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Biomedical subjects

M Rich

Publications and source records attributed to M Rich.

At least 19 recordsLinked to original sources
PubMed2001

Identification and characterization of a melanin-concentrating hormone receptor.

Melanin-concentrating hormone (MCH), a neuropeptide expressed in central and peripheral nervous systems, plays an important role in the control of feeding behaviors and energy metabolism. An orphan G protein-coupled receptor (SLC-1/GPR24) has recently been identified as a receptor for MCH (MCHR1). We report here the identification and characterization of a G protein-coupled receptor as the MCH receptor subtype 2 (MCHR2). MCHR2 has higher protein sequence homology to MCHR1 than any other G protein-coupled receptor. The expression of MCHR2 has been detected in many regions of the brain. In contrast to MCHR1, which is intronless in the coding region and is located at the chromosomal locus 22q13.3, the MCHR2 gene has multiple exons and is mapped to locus 6q21. MCHR2 is specifically activated by nanomolar concentrations of MCH, binds to MCH with high affinity, and signals through Gq protein. This discovery is important for a full understanding of MCH biology and the development of potential therapeutics for diseases involving MCH, including obesity.

Alternative Splicing↗
PubMed2001

The use of direct susceptibility tests from BACTEC 9240 to Microscan Walkaway.

Using a straight-from-the-bottle into-the-instrument technique, a series of direct susceptibility tests were performed with the BACTEC 9240 and Microscan Walkaway systems. Although rapid, unacceptably high error rates were obtained when compared with a standardized method. This procedure is not sufficiently accurate for clinical use.

Cell Culture Techniques↗
PubMed2001

Child health in the information age: media education of pediatricians.

OBJECTIVE: Substantial research has associated exposure to entertainment media with increased levels of interpersonal violence, risky sexual behavior, body image distortion, substance abuse, and obesity. The objective of this study was to determine what pediatric residency programs are teaching trainees about media and the influence of media on the physical and mental health of children and adolescents. DESIGN: Survey of residency curricula, consisting of 17 items about children's exposure to media, including television, movies, popular music, computer/video games and the Internet, the effects of this exposure on specific health risks, and associations between program characteristics and media education in the residency curriculum. Participants. Directors of the 209 accredited pediatric residency programs in the United States. RESULTS: Two hundred four programs (97.6%) responded. Fifty-eight programs (28.4%) offered formal education on 1 or more types of media; 60 programs (29.4%) discussed the influences of media when teaching about specific health conditions. Residents in 96 programs (47.1%) were encouraged to discuss media use with patients and parents; 13 programs (6.4%) taught media literacy as an intervention. Among program characteristics, only media training received by program directors was significantly associated with inclusion of media in residency curricula. CONCLUSIONS: Despite increasing awareness of media influence on child health, less than one-third of US pediatric residency programs teach about media exposure. Developing a pediatric media curriculum and training pediatric residency directors or designated faculty may be a resource-effective means of improving health for children growing up in a media-saturated environment.

Adolescent↗
PubMed2001

Social and environmental infantilization of aged persons: observations in two adult day care centers.

This study examines the social environments, staff behavior, and social interaction of elderly clients in two adult day care centers. Goffman's (1961) description of the psycho-social effects of the "total institution" is used as a framework for conceptualizing the effects of "partial institutions" on older persons. Using qualitative research techniques, we observed the environments, activities, and interactions of approximately seventy-two clients in two adult day care settings. When the staff and environment were more infantilizing, provided less autonomy, and fewer opportunities for privacy regulation, the clients had lower social interaction with peers. In contrast, when the center had a more adult setting, with age appropriate activities, there was greater privacy regulation, autonomy, social contact, and friendships among clients.

Activities of Daily Living↗
PubMed2001

Consumerism: its impact on the health of adolescents.

