[A clear expression of concern for the health of the Soviet people].
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Health Facilities↗
SEARCH · PubMed Health
Results for “Expression of Concern”
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.
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Managers express deep concern about the future of psychiatric nursing following Griffiths Report.
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Humans↗
What communication skills are most helpful with families grieving a perinatal loss? How can I express my concern while providing appropriate care?
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Communication↗
Exploiting scale-free information from expression data for cancer classification.
Most studies concerning expression data analyses usually exploit information on the variability of gene intensity across samples. This information is sensitive to initial data processing, which affects the final conclusions. However expression data contains scale-free information, which is directly comparable between different samples. We propose to use the pairwise ratio of gene expression values rather than their absolute intensities for a classification of expression data. This information is stable to data processing and thus more attractive for classification analyses. In proposed schema of data analyses only information on relative gene expression levels in each sample is exploited. Testing on publicly available datasets leads to superior classification results.
Breast Neoplasms↗
Parents of children with cleft lip and plate.
The preceding literature review and parent interviews are intended to provide novel insight into the stress, anxiety, and fears faced by parents of children born with a cleft lip and palate. Professionals need to be available to assist with the adjustments and transitions that the parents will face and to tailor their interactions to the specific needs of the parents and the child. Several conclusions are apparent. 1. Needs appear to be greatest at times of transition: birth, operation, and school. 2. Feelings of loss and grief may accompany the birth of a child with a cleft. The birth may be marked by the realization that the perfect child is lost and by the grief that this imperfect child must be loved and nurtured. The rearing process is complicated by the parents' own insecurities and can be assisted by positive coping strategies and the support of other parents of children with clefts. 3. Parents may feel uncomfortable discussing aspects of finance and personal fears. The parents interviewed indicated that the fears and concerns expressed here were the very concerns that they do not raise with professionals. 4. Parents are highly variable in their experience and needs. The age of the parents, the extent of the cleft, and familiarity with clefting appear to be major factors in determining how well parents deal with the birth of a child with a cleft. 5. Cleft palate team members have innumerable opportunities to assist parents.(ABSTRACT TRUNCATED AT 250 WORDS)
Adaptation, Psychological↗
Patient attitudes to perioperative suppository administration for postoperative analgesia.
Four hundred surgical patients were questioned preoperatively to ascertain their attitudes to suppository analgesia. Given a choice, 82 per cent of patients expressed a preference for intramuscular administration of diclofenac, with 18 per cent choosing a suppository. Males were more likely than females to choose an intramuscular injection. Males choosing a suppository were more likely to belong to a higher socio-economic group while females choosing a suppository were more likely to be married. Twenty-three per cent of patients who initially opted for intramuscular administration changed to suppository administration when the possibility of pain or discomfort at the injection site was explained. Females who changed to suppository administration were more likely to belong to a higher socio-economic group and to be married. Twenty-seven per cent of patients choosing an intramuscular injection expressed concern if a suppository were to be inserted without consent. Eleven per cent of patients choosing a suppository expressed similar concern. There is an overall reluctance, particularly within the male population to accept suppository analgesia. Patients from higher socio-economic groups may be more willing to accept what they perceive to be less traditional forms of treatment.
Analgesia↗
Emotional concerns and treatment of male partners of female sexual abuse survivors.
Many men are discovering that they are involved with women who were sexually abused as children. However, male partners of female sexual abuse survivors have thus far received little attention in the literature. As these men increasingly seek treatment with concerns of their own, social workers must become familiar with their emotional experiences and treatment needs. This article outlines the major concerns expressed by 20 male partners of sexual abuse survivors. These concerns included conflicts about expressing needs, frustration with various aspects of their relationships, guilt and shame at having feelings, questions about how to deal with relatives, and sexual issues. The author recommends a treatment approach that combines attention to both the individual's and the couple's concerns and uses insight and the safety of the therapeutic relationship to promote growth. The importance of further outreach to partners of women who were sexually abused as children and the need for increased attention to other partner populations are highlighted.
Adult↗
Questions people ask about stroke.
