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At least 163 records · Page 9Linked to original sources
PubMed1989

Bivalent ligands and the message-address concept in the design of selective opioid receptor antagonists.

Metabolically stable receptor antagonists that are subtype selective are indispensable pharmacological tools. In this article, Philip Portoghese describes the bivalent ligand approach to drug design which has resulted in the development of several highly selective non-peptide opioid receptor antagonists, such as the kappa-selective norbinaltorphimine and the delta-selective naltrindole. Models used resemble Schwyzer's message-address concept which originally described the recognition elements of peptide hormones; their success augurs well for the possibility of altering antagonist selectivity in a predictable fashion by simulating a portion of the address peptide component with a rigid nonpeptide moiety.

Animals↗
PubMed1996

Addressing life style in primary health care.

The problem studied concerns how patients and physicians talk about and make use of information regarding patient life style in the daily practice of primary health care. The study has been carried out at two primary health care centers in central Sweden. Transcribed dialogues between 42 patients and 12 physicians have been used as a data corpus. The analyses concern the interactional patterns in the dialogues between patient and physician, how the interlocutors address life style and for what purposes. The results show a similarity between patients and physicians with respect to the extent to which they use the discourse space. However, salient differences were found in the following way: the physicians not only introduced and closed life style topics more frequently than the patients did, they also used what is referred to as an agenda driven strategy to introduce them. The patients, on the other hand, used an interactively anchored strategy. The patients, by taking the reference in the life world and by making use of the life style topics, present and articulate their identity. The physicians subsume life style issues under a medical framing of the patients' problem and they mainly address life style in order to construe a proto-typical patient rather than an individual.

Adolescent↗
PubMed1986

Assessment-based group counseling to address concerns of chronic hemodialysis patients.

A Dialysis Patient Concerns Inventory (DPCI) was administered to 15 chronic hemodialysis outpatients by their nurses to assess concerns related to being a hemodialysis patient. This direct information from patients rather than experts in the field was used to construct a group counseling program to address these and other concerns later acknowledged by patients once group counseling began. Components of the counseling program, how the program was implemented, its effects, and factors important in effective program implementation with nurse involvement are discussed. It was concluded that it is important for nurses to play key roles in group counseling to address patients' concerns. It is also important for such counseling to be based on structured assessment of specific concerns reported from patients. Furthermore, it was concluded that group counseling should be planned and executed in ways that actively involve patients and that allow patients to participate for skill development and for life enhancement, rather than to get help with personal problems--a motivator that is often stigmatized.

Adult↗
PubMedDate not supplied

Following the pioneers. Addressing tobacco in chemical dependency treatment.

Traditionally, tobacco has been ignored as an issue in the treatment of addictions to alcohol and other drugs. Beginning in 1985, and especially since the publication of the 1988 Surgeon General's Report on nicotine addiction, a handful of treatment programs have worked at coming to terms with tobacco. This article explores the reasons for addressing nicotine in the course of managing other addictions and summarizes the lessons learned from the programs which have done pioneering work in this area. The reasons for addressing nicotine are compelling, and the accumulated experiences among the pioneering programs are consistently encouraging. Regional projects to help alcohol and drug treatment programs come to terms with tobacco are an appropriate next step.

Aftercare↗
PubMed1994

Mechanism of delta-opioid receptor selection by the address domain of dermenkephalin.

Dermenkephalin (Tyr-D-Met-Phe-His-Leu-Met-AspNH2) is a highly potent and selective delta-opioid peptide isolated from frog skin. It was recently recognized that the C-terminus His4-Leu5-Met6-Asp7NH2 of dermenkephalin was responsible for the addressing of the peptide towards the delta-opioid receptor. In order to investigate the role played by residues 4, 5 and 6 in this 'delta address', we synthesized and evaluated 20 new analogues for their ability to displace tritiated ligands from mu- and delta-opioid sites. Results showed that position 4 of dermenkephalin contributes to delta selectivity independently of delta-opioid receptor binding by preventing a high affinity mu binding. Position 5 requires a hydrophobic side chain to enhance delta affinity. A high delta affinity was obtained with any amino acids introduced in position 6 suggesting that residue 6 serves as a neutral spacer. Thus, the main features responsible for the high delta-opioid selectivity of dermenkephalin are electrostatic repulsions with the mu-opioid receptor, additional hydrophobic interactions with the delta-opioid receptor and folding of the C-terminal domain.

Amino Acid Sequence↗
PubMed1993

Detection of sub-nanogram quantities of Mojave toxin via enzyme immunoassay with light addressable potentiometric detector.

