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At least 307 records · Page 17Linked to original sources
PubMed1980

Control of X chromosome transcription by the maleless gene in Drosophila.

In Drosophila, a large group of structural genes exhibit coordinate regulation, not because they function in a common developmental pathway but because they happen to reside on the X chromosome. These genes are subjected to the regulatory mechanism of dosage compensation which insures that their phenotypic products are identical in the sex with one and in the sex with two X chromosomes. This equilization of gene products is achieved by regulating the level of transcription of both X chromosomes in females and of the single X chromosome in males. We report here that, reasoning that sex-specific lethal mutations may represent lesions in the processes controlling the transcription of X-linked loci, we sought and recovered several male-specific lethal mutations and noted that they affect the levels of X-linked enzyme activities in crude extracts of homozygous male larvae. Autoradiographic monitoring of RNA synthesis in larval polytene chromosomes of males homozygous for one of these mutations, mlets, reveals a significant reduction in the rate of X chromosome transcription.

Animals↗
PubMedDate not supplied

Practical guidelines for developing an office-based program for outpatient intravenous therapy.

As early discharge from the hospital and initiation of outpatient iv therapy have become more common, physicians have found that although their role as care giver has not diminished, compensation by insurers for that care has. Therefore, physicians may wish to establish their own office-based programs for providing cost-effective, quality care for patients who can be treated on an outpatient basis. Important factors in the establishment of such a program are obtaining the services of a nurse skilled in administration of iv antibiotics and the services of a cooperative pharmacist, utilizing treatment consent forms and instructive handouts for patients, and providing 7-day-per-week nursing care. Physicians must immediately hospitalize program participants who experience complications. To ensure cooperation from third-party payers, familiarity with their codes for procedural terminology is necessary. It is also highly advisable to obtain written approval for a patient's participation in the program from the medical director or another key official of the insurance company.

Ambulatory Care↗
PubMed2001

A comparison of fear-avoidance beliefs in patients with lumbar spine pain and cervical spine pain.

STUDY DESIGN: A prospective consecutive cohort study of patients with cervical spine pain and patients with lumbar spine pain referred to an academic medical center. OBJECTIVES: To investigate the presence of fear-avoidance beliefs in a sample of patients with cervical spine pain and to compare the association of pain intensity, disability, and fear-avoidance beliefs in patients with cervical spine pain with that in patients with lumbar spine pain. SUMMARY OF BACKGROUND DATA: Fear-avoidance beliefs are a specific psychosocial variable involved in the development of disability from low back pain. Psychosocial variables are believed to play a role in cervical disability, but specific variables have not been investigated. METHODS: Consecutive patients referred to a multidisciplinary center completed self-reports of disability, pain intensity, and fear-avoidance beliefs during an initial evaluation session. Gender, type of symptom onset, acuity, and payer source were also recorded. Associations between disability, pain intensity, and fear-avoidance beliefs were investigated in patients with cervical spine pain and patients with lumbar spine pain. RESULTS: In all, 163 patients completed the self-reports and were included in this study. Weaker relations between fear-avoidance beliefs and disability were found in patients with cervical pain than in those with lumbar pain. Significant differences in fear-avoidance beliefs were found for gender, type of symptom onset, and payer source (workers' compensation, auto insurance, and traditional insurance). CONCLUSION: The associations among fear-avoidance beliefs, pain intensity, and disability differed between patients with cervical spine pain and patients with lumbar spine pain. Fear-avoidance beliefs were significantly different in subgroups of patients.

Adult↗
PubMed2001

A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature.

STUDY DESIGN: Systematic review of prognostic studies of acute whiplash. OBJECTIVES: To update the systematic review on the prognosis of acute whiplash published by the Quebec Task Force on Whiplash-Associated Disorders and to propose a new conceptual framework to conduct systematic reviews on prognosis. SUMMARY OF BACKGROUND DATA: In 1995, the Quebec Task Force published a systematic review of the literature on whiplash and concluded that its prognosis is favorable. However, few prognostic factors were identified. Recent studies have added to this knowledge, and there is a need to update the review conducted by the Quebec Task Force. METHODS: A bibliographic search of four electronic databases was performed to identify prognostic studies of acute whiplash published after 1995. The literature was appraised with standard review criteria. The consistency of evidence across studies was assessed. A conceptual framework was designed to classify the literature according to methodologic quality, target population, and phases of investigation. RESULTS: Thirteen cohort studies were included in the review. The framework used in this study demonstrates that most of the recent prognostic studies are descriptive in nature. The prognosis of acute whiplash varies according to the population sampled and the insurance/compensation system under which individuals are allowed to claim benefits. Besides age, gender, baseline neck pain intensity, baseline headache intensity, and baseline radicular signs and symptoms, there is little consistency in the literature about the prognostic factors for the recovery of whiplash. CONCLUSIONS: Scant knowledge about the prognosis of whiplash has been gained since the release of the Quebec Task Force report. However, it is becoming obvious that the insurance and compensation systems have a large impact on recovery from acute whiplash injuries. The conceptual framework used in this study demonstrates that large cohort studies investigating a wide range of prognostic factors are necessary to improve the understanding of this problem.

Concept Formation↗
PubMedDate not supplied

Antepartum bed rest: effect upon the family.