BACKGROUND AND PURPOSE: We sought to identify the type and frequency of questions asked about stroke by patients, relatives, and caregivers. METHODS: All stroke-related inquiries made to Stroke Association Advice Centers in the United Kingdom during a 4-month period were recorded. RESULTS: During the study period, 1,397 people asked 1,908 questions. Nearly one quarter needed more information about the nature of stroke. The other most common inquiries concerned help at home (with many expressing concern about their current level of community support), requests for information about stroke clubs, speech difficulties, rehabilitation, personality changes, and depression. CONCLUSIONS: Knowledge of the questions asked should enable health professionals to provide better information to stroke victims and allow modification of stroke information pamphlets.
Age Factors↗
Cutaneous concerns of scleroderma patients.
The clinical features of facial and oral involvement in scleroderma are striking. We conducted a survey of patients with systemic sclerosis (scleroderma). The purpose of our study was to ascertain what was most bothersome aesthetically to scleroderma patients. We also looked at the differences between age groups and genders. The survey was mailed to 1,000 individuals who subscribe to a national lay group organization. We received 303 completed surveys indicating the patient's age, gender, age at onset of disease, and a checklist of 14 physical variables involving the central face and non-face. The respondents were asked to rate their level of concern [on a scale of great (1) -moderate (2) -little (3) -none (4)] in regards to 14 different physical variables. The respondents consisted of 92% females and 8% males. The mean age was 59 years +/- 13 (SD), and the median age was 60. The mean and median age at diagnosis was 45 years +/- 15 (SD). The percentage of respondents expressing concern for specific features was the following: for thin lips (73%), mouth furrows (80%), loss of facial lines (68%), and a smaller, tighter mouth (77%). There was less concern over the non-face features. The percentage of respondents expressing no concern was the following: for absence of sweating (57%), skin darkening (50%), nail dystrophy (57%), and skin atrophy (63%). There was a highly statistically significant difference (p<0.0001) between those respondents concerned with central face features vs. non-face features. With advancing age and longer disease duration, there was increased concern over the aforementioned central face features (p<0.0001). The vast majority of patients with systemic sclerosis have great concerns over changing facial features, and this worsens with age.
Aged↗
Fear of recurrence and possible cases of anxiety and depression in orofacial cancer patients.
Recurrence risk in orofacial cancer patients is relatively high in comparison to other cancers. Little information exists on whether patients are unduly concerned over the possibility of recurrence and the association of this concern with psychological morbidity. Aim of study was to assess fear of recurrence and psychological morbidity in orofacial cancer patients. Two samples of patients with orofacial cancer were followed prospectively. First sample (n = 87) were consecutively drawn 3 months and 7 months following initial treatment. Second sample (n = 100) were cross-sectionally drawn from out-patient list and followed 2 years later. A single question item was employed to assess fear of recurrence used in previous work. Hospital Anxiety and Depression Scale was adopted as the measure of psychological morbidity. A prospective survey design was employed. Over 80% of patients expressed concern over the possibility of recurrence at 3 months post treatment. This level reduced to 72% at 7 months (P=0.06). Approximately two-thirds of patients sampled cross-sectionally were concerned at both assessment occasions. Psychological morbidity was greatest at 3 months post treatment (possible cases: anxiety 37% and depression 28%). Women were more likely to report anxiety (at possible case level) than men 3 months following treatment (P<0.05). Patients aged 65 or more years were less concerned about recurrence. This effect was significant on both occasions that sample two patients were assessed (P's<0.002). Very few patients who expressed no concern about recurrence, at 3 months, were found to report anxiety or depression sufficient to be recognized as a possible case (3 and 0% respectively). The positive association between psychological morbidity and fears of recurrence was significant at the majority of data collection points, with the exception that depression was more independent of these concerns.
Age Factors↗
Immunocytochemical localization of endopeptidase-24.11 in cultured neurons from pig striatum.
Endopeptidase-24.11 ("enkephalinase") appears to play a key role in the metabolism of a number of neuropeptides at cell surfaces. It has been previously mapped in the central nervous system, but some doubt has been expressed concerning the identity of the cell type expressing this peptidase. Primary cell cultures derived from striata of new-born piglets were set up and cells were characterized by immunocytochemistry using antibodies to neurofilament protein, a glial fibrillary acidic protein and a neuronal antigen recognized by a monoclonal antibody BM88 and by histochemistry for acetylcholinesterase. Some cultures were set up in which neurons were selectively enriched. Cells which were thus morphologically defined as neurons were recognized by an affinity-purified polyclonal antibody to endopeptidase-24.11. The staining for the peptidase, which was punctate in appearance, was shown to be at the cell surface and extended to the perikaryon and all neurites. Compared with the number of neurofilament protein-positive cells, relatively few cells were positive for endopeptidase-24.11. No glial cells, immunochemically defined by glial fibrillary acidic protein, were stained by the antibody to endopeptidase-24.11. We conclude that endopeptidase-24.11 is expressed on the surface of a set of neurons derived from the striatum in primary culture and not by any glial cells in these cultures.
