cancer patients receiving chemotherapy. METHODS: The guideline development methods included a search for existing guidelines, literature searches in medline and embase for systematic reviews and primary studies, internal review by content and methodology experts, and external review by targeted experts and intended users. RESULTS: The search identified eight guidelines that had partial relevance to the topic of the present guideline and thirty-eight primary studies. The studies were mostly noncomparative prospective or retrospective studies. Few studies directly addressed the topic of fever except as one among many symptoms or adverse effects associated with chemotherapy. The recommendations concerning fever definition are supported mainly by other existing guidelines. No evidence was found that directly pertained to the assessment of fever before a diagnosis of febrile neutropenia was made. However, some studies evaluated approaches to symptom management that included fever among the symptoms. Few studies directly addressed information needs and resources for managing fever in cancer patients. CONCLUSIONS: Fever in patients with cancer who are receiving systemic therapy is a common and potentially serious symptom that requires prompt assessment, but currently, evidence to inform best practices concerning when, where, and by whom that assessment is done is very limited.

6.
J Dairy Sci ; 97(5): 2763-70, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24612816

RESUMO

Multiparous Holstein cows (n=108) were used to determine the associations of cytological endometritis (CE) with plasma nonesterified fatty acids (NEFA) and ß-hydroxybutyrate (BHBA) as markers of energy metabolism, calculated energy balance (EB), and plasma haptoglobin (Hp) as a marker of inflammation during the periparturient period and early lactation. Evaluation of endometrial cytology by low-volume uterine lavage was conducted on 1d between 40 and 60 d postcalving. The incidence of CE among cows sampled was 40%. The area under the curve (AUC) was calculated for both NEFA and BHBA using data collected from 3 wk before to 3 wk after parturition. Data for NEFA and BHBA AUC were stratified into prepartum (wk -3 to parturition) and postpartum (parturition to wk +3) for statistical analysis. Prepartum AUC for neither NEFA nor BHBA was associated with subsequent CE; however, cows that subsequently developed CE tended to have higher postpartum AUC for NEFA and had higher postpartum AUC for BHBA. Consistent with the results for plasma NEFA and BHBA, calculated EB during the prepartum period was not different in cows that did or did not develop CE; however, cows with CE had lower EB during the 6-wk postpartum period compared with cows without CE. Analysis of EB by week (wk -3 to -1 before calving and wk +1 to +6 postcalving) indicated that EB in cows with CE was lower at wk +1, +2, and +3 and tended to be lower at wk +6 than cows without CE. Plasma Hp concentrations were analyzed from wk +1 to +8 of lactation; concentrations of Hp were not different during either wk +1 or the entire postpartum period between cows that did or did not develop CE. These results suggest that lower energy status during the first 3 wk postpartum, but not necessarily systemic inflammation, is associated with subsequent development of CE.


Assuntos
Doenças dos Bovinos/fisiopatologia , Bovinos/metabolismo , Endometrite/veterinária , Metabolismo Energético , Ácido 3-Hidroxibutírico/sangue , Animais , Endometrite/fisiopatologia , Ácidos Graxos não Esterificados/sangue , Feminino , Haptoglobinas/análise , Inflamação/veterinária , Lactação , Parto , Período Periparto , Período Pós-Parto
7.
Ecol Lett ; 14(8): 733-40, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21627748

RESUMO

Here, we review consumer-resource (C-R) theory to show that the paradox of enrichment is a special case of a more general theoretical result. That is, we show that increased energy flux, relative to the consumer loss rate, makes C-R interactions top heavy (i.e., greater C:R biomass ratio) and less stable. We then review the literature on the attributes of aquatic and terrestrial ecosystems to argue that empirical estimates of parameters governing energy flux find that aquatic ecosystems have higher rates of relative energy flux than terrestrial ecosystems. Consistent with theory, we then review empirical work that shows aquatic ecosystems have greater herbivore:plant biomass ratios while we produce novel data to show that aquatic ecosystems have greater variability in population dynamics than their terrestrial counterparts. We end by arguing that theory, allometric relationships and a significant, negative correlation between body size and population variability suggest that these results may be driven by the smaller average body sizes of aquatic organisms relative to terrestrial organisms.