OBJECTIVE: To identify the effects of antepartum bed rest upon the family. DESIGN: Descriptive, retrospective survey. PARTICIPANTS: A national random selection of 89 women who had been prescribed antepartum bed rest in the hospital or at home and who contacted a high-risk pregnancy support group for information. MAIN OUTCOME MEASURE: An open-ended questionnaire. RESULTS: Families experienced difficulty assuming maternal responsibilities, anxiety about maternalfetal outcomes, and adverse emotional effects on the children. Child care was managed by various people across time. Child care problems included negative reactions from the children, concern about the quality of the provider, and maternal worry about care. Families also experienced financial difficulties, the majority of which were not compensated by insurance or work benefits. Almost all, 96.6%, families received some type of support during bed rest. Instrumental support was the most commonly received; however, emotional support was considered the most helpful. The least helpful type of support was that which was unreliable. The primary providers of support to the family were parents and family, followed by friends. The women reported that health care providers offered minimal support to the family. CONCLUSION: Despite support, antepartum bed rest creates difficulties that affect the entire family and its finances.

Adaptation, Psychological↗
PubMedDate not supplied

The human right to dignity v. physical integrity in manual handling.

In the case of The Queen v. East Sussex County Council and The Disability Rights Commission [2003] the position in English and European Law with regard to the rights of disabled people to be lifted manually in their homes was reviewed. The judgement also reviewed the position with regard to the risks posed to carers when they manually lift. The judgement stated that where the human rights of disabled people were in issue--where their Article 8 right to "dignity" was offended--then carers would in certain situations have to find ways to lift those people manually. This article reviews and challenges the findings in this case. A conclusion is reached that a reading of English and European law does not suggest that nurses and carers can be expected to be caused a physical harm to their persons, in order to assuage the "dignity" rights of those they lift. Further, that issues such as insurance and compensation, possibly owing to a nurse who manually lifts, have not been settled, and that all of these issues have not been determined where lifting occurs manually in a hospital setting.

Persons with Disabilities↗
PubMedDate not supplied

A guide to the EEOC's final regulations on the Americans with Disabilities Act.

The Equal Employment Opportunity Commission (EEOC) recently issued its final regulations on the Americans with Disabilities Act (ADA). Although the regulations offer some guidance for employers on how to comply with the Act, they fail to provide specific answers to the many complicated compliance questions that will surely arise. Further, the regulations are almost totally silent on certain critical issues related to insurance, workers' compensation, and potential conflicts between ADA obligations and terms of collective bargaining agreements. The EEOC has essentially left the resolution of many important ADA questions to case-by-case determination and the litigation process.

Architectural Accessibility↗
PubMed1999

Occupational allergies and asthma.

OBJECTIVE: To review aspects of occupational allergies and asthma for primary care physicians recognizing, diagnosing, and managing patients with these conditions. QUALITY OF EVIDENCE: Studies in the medical literature mainly provide level 2 evidence, that is, from at least one well-designed clinical trial without randomization, from cohort or case-control analytical studies, from multiple time series, or from dramatic results in uncontrolled experiments. MAIN MESSAGE: Occupational allergies and asthma have the best prognosis with an early, accurate diagnosis and subsequent avoidance of exposure to the relevant sensitizer. These diagnoses can normally be suspected from the clinical history. Primary care physicians can also initiate investigations to make an objective diagnosis, can assess workplace exposure agents from the history, and can review appropriate data sheets on material safety. Specialist evaluation is likely to be needed for skin tests, however, and for other specialized tests (such as pulmonary function assessments at work and off work or specific challenges with the suspected workplace agent). Patients with a confirmed diagnosis need appropriate medical management of their allergic manifestations or asthma, but also often require psychosocial support during the period of investigation and management, especially in relation to required changes in their work and to compensation or insurance claims. CONCLUSIONS: Consider workplace exposure as a source of patients' allergies or asthma and aim to make an early, accurate diagnosis.

Asthma↗
PubMed2000

[In Process Citation]

The traumatic etiology of rotator cuff lesions is a||| matter of controversial discussed in legal assessments. Because of the||| relatively high prevalence of degenerative changes with increasing age,||| including partial and complete rotator cuff tears, it may be difficult to||| demonstrate the cause of an acute traumatic rotator cuff tear. This article||| presents a review of the literature concerning current knowledge of the||| anatomy, biomechanics and pathogenesis of rotator cuff pathology. According to||| this, a catalogue of potentially adequate and inadequate trauma mechanisms is||| proposed. Another focus of this work is in the post-traumatic diagnostic steps||| following persistent rotator cuff-deficient shoulder function. X-ray,||| ultrasound, MRI and operative findings in rotator cuff tears underline the||| criteria for distinguishing between traumatic and degenerative lesions. From a||| legal point of view (e.g., private accident insurance, workers compensation||| claims), various minor and major arguments are defined, which could help the||| expert in judging the cause of post-traumatic rotator cuff||| deficiency.

Journal Article↗
PubMed1993

[Dental hygienist in financial independent practice: an established institute?].

The purpose of this article was to describe the development and actual status of the financial independent dental hygienist in The Netherlands. In 15 years nearly 100 dental hygienists started in financial independent practice after a few years of experience. In a survey (response: 80%, N = 58) respondents reported that especially patients with advanced periodontal diseases were treated in their practice. A majority of the respondents also works for a dentist employer. Compensation by insurance companies makes the treatment by independent dental hygienists approachable for more patients and is therefore advisable.

Dental Hygienists↗
PubMed2003

[Lasers in dentistry. Epilogue].

Laser use in the dental clinic requires scientifically demonstrated improvement for patient and/or dentist, easily obtainable equipment, adequate training and safety. These aspects are summarized for all laser applications. Improvement has not been shown for all applications. In the Netherlands manufacturer-independent training is little available. Safety requires care, but not a large investment. Economical aspects include an adequate compensation for the necessary investment. For only a few applications laser treatment leads to decreased cost or time of treatment. However, also increased compensation by insurers or patients may be possible; some patients will be willing to pay more when laser treatment is less unpleasant than traditional treatment or, in the case of diagnosis, leads to better information.

Dental Equipment↗