PubMed Health⌕ Search

Biomedical subjects

K Hacker

Publications and source records attributed to K Hacker.

15 recordsLinked to original sources
PubMed1998

School-based health centers and school nurses: cementing the collaboration.

As school health personnel respond to the changing needs of children, new models are being developed and traditional models are being reexamined. The role of the school nurse is expanding at the same time as school-based health centers are increasing in number. Partnerships between school-based health centers and school nurses are critical for the success of school-based health centers, and partnerships will enhance and expand roles for school nurses. This paper clarifies the role of each in three areas: collaboration, communication, and cooperation. In addition, obstacles to partnerships are examined. The goal of this collaboration is a shared vision for the continuum of school health services in which school nurse and school health center serve integral roles. Elements for successful collaboration between nurse and health center are reviewed, including clarifying roles, shared leadership and program ownership, cooperative training and continuing education, negotiating conflict, and most importantly, maintaining mutual support and respect.

Communication↗
PubMed1996

Integrating school-based health centers into managed care in Massachusetts.

Contemporary school-based health centers (SBHCs) face dwindling financial resources and pressures to maximize reimbursement. As managed care becomes the dominant system of health care financing, SBHCs must integrate their service delivery with managed care systems. In Massachusetts, through a combination of advocacy, state, and local collaboration, SBHCs successfully developed partnerships with managed care plans. Strategies include enhancing communication between SBHCs and health maintenance organizations, standardizing school-based care, and mandating integration of services through state contract language. This article delineates the process that occurred and key elements necessary for developing these relationships. This experience is a valuable resource for other states and school-based providers as Medicaid populations are funneled into managed care arrangements.

Community Health Centers↗
PubMed1996

Lateral Neck Mass in an Adolescent Athlete.

A 17-year-old African-American athlete presented with complaints of allergies. He had a history of seasonal allergic rhinitis and otorrhea for many years, but this time it was accompanied by right-sided neck swelling. His right sternocleidomastoid was slightly enlarged, soft, nontender, and no discrete masses were palpable. He was active in shot-put and was right-handed. Following discharge with antihistamine therapy, he returned a month later with a visible enlargement of the right lateral neck and bilateral cervical adenopathy. The biopsy of the nasopharyngeal mass revealed an undifferentiated squamous nasopharyngeal carcinoma, staged at T2N3MX. Chemotherapy followed by radiation was recommended.

Journal Article↗
PubMed1994

A nationwide survey of school health services delivery in urban schools.

To understand school health service delivery models, and to plan for reorganization of a local school health service, a telephone survey of school-based health programs from around the country was conducted in 1992. Responses were elicited from 33 school departments in some of the largest American cities. Respondents described their current programs, obstacles they face, and approaches they have chosen to address the needs of urban schoolchildren. City size did affect amount of services provided overall, but a clear relationship existed between number of providers employed, and the number/amount of screening services available. Cities employed a range of strategies to enhance services, including collaboration with local health authorities, creation of school clinics, and billing for services.

Adolescent↗
PubMed1992

Uptake of minocycline by Escherichia coli.

Uptake of tetracyclines into Escherichia coli was assessed with a strain carrying a tetA-lacZ translational fusion, in which expression of the enzyme is controlled by the pSC101 tetR repressor gene, by examining beta-galactosidase induction. The ability of tetracycline analogues to induce beta-galactosidase synthesis was correlated with their hydrophobicity, such that hydrophobic analogues were poor enzyme inducers. Treatment of E. coli with polymyxin B nonapeptide (PMBN) rendered cells more permeable to minocycline, but not to tetracycline.

Enzyme Induction↗
PubMed1990

Sensitive biological detection method for tetracyclines using a tetA-lacZ fusion system.

A sensitive microbiological detection system for tetracyclines, utilizing an Escherichia coli strain containing a cloned tetA-lacZ gene fusion, is described. Expression of beta-galactosidase by the fusion plasmid pUB3610 remained subject to regulatory control by the TetR repressor protein, with the presence of tetracyclines in the growth medium leading to a 12-fold induction of beta-galactosidase synthesis. Because synthesis of beta-galactosidase was influenced to a small extent by the carbon source and the addition of cyclic AMP to the medium, cells were grown in the presence of cyclic AMP to enhance the sensitivity of the assay. All commonly marketed tetracyclines and some derivatives at concentrations as low as 0.1 ng/ml could be detected in the growth medium. A plate assay utilizing the fusion plasmid that detects 1 ng of tetracycline has also been developed.