Assuntos
Ecossistema , Metabolismo Energético , Biomassa , Tamanho Corporal , Cadeia Alimentar , Modelos Biológicos , Dinâmica Populacional
8.
Ecol Appl ; 16(3): 1238-48, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16827015

RESUMO

With the depletion of many natural resources, we are growing aware of the need to understand the risks that stem from different management decisions. Here, we outline an approach to test the ability of different dynamical signatures to characterize time-series data: how likely is it that a natural population is declining, sustainable, or increasing, and at what rates are these temporal changes likely occurring? These dynamical signatures can serve as a robust foundation on which to formulate alternative scenarios in a decision analysis. They take account of much of the uncertainty in model parameters and have precise mathematical underpinnings with associated risks. We present methods to evaluate the likelihood of these scenarios, and ways that the analysis can be graphically represented. We discuss different ecological factors such as climate variability, life history, ecosystem interactions, and a changing population age structure, all of which impact the dynamics of natural populations. Considering the types of dynamical signatures that emerge from these factors can change our understanding of risk and the decisions that we make.


Assuntos
Medição de Risco , Tomada de Decisões Gerenciais , Ecologia
9.
Cancer Treat Rev ; 51: 35-45, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27842279

RESUMO

PURPOSE: To define the optimal model of care for patients receiving outpatient chemotherapy who experience a fever. Fever is a common symptom in patients receiving chemotherapy, but the approach to evaluation of fever is not standardized. METHODS: We conducted a search for existing guidelines and a systematic review of the primary literature from database inception to November 2015. Full-text reports and conference abstracts were considered for inclusion. The search focused on the following topics: the relationship between temperature and poor outcome; predictors for the development of febrile neutropenia (FN); the timing, location, and personnel involved in fever assessment; and the provision of information to patients receiving chemotherapy. RESULTS: Eight guidelines and 38 studies were included. None of the guidelines were directly relevant to the target population because they dealt primarily with the management of FN after diagnosis. The primary studies tended to include fever as one of many symptoms assessed in the setting of chemotherapy. Temperature level was a weak predictor of poor outcomes. We did not find validated prediction models for identifying patients at risk of FN among patients receiving chemotherapy. Several studies presented approaches to symptom management that included fever among the symptoms, but results were not mature enough to merit widespread adoption. CONCLUSION: Despite the frequency and risks of fever in the setting of chemotherapy, there is limited evidence to define who needs urgent assessment, where the assessment should be performed, and how quickly. Future research in this area is greatly needed to inform new models of care.


Assuntos
Antineoplásicos/efeitos adversos , Febre/induzido quimicamente , Febre/diagnóstico , Neoplasias/tratamento farmacológico , Assistência Ambulatorial/métodos , Neutropenia Febril Induzida por Quimioterapia/diagnóstico , Humanos , Pacientes Ambulatoriais , Guias de Prática Clínica como Assunto , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Biochim Biophys Acta ; 1209(1): 107-10, 1994 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-7524679

RESUMO

The base sequence of cDNA encoding the complete human liver cysteine dioxygenase type I (CDO-I; EC 1.13.11.20) message, and the derived amino-acid sequence are reported. CDO-I is encoded on a single mRNA species (approx. 1.5 kb). Human CDO-I clones were identified by screening a liver cDNA library, and inserts were isolated and sequenced. In addition, human liver total RNA was reverse-transcribed and CDO-I cDNA amplified by PCR using a modified poly-T primer and specific CDO-I primers to give a second source of sequencing template. The CDO-I message encodes a 200 amino-acid residue protein, the sequence of which has greater than 90% homology with the equivalent rat enzyme. The message was not expressed in a human hepatoma cell line (Hep G2).


