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Biomedical subjects

M K Grant

Publications and source records attributed to M K Grant.

18 recordsLinked to original sources
PubMed1999

Regulation of acetylcholine binding by ATP at the muscarinic M(1) receptor in intact CHO cells.

ATP may have a modulatory effect on cholinergic transmission, as it is known that ATP is released as a co-transmitter with acetylcholine from nerve terminals. The ability of ATP to influence the binding of acetylcholine to the M(1) muscarinic acetylcholine receptor expressed in intact CHO cells was investigated. In competition binding experiments, acetylcholine completely inhibited the binding of [3H]N-methylscopolamine, but yielded a shallow competition isotherm that was best described in terms of two affinity states. When these experiments were repeated in the presence of 1 mM ATP, the acetylcholine competition curve was better described in terms of a single, low-affinity state with a Hill slope not significantly different from unity. This modulatory effect of ATP was completely reversed by the addition of the P(2) purinoceptor antagonist, suramin, to the assay medium. When the competition between the muscarinic receptor antagonist, atropine, and [3H]N-methylscopolamine was investigated, however, ATP was unable to modulate the binding of atropine, which was consistent with a one-site binding model in each instance. In contrast to the intact cell studies, ATP did not affect either affinity state of acetylcholine binding when studied in homogenate preparations. The results of the present study indicate that ATP, acting via endogenously expressed purinoceptors, is able to influence agonist binding to the M(1) muscarinic acetylcholine receptor via a cross-talk that requires the functional integrity of intact CHO cells.

Acetylcholine↗
PubMed1992

The necessity of mission integration. A system develops processes to weave values into the life of the organization.

Essential to the future vitality and viability of a mission-driven organization is the integration of the mission into the organization's programs, policies, practices, and accountability. Holy Cross Health System (HCHS), South Bend, IN, launched an intensive educational effort with managers, staff members, and trustees to reinforce the basic belief that mission permeates all departments. Using the mission statements principles of fidelity, excellence, empowerment, and stewardship, HCHS leaders initiated a systemwide mission assessment and development effort. During assessment, each facilities' ad hoc team addressed and responded to the organization's mission standards on the basis of availability of personnel, size, facility, and particular circumstances. The assessment process called for interdisciplinary, institutional review teams to explore all aspects of mission activity. This process enabled HCHS to launch a systemwide educational effort about the importance and necessity of mission integration. HCHS then used the mission statement elements fidelity, excellence, empowerment, and stewardship to define new relationships of accountability.

Budgets↗
PubMed1990

Sponsorship in evolution.

Sponsorship appears to be evolving from an original model in which the sponsoring religious institute related to its facilities in a manner resembling a family business, to a model of sponsorship akin to a franchise, to a ministerial partnership. Factors leading to this evolution include tremendous changes within the religious institute itself, including decreases in the number of members and financial stability. Changes within healthcare itself--such as greater competition and declining revenues-have forced hospitals to diversify. One result of these developments has been a radical change in the "rules" of the game. Historically independent entities--hospitals, sponsors, physicians--now have to value interdependence and mutuality. In the family-run model the family (sponsor) had special privileges, as though they "owned" the business. When the number of family members dropped below that necessary to govern, administer, and staff the institute's facilities, they began to move away from the family model to the franchise model, which has more open communication, greater input to decision making by non-family members, and a shift in the family's attention from actual operations to oversight and accountability. Eventually, the franchise model began to give way to the ministerial partnership, characterized by mutuality. Both family and others have roles not only in carrying out the mission, but in actually shaping and forming it.

Catholicism↗
PubMed1990

The call to collaboration. Pursuing and completing a merger requires planning and perseverance.

In 1987 Mercy Health Care System (MCHS) of Scranton, PA, and Mercy Health System (MHS) of Cincinnati took the first steps toward a merger. Leaders of the Scranton province, who had for some time been seeking to establish a relationship with another Mercy-sponsored health system, had approached MHS with the proposal. In late summer 1988 MHS began a thorough analysis of the facilities of the Pennsylvania system, assessing their mission, margin, and market strength; plant and property conditions; and human resources. At the same time the two provincial teams and CEOs from facilities in both systems, along with an outside consultant, began to negotiate the proposed merger's sponsorship and governance structure. Careful avoidance of "we-they" thinking was the hallmark of the entire negotiating process. Having agreed that they wanted a cosponsored system, the negotiating teams struggled to determine the degree of representation the Scranton province (five facilities) and the Cincinnati province (18 facilities) would have. The teams also had to iron out differences of opinion regarding the viability of one facility. Negotiators also worked out a decision-making procedure ensuring appropriate input from the Scranton member of the corporation. Help was sought to ensure that the merger agreement was in accordance with both canon and civil law. A sophisticated, step-by-step implementation process helped bring MHCS facilities on line as quickly as possible with minimal disruption. A series of celebrations commemorated the merger's completion.

Catholicism↗
PubMed1986

Sponsorship challenge: influence through governance.

