Embedded inefficiencies in health care.
Explore the source record for details and available documents.
SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Monoclonal antibodies (MAbs) have been prepared against apolipoprotein (apo) B which had been delipidated and resolubilized (apo Bsol). The MAbs were classified into nine groups according to their behavior in competitive binding assays and, following SDS electrophoresis and immunoblots, their corresponding epitopes were assigned to apo B48, apo B74, apo B26 and to fragments of LDL apo B (apo BLDL) generated by limited tryptic proteolysis. In addition to their reactivity with soluble apo B all antibodies also reacted with LDL which had been adsorbed to polystyrene. Competitive binding of MAbs to insolubilized antigen also indicated conformational similarities between apo Bsol and apoBLDL. These similarities were, however, less apparent when the respective antigens were in solution. In competitive radioimmunoassays the majority of anti-apo Bsol MAbs reacted better with apo Bsol than with LDL although the opposite was true for one group of MAbs. In immunoprecipitation studies the MAbs which preferentially recognize apo BLDL could precipitate 95% of 125I-LDL whereas the immunoprecipitation with those MAbs which preferentially recognize soluble apo B varied between 0 and 95%. Between 65 and 82% of 125I-apo Bsol was immunoprecipitated under the same conditions. Thus, epitopes defined by MAbs prepared against apo Bsol may be expressed on apo BLDL when it is adsorbed to plastic but not necessarily when it is in solution. For those epitopes preferentially expressed on apo BLDL, reincorporation of soluble apo B into phospholipid-cholesteryl ester microemulsions or phospholipid-cholesterol liposomes increased their immunoreactivity, whereas, the reincorporation of apo B into lipid vesicles resulted in a decreased reactivity with those MAbs which recognized better apo Bsol than apo BLDL. Thus, while the respective conformations of apo Bsol and apo BLDL are only partially similar, they can be reversibly interchanged by delipidation and relipidation.
23 patients with a diagnosis of panic disorder with agoraphobia were randomly assigned to 8 weeks' treatment with alprazolam or placebo. They filled in self-ratings before and after treatment and competed on a competitive reaction time task, designed to measure behavioural aggression, after 8 weeks' treatment. Patients taking both alprazolam and placebo rated decreased anxiety after 8 weeks' treatment but those on alprazolam also tended to report less hostility. On the behavioural task, patients on alprazolam behaved more aggressively in response to provocation. This is the first study to confirm clinical reports of benzodiazepine-induced dyscontrol on an objective laboratory measure. It is important that it is followed up in a larger group of patients.
In rats with previous experience of chocolate this is a food that is rapidly taken and eaten for which rats will compete. Female rats preferred white and milk chocolate to dark chocolate, but male rats displayed no preferences among the different types, regardless of whether it was offered in a novel environment or in the home-cage. Chronic (5 days) administration of chlordiazepoxide (5 mg/kg) to dominant animals, as judged in a previous competition for chocolate, led to a fall in success, whether the animals had been previously housed together for 1, 2 or 6 months. There were no significant effects of chlordiazepoxide treatment on the behaviour of subordinate rats. The potential usefulness of serial chocolate competition as a test of dominance is discussed.
After having individually been accustomed to consume palatable sucrose-pellets, the individual's competition-rate for sucrose-pellets within its familiar triad has been observed in male Wistar rats. In this fixed-triad, food competition paradigm high-performing rats (high competition-rate, majority of pellets consumed), medium-performing rats (medium competition-rate, consumption of some pellets) and poor-performing rats (almost completely abstaining from competition with only rare incidence of pellet consumption) can be distinguished. Intra-group rank-orders, defined according to the individuals' competition-rates (expressed as a score), were present in many triads and, once established, these were stable over months. No additional differences were observed between high- and poor-performing rats, neither when these were individually tested in an open field or in the elevated plus-maze, nor with regard to the preference for a sucrose solution.
One problem in the optimization of athletic performance is that consistency in practice situations is not always carried over to competitive situations. There is an increase in irrelevant stimuli in competition which cannot always be gated out satisfactorily by the anxious athlete. We investigated the physiological responses to relevant and irrelevant stimuli of 48 elite female gymnasts differing in levels of anxiety and defensiveness. Cardiac responses were recorded to tone presentations and analyzed as a function of instructions, anxiety manipulation and group. The results suggest that phasic responses of high-anxious gymnasts were larger than those of low-anxious gymnasts. High-anxious gymnasts experience more difficulty in completely gating out the occurrence of irrelevant stimuli than do low-anxious gymnasts. Finally, under anxiety-producing conditions, high levels of defensiveness and anxiety in combination appear to have a debilitating effect on the gymnast's ability to discontinue processing of irrelevant stimuli, while truly low-anxious subjects appear distracted from processing relevant stimuli. Further investigation of the interactions between levels of trait anxiety and anxiety-producing situations in a sport-specific domain appear warranted. The role of defensiveness in these interactions should also be investigated.