Marketplace practices are integral to the larger economic and social context of adolescent health risk behaviors. To corporations and marketers, adolescents represent a gold mine of current and future profits. Adolescent incomes increased by almost a third in the 1990s. The annual spending of the U.S. adolescent population is estimated now to have reached 155 billion US dollars. The sheer size of the adolescent population and its spending power are of keen interest to corporations and marketers. This chapter presents a brief history of youth-targeted marketing and examines the major avenues in the media and inside schools that marketers and corporations use today to reach adolescents with their messages and products. It outlines the impact of consumerism and marketing on adolescent health using five case examples: tobacco, alcohol, cosmetic surgery, laxatives, and diet pills. It then concludes with a discussion of resistance efforts, led by health advocates, policy makers, parents, and youth themselves to restrict sales of harmful products to youth and curtail advertisers' access to adolescents in schools. A critical role for adolescent health researchers and advocates is to contribute a public health perspective into ongoing debates over regulating business practices that negatively affect the health of young people.

Adolescent↗
PubMed2000

Video intervention/prevention assessment: a patient-centered methodology for understanding the adolescent illness experience.

OBJECTIVE: To better understand the issues and needs of adolescents with chronic health conditions, the Video Intervention/Prevention Assessment (VIA) integrates video technology with qualitative research methods to obtain a patient-centered perspective on illness and health care. METHODS: Young people with chronic disease are interviewed for condition-specific verbal reports (CSVRs) of their medical and psychosocial histories. Standardized health-related quality of life (HRQL) instruments are administered. Trained to use video camcorders, participants record visual narratives of their illness experiences. They document their daily lives, interview families and friends, and record personal monologues regarding their observations, behaviors, understandings, and beliefs about their disease. On completion of the visual narratives, HRQL is again evaluated. Verbal, scaled, and visual data are analyzed from three perspectives: medical, psychosocial, and anthropological. Data from the CSVRs, HRQLs, and visual narratives are triangulated to validate and enrich findings. RESULTS: Investigating the illness experience from the adolescent patient's perspective, the VIA method was pilot-tested with children and adolescents with asthma. As a research tool, VIA found environmental risk factors, medication adherence problems, and outcome-affecting illness beliefs and psychological states that were not identified by standard clinical tools. As an intervention, VIA showed that it may be an effective tool for health-related environmental surveys. Participants' condition-specific quality of life showed measurable improvement after the self-examination process of VIA. As communication, VIA made apparently counterproductive patient behaviors understandable by showing them in context with the adolescent's experience of illness and health care. VIA can enhance medical history-taking and management strategies, improve adolescents' self-management skills, and educate clinicians, families, and students of the health care professions about the realities of the adolescent living with a chronic health condition.

Adolescent↗
PubMed2000

Nonsteroidal anti-inflammatory drug gastropathy at the new millennium: mechanisms and prevention.

OBJECTIVES: Nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal (GI) toxicity remains the most frequent adverse drug event in the United States. The objective of this review is to update clinicians in recent advances in basic and clinical investigation regarding the pathogenesis and management of NSAID gastropathy. METHODS: Based upon an extensive review of the published literature and abstracts of key work within the past decade, the framework for new approaches to the prevention and treatment of NSAID-associated ulceration is summarized. RESULTS: The pathophysiology of NSAID-induced injury to the GI tract is multifaceted and includes both prostaglandin-dependent and independent components. The pharmaceutical industry has capitalized on the identification of two different isoforms of cyclooxygenase, enabling the development of specific inhibitors of one isoform that minimizes prostaglandin-dependent mechanisms that contribute to NSAID-induced injury. Clinical trials support the efficacy and reduced toxicity of these agents. Because acid exacerbates the injury initiated by NSAIDs, potent acid suppressive therapy, typically with proton pump inhibitors, is another common approach to the treatment of NSAID-related dyspepsia as well as NSAID-induced ulcer disease. CONCLUSIONS: Recent improvements in the understanding of NSAID-induced damage and new drug development have provided the opportunity for effective anti-inflammatory therapy with reduced GI toxicity. This illustrates the importance of identifying patients at risk for potential complications and the appropriate use of strategies to prevent and treat NSAID-induced complications.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Is upper gastrointestinal radiography a cost-effective alternative to a Helicobacter pylori "test and treat" strategy for patients with suspected peptic ulcer disease?