Animals↗
Healthcare CEOs and physicians: reaching common ground.
A survey of 670 hospital and health system CEOs was conducted to understand why they chose a career path to CEO, what characteristics typify their career paths, and what major concerns they have about the future. Respondents expressed very strong altruistic reasons for becoming CEO, a finding that is consistent with the rationale many physicians express for entering medical practice. Early CEO career paths were diverse but typically led respondents to a senior managerial position before becoming CEO. Nine percent started as direct providers of healthcare. The respondents' most frequently expressed concerns for the future centered on reimbursement/financing issues and staffing shortages. Physicians may be surprised to learn that healthcare CEOs share their core values, experience similar frustrations, and have identical fears about the future of healthcare. Rather than emphasizing the differences between CEOs and doctors as a stumbling block to alliance, we urge the establishment of a common ground based on similar core values and purposes that will lead to improved communication and the powerful combination of talents derived from collegial collaboration.
Career Choice↗
Medicinal marijuana use: experiences of people with multiple sclerosis.
OBJECTIVE: To describe medical marijuana use from the perspectives of patients with multiple sclerosis. DESIGN: A qualitative, descriptive design was used. Participants discussed their medicinal marijuana use in one-to-one, semistructured interviews. SETTING: Interviews were conducted at a time and place convenient to participants. PARTICIPANTS: Six men and eight women with multiple sclerosis participated. METHOD: Potential participants identified themselves to the researcher after receiving an invitation in a mailed survey. Eligibility was confirmed, and purposive sampling was used to recruit subjects. A range of issues emerged from the interviews. Interviews and data analysis continued until saturation occurred. MAIN FINDINGS: Descriptions fell into three broad areas: patterns of use, legal or social concerns, and perceived effects. Consumption patterns ranged from very infrequent to very regular and were influenced by symptoms, social factors, and supply. Legal concerns expressed by most respondents were negligible. Social concerns centred on to whom use was revealed. The perceived benefits of use were consistent with previous reports in the literature: reduction in pain, spasms, tremors, nausea, numbness, sleep problems, bladder and bowel problems, and fatigue and improved mood, ability to eat and drink, ability to write, and sexual functioning. Adverse effects included problems with cognition, balance, and fatigue and the feeling of being high. Although participants described risks associated with using marijuana, the benefits they derived made the risks acceptable. CONCLUSION: Further research is needed to clarify the safety and efficacy of marijuana use by patients with multiple sclerosis. If evidence of benefit is seen, medicinal marijuana should be made available to patients who could benefit from it. Until then, discussing medicinal marijuana use with patients will be awkward for health professionals.
Adult↗
Persistence of maternal concerns surrounding neonatal jaundice: an exploratory study.
OBJECTIVES: To explore whether mothers currently express concerns about neonatal jaundice and perceive it as a serious condition; if so, to identify factors influencing these perceptions; and to elicit maternal recommendations for improved health care interactions. DESIGN: Ethnographic interviews using grounded theory methods. Audiotaped data were transcribed and analyzed for themes using a qualitative data analysis software program. SETTING: University and community hospitals. PARTICIPANTS: Forty-seven Spanish- and English-speaking breastfeeding mothers of otherwise healthy infants with a diagnosis of neonatal jaundice and treated in inpatient and/or outpatient settings. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Qualitative descriptions of maternal experiences with neonatal jaundice. RESULTS: Mothers continued to voice concerns about jaundice and perceive it as serious. They expressed misconceptions, wished to have jaundice explained further, and offered suggestions to improve communications with medical staff. Guilt was common, with mothers believing that they had caused the jaundice. Mothers voiced alarm about the yellow skin and discomfort about jaundice management and worried about perceived short- and long-term effects. Maternal perceptions were exacerbated by cultural differences, language barriers, and subtlety of language and its meaning. Key factors in creating perceptions of jaundice as serious included unexpectedness of and lack of knowledge about jaundice, quality of information received, levels of intervention, and prolonged duration of illness and yellow color. Interactions with health care professionals and other mothers with personal experience with jaundice were important mediators in the way mothers reacted to information. CONCLUSION: Practitioners need to address these persisting misconceptions and concerns about neonatal jaundice with mothers.