Assuntos
Dioxigenases , Oxigenases/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Northern Blotting , Cisteína Dioxigenase , Sondas de DNA , DNA Complementar , Biblioteca Gênica , Humanos , Fígado/enzimologia , Dados de Sequência Molecular , Reação em Cadeia da Polimerase/métodos , RNA Mensageiro/genética , DNA Polimerase Dirigida por RNA , Ratos , Homologia de Sequência de Aminoácidos , Células Tumorais Cultivadas
11.
Biochim Biophys Acta ; 1216(3): 446-54, 1993 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-8268226

RESUMO

A portion of the human X-chromosome (> 5 kb) encoding the translated portion of the thyroxine-binding globulin (TBG) gene was sequenced. The primary templates for sequencing were isolated from a human X-chromosome library (two positive plaques from 400,000 screened initially with a TBG cDNA probe) or were produced by PCR amplification using leucocyte genomic DNA as the amplification template. Potential hormone response elements (HREs) were identified at either end of the gene. These HREs have sequences based on the consensus half-site of thyroid hormone response elements, although it is unclear whether the structures are functional HREs. Other potential regulatory elements also were identified towards the 3' end of the gene.


Assuntos
Hominidae/genética , Proteínas de Ligação a Tiroxina/genética , Cromossomo X , Animais , Sequência de Bases , Sequência Consenso , Sondas de DNA , Éxons , Humanos , Dados de Sequência Molecular , Oligonucleotídeos Antissenso , Reação em Cadeia da Polimerase , Biossíntese de Proteínas , Mapeamento por Restrição , Homologia de Sequência do Ácido Nucleico , Moldes Genéticos
12.
Ecol Lett ; 8(5): 513-23, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-21352455

RESUMO

The dynamics of ecological systems include a bewildering number of biotic interactions that unfold over a vast range of spatial scales. Here, employing simple and general empirical arguments concerning the nature of movement, trophic position and behaviour we outline a general theory concerning the role of space and food web structure on food web stability. We argue that consumers link food webs in space and that this spatial structure combined with relatively rapid behavioural responses by consumers can strongly influence the dynamics of food webs. Employing simple spatially implicit food web models, we show that large mobile consumers are inordinately important in determining the stability, or lack of it, in ecosystems. More specifically, this theory suggests that mobile higher order organisms are potent stabilizers when embedded in a variable, and expansive spatial structure. However, when space is compressed and higher order consumers strongly couple local habitats then mobile consumers can have an inordinate destabilizing effect. Preliminary empirical arguments show consistency with this general theory.

13.
Org Lett ; 2(15): 2261-3, 2000 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-10930258

RESUMO

Cycloartenol synthase converts oxidosqualene to the pentacyclic sterol precursor cycloartenol. An Arabidopsis thaliana cycloartenol synthase Ile481Val mutant was previously shown to produce lanosterol and parkeol in addition to its native product cycloartenol. Experiments are described here to construct Phe, Leu, Ala, and Gly mutants at position 481 and to determine their cyclization product profiles. The Phe mutant was inactive, and the Leu mutant produced cycloartenol and parkeol. The Ala and Gly mutants formed lanosterol, cycloartenol, parkeol, achilleol A, and camelliol C. Monocycles comprise most of the Gly mutant product, showing that an alternate cyclization route can be made the major pathway by a single nonpolar mutation.


Assuntos
Arabidopsis/enzimologia , Transferases Intramoleculares/química , Transferases Intramoleculares/metabolismo , Substituição de Aminoácidos , Arabidopsis/genética , Ciclização , Cromatografia Gasosa-Espectrometria de Massas , Transferases Intramoleculares/genética , Lanosterol/análogos & derivados , Lanosterol/biossíntese , Lanosterol/metabolismo , Espectroscopia de Ressonância Magnética , Mutação , Fitosteróis/biossíntese , Fitosteróis/metabolismo , Prótons , Relação Estrutura-Atividade , Triterpenos
14.
J Consult Clin Psychol ; 57(3): 450-2, 1989 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2500466

RESUMO

In this study we tested whether the efficacy of behavior therapy for obesity might be improved by lengthening the duration of treatment. Forty-eight obese clients were randomly assigned to either a standard treatment of 20 weekly sessions or to an extended treatment of 40 weekly sessions. The content of each program was identical, but the treatment procedures were introduced in a more gradual manner in the extended condition. At Week 20, the conditions showed equivalent weight losses. At 40- and 72-week evaluations, however, the extended treatment produced significantly greater mean weight losses than did the standard treatment.