Sensitive detection of Mojave toxin (MoTX), a potent neurotoxin isolated from the venom of Crotalus scutulatus scutulatus, was developed using an enzyme immunoassay (EIA) and light addressable potentiometric detection. This EIA utilizes both biotin- and fluorescein-labeled anti-MoTX antibodies to immobilize and detect sub-nanogram to nanogram quantities of toxin. Labeled mono- and polyclonal anti-MoTX antibodies were used alone and/or in combination to determine maximum assay sensitivity. Assays performed using a combination of biotinylated poly- and fluoresceinated monoclonal antibodies produced an assay with a lower detection limit near 2.5 ng. Assays performed using labeled polyclonals alone, or in combination with biotinylated mono- and fluoresceinated polyclonal antibodies, indicated increased sensitivity with a detection limit near 300 pg. In conclusion, we describe an enzyme immunoassay using different labeled antibody schemes which detects sub-nanogram quantities of MoTX via light addressable potentiometric detection.

Antibodies↗
PubMed2006

Direct electrochemical addressing of immunoglobulins: immuno-chip on screen-printed microarray.

An original immobilisation technology is presented for the development of chemiluminescent protein biochips, suitable for measurement in complex matrices. The immobilisation strategy involved is based on diazotated aniline derivatives, which could be electro-addressed, thus creating a covalent linkage with a conducting material surface. The present electrochemical system is a cost effective and mass-produced carbon paste screen-printed (SP) microarray composed of eight 0.2 mm2 working electrodes, one carbon pseudo-reference electrode and one auxiliary electrode. Rabbit immunoglobulins (IgG) were chemically modified with an aniline derivative (4-carboxymethylaniline) in order to be easily electro-grafted to the SP microarray surface. The possibility of successively electro-address the eight sensing layers of a particular array, with a good reproducibility (more than 80%) and without loss of reactivity was demonstrated. Moreover, these immobilised proteins were subsequently used as a capture agent for the determination of rheumatoid factor (RF) in human sera. The absence of non-specific signal or interference problem enabled the detection of RF values in complex samples in the 5.3-485 IU/ml range with a good correlation with the standard Auraflex ELISA test method.

Animals↗
PubMed2005

FlexPen: addressing issues of confidence and convenience in insulin delivery.

BACKGROUND: In people with type 1 or type 2 diabetes, poor adherence to insulin therapy can compromise disease management. There are several reasons for poor adherence, including social embarrassment, inconvenience, needle anxiety, fear of injection pain, and complicated regimens. Attempts to facilitate implementation of insulin therapy and to improve treatment adherence have focused on expanding the choices and features of insulin delivery devices. OBJECTIVE: This review addresses the features, advantages, and disadvantages of insulin pen devices, with particular reference to FlexPen (Novo Nordisk, Bagsvaerd, Denmark), a prefilled/disposable pen device. METHODS: Data from clinical studies published through June 2005 that evaluated the safety or efficacy of FlexPen in patients with type 1 or type 2 diabetes were reviewed. Key studies were selected following assessment of the sponsor's reference collection and as a result of MEDLINE searches (key words: FlexPen and pen devices). Particular attention was paid to studies comparing the FlexPen device with other pen devices. Peer-reviewed journal articles and published conference papers were included in the evaluation, as were reviews addressing the general use of these devices in the treatment of diabetes and associated issues. RESULTS: Up to 65% of patients with type 1 or type 2 diabetes are not confident in their ability to effectively self-manage their disease. Only 23% of people with type 2 diabetes believe that insulin therapy would help them to better manage their disease. As many as 25% of people with diabetes who require insulin describe some anxiety regarding self-injection. Other barriers to effective insulin therapy include fear of injection pain, weight gain, and hypoglycemia; feelings of failure and guilt; and lack of motivation. CONCLUSIONS: Insulin pen devices are discreet and offer patients convenience and flexibility. These features may give patients the confidence to overcome issues of needle anxiety and the social embarrassment associated with self-injection and, therefore, may lead to improved adherence to recommended insulin dosing schedules and compliance with multiple-injection regimens.

Anxiety↗
PubMed2005

The accuracy of address coding and the effects of coding errors.

Studies that estimate the influence of characteristics of place on health often use geocoded addresses to identify location of study subjects. This study uses housing built before 1990 selected for the 1995-2001 National Health Interview Survey (N=252,421) to develop a standard against which geocodes obtained from an address-coding program are compared. The results show that geocoding is generally accurate and is more successful in urban areas. Blockgroups with missing codes are more rural and somewhat poorer than blockgroups with correct codes. The effect of incorrect codes on statistical analyses depends on the proportion rural in a study population.

Censuses↗
PubMed2006

Knowledge into action? understanding ideological barriers to addressing health inequalities at the local level.

