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Biomedical subjects

J S Abramson

Publications and source records attributed to J S Abramson.

At least 19 recordsLinked to original sources
PubMed2000

Collaboration between social workers and physicians: perspectives on a shared case.

As health care is being restructured, health care institutions are recognizing that interdisciplinary collaboration is an essential element of both effective patient care and organizational survival. This paper analyzes self-reported views of actual collaborative activities between 50 pairs of social workers and physicians on a specific shared case in an acute care hospital setting. Through examining the degree of congruence in perspectives of each pair of collaborators, we compare the two professions' views of the collaborative process and outcome. Additionally, each profession's outlook on its own and the other profession's roles and responsibilities in the case is examined. Our findings indicate that many social work and physician collaborators share similar perspectives about many aspects of their joint patient care endeavors. Where there was disagreement within a pair, almost always, it was a social worker selecting or discussing a variable when her physician counterpart did not. Physicians were less likely than their social work counterparts to identify patient/family problems related to adjustment to illness and problems connected to hospital and community resources as well. Social workers were much less satisfied with the collaboration, saw many more things that they or their collaborator could have done differently and even perceived more disagreement about the approach to the case than did their physician collaborators. It is important to understand, empirically, the dynamics of successful collaboration and to assist social workers in becoming influential and effective collaborators with other health professionals.

Attitude of Health Personnel↗
PubMed1996

When social workers and physicians collaborate: positive and negative interdisciplinary experiences.

Interdisciplinary collaboration is becoming increasingly important as the current complexity and cost of health care require an efficient and well-coordinated service delivery system. To understand the factors contributing to positive and negative collaboration, 53 social workers and 50 physicians in 12 hospital settings were interviewed about their best and worst experiences collaborating on a case. Thirty precoded items were classified into three constructs that reflect aspects of collaboration related to the case, to interaction between collaborators, and to the competence of the collaborator. Differences between the two professions were greatest on the interactional factors, with social workers valuing them much more than physicians did. Communication appeared to be the only intrinsic or universal aspect of collaboration equally important to both groups in both types of cases. Implications for social work practice and leadership are discussed.

Attitude of Health Personnel↗
PubMed1995

Decreased binding of specific monomeric and trimeric G-proteins with the plasma membrane of polymorphonuclear leukocytes exposed to influenza A virus.

Influenza A virus (IAV)-induced polymorphonuclear leukocyte (pMNL) dysfunction is important in causing secondary bacterial infections that lead to most influenza-related deaths. We previously showed that PMNLs exposed to IAV followed by a variety of stimuli (e.g., FMLP, PMA) demonstrate inhibition of various activation steps and endstage functions, suggesting IAV alters an early step in cell signalling. The present study examined IAV's effect on trimeric and monomeric G-proteins, since alterations of these proteins could explain IAV-induced PMNL dysfunction to various stimuli. PMNLs exposed to IAV for 30 min had decreased membrane-associated basal and high affinity guanosine triphosphatase (GTPase) activity compared with control cells. immunoblotting studies, using trimeric G-protein alpha and beta subunit-specific Abs, showed IAV decreased plasma membrane association of the trimeric G-proteins alpha subunits Gi2 and Gq by 33% +/- 5 and 46% +/- 8, respectively; binding of Gi3 and Gs was not altered. Similar studies involving monomeric G-proteins demonstrated that IAV decreased the membrane binding of rap1A (35% +/- 4), but not rac G-proteins. Corresponding increases in these IAV-altered G-proteins were detected in intracellular compartments. These data suggest the mechanism of IAV-induced PMNL dysfunction involves alterations in the binding of trimeric and monomeric G-proteins to plasma membranes.

Adult↗
PubMed1995

Role of the sialophorin (CD43) receptor in mediating influenza A virus-induced polymorphonuclear leukocyte dysfunction.

Polymorphonuclear leukocytes (PMNLs) exposed to influenza A virus (IAV) undergo activation of the respiratory burst followed by depression of cell function when subsequently exposed to particulate or soluble stimuli. The effect of IAV on PMNLs is likely to be mediated through the attachment of IAV to one or more specific receptors. Recently, IAV has been shown to bind to the sialophorin protein (CD43) receptor on PMNL plasma membranes. The present study was performed to determine if the sialophorin receptor was responsible for IAV-induced PMNL dysfunction. When PMNLs were incubated with IAV or CD43 monoclonal antibody (MoAb) for 30 minutes and then exposed to a secondary particulate (opsonized zymosan) or soluble (FMLP or phorbol 12-myristate 13-acetate) stimulus, there was significant depression of the PMNL chemiluminescence response compared with the equivalent control (P < .05). When PMNL were incubated with the CD43 MoAb and then cross-linked with a goat antimouse IgG antibody, no depression of PMNL function occurred upon secondary stimulation. Exposure of cells to IAV aggregates also eliminated the PMNL dysfunction that normally occurs due to the virus. Similar to IAV, PMNL dysfunction due to the CD43 MoAb could be overcome by priming the cells with granulocyte-macrophage colony-stimulating factor. These findings indicate that IAV-induced PMNL dysfunction is mediated, at least in part, through the sialophorin receptor.

