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At least 19 recordsLinked to original sources
PubMed2003

Leaving sex work: barriers, facilitating factors and consequences for female sex workers in northern Thailand.

Factors facilitating or inhibiting women's ability to leave sex work are still poorly characterized, and little is known about women's lives after they leave the profession. This paper presents findings from a qualitative study about factors affecting women's ability to leave sex work and influencing their lives after leaving. We interviewed 42 current and former female sex workers (FSWs) drawn from a cohort study of 500 FSWs in northern Thailand. All but one of the participants had quit sex work at least once. The majority experienced one or more quit-re-entry-quit cycles. Women's ability and decisions to leave sex work were determined primarily by four factors: economic situation, relationship with a steady partner, attitudes towards sex work and HIV/AIDS experience. Economic concerns, ranging from survival needs to materialistic desires, had the strongest influence. Most women perceived their risk for HIV infection to be lower after leaving sex work, but three of the 17 HIV-infected women acquired infection after having left, presumably from their steady partners. Prevention efforts should guide women as they transition out of commercial sex work. Interventions aimed at assisting women wanting to leave sex work need to address the role of economic factors.

Adult↗
PubMed1993

Suppression of the delayed type hypersensitivity response by tumor facilitating factor of B16 melanoma. A tumor factor suppresses immune responses.

BACKGROUND: Tumor facilitating factor is a cell surface glycoprotein produced by B16 melanoma that has been found to reduce the lethal inoculum for B16. Tumor facilitating factor induces macrophage spreading in vitro, reduces macrophage chemotaxis in vivo, and depresses lymphocyte mitogenesis in vitro. OBJECTIVE: It is assumed that the immune modifying effects are responsible for tumor facilitation. As tumors may be poor immunogens or inducers of inflammation, studies were conducted to determine whether tumor facilitating factor alters the inflammatory cascade of cells found in infiltrates of delayed type hypersensitivity. RESULTS: Freeze-thawed B16 cells, used as the source of TFF, caused a suppression of delayed type hypersensitivity measured as ear swelling in the mouse. When culture supernatant was substituted for freeze-thawed cells as a source of TFF and injected at different time points of the delayed type hypersensitivity response, the greater suppression was with tumor facilitating factor injections at 24 hours pre-elicitation only (82%), and 24 hours both presensitization and pre-elicitation (89%). Immunohistological staining demonstrated that tumor facilitating factor decreases ear thickness and cellular infiltrates, specifically Mac-1 staining cells, to a site of delayed hypersensitivity. Peritoneal cell analysis confirmed these findings. CONCLUSION: These data are consistent with the hypothesis that tumor facilitating factor alters immune functions including macrophage and lymphocyte mobility and recruitment to a target site, thereby allowing for facilitation of tumor growth.

Animals↗
PubMed2002

Facilitating factors and barriers to the implementation of intensive home-based behavioural intervention for young children with autism.

BACKGROUND: Although international interest in intensive home-based early behavioural intervention for children with autism is increasing, there is little or no published research on the experiences of families conducting these programmes. METHODS: One hundred and forty-one UK parents conducting Lovaas-style interventions with their young child with autism were asked to identify factors that acted as facilitative factors and barriers to the implementation of these programmes. Parents responded to written questions contained within a questionnaire survey, and their responses were subjected to a content analysis procedure. RESULTS: Several of the facilitative factors and barriers were found to be similar. For example, a supportive therapy team was the most frequently cited facilitative factor, and problems recruiting and maintaining a suitable team was the most frequently reported barrier. Other factors seemed to be more independent constructs. For example, an important barrier was the lack of time and personal energy, but plenty of time and energy was not cited as a facilitative factor. CONCLUSIONS: The practical implications of these results for families and for services supporting families engaged in intensive early behavioural intervention are discussed. In addition, more general implications for the designers of behavioural intervention programmes are identified.

Adult↗
PubMed2004

Acceptability of emergency contraception in Brazil, Chile, and Mexico. 2 - Facilitating factors versus obstacles.

A multi-center study was performed in Brazil, Chile, and Mexico to identify factors that may facilitate or hinder the introduction of emergency contraception (EC) as well as perceptions concerning emergency contraceptive pills. Background information on the socio-cultural, political, and legal context and the characteristics of reproductive health services was collected. The opinions of potential users and providers were obtained through discussion groups, and those of authorities and policymakers through semi-structured interviews. Barriers to introduction included: perception of EC as an abortifacient, opposition by the Catholic Church, limited recognition of sexual and reproductive rights, limited sex education, and insensitivity to gender issues. Facilitating factors were: perception of EC as a method that would prevent abortion and pregnancy among adolescents and rape victims; interest in the method shown by potential users as well as by some providers and authorities. It appears possible to reduce barriers through support from segments of society committed to improving sexual and reproductive health and adequate training of health care providers.

Adolescent↗
PubMed1995

Initial onset of accessory pathway-mediated and atrioventricular node reentrant tachycardia after age 65: clinical features, electrophysiologic characteristics, and possible facilitating factors.

OBJECTIVE: To evaluate the clinical features electrophysiologic characteristics, and possible facilitating factors in older patients (> or = 65 years) with initial onset of accessory pathway-mediated and atrioventricular (AV) node reentrant tachycardia. DESIGN: Of the patients undergoing electrophysiologic study and radiofrequency catheter ablation of accessory pathway-mediated and AV node reentrant tachycardia at this institution, patients with initial tachyarrhythmia after age 65 years were compared with those presenting initially before age 30. SETTING: A tertiary medical center for the general public. PARTICIPANTS: Sixty-six patients had their initial symptoms after age 65: Group I, 32 patients with accessory pathway-mediated tachycardia, and Group II, 34 patients with AV node reentrant tachycardia. Four-hundred forty patients had their initial symptoms before age 30: Group III, 283 with accessory pathway mediated tachyarrhythmia, and Group IV, 157 with AV node reentrant tachycardia. INTERVENTION: All patients underwent electrophysiological study to determine the mechanisms of tachyarrhythmia, and radiofrequency catheter ablation for treatment of tachycardia. RESULTS: (1) Older patients with initial arrhythmia had incidence of critical clinical manifestations, including tachyarrhythmia-related syncope and cardioversion, similar to those with initial arrhythmia at a younger age. (2) Patients in Group III, showed anterograde effective refractory period (ERP) of the AV node (P = .432), longer anterograde ERP of the accessory pathway (P = .004), and greater difference of the anterograde ERP between the AV node and the accessory pathway (D-ERP) (P = .003) similar to patients in group I. In Group II, the ERP and Wenckebach cycle length of the retrograde fast pathway was significantly longer than in Group IV (P = .037 and P < .001, respectively), and a greater percentage of patients in Group II than in Group IV AV node reentrant tachycardia needed isoproteronol to facilitate the induction of reentrant tachycardia (P = .034). (3) Patients in Group I and Group II had a higher incidence of supraventricular and ventricular ectopic activity than those in Group III