PubMed Health⌕ Search

Biomedical subjects

A M Wells

Publications and source records attributed to A M Wells.

14 recordsLinked to original sources
PubMed1998

A comparison of the effectiveness of pharmacologic treatment of otitis media with effusion in children: integrative and meta-analysis.

The treatment of otitis media with effusion is controversial and has inconsistent variations of pharmacotherapeutic practices. Current pharmacologic practices include use of antibiotics, antihistamine and/or decongestants, or a combination of antibiotics with antihistamine and/or decongestants. The effectiveness of these treatment protocols was examined through an integrative and meta-analysis of published research. Data was collected from research published over a 17 year period from 1980 to 1997. The hypothesis is that children, ages three months to 12 years, with otitis media with effusion who are untreated will demonstrate successful resolution of effusion equal to those treated with pharmacologic agents (P < 0.05). The integrative and meta-analytic results reject this hypothesis, as pharmacologic treatment is statistically significant in its resolution when compared to no treatment (P=0.0017). However, there is a weak effect size (R=0.07).

Journal Article↗
PubMed1998

Evaluation of indicated preventive intervention (secondary prevention) mental health programs for children and adolescents.

Evaluated the outcomes of 130 indicated preventive interventions (secondary prevention) mental health programs for children and adolescents that seek to identify early signs of maladjustment and to intervene before full-blown disorders develop. Results indicate such programs significantly reduce problems and significantly increase competencies. In particular, behavioral and cognitive-behavior programs for children with subclinical disorders (mean ESs in the 0.50s) appear as effective as psychotherapy for children with established problems and more effective than attempts to prevent adolescent smoking alcohol use, and delinquency. In practical terms, the average participant receiving behavioral or cognitive-behavior intervention surpasses the performance of approximately 70% of those in a control group. Of particular interest was the high mean effect (0.72) achieved by programs targeting incipient externalizing problems which are customarily the least amenable to change via traditional psychotherapeutic efforts when they reach clinical levels. Priorities for future research include greater specification of intervention procedures, assessment of treatment implementation, more follow-up studies, and identifying how different participants respond to early intervention.

Adolescent↗
PubMed1997

Telephone-based guided self-help for binge eating disorder: a feasibility study.

This feasibility study describes a novel form of guided self-help for treating binge eating disorder (BED). Over a 3-month period, a lay therapist provided first weekly (for 1 month) and then biweekly telephone-based guidance to supplement a self-help program. Eligible participants met DSM-IV criteria for BED, based on the Eating Disorder Examination (EDE). Of 9 women initially admitted into the study, 7 completed the self-help program. Upon completion, outcome was determined using the EDE-Questionnaire and the Brief Symptom Inventory (BSI). Binge eating frequency decreased markedly; BSI scores also decreased significantly. All women reported high levels of satisfaction with the intervention. Participants commented favorably about the flexibility, accessibility, and autonomy afforded by the telephone-based administration of guidance. Results suggest that telephone-based guided self-help is a viable mode of service delivery for some women with BED. Recommendations are made for further improvement of this form of self-help.

Adult↗
PubMed1997

Primary prevention mental health programs for children and adolescents: a meta-analytic review.

Used meta-analysis to review 177 primary prevention programs designed to prevent behavioral and social problems in children and adolescents. Findings provide empirical support for further research and practice in primary prevention. Most categories of programs produced outcomes similar to or higher in magnitude than those obtained by many other established preventive and treatment interventions in the social sciences and medicine. Programs modifying the school environment, individually focused mental health promotion efforts, and attempts to help children negotiate stressful transitions yield significant mean effects ranging from 0.24 to 0.93. In practical terms, the average participant in a primary prevention program surpasses the performance of between 59% to 82% of those in a control group, and outcomes reflect an 8% to 46% difference in success rates favoring prevention groups. Most categories of programs had the dual benefit of significantly reducing problems and significantly increasing competencies. Priorities for future research include clearer specification of intervention procedures and program goals, assessment of program implementation, more follow-up studies, and determining how characteristics of the intervention and participants relate to different outcomes.

Adolescent↗
PubMed1997

Primary prevention mental health programs: the future is exciting.

Current outcome research on primary prevention mental health programs is encouraging and the future is exciting. Data continue to accumulate regarding the efficacy of preventive intervention. Exemplary programs can prevent multiple problems across different outcome domains suggesting the need for collaboration among preventionists across disciplines and research areas. The commentators on our review (Durlak and Wells, 1997) offered many useful suggestions to improve the next generation of research. Most recommendations fall broadly under the rubric of increasing the precision of theory, design, and program evaluation. If current recommendations for improving future research are followed, the next reviewers of primary prevention mental health programs for children and adolescents will have a more complete and useful database for analysis.

Adolescent↗
PubMed1996

Insulin action in cultured human myoblasts: contribution of different signalling pathways to regulation of glycogen synthesis.