OBJECTIVE: Current clinical consensus supports an initial Helicobacter pylori (HP) "test and treat" approach when compared to immediate endoscopy for patients with suspected peptic ulcer disease. Alternative diagnostic approaches that incorporate upper GI radiography (UGI) have not been previously evaluated. We sought to determine the cost effectiveness of UGI compared to a HP test and treat strategy, incorporating recent data addressing the reduced prevalence of HP, lower cost of diagnostic interventions, and reduced attribution of PUD to HP. METHODS: Using decision analysis, three diagnostic and treatment strategies were evaluated: 1) Test and Treat--initial HP serology, treat patients who test positive with HP eradication and antiulcer therapy; 2) Initial UGI series--treat all patients with documented ulcer disease with HP eradication and antiulcer therapy; and 3) Initial UGI series, HP serology if ulcer present--treat ulcer and HP based on diagnostic test results. RESULTS: The estimated cost per ulcer cured for each strategy were as follows: test and treat, $3,025; initial UGI, $3,690; and UGI with serology, $3,790. The estimated cost per patient treatment were: test and treat, $498; initial UGI, $610; and UGI with serology, $620. When UGI reimbursement was decreased to less than $50, the UGI strategies yielded a lower cost per patient treated than the test and treat strategy. CONCLUSION: At the current level of reimbursement, UGI should not be considered a cost-effective alternative to the HP test and treat strategy for the initial evaluation of patients with suspected peptic ulcer disease.

Anti-Ulcer Agents↗
PubMed2000

Asthma in life context: Video Intervention/Prevention Assessment (VIA)

OBJECTIVE: Video Intervention/Prevention Assessment (VIA) was developed to determine whether medical information gathering might be augmented by video diaries created by patients to show clinicians the realities of managing chronic disease in the contexts of their lives. DESIGN: Children and adolescents who met National Heart, Lung, and Blood Institute criteria for moderate or severe asthma were enrolled from an urban pediatric hospital and an inner-city health center. Comprehensive, asthma-specific medical histories were obtained from study participants in standard clinical interviews. Participants were trained to use video camcorders and recorded visual narratives of how they lived with and managed their asthma over a 4- to 8-week period. These visual narratives were screened by a trained observer, who completed the initial comprehensive medical history based solely on viewing the video. Information from participants' medical history interviews was compared with observations of their visual narratives. RESULTS: Twenty young people 8 to 25 years old completed the VIA Asthma study. Important variations were found between participants' medical history interviews and their visual narratives. All 20 participants reported specific environmental triggers for their asthma; 19 had 1 or more of these triggers documented on video in their daily living environments (video illustrations online, available at: ). Exposures to known triggers ranged from 25% (noxious fumes) to 91% (mold). Exposure to tobacco smoke that was denied in the interview was revealed on video in 63%. The 18 participants who revealed medication use in their visual narratives were assessed for adherence: 33% exceeded prescribed doses, 28% discontinued medications without consulting a clinician, and 72% used ineffective inhaler technique. CONCLUSIONS: VIA visual narratives extended a comprehensive, standard of care medical history, yielding a more complete and accurate understanding of exacerbating environmental exposures and inappropriate medication usage of children and adolescents with asthma. VIA is an effective tool for revealing the physical and psychosocial environments in which young people live with disease. Patient-created video can enrich our understanding of the illness experiences of children and adolescents. VIA has the potential to enhance clinical data gathering, guide the development of more effective and sensitive management strategies, and educate clinicians about the realities of the young person living with illness.

Adaptation, Psychological↗
PubMed1999

Rhetoric to practice: the challenge of collaboration of academe and industry.

Community health nursing is a complex practice that encompasses nurses working in many diverse settings. This article discusses the development of a project which focused on better preparation of students for potential employment in community settings. The formation of the working team and the development of the curriculum is outlined. A focus is given to the linking of primary health care principles in the teaching and facilitation of students within hospital and community settings. Comprehensive conclusions cannot be made yet from the project's preliminary findings. However, the process of collaboration has demonstrated several issues. These will have an impact on everyone who has been part of this project, and the issues are discussed in this article. The article provides an overview of the first year of collaboration of a 4-year project.

Community Health Nursing↗