Adolescent↗
Experience of dying: concerns of dying patients and of carers.
BACKGROUND: Terminally ill patients frequently express concerns about what dying will be like: how their bodies may change as disease progresses, how medication may alter the effect of these changes and whether and how their preferences will be respected as they become more ill. METHODS: Thirty-six patients admitted to a hospice were interviewed and 18 carers of patients of the Palliative Care service, who had died participated in focus groups. Thirty-three patients had advanced malignant disease, 13 were women; their mean age was 68 years (range 44-92 years). RESULTS: The areas of concern consistently identified by patients were (i) privacy and autonomy, principally in regard to families, (ii) a lack of information about physical changes and medication use as death approached and (iii) the desire to shorten life, which was expressed by all patients. Carers recalled problems accessing services and support and had needed more help with practical issues such as medication timing and dose. They believed that not enough information about the patients' illnesses had been given to them and they were insistent that carers should have information against the wishes of patients. CONCLUSION: Some of the patients' and carers' concerns can be readily addressed. Others, particularly access to confidential information, cannot be addressed without a realignment of professional ethical standards and community expectations. The patients' discussions of their desire to shorten life may have implications for the debate on euthanasia and physician-assisted suicide.
Adult↗
[Molecular mechanisms of nephro-protective action of enalapril in experimental chronic renal failure].
Locally increased synthesis of angiotensin II (ANG II) in the kidney has been linked to glomerular hypertrophy, glomerulosclerosis and tubulo-interstitial fibrosis observed in chronic renal failure after subtotal nephrectomy. This action of ANG II is thought to be mediated mainly by transforming growth factor-beta (TGF-beta), which stimulates the synthesis and decreases the degradation of extracellular matrix (ECM) components, including various collagen types and fibronectin. Some recent reports indicate that reduced ANG II activity diminishes TGF-beta overexpression, and in consequence renal injury. However, no studies in SNx models concerning the influence of ANG II on gene expression regulated by TGF-beta have so far been performed. Therefore, the present study has been initiated with the following aims: 1. To develop a RT-PCR assay for evaluating gene expression concerning renin (REN), angiotensinogen (ATG) and the following ECM components: transforming growth factor-beta 1 (TGF-beta 1), fibronectin (FN), matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinases-2 (TIMP-2); 2. To assess the influence of renal mass reduction (RMR) caused by subtotal (5/6) or partial (2/6) nephrectomy on gene expression for TGF-beta 1, FN, MMP-2 and TIMP-2; 3. To evaluate the correlation between expression of these genes and activity of the circulatory or renal renin-angiotensin systems; 4. To assess the influence of treatment with enalapril (angiotensin-converting enzyme inhibitor) on renal expression of these genes, renal morphology and function in rats, relative to duration of treatment and RMR. The study consisted of two independent experiments performed in adult male Sprague-Dawley rats. Ten days prior to surgery, the animals were matched for body weight and systolic blood pressure (SBP) values and subsequently were distributed into untreated (control) and enalapril treated groups. Treatment with enalapril (EN) (50 mg/l in drinking water) was started 9 days prior to surgery. The first (short-term) experiment was performed in rats with chronic renal failure caused by subtotal nephrectomy. Remnant kidneys were taken for molecular studies at the day of SNx and 3, 7 and 21 days thereafter. Blood samples collected at the time of sacrifice served to determine plasma renin activity and plasma concentration of angiotensinogen and angiotensin II. The second (long-term) experiment was done in subtotally (5/6) and partially (2/6) nephrectomized rats. Remnant kidneys were taken for molecular and morphological studies at the day of surgery and 1 or 16 weeks thereafter. 24-hour proteinuria, hematocrit, serum creatinine and creatinine clearance values were also measured. Quantitation of renal gene expression for REN, ATG, TGF-beta 1, FN, MMP-2 and TIMP-2 was performed using RT-PCR assay and comparing amounts of respective gene mRNA with house-keeping gene mRNA encoding L19 ribosomal protein. The results obtained have led to the following conclusions: 1. The RT-PCR assay developed here ensures a reliable quantitation of gene expression for renin, angiotensinogen, transforming growth factor-beta 1, fibronectin, matrix metalloproteinase-2 and tissue inhibitor of metalloproteinases-2. 2. Renin gene expression in the kidney depends on renal synthesis of angiotensin II. In contrast, regulation of angiotensinogen mRNA expression seems to be independent of ANG II. 3. Long-term treatment with enalapril prevents an early increase in renal TGF-beta 1 and FN gene expression, retards the progression of chronic renal failure caused by critical renal mass reduction, and prolongs survival. 4. Intrarenal activity of the renin-angiotensin system is not a principal factor in the regulation of gene transcription for matrix metalloproteinase-2 and tissue inhibitor of metalloproteinases-2.