A key metabolic action of insulin is the stimulation of non-oxidative glucose utilization in skeletal muscle, by increasing both glucose uptake and glycogen synthesis. The molecular mechanism underlying this process has been investigated using a variety of experimental systems. We report here the use of cultured human myoblasts to study insulin control of glycogen synthesis in humans. In these cells insulin stimulates glycogen synthesis approx. 2.2-fold, associated with a similar activation of glycogen synthase (GS) which occurs within 5-10 min of the addition of insulin. Insulin also causes inactivation of glycogen synthase kinase-3 (GSK-3) and activation of protein kinase B, both processes being sufficiently rapid to account for the effects of insulin on GS. Activation by insulin of the protein kinases p70s6K, p90s6K and extracellular signal-regulated kinase 2 (ERK2) is observed, but is significantly slower than the activation of GS. Selective inhibitors of the p70s6K pathway (rapamycin), the ERK2/p90s6K pathway (PD98059) and phosphatidylinositol 3-kinase (wortmannin) have been used to probe the contribution of these components to insulin signalling in human muscle. Wortmannin blocks activation of both glycogen synthesis and GS and inactivation of GSK-3. PD98059 is without effect on these events, while rapamycin is without effect on inactivation of GSK-3 but partially blocks activation of glycogen synthesis and GS. Taken together, these findings suggest that protein kinase B is responsible for the inactivation of GSK-3, but that an additional rapamycin-sensitive mechanism may contribute to the activation of GS and stimulation of glycogen synthesis.

Androstadienes↗
PubMed1995

Inhibition of glycogen synthase kinase-3 by insulin in cultured human skeletal muscle myoblasts.

The acute effects of insulin on the activity of glycogen synthase kinase 3 (GSK-3) have been investigated both in the rat L6 muscle cell line and in cultured human myoblasts. The alpha and beta isoforms of GSK-3 are present in both cell types, with the beta isoform being predominant in the human cells. Insulin causes a rapid inactivation of both isoforms in both cell lines, with 50% inactivation being observed in the human myoblasts.

Amino Acid Sequence↗
PubMed1993

Abnormal activation of glycogen synthesis in fibroblasts from NIDDM subjects. Evidence for an abnormality specific to glucose metabolism.

To determine whether the tendency for NIDDM to run in families could relate to genetically determined defects in insulin stimulation of glycogen synthesis, skin fibroblasts from subjects with a strong family history of NIDDM were studied. Fibroblasts from nondiabetic subjects without any family history of NIDDM were studied as control subjects. The cells were studied after 7-16 passages in culture. Rates of glycogen synthesis were lower in fibroblasts from NIDDM subjects both basally and with maximal insulin stimulation (0.77 +/- 0.11 vs. 0.46 +/- 0.04 pmol.well-1 x h-1 [P < 0.02] and 1.49 +/- 0.26 vs. 0.69 +/- 0.05 pmol.well-1 x h-1 +adP < 0.01]). Rates of glycogen synthesis were stimulated 1.9 +/- 0.2-fold above basal in the control cells and 1.5 +/- 0.1-fold above basal in the NIDDM cells (P < 0.02). Rates of [3H]thymidine uptake were similar in control and NIDDM fibroblasts (basal, 28.3 +/- 2.8 vs. 39.2 +/- 8.0; maximum, 50.9 +/- 7.2 vs. 69.3 +/- 16.9 dpm x 10(-3), respectively). Rates of uptake increased similarly in control and NIDDM cells by 1.8 +/- 0.1- and 1.7 +/- 0.1-fold above basal. Maximum specific fibroblast insulin binding was similar for control and NIDDM subjects (194.0 +/- 29.2 vs. 176.1 +/- 24.9 fmol 125I-labeled insulin bound/mg protein respectively). The tyrosine kinase activity of insulin receptors isolated from the control and NIDDM fibroblasts was similar (basal, 135 +/- 30 vs. 149 +/- 33; submaximal, 153 +/- 28 vs. 155 +/- 30; and maximal insulin, 191 +/- 45 vs. 213 +/- 48 dpm.mg protein-1 x min-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Cells, Cultured↗
PubMed1985

Pressor and vascular responsiveness in renal prehypertensive rabbits with a nonfiltering kidney.

This study examined the possibility that the renal tubules are the site of the sensors that respond to renal artery stenosis (RAS) and which initiate the events leading to pressor hyperresponsiveness. A nonfiltering kidney (NFK) was produced in 32 rabbits by 2 hr of total renal ischemia plus permanent ligation of the ureter; the opposite kidney remained undisturbed. Sixteen of these rabbits also received RAS of the NFK. An additional 16 rabbits received RAS without production of a NFK, and 16 more rabbits were sham-operated controls. In acute experiments 3 days later in conscious rabbits, infusions of norepinephrine at several doses resulted in greater increases in mean arterial pressure in the RAS rabbits, with filtering kidneys (2-K, 1-clip) and with NFKs (2-K, 1-clip with NFK), than in the NFK rabbits without RAS (2-K control with NFK) or in the control rabbits (2-K control). Measurements of cardiac output revealed greater increases in total peripheral resistance as well as in mean arterial pressure in response to norepinephrine in the RAS rabbits both without and with a NFK. Because production of a NFK in rabbits did not prevent the development of pressor and vascular hyperresponsiveness 3 days after RAS, these studies indicated that the renal sensors that detect changes in the kidney following RAS and which initiate the series of events leading to pressor and vascular hyperresponsiveness, probably are not located in the renal tubules.

Animals↗
PubMedDate not supplied

Participant reactions to a cognitive-behavioral guided self-help program for binge eating: developing criteria for program evaluation.

This article evaluates the effectiveness of a telephone-based guided self-help program for women who binge eat. We report how key program components (e.g., phone sessions, the self-help book) contribute to the four self-help goals identified in the clinical literature: (1) decrease isolation/increase support; (2) increase knowledge of the problem; (3) broaden coping skills; and (4) improve self-esteem. Using the example of our feasibility study, we illustrate that even minimal interventions create a relational context which can promote entry into and engagement with treatment. We conclude that program evaluation should include not only traditional measures of outcome (e.g., reduction in symptomatology), but utilize outcome measures related to the specific goals of minimal interventions (e.g., changes in help-seeking behavior).

Attitude↗