Antibodies, Monoclonal↗
PubMed1995

Development of a vaccine tracking system to improve the rate of age-appropriate primary immunization in children of lower socioeconomic status.

We conducted a randomized, controlled trial to determine the effectiveness of an immunization tracking system designed to increase the number of infants of lower socioeconomic status who receive their primary series of vaccinations at age-appropriate times. By 7 months of age, 91% (274/301) of the infants in the intervention group were up-to-date on their primary series of vaccinations versus 72% (214/296) of the infants in the control group (p < 0.0001). The estimated cost of follow-up for each infant in the intervention group was $18.05.

Child, Preschool↗
PubMed1994

Effect of priming polymorphonuclear leukocytes with cytokines (granulocyte-macrophage colony-stimulating factor [GM-CSF] and G-CSF) on the host resistance to Streptococcus pneumoniae in chinchillas infected with influenza A virus.

Patients infected with influenza A virus (IAV) are at increased risk for bacterial superinfections, and this occurs in association with depressed polymorphonuclear leukocyte (PMNL) function. Recently, we reported that in vitro exposure of human PMNL to granulocyte-macrophage colony-stimulating factor (GM-CSF) reverses IAV-induced cell dysfunction. The present study used an established animal model of IAV infection to examine whether G-CSF and/or GM-CSF can overcome IAV-induced PMNL dysfunction and thereby prevent secondary infections. Preliminary studies determined a dosing schedule of these cytokines that caused significant priming of chinchilla PMNL. In subsequent studies, animals were inoculated intranasally with IAV (day 1) followed 3 days later by Streptococcus pneumoniae, and administered daily intraperitoneal injections with a cytokine or placebo on days 3 through 9. Animals had blood obtained on multiple occasions for PMNL studies, and were followed-up for evidence of pneumococcal disease. Both cytokines caused significant priming of the PMNL chemiluminescence response and this was associated with reversal of the IAV-induced PMNL dysfunction. However, neither cytokine decreased the incidence of pneumococcal disease.

Animals↗
PubMed1993

Response to Haemophilus influenzae type b conjugate vaccine in chronically ill premature infants.

Twenty-two premature infants with chronic lung disease (median gestational age 28 weeks) received polyribosylribitol phosphate-outer membrane protein conjugate Haemophilus vaccine at 2 and 4 months of chronologic age. The proportions with antibodies to polyribosylribitol phosphate at levels > 1 microgram/ml after doses 1 and 2 were 27% and 55%; geometric mean titers were 0.43 and 0.73 microgram/ml, significantly lower than values for term infants.

Age Factors↗
PubMed1993

Disagreements in discharge planning: a normative phenomenon.

The process of discharge planning is often impeded by disagreements among family members and others involved. A discharge plan must be negotiated to meet the varying needs of participants within the context of regulatory and organizational mandates. Under such circumstances, disagreements in decision making can be anticipated, particularly for family members, who must readjust roles and relationships in the face of the crisis of illness. Support for this conceptual formulation is found in the literature, particularly in two studies that evaluated the incidence of disagreements in discharge planning caseloads. In both studies, disagreements occurred in at least one-third of the cases, with most disagreements involving family members. Neither study found substantial disagreement among professionals. Social workers who provide discharge planning services in hospitals clearly are dealing with substantial levels of disagreements among principals in the process; in fact, disagreement needs to be accepted as a normative phenomenon in such planning. This article discusses the sources of family disagreements related to discharge planning, identifies the implications for social work practice, and uses a family systems perspective to articulate an approach to intervention.

Decision Making↗
PubMed1992

Outbreak of Candida bloodstream infections associated with retrograde medication administration in a neonatal intensive care unit.

An outbreak of candidemia involving five infants receiving total parenteral nutrition in the neonatal intensive care unit was investigated. Cultures of the intravenous fluids demonstrated that the retrograde medication syringe fluids were significantly more likely to be contaminated with Candida than were other fluids being administered to the infants (p less than 0.001). Candidemia was significantly associated with total parenteral nutrition (p = 0.04) and retrograde medication administration (p = 0.02). A survey of nursing practice found that reuse of the retrograde syringes was the most likely cause of contamination. Molecular typing showed that the strains of Candida albicans that were isolated from the bloodstream were also found in the retrograde syringes and that at least three strains of C. albicans and one strain each of Candida tropicalis and Candida parapsilosis were involved. In vitro growth curves demonstrated that Candida species had a selective growth advantage versus bacteria in the total parenteral nutrition fluid. An in vitro simulation of the retrograde medication administration system suggested that the outbreak probably developed after the frequency of changing intravenous tubing was decreased from every 24 hours to every 72 hours. The outbreak was terminated by using syringes only once and resuming intravenous tubing changes every 24 hours. Retrograde medication administration in association with total parenteral nutrition may increase the risk of Candida line infection.

Candida↗