Clinical specialist nurse practitioners would combine expertise of two roles.
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Biomedical subjects
Publications and source records attributed to M S Davis.
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Natural family planning includes the calendar (rhythm), basal body temperature, ovulation (mucus), and sympto-thermal methods. Reliability of such methods often is underestimated, but effectiveness of various methods has been reported. Correct understanding and use of proper techniques, primarily abstinence during fertile periods, is imperative for effectiveness. New methods being studied may heighten awareness of fertile times and shorten required periods of abstinence or use of back-up methods.
It has been reported that siblings of children with cancer often lack information and understanding about their brother's or sister's disease and treatment. The purpose of this paper is twofold: (1) to describe a camping program for siblings, which was designed, in part, to provide these children with age-appropriate medical information; and (2) to report the results of a study which examined how this intervention influenced siblings' knowledge and understanding of their brother's or sister's disease. Ninety siblings between the ages of 6 and 17 who completed a pre/post camp medical information questionnaire participated in this investigation. The results revealed that younger (6- to 11-year-old) siblings attending camp for at least the second time and older (12- to 17-year-old) siblings attending camp for the first time experienced significant (p less than .05) improvement in their overall knowledge and understanding of their brother's or sister's cancer. The results also revealed positive changes in the desired direction with respect to siblings' fear or their friends' fear about catching their brother's or sister's cancer. The results of this study provide a conceptual model for other pediatric cancer facilities engaged in developing intervention programs for siblings.
Cohesiveness has been viewed as the group psychotherapy equivalent of the therapeutic alliance in individual treatment. Although researchers have attempted to study the concept of cohesion in group treatment, understanding of this so-called "curative" group factor remains quite primitive. In this study of 12 time-limited psychotherapy groups, with a total of 90 nonpsychotic outpatients, we explore the relationships between cohesion, alliance and treatment outcome. Our cohesion measure is a new instrument, the Harvard Community Health Plan Group Cohesiveness Scale, developed for use with group therapy videotapes. To measure alliance we have modified the Penn Helping Alliance Scale (Group Alliance Scale) to be scored from videotapes of group sessions. Both of these instruments use trained observers to make ratings for the group-as-a-whole. The outcome battery for patients in these groups included a widely varied set of measures, enabling us to view change from a number of perspectives. Our findings indicate that cohesion and alliance as measured here are related concepts. We also find that both cohesion and alliance appear to have strong relationships with improved self-esteem and reduced symptomatology for patients in these groups. In addition, it appears that outcome is most related to cohesion in the first 30 minutes of a group session. Implications of these and other findings are discussed.
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The primary structures of three peptides from extracts from the pancreatic islets of the daddy sculpin (Cottus scorpius) and three analogous peptides from the islets of the flounder (Platichthys flesus), two species of teleostean fish, have been determined by automated Edman degradation. The structures of the flounder peptides were confirmed by fast-atom bombardment mass spectrometry. The peptides show strong homology to residues (49-60), (63-96) and (98-125) of the predicted sequence of preprosomatostatin II from the anglerfish (Lophius americanus). The amino acid sequences of the peptides suggest that, in the sculpin, prosomatostatin II is cleaved at a dibasic amino acid residue processing site (corresponding to Lys61-Arg62 in anglerfish preprosomatostatin II). The resulting fragments are further cleaved at monobasic residue processing sites (corresponding to Arg48 and Arg97 in anglerfish preprosomatostatin II). In the flounder the same dibasic residue processing site is utilised but cleavage at different monobasic sites takes place (corresponding to Arg50 and Arg97 in anglerfish preprosomatostatin II). A peptide identical to mammalian somatostatin-14 was also isolated from the islets of both species and is presumed to represent a cleavage product of prosomatostatin I.
Insulin and glucagon have been isolated from the Brockmann bodies of the flounder, a teleostean fish, and their primary structures established by automated Edman degradation. The A-chain of flounder insulin shows strong homology to the A-chains from the coho salmon (Oncorhynchus kisutch; 100%) and the anglerfish (Lophius americanus; 95%) but homologies in the B-chain region are weaker (salmon 79%, anglerfish 83%). Flounder insulin B-chain contains the novel sequence Val-Val-Pro-Pro at the NH2 terminus and the highly conserved seryl residue at position 10 (B 9 in mammals) is replaced by an alanyl residue. Flounder glucagon is identical to anglerfish glucagon II but shows four amino acid substitutions compared with salmon glucagon.
A significant number of adolescents treated for attempted suicide have made previous attempts and will make subsequent attempts. These youths have a high risk of actually committing suicide. To find predictive factors of suicide risk, the authors compared 43 adolescent patients who had attempted suicide once with 38 who reported multiple attempts. The repeaters were less successful in school, displayed more hostility, reported more dysphoria, and had undergone more long-term stress. The authors believe assessing suicide risk requires evaluating the repeater's internal state of rage and dysphoria; they recommend that future studies look closely at these internal states as well as at external factors.