Cardiovascular responses to a competitive reaction-time task were monitored in 13 male subjects tested twice, 3 months apart. The temporal stability of blood pressure responses was in line with previous reports. However, in this study impedance cardiography permitted the investigation of the hemodynamic adjustments underlying the observed blood pressure responses. Analyses revealed that cardiac output and total peripheral resistance responses displayed temporal stability, indicating that subjects' blood pressure responses on the two occasions were the result of similar hemodynamic responses. These data thus extend the literature by demonstrating that the hemodynamic response pattern itself represents a stable individual difference variable.
Cynical hostility has been linked to coronary heart disease (CHD), and there is mixed support for the hypothesis that cynical hostility may contribute to CHD through exaggerated cardiovascular responses to anger-provoking stressors. The present study tested the influences of cynical hostility on affective and cardiovascular responses to provocation in 68 undergraduate men. Subjects were divided into high and low cynical hostility groups by a median split on Cook-Medley Hostility Scale scores, and half of the subjects in each group were harassed during competition on a video game. High hostile subjects reported greater anger than low hostile subjects during the competition, independently of harassment, and harassment produced stronger feelings of mistreatment, independently of hostility. Harassed subjects experienced larger systolic blood pressure responses only during an affect rating period after the competition, but the responses were not influenced by hostility. These findings provide further evidence that cynical hostility, anger, and cardiovascular reactivity are not simply nor consistently related.
Recent work on the behaviour pattern characteristic of men developing coronary heart disease (CHD) has been aimed at increasing the predictive utility of methods designed to assess 'proneness' and at refining the Type A typology. This has had the indirect effect of restricting the elaboration of theory relating to clinical evidence drawing upon the personal and social context of CHD. This paper reviews such evidence and concludes that explanations of 'coronary-prone behaviour' should acknowledge that it is embedded in particular uses of the body and in particular forms of social relationship. Based upon this premise, a conceptual analysis is presented to demonstrate that 'coronary proneness' is insufficiently described as a behaviour pattern, but is more usefully considered as a mode of action constituting a contradiction in the person's social relationships. It is further proposed that the bodily style of many CHD patients is necessarily understood as an expression of the development of this modality.
Three experiments are reported which examined the temporal stability of cardiac reactions to a video game of the 'space invaders' genre. Experiment 1 also addressed the matter of inter-task consistency; in addition to the video game, subjects were presented with an unsignalled reaction time task and led to believe that relatively quick reactions attracted financial reward, while slower ones brought either a burst of loud noise or withdrawal of money previously earned. Forty-two male subjects were tested on both tasks on two occasions, a week apart. Of the two tasks, the video game elicited the greater reactivity. In addition, individual variations in reactivity showed striking temporal stability for both tasks. However, inter-task consistency was much less marked; in fact, a significant inter-task correlation was obtained only on the first occasion of testing. It is probable that limited consistency here was in some measure due to the ineffectiveness of our reaction time task in eliciting substantial reactivity. Finally, reactivity was independent of baseline heart rate level. In experiment 2, three extreme high and three extreme low cardiac reactors were selected from an initial sample of 23 male subjects, on the basis of reactivity during an initial session with the video game, and subsequently studied during four further sessions. Once more, impressive stability of heart rate reactivity was apparent over sessions. In experiment 3, we examined the reliability of individual variations in cardiac reactivity in women and the issue of whether temporal stability is constrained by menstrual cycle effects. Twenty-four females were tested on the video game both preovulatory and postovulatory, with half being tested first during the preovulatory phase and half being tested first during the postovulatory phase. Again, the most striking finding was the marked stability of individual variations in cardiac reactivity over both time and menstrual cycle phase.
Previous research has suggested that homosexual men are less aggressive than heterosexual men, but limitations of available studies prevent them from being conclusive. The empirical evidence is even more mixed regarding the relation of aggressiveness to female sexual orientation. We examined the relation between self-reported physical and verbal aggressiveness, interpersonal competitiveness, and sexual orientation in both men and women. The aggressiveness and competitiveness scales yielded significant sex differences, with men being more aggressive and competitive. Consistent with past findings, heterosexual men were more physically aggressive than were homosexual men; no other within-sex relationship was significant. We discuss the implications of our findings for developmental theories of sexual orientation, aggressiveness, and competitiveness.
Thirty-two black and 32 white male normal drinkers participated in a beer taste test either simultaneously (co-action condition) with a heavy drinking black or white experimental accomplice or while the accomplice completed an art rating task (control observer condition). Subjects in the co-action condition drank significantly more beer (p less than .001) than subjects in the control observer condition, regardless of their race or the race of the accomplice. Subjects' post-experimental questionnaire answers indicated they did not perceive themselves to be in competition with the accomplice. The mechanism underlying the robust co-action facilitation effect on drinking, now demonstrated in several studies and extended to black males in the present study, remains unexplained.
Type A behavior has been shown in adults to be a predictor of heart disease equal in magnitude to cigarette smoking and cholesterol level. This article reviews current thinking on Type A behavior and its relationship to cardiovascular health. Particular emphasis is given to current literature about Type A behavior in adolescents, school-aged children, and preschoolers. Discussion covers the importance of the primary subcomponents of Type A behavior (i.e., competitiveness, hostility, and impatience). Clinical cautions and applications of this research are included.