Angiotensins↗
Teenagers' perceptions of personal safety and the role of the emergency health care provider.
STUDY OBJECTIVE: We designed this study to determine the experiences, attitudes, and beliefs of teenagers regarding violence in their lives and to gain an understanding of the perceived role of the emergency health care professional. METHODS: A qualitative study involving 10-person focus groups was conducted in 4 cities representing urban/low socioeconomic and suburban/high socioeconomic areas. Participants were 14 or 15 years of age and were recruited from local community centers. Moderators were matched by sex to the teenagers, and groups were segmented by race and sex. A semistructured guide was developed to help facilitate the discussion. All groups were audiotaped and videotaped, and the tapes were reviewed by the investigators for reoccurring themes. RESULTS: A total of 140 adolescents (14 groups of 10) participated; one half were male. Urban teenagers expressed concerns about gangs, rape, and homicide; suburban teenagers were concerned about parental pressure and suicide. The teenagers expressed distrust of teachers, police officers, and doctors and felt safest with their parents. The emergency department was viewed as a confusing and frightening place, and participants believed that the role of the ED staff was to treat the patient's medical problem and not inquire or counsel about violence. CONCLUSION: All of the teenagers, regardless of socioeconomic status, were concerned about violence in their lives. All of the teenagers believed that the emergency department is not the place for patients to be counseled about safety and violence prevention. A better understanding of the problem of violence from the point of view of the teenager is important in refining an effective role for the emergency health care provider in adolescent violent injury prevention.
Adolescent↗
Mouse alpha N-catenin: two isoforms, specific expression in the nervous system, and chromosomal localization of the gene.
We isolated cDNAs encoding mouse homologues of chicken alpha N-catenin, a protein associated with the cadherin cell adhesion molecules, and identified two isoforms of this protein. One isoform (alpha N-catenin I) was identical to the chicken alpha N-catenin that had previously been identified, and the other (alpha N-catenin II) differed in having a 48-amino acid insertion in its C-terminal region. The ratio of the two isoforms changed during development; the isoform II was more abundant than the other in earlier embryonic stages, whereas isoform I was predominant in the adult stage. Immunostaining and in situ hybridization analyses revealed that the mouse alpha N-catenin was expressed almost exclusively in the nervous system. During embryogenesis, alpha N-catenin was first detected in nerve fibers of cranial and dorsal root ganglia and also in early neurons in the neural tube, including motor neurons. Thereafter, the expression of this protein occurred in various regions of the nervous system. Neurons, in general, strongly expressed alpha N-catenin, especially in their axonal fibers. On the other hand, the expression in glial cells varied with the region. For example, the ependymal layers of the neural tube generally expressed low levels of alpha N-catenin except at the inner limiting membrane facing the central canal, whereas the floor and roof plate exhibited strong expression of this protein at various portions of the central nervous system. The choroid plexus was devoid of alpha N-catenin. In the alpha N-catenin-negative regions, another subtype of alpha-catenin, alpha E-catenin, was expressed. Concerning nonneural tissues, alpha N-catenin was expressed only in some local mesenchymal cell clusters and the lens fibers. These results suggest that alpha N-catenin plays specific roles in neural cell-cell interactions. We also localized the mouse alpha N-catenin gene to chromosome 6.
Amino Acid Sequence↗