Chromosomes, Bacterial↗
PubMed1989

Effects of tetracyclines on the production of extracellular proteins by members of the propionibacteriaceae.

The effect of tetracyclines on the synthesis of proteins in Propionibacterium avidum and P. acnes was examined. Synthesis of an extracellular lipase by P. avidum was slightly more sensitive to inhibition by tetracycline than total (cellular and extracellular) protein synthesis. The effect of tetracycline and other analogues on the synthesis of secreted proteins was also examined in P. avidum and P. acnes by protein radiolabelling experiments. In all cases the synthesis of secreted proteins was only about 2-fold more sensitive to inhibition by tetracyclines than total protein synthesis. These results contrast with previously published findings in Escherichia coli which show that synthesis of secreted proteins is highly susceptible to inhibition by tetracycline. The implications of these findings in relation to inhibition of membrane bound ribosomes by tetracyclines are discussed.

Bacterial Proteins↗
PubMed1989

Natural history of recurrent carotid artery disease.

Controversy exists as to whether early and late recurrent stenosis of the carotid artery represents two distinct types of recurrence or whether it is the same type of lesion detected at different times. Eleven specimens from patients whose carotid arteries were reoperated upon were examined. A temporal sequence was noted: with increasing intervals, the relative presence of areas of myointimal hyperplasia tended to decrease, whereas the relative presence of features of atherosclerosis tended to increase. The clinical data and B-mode ultrasound studies performed from one to 190 months after 210 carotid endarterectomies were reviewed. Twenty-seven carotid arteries (12.9 per cent) exhibited hemodynamically significant restenosis. Three ultrasonographic patterns were described: homogenous soft plaque, homogenous hard plaque and heterogenous plaque. A previous correlation between ultrasonographic and pathologic findings showed the three ultrasound patterns to correlate with myointimal hyperplasia, fibrous atherosclerotic plaque and complex atherosclerotic plaque, respectively. Soft plaques were detected earlier than heterogenous plaques (p less than 0.001). Results from serial studies showed progression of soft plaque to hard or heterogenous plaque, or both. Early and late recurrent lesions are the same type of lesion detected at different intervals. Symptoms of cerebral ischemia are more common at the stage of heterogenous plaque (p = 0.02).

Aged↗
PubMed1988

Seeding with endothelial cells derived from the microvessels of the omentum and from the jugular vein: a comparative study.

Segments of an experimental polytetrafluoroethylene graft (9 cm long, 6 mm I.D.) of high porosity were implanted in 25 dogs as aortic interposition grafts. Nine grafts were seeded with a mean of 7 x 10(5) viable endothelial cells (ECs) derived from the jugular vein (group A) and eight were seeded with a mean of 7 x 10(5) viable ECs derived from the microvessels of the omentum (group B). Eight grafts were not seeded and they served as controls (group C). Animals were put to death 5 weeks after graft implantation. The thrombus-free area was measured at 81% +/- 10% in group A, 65% +/- 22% in group B, and 25% +/- 13% in group C (p less than 0.05, group A vs group B; p less than 0.05, group B vs group C). The thickness of the subendothelial layer was 151 +/- 60 microns in group A, 280 +/- 60 microns in group B, and 100 +/- 75 microns in group C (p less than 0.001, group B vs groups A and C). The production of 6-keto-PGF1 alpha in the presence of sodium arachidonate was higher in seeded grafts (p less than 0.05). Omentally derived microvessel ECs can be seeded in vascular grafts; refinements in the technique of EC procurement are required to minimize contamination and to obtain ECs with more effective biologic activity.

6-Ketoprostaglandin F1 alpha↗
PubMed1987

Effect of immunization with Escherichia coli K1 antigen on the course of experimental infection of the urinary tract of the rat.

The influence of vaccination with an immunogenic K1 antigen of Escherichia coli on the course of pyelonephritis induced experimentally in rats by infection with Escherichia coli O2:K1:H4 was investigated. The immunogenic properties of K1 antigen are poor. A conjugate of K1 antigen with bovine serum albumin (BSA) was therefore tested. Preliminary experiments showed that the K1-BSA conjugate is immunogenic. Renal inflammatory activity in rats after retrograde infection was significantly reduced after vaccination of the animals with K1-BSA conjugate within six weeks of infection.

Animals↗
PubMed1987

[Modification by cyclophosphamide of the effect of autovaccination in chronic pyelonephritis in an animal experiment].