References to sponsorship first appeared in the health care literature in the late 1970s and coincided with dramatic changes in the health care industry and a resurgence of lay commitment to Church ministries. During this period, religious institutes' traditionally managed health care organizations became corporate businesses. One of the first attempts to define "sponsorship" was led by Sr. Concilia Moran, RSM, who introduced the notion of influence and control over the direction of a corporate ministry as the principal concern of sponsorship. Sponsorship in its strictest sense refers to the exercise of reserved powers, which include establishing the ministry's philosophy, approving articles and bylaws, approving trustees, administering real property, and approving merger and dissolution actions. Religious-sponsored health care today is in a precarious situation: The majority of sponsors have fewer than four facilities and the survival of organizations sponsored by religious institutes with fewer and older members is at stake. As increasing numbers of laypersons have joined the ranks of leadership in Catholic health care, religious institutes' involvement has shifted from management to governance. Of key importance now is the development of skills in extending influence through governance.

Catholicism↗
PubMedDate not supplied

Effects of speech therapy and pharmacologic and surgical treatments on voice and speech in Parkinson's disease: a review of the literature.

The purpose of this review was to examine the different treatment approaches for persons with Parkinson's Disease (PD) and to examine the effects of these treatments on speech. Treatment methods reviewed include speech therapy, pharmacological, and surgical. Research from the 1950s through the 1970s had not demonstrated significant improvements following speech therapy. Recent research has shown that speech therapy (when persons with PD are optimally medicated) has proven to be the most efficacious therapeutic method for improving voice and speech function. Pharmacological methods of treatment in isolation do not appear to significantly improve voice and speech function in PD across research studies. Surgical treatment methods including pallidotomy and deep brain stimulation may be significant treatment options which improve voice and speech function in some persons with PD. Possible explanations for the differential responses to treatment are discussed. Future studies should investigate the effects of combined treatment approaches. Perhaps the combination of pharmacological, surgical and speech treatment will prove superior to treatments combining pharmacological and surgical or pharmacological and speech therapy in improving the communication abilities of persons with PD.

Antiparkinson Agents↗
PubMedDate not supplied

Transducer abstraction: a novel approach to the detection of partial agonist efficacy in radioligand binding studies.

The properties of the ternary complex model (TCM) of drug action at G protein-coupled receptors (GPCRs) were examined, using theoretical computer simulations, with regard to the predicted effects of the presence of a fixed concentration of one agonist on the competition binding profile of another. Subsequently, the binding properties of the full muscarinic acetylcholine receptor (mAChR) agonists acetylcholine (ACh) and carbachol (CCh), and the partial agonists pilocarpine and McN-A-343, were investigated in competition experiments against [(3)H]N-methylscopolamine using homogenate preparations from Chinese hamster ovary cells, stably expressing the human M(1) or M(2) mAChR. At the M(2) mAChR, all agonists displayed biphasic binding curves and were readily modulated by the non-hydrolyzable GTP analogue, Gpp(NH)p, in accordance with previously established experimental observations. In contrast, agonist binding at the M(1) mAChR showed no significant change in the presence of Gpp(NH)p, even in the case of a full agonist. This phenomenon precludes using the "GTP-shift" to assess agonist efficacy at the M(1) mAChR. When the ACh competition curves were reconstructed in the presence of graded concentrations of either a full or a partial agonist, a significant redistribution of the fraction of the high-affinity state recognized by ACh was observed. However, when the procedure was repeated using the antagonist, atropine, no significant effect on the fraction of either the high or low affinity ACh binding components at the mAChR was observed. Taken together, these results indicate that changes in the profile of full agonist binding isotherms, when constructed in the presence of a partial agonist, may be more sensitive indicators of partial agonist efficacy than regular assays that directly measure partial agonist binding.

(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethy↗
PubMedDate not supplied

Surveys explore critical governance relationship.

The transition in religious-sponsored health care from a ministry of direct service to one of governance has generated serious and penetrating questions, analyses, and retrenchment. Emphasis on and demand for value-laden leadership development programs are growing at the same time that sponsoring groups are becoming more actively involved in the governance and oversight of their corporate ministries. Two recent Catholic Health Association (CHA) studies focused on the critical governance relationship between the sponsoring group and its incorporated ministries. The first study asked religious institutes and dioceses that were sponsors of CHA member health care freestanding facilities and systems to describe their current governance structure. The second study represented an initial attempt to identify qualitative components of effective governance or sponsorship and asked 19 major superiors and system chief executive officers (CEOs) to characterize an ideal relationship between sponsor and ministry. The studies' findings included the following: In freestanding facilities, lay-religious governing boards have all but replaced the all-sponsor and all-lay advisory boards of the past. Trustee orientation, development, and evaluation were not equally stressed in the three groups surveyed, with trustee evaluation programs lagging behind in all three. Major superiors and CEOs had remarkably similar expectations relating to accountability for mission, relationships between sponsor and corporation, communication, and leadership development. Both major superiors and CEOs looked for greater collaboration in defining roles, translating mission into "business plan", and developing formation programs for leadership. Major superiors' emphasized simplicity of life-style, whereas the CEOs stressed stable commitment to corporate ministry.

Catholicism↗