The objective of this study was to explore the presence of ideological barriers to addressing local health inequalities in Hamilton, Ontario, Canada. A survey of active citizens revealed low levels of awareness of the social determinants of health (SDOH) framework, and some incongruence between understanding and attitudes towards the SDOH. Support for addressing health inequalities was associated with awareness of the SDOH framework, liberal value-systems, and a cluster of socio-demographic characteristics. Liberal leaning participants were also more politically active than their conservative counterparts. Ideological barriers included lack of SDOH awareness, narrow understandings of the relative influences of the SDOH, resistance to de-prioritizing healthcare, and conservative values. Advancement of a SDOH policy agenda should incorporate wider dissemination efforts to citizens and local service providers to increase support for this framework, and utilization of existing support and political engagement from liberal-leaning demographics.

Adult↗
PubMed2005

A stromal address code defined by fibroblasts.

To navigate into and within tissues, leukocytes require guidance cues that enable them to recognize which tissues to enter and which to avoid. Such cues are partly provided at the time of extravasation from blood by an endothelial address code on the luminal surface of the vascular endothelium. Here, we review the evidence that fibroblasts help define an additional stromal address code that directs leukocyte behaviour within tissues. We examine how this stromal code regulates site-specific leukocyte accumulation, differentiation and survival in a variety of physiological stromal niches, and how the aberrant expression of components of this code in the wrong tissue at the wrong time contributes to the persistence of chronic inflammatory diseases.

Dendritic Cells↗
PubMedDate not supplied

Fit WIC: attitudes, perceptions and practices of WIC staff toward addressing childhood overweight.

OBJECTIVE: To assess the attitudes, perceptions, and practices of staff of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in providing nutrition education on childhood overweight topics with WIC participants. DESIGN: Descriptive and correlational study. SETTING: WIC clinics in Virginia. PARTICIPANTS: 106 employees working in direct contact with WIC participants. MEAN OUTCOME MEASURE(S): Demographic information; comfort level and frequency of discussing childhood overweight-related topics with participants; perception of WIC's ability to prevent and help address overweight among children and adults; body mass index (BMI); and attitudes toward personal weight. ANALYSIS: Descriptive statistics, regression, and analysis of variance. RESULTS: WIC staff in this study reported a lack of comfort, practice, and confidence in addressing and/or preventing childhood overweight with WIC participants, with differences existing based on job title (P < .05). Barriers to implementing programs included perceived attitudes of participants, transportation, time, cultural issues, and childcare. Staff BMIs were significantly correlated to ethnicity, age, feeling overweight, unhappiness with current weight, and comfort level discussing fruit and vegetable intake and physical activity (P < .05). CONCLUSIONS AND IMPLICATIONS: Staff training, health promotion programs, and culturally relevant educational materials are warranted for WIC staff to build a strong knowledge base and promote self-efficacy about childhood overweight-related topics.

Adult↗
PubMed2005

Seizing the 9-month moment: addressing behavioral risks in prenatal patients.

OBJECTIVE: Our qualitative study explored prenatal care providers' methods for identifying and counseling pregnant women to reduce or stop smoking, alcohol use, illicit drug use, and the risk of domestic violence. METHODS: We conducted six focus groups (five with OB/Gyn physicians, one with nurse practitioners and certified nurse midwives), total N=49, using open-ended questions. Investigators analyzed transcripts to identify and describe themes. RESULTS: Three major themes emerged: (1) specific risk-prevention tactics or strategies exist that are useful during pregnancy; (2) some providers address patients' isolation or depression; and (3) providers can adopt a policy of "just chipping away" at risks. Specific tactics included normalizing risk prevention, using specific assessment techniques and counseling strategies, employing a patient-centered style of smoking reduction, and involving the family. CONCLUSIONS: Providers generally agreed that addressing behavioral risks in pregnant patients is challenging. Patient-centered techniques and awareness of patients' social contexts help patients disclose and discuss risks. PRACTICE IMPLICATIONS: Brief but routine assessment and risk reduction messages require little time of the provider, but can make a big difference to the patient, who may make changes later.

Attitude of Health Personnel↗
PubMedDate not supplied

Using community-partnered participatory research to address health disparities in a Latino community.

Working in collaborative partnership with communities experiencing health disparities has been identified as a successful strategy to address population health disparities. This article illustrates a collaborative outreach program designed to address health disparities in a poor Latino community in Los Angeles County, California, by training community members to function as lay health advisors (LHAs) to provide health education to members of their own community. The study consisted of three phases, each accomplished in a collaborative partnership among researchers, community residents, community-based organizations, and health officials. In Phase 1, a community needs assessment was conducted to identify a community with demonstrated health disparities and agencies within that community willing to become partners in providing health education. In Phase 2, community members were recruited and trained to function as LHAs. Phase 3 consisted of implementation of community outreach and education activities by the LHAs in their community. This article describes how the study changed over time through responding to challenges that arose in the process of conducting the project, the participatory or collaborative methods used, and feedback received. Strategies for successful research using community partners are presented and implications discussed for future research efforts using community-partnered participatory methods for reducing health disparities.