In an existing chronic pyelonephritis the influence of cyclophosphamide on the efficacy of an immunisation with autopathogenic antigens and the surface antigen of an E. coli rough strain was tested in an animal experiment. After an existence of the infection of about five weeks a decisive decrease of the antibody production by cyclophosphamide was not to be observed. The animals treated with cyclophosphamide did not show any improved elimination of germs. The histological findings of the kidneys documented the cytotoxical effect of the cyclophosphamide on the renal tissues and the epithelium of the urinary tract. The immunisation of animals with chronic pyelonephritis with various autopathogenic antigens altogether led to a statistically significant decrease of inflammatorily changed kidneys.

Animals↗
PubMed1986

Inhibition of K88-mediated adhesion of Escherichia coli to mammalian receptors by antibiotics that affect bacterial protein synthesis.

The ability of ten inhibitors of bacterial protein synthesis to decrease adhesion of Escherichia coli bearing K88ac fimbriae was examined. In the presence of the antibiotics at concentrations below the MIC values neomycin was the least effective inhibitor of adhesion and minocycline the most active. The effect of minocycline on the synthesis of individual polypeptides encoded by the K88ac determinant was examined in detail. The rate of synthesis of K88ac pilus protein in the presence of minocycline 0.75 mg/l (0.5 MIC) was less than that of total cell protein synthesis, suggesting that pilus protein becomes progressively 'diluted' in the outer membrane during exposure to this antibiotic concentration. Furthermore, the synthesis of two 'helper' polypeptides (molecular weights of 27.5 K and 27 K) which are probably involved in secretion of K88ac pilus protein through the cell envelope, was particularly sensitive to minocycline. Our observations suggest that the ability of translational inhibitors to decrease K88ac mediated adhesion probably results from direct inhibition of synthesis of fimbrial protein itself, together with inhibition of 'helper' polypeptide synthesis.

Animals↗
PubMed1986

[Incidence of antibody-coated bacteria in patients with chronic pyelonephritis].

Of 168 urine sediments, which were obtained from 55 patients with chronic pyelonephritis in the course of 3 years when a significant bacteriuria with E. coli was present, we demonstrated antibody-loaded bacteria in 81 cases (48.21%). In the active stage of the disease with 54.10% were found significantly more than in the inactive with 32.61%. In obstructive chronic pyelonephritis the positive rate was 54.79% in contrast to 43.16% in non-obstructive chronic pyelonephritis. While in the active stage of the obstructive chronic pyelonephritis with 57.41% more antibody-containing bacteria were excreted than with 47.31% in the inactive stage, the positive rate in the active stage of the non-obstructive chronic pyelonephritis was with 54.47% significantly increased in contrast to 22.22% in the inactive stage. 25.71% of the patients excreted only ACB+-, 34.29% only ACB(-)- and 40% ACB+- and ACB(-)-germs in the course of the disease. The ACB-positive quote was in rough forms with 62.50% statistically significantly increased in contrast to 45.54% in O-typable and 42.86% in non-O-typable strains. In the ACB+- group the immunofluorescence titres to the homologous strain and the C3-activator in the serum as well as the urine lysozyme were significantly higher than in the ACB(-)-group.

Antibody-Coated Bacteria Test, Urinary↗
PubMedDate not supplied

Mental health and illness in Boston's children and adolescents: one city's experience and its implications for mental health policy makers.

In 1999, the Boston Public Heath Commission used data from a variety of sources to explore the level of mental health disturbance in Boston's children and adolescents. Data for 1997 from the Youth Risk Behavior Survey showed that about 20% of Boston public high school students had ever experienced suicidal ideation, while approximately 10% had actually attempted suicide. About one in five teenage respondents to the Boston Youth Survey said they were frequently depressed. While females were more likely to report depression, males were more likely to report isolation and less likely to consider counseling. Medicaid claims data revealed differences by gender and age, with males using psychiatric emergency and Medicaid mental health services more than females, and 10- to 15-year-olds using these services more than other age groups. Emergency room injury surveillance and death certificate data indicated that among children and adolescents, females were twice as likely to attempt suicide as males, although males were more likely to complete a suicide. This data analysis helped pinpoint areas of need and has proven useful in the development of a child and adolescent mental health action agenda. Efforts to date have included expansion of surveillance, legislative advocacy, coalition building, and new services. Key indicators including suicidal ideation and attempts, service utilization, and service capacity have been chosen as markers for future improvement.

Adolescent↗