The mechanisms of inhibition of branchial ion transport by epinephrine and somatostatin were investigated in the isolated perfused gill preparation of seawater-adapted flounder Platichthys flesus. The electrogenic transepithelial potential recorded in gills perfused and bathed with identical salines was stimulated by glucagon, forskolin, or a cyclic adenosine 5' monophosphate (AMP) derivative, each administered at a concentration identified in preliminary experiments as being submaximally effective. The subsequent abilities of epinephrine and somatostatin to inhibit the stimulated potential were found to be dependent on the site of action of the stimulatory agent with respect to the formation of cyclic AMP. Thus the maximal adrenergic or peptidergic inhibition of the potential stimulated by exogenous cyclic AMP was significantly reduced compared with the maximal inhibition of the potential stimulated by either forskolin or glucagon. The data indicate dual modes of action by which epinephrine and somatostatin achieve maximal inhibition of branchial ion transport; a cyclic AMP-independent mechanism that is effective in the presence of cyclic AMP and an additional mechanism to inhibit cyclic AMP synthesis.
The authors discuss two bulimic adolescent girls who also met the criteria for narcissistic personality disorder. The literature for both disorders is reviewed and three areas of common dynamics are elucidated. Bulimia appears to be part of a constellation of symptoms.
Hormonal regulation of the ionoregulatory function of the branchial epithelium in marine teleosts has been investigated using an isolated gill preparation of the seawater-adapted flounder Platichthys flesus. Agents which are assumed to elevate the effective intracellular concentration of cyclic AMP caused a stimulation of Cl- secretion as determined by measurement of the transepithelial electrical potential difference in the isolated gill. The pancreatic endocrine glucagon may act as an endogenous regulator of ion excretion in the gill as this peptide stimulated the transepithelial potential. Another islet peptide, somatostatin, inhibited branchial electrogenic ion transport. Attempts to investigate the mode of action of these peptides by measuring cyclic AMP levels in isolated gills were unsuccessful, since it appears that the pool of cyclic nucleotide which specifies the epithelial Cl- transport rate is small compared to total cyclic AMP content. A second approach investigating the ability of somatostatin to inhibit the transepithelial potential in gills stimulated by different secretagogues suggested dual modes of action for this peptide.
Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.
Fibrobullous disease of the upper lobes of the lungs is a rare extraskeletal manifestation of ankylosing spondylitis, occurring in 1.3% of patients with ankylosing spondylitis. We present a patient with this disease, and discuss this pulmonary manifestation. Because the radiographic appearance of the chest in this disease resembles that in tuberculosis, many patients are misdiagnosed and treated for tuberculosis despite negative bacteriology. Computed tomography is useful in delineating the extent of pleural thickening, bullous changes, volume loss, parenchymal fibrosis, and bronchiectasis, as well as identifying or excluding an intracavitary pulmonary mycetoma.
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The simian virus 40 (SV40) origin region includes the viral replication origin and the early and late promoters and consists of a few palindromes, a 17-base-pair (bp) A + T-rich sequence, three copies of a G + C-rich 21-bp repeat, and two copies of a 72-bp repeat. We have made sequential deletions in the SV40 origin region and determined the early promoter efficiencies of these truncated DNA segments by connecting them in the correct orientation with the coding regions of selectable marker genes and assaying the expression of the chimeric marker genes in vivo in different host cell lines. A truncated SV40 early promoter segment containing only the TATA box and the major in vivo mRNA initiation sites has essentially no promoter efficiency. We have located the major component of the SV40 early promoter within the 21-bp repeated sequences, which consist of an alternating and mutually overlapping array of two C-rich oligonucleotides having the consensus sequences Y-Y-C-C-G-C-C-C (Y = pyrimidine nucleoside) and G-C-C-C-(C)-TA-AT-A(T)-C-T. Between one and two copies of the 21-bp repeat were adequate for gene expression under conditions in which the enhancement effect of the 72-bp repeat was minimal. We also find that the SV40 72-bp repeat exhibits a pronounced host range in its enhancement of gene expression; the enhancement is only 2-fold in the nonpermissive mouse cells but amounts to 10- or 20-fold in the permissive monkey cells or the semipermissive human cells, respectively.
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As a preventive mental health worker in a community mental health center, I considered it part of my role to explore the possible therapeutic value of women's liberation groups in the community. I was particularly concerned with countering the sense of isolation and powerlessness prevalent among female adults in our suburban catchment area. Subsequent investigation and participant observation of women's groups bore out my expectation that many of the goals, premises, and methods of preventive mental health were compatible with those of women's liberation groups. These groups provided a very effective framework for personal as well as interpersonal and sociocultrual change in the direction of psychological growth.
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