Assuntos
Terapia Comportamental/métodos , Dieta Redutora/psicologia , Obesidade/terapia , Redução de Peso , Adulto , Feminino , Seguimentos , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia
15.
Soc Sci Med ; 20(9): 877-85, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-4012365

RESUMO

This paper examines the psycho-social effects on wives of their husbands' intermittent absence on off-shore oil rigs. It is based on data gathered from a random sample of wives living in the Aberdeen area, and it proceeds in three stages. The analysis begins with a comparison between wives whose husbands work on- and off-shore, it goes on to examine differential reaction to husband absence in the off-shore group and concludes with an attempt to estimate prevalence of the 'intermittent husband syndrome'. All the available evidence suggests that the psycho-social effects of intermittent husband absence have been exaggerated. The mental and physical health of wives of men working off-shore was similar in most respects to the health of wives whose husbands work on-shore. Within the sample of wives whose husbands worked off-shore those most affected by intermittent husband absence were 'Novices' (newly married wives with preschool children and no previous experience of husband absence), those with outside employment and those experiencing irregular absences. But even among such groups with fairly pronounced mood and behaviour changes there was little evidence of raised levels of morbidity. When defined in terms of specified levels of reactivity, marital conflict and morbidity prevalence of the 'intermittent husband syndrome' was found to be around 10%.


Assuntos
Emprego , Casamento , Transtornos Psicofisiológicos/psicologia , Ajustamento Social , Isolamento Social , Transtornos de Adaptação/psicologia , Conflito Psicológico , Feminino , Humanos , Risco , Meio Social
16.
Am J Clin Oncol ; 12(1): 68-74, 1989 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2463753

RESUMO

Since 1982, physicians at the Medical College of Ohio, Toledo, have performed 41 hepatic intraarterial chemotherapy infusion pump implantations for palliative treatment of metastatic liver disease from various primary tumors of the gastrointestinal tract. Radionuclide hepatic arterial pump imaging has proven to be a very reliable, cost-effective, and uncomplicated method of evaluating liver perfusion as it relates to pump function, catheter integrity, and positioning. Confirmation of satisfactory hepatic perfusion is the key to acceptable treatment by this modality. In combination with periodic computed tomography (CT) scanning and CEA determinations, scintigraphy plays a major role in establishing effective therapy and aids in determining causal factors behind treatment failures.


Assuntos
Quimioterapia do Câncer por Perfusão Regional , Artéria Hepática , Bombas de Infusão , Infusões Intra-Arteriais , Neoplasias Hepáticas/diagnóstico por imagem , Adulto , Idoso , Cateteres de Demora , Estudos de Avaliação como Assunto , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Cintilografia , Agregado de Albumina Marcado com Tecnécio Tc 99m
17.
Can J Neurol Sci ; 10(1): 47-9, 1983 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-6839228

RESUMO

Different groups of rats were maintained on choline-deprived (CD), choline-supplemented (CS) or standard rat chow diets beginning at a body weight of approximately 100 g, and electrically kindled in the amygdala beginning not less than 40 days later. The CS group kindled significantly faster than the CD group, whereas the CD and chow-fed groups did not differ in their rate of kindling. This result is consistent with both the known effects of the dietary manipulation of choline on brain acetylcholine level, and the idea that acetylcholine has a role in amygdaloid kindling.


