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Alison P Smith

Publications and source records attributed to Alison P Smith.

16 recordsLinked to original sources
PubMed2005

Viral replication-independent blockade of dendritic cell maturation and interleukin-12 production by human herpesvirus 6.

Human herpesvirus 6 (HHV-6) is a potentially immunosuppressive CD4(+)-T-lymphotropic betaherpesvirus that causes severe human thymocyte depletion in heterochimeric SCID-hu thy/liv mice and has been implicated as a potential cofactor in the progression of AIDS. However, the mechanisms of HHV-6-mediated immunosuppression have not yet been fully elucidated. We investigated the phenotypic and functional alterations induced by HHV-6 on peripheral blood-derived human dendritic cells (DC). The infection of DC with HHV-6 A or B was nonproductive, as revealed by calibrated real-time PCR measuring the accumulation of viral genome equivalents over time. Nevertheless, preexposure to HHV-6 markedly impaired the maturation of DC driven by gamma interferon and lipopolysaccharide, as shown by the reduced surface expression of major histocompatibility complex class I molecules, HLA-DR, CD40, and CD80. Moreover, HHV-6, but not the closely related betaherpesvirus HHV-7, dramatically suppressed the secretion of interleukin-12 (IL-12) p70 by DC, while the production of other cytokines that influence DC maturation, i.e., IL-10 and tumor necrosis factor alpha, was not significantly modified. Likewise, the secretion of the CC chemokines macrophage inflammatory protein 1beta and RANTES was unaltered. Functionally, a pretreatment with HHV-6 impaired the ability of DC to stimulate allogeneic T-cell proliferation. Altogether, these data identify interference with the functional maturation of DC as a potential mechanism of HHV-6-mediated immunosuppression.

Cell Differentiation↗
PubMedDate not supplied

Case management: key to access, quality, and financial success.

Several strategic, organizational, and operational variables drive successful case management programs. Organizational goals and accountability for support by administrative and medical staff leaders set the stage for a comprehensive program. The integration of utilization review, discharge planning, and other functions into the role of the case manager improves productivity and continuity. Choosing a model for assigning patients, a variable unique to the institution, should be carefully considered. Regardless of the power of strategic goals or the creative selection of a model, daily practices that promote daily review and communication will reveal all of the opportunities for improved performance. Complications are avoided one patient at a time and patients deserve vigilance. Length of stay is shortened 1 day at a time and we can no longer afford to miss these opportunities. In the period of high census, an unnecessary day for one patient at the end of his/her stay may mean another patient being diverted to another hospital away from his/her physician and past medical records. Creating constructive physician partnerships and cooperative relationships with postacute care providers can bring a case management program to higher level of performance. While many organizations have employees called "case managers," fewer have a comprehensive approach that has the potential to drive so many important indicators of performance.

Case Management↗
PubMedDate not supplied

A balancing act: managing your personal and professional life--Part II.

Managing your personal and professional life is a lifelong balancing act due to situations that arise in the course of expected and unexpected normal life events. Identifying and dealing with these issues in your own life will likely make you a stronger leader in the eyes of your employees who often struggle with similar issues. Acknowledging these struggles among your employees can help create community in work teams, which ultimately translates into retention. Advocating for work life policies in your organization will transform personal compassion into organizational culture and, ultimately, into corporate policy.

Humans↗
PubMedDate not supplied

Saving nurses, saving patients: responses to the labor crisis.

While numerous task forces have spent enormous time and energy studying the size and scope of the nursing shortage, other organizations have been hard at work solving the difficulties faced by nurses and reducing the effects of the labor shortages on patient care. These efforts range from national legislative activities to grassroots innovations. Many of these efforts have already produced tangible results and take the form of major investments in professional development and improvements to the workplace environment. Physicians play an important role in the hospital work environment and can affect teamwork, a clear driver of nurse satisfaction.

Education, Nursing↗
PubMedDate not supplied

The Schiavo legacy.

Explore the source record for details and available documents.

Advance Directives↗
PubMedDate not supplied

Managing people or places?

Based upon a growing body of nursing research, emphasizing the management of the work environment is more likely to lead to strong individual and organizational performance than focusing on individual performance. In several studies, individual variables among staff such as age, experience, and tenure were less predictive of their perceptions of an organization than were variables in the work environment.

Humans↗