Community Health Workers↗
PubMed1997

National survey of Clerkship Directors in Internal Medicine on the competencies that should be addressed in the medicine core clerkship.

PURPOSE: To prioritize competencies that should be addressed in the medicine core clerkship, assess factors influencing this prioritization, and estimate the percentage of clerkship time that should be devoted to inpatient versus outpatient care. METHODS: A national survey of the Clerkship Directors in Internal Medicine (CDIM) was used. Using explicit criteria, respondents assigned priority scores, on a 1 to 5 scale, to 17 general competencies and 60 disease-specific clinical competencies pertinent to care of adult patients in inpatient. ambulatory, intensive care, and emergency settings. RESULTS: Ninety-three (75%) of 124 CDIM members responded. The highest mean priority scores were assigned to 6 general competencies: case presentation skills (4.65), diagnostic decision-making (4.64), history and physical diagnosis (4.61), test interpretation (4.47), communication with patients (4.35), and therapeutic decision-making (4.12). Disease-specific clinical competency areas receiving the highest mean priority scores were: hypertension (4.57), coronary disease (4.53), diabetes mellitus (4.45), heart failure (4.42), pneumonia (4.39), chronic obstructive pulmonary disease (4.26), acid-base/electrolyte disorders (4.19), and acute chest pain (4.08). Priorities for general competencies were moderately correlated with importance to the practice of general internists (mean Spearman rho 0.49) and with importance to students pursuing careers outside internal medicine (mean Spearman rho 0.45), but only weakly correlated with the adequacy with which a competency was addressed in other parts of the curriculum. Respondents' mean recommended allocation of clerkship time was: 52% inpatient, 33% ambulatory care, 8% intensive care, and 7% emergency medicine. This time allocation did not differ by any characteristics of respondents. CONCLUSION: There is consensus among medicine clerkship directors that the medicine core clerkship should emphasize fundamental competencies and devote at least one third of the time to clinical competencies pertinent to ambulatory care.

Clinical Clerkship↗
PubMed2003

Other high-risk factors for young drivers--how graduated licensing does, doesn't, or could address them.

PROBLEM: Young drivers, particularly those who are newly licensed, have a very high crash risk. This paper examines the risk factors underlying their high crash rates and assesses the extent to which existing graduated licensing programs address these risks and whether improvements to these programs should be considered. METHOD: Review and synthesis of the literature. RESULTS: The elevated risk among young drivers of being in an injury crash is the result of a number of factors found alone or in combination, such as risky driving, alcohol use, seat belt nonuse, driver distraction, fatigue, and vehicle choice. Nighttime and passenger restrictions, adopted widely in the United States, work by keeping drivers out of hazardous situations rather than by addressing risk factors directly. However, the risk factors remain in play in driving situations not specifically restricted by law. Although other graduated licensing components adopted around the world-more stringent exit tests (i.e., you need to pass a test to move to the next stage), hazard perception tests, and restrictions on speed, vehicle power, and roadway access-make sense based on the identified risk factors, they are not yet supported by research. Should research findings warrant it, consideration should be given to providing guidance to parents about how to keep their beginning drivers safe, including information on vehicle choice. IMPACT ON RESEARCH, PRACTICE, AND POLICY: Researchers should continue to monitor and to evaluate innovative approaches to reduce the crash risk of young drivers. The effectiveness of new approaches should be established before adoption on a wider scale takes place.

Accidents, Traffic↗
PubMed2002

The moral tollbooth: a method that makes use of the patent system to address ethical concerns in biotechnology.

Patents granted for biotechnological innovations continue to cause social and ethical dilemmas. For example, much controversy surrounds the patenting of genes that predispose to breast-cancer, and in the USA the debate continues about whether or not stem-cell technology should be accessible to all. In this report, we argue that some of these concerns can be addressed within national patent systems. In particular, we examine the "order public or morality" clause that exists in most national patent procedures. Furthermore, we propose that patents for inventions that present social and ethical questions should be subject to suspension by an independent, transparent, and responsible tribunal made up of specialists in ethics, research, and economics. This suspension should be reversible so that, when the social or ethical concerns have been addressed in an appropriate manner, the suspension can be lifted. Although controversial, such a flexible mechanism would assist governments and industry in enhancing public support for patents in the biotechnology area.

Animals↗