Assuntos
Colina/farmacologia , Dieta , Excitação Neurológica/efeitos dos fármacos , Convulsões/etiologia , Tonsila do Cerebelo/fisiopatologia , Animais , Colina/administração & dosagem , Estimulação Elétrica , Masculino , Ratos , Convulsões/fisiopatologia
18.
Br J Gen Pract ; 42(356): 107-10, 1992 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-1493026

RESUMO

In a study of 263 homosexual men positive for the human immunodeficiency virus (HIV), it was found that 87% were registered with a general practitioner and of these, 55% said that the general practitioner knew their HIV status. Of the 104 men who had experienced symptoms, 39% had consulted the general practitioner for HIV-related advice. A total of 49% of those who were not registered used a specialist outpatient clinic for all their medical needs. Of those who were registered and whose general practitioner was aware of their HIV status but who did not consult their doctor, 72% used a specialist outpatient clinic. Reasons for not consulting the general practitioner included fears of breach of confidentiality and lack of confidence in the general practitioner's understanding of HIV. Fifteen per cent of the sample continued to see a general practitioner who was unaware of their HIV status, for non-HIV related advice. The needs of patients must be taken into account when planning more integrated hospital and community care for those with HIV infection or the acquired immune deficiency syndrome (AIDS).


Assuntos
Síndrome da Imunodeficiência Adquirida/psicologia , Atitude Frente a Saúde , Medicina de Família e Comunidade , Infecções por HIV/psicologia , Homossexualidade/psicologia , Assistência Ambulatorial/estatística & dados numéricos , Confidencialidade , Seguimentos , Soropositividade para HIV/diagnóstico , Humanos , Masculino , Inquéritos e Questionários
19.
Spine (Phila Pa 1976) ; 23(23): 2601-7, 1998 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-9854759

RESUMO

STUDY DESIGN: Eighteen-month, randomized controlled trial with partial crossover. OBJECTIVES: To test the hypothesis that the control of lumbar flexion in the early morning will significantly reduce chronic, nonspecific low back pain. SUMMARY OF BACKGROUND DATA: Previous studies have indicated an increased risk of low back pain with bending forward in the early morning, primarily because of increased fluid content in the intervertebral discs at that time. METHODS: After 6 months of recording baseline data, 85 subjects with persistent or recurring low back pain were randomly assigned to treatment and control groups. The treatment group received instruction in the control of early morning lumbar flexion. The control group received a sham treatment of six exercises shown to be ineffective in reducing low back pain. Six months later, the control group received the experimental treatment, Diaries were used to record daily levels of pain intensity, disability, impairment, and medication usage. RESULTS: Significant reductions in pain intensity (P < 0.01) were recorded for the treatment group, but not for the control group (point estimate, 33%; 95% confidence interval, 11-55%). After receiving the experimental treatment, the control group responded with similar reductions (P < 0.05). Significant reductions also were observed in total days in pain, disability, impairment, and medication usage. CONCLUSIONS: Controlling lumbar flexion in the early morning is a form of self-care with potential for reducing pain and costs associated with chronic, nonspecific low back pain.


Assuntos
Dor Lombar/reabilitação , Região Lombossacral/fisiologia , Movimento/fisiologia , Atividades Cotidianas , Adulto , Avaliação da Deficiência , Feminino , Humanos , Dor Lombar/tratamento farmacológico , Dor Lombar/prevenção & controle , Masculino , Pessoa de Meia-Idade , Medição da Dor , Autocuidado , Método Simples-Cego , Resultado do Tratamento
20.
J Sch Health ; 60(2): 49-52, 1990 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2299820

RESUMO

This evaluation examined the diffusion of an innovation entitled the Coalition Index: A Guide to School Health Education Materials. After distributing the Index to a sample of school district health coordinators (n = 39), interviews were completed with 92% of coordinators about their perceptions of the Index and their concern for organizing health resources within their professional role. A one-year follow-up interview was conducted to determine levels of implementation and diffusion. Coordinators responded favorably to the Index as an innovation. Concern scores were limited to those relating to self-management and task-management. Moreover, concern scores demonstrated significant, positive associations (p less than .01) with current use of the Index, and 49% of coordinators were users of the innovation one year after introduction. Results are discussed as they relate to diffusion of innovation stages.


Assuntos
Educação em Saúde , Serviços de Saúde Escolar , Materiais de Ensino , Indexação e Redação de Resumos , Atitude , Difusão de Inovações , Estudos de Avaliação como Assunto , Humanos , North Carolina
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