Serial position effects may occur whenever options are judged in sequence, as is the case in figure skating competitions. International figure skating competitions consist of at least two rounds, with serial position being randomized in the first round. Figure skaters with better scores in the first round perform later in the second round. Despite the initial randomization of serial position, figure skaters who perform later in the first round receive better scores in first and in the second round. The findings presented here replicate those of Bruine de Bruin (2005) [Save the last dance for me: unwanted serial position effects in jury evaluations. Acta Psychologica, 118, 245-260], using a larger dataset, and addressing potential concerns about Bruine de Bruin's analyses.
PURPOSE: Despite a large public health interest in substance use among athletes, only a few works have addressed illicit drug use in relation with sport practice. We have studied cannabis use to enhance both sportive and non-sportive performance among French sport university students. METHODS: An anonymous self-reported questionnaire was administered to a sample of students from six Sport Science Universities from Southern France. Information on sport practice and cannabis use (frequency, quantity, motives) was collected. RESULTS: Males were more prone to have already used cannabis to enhance non-sportive performance as well as sportive performance. The simultaneous equation model indicated that both kinds of enhancing-substance use were endogenous: cannabis use to enhance sportive performance leads to cannabis use to enhance non-sportive performance and reciprocally. Moreover, the relaxing properties of cannabis may be frequently used to enhance performance. Cannabis use to enhance sportive performance was positively related to the competitive level and to sliding sports. CONCLUSIONS: The present study helps to improve understanding on an empirical paradox about the relationship between doping agents use and so-called 'recreational' drug use among athletes. Indeed, people who use doping agents may also use 'recreational' drugs for a 'non-recreational' purpose.
OBJECTIVE: To compare the ergometer rowing technique of a person with spinal cord injury (SCI), using functional electric stimulation (FES) of his leg muscles, with that of a well-defined group of able-bodied rowers. DESIGN: Whole-body kinematics and kinetics and electric activity of selected muscles were measured during ergometer rowing. SETTING: A hospital-based motion analysis laboratory. PARTICIPANTS: Five male university varsity-level rowers and 1 male rower with SCI. INTERVENTIONS: Eight rowing trials were collected on the university-level rowers, 2 trials each at 20, 24, 28, and 32 strokes/min. The rower with SCI had surface electrodes applied to his medial hamstrings and medial quadriceps muscle bellies. The electrodes were attached to a stimulator that was activated using a button in the ergometer handle. The subject with SCI rowed at a self-selected stroke rate. MAIN OUTCOME MEASURES: Forces at the ergometer handle and foot cradle, 3-dimensional whole-body kinematics, net joint moments, and phasic activity of muscles. RESULTS: Motion of the arms, ankles, and knees of the rower with SCI was similar to those of the university-level rowers; other joint motions and forces applied to the ergometer differed. CONCLUSIONS: FES-assisted rowing in its current implementation cannot reproduce a race-winning rowing stroke. Further development work is required.
The purpose of this study was to investigate whether, in a stable social environment, social interactions are responsible for individual, endocrine and immune differences among group members. Cage-mates were classified according to their rank in a food competition test. The influence of the rank was evaluated in two different situations activating neuroendocrine and immune systems. A first experiment used a context of repeated social stress. A second experiment investigated the influence of rank on the response to a bacterial infection by BCG. Endocrine and immune functions were assessed by measuring plasma corticosterone levels, splenocyte proliferation and in vitro cytokine production. In control undisturbed groups, plasma levels of corticosterone were lower in low ranking (LR) mice than in intermediate (IR) and high ranking (HR) mice. LPS-induced splenocyte proliferation and in vitro cytokine production were independent of rank. In response to social stress, corticosterone increased similarly in all categories but the increase in splenocyte proliferation was more pronounced in HR animals. During BCG infection, the rank influenced the production of IL-10 and IFN-gamma by tuberculin-stimulated splenocytes during the acute phase of the infection but not after 94 days of infection. Cytokine production in response to LPS and bacterial growth were not affected by the rank. Therefore, social interactions emerging in a stable social group may be involved in the individual differences observed in endocrine activity and in immune system reactivity.
When a small number of females contribute offspring to a discrete mating group, sex allocation (Local Mate Competition: LMC) theory predicts that females should bias their offspring sex ratio towards daughters, which avoids the fitness costs of their sons competing with each other. Conversely, when a large number of females contribute offspring to a patch, they are expected to invest equally in sons and daughters. Furthermore, sex ratios of species that regularly experience variable foundress numbers are closer to those predicted by LMC theory than species that encounter less variable foundress number scenarios. Due to their patterns of resource use, female Callosobruchus maculatus are likely to experience a broad range of foundress number scenarios. We carried out three experiments to test whether female C. maculatus adjust their sex ratios in response to foundress number and two other indicators of LMC: ovipositing on pre-parasitised patches and ovipositing with sisters. We did not find any evidence of the predicted sex ratio adjustment, but we did find evidence of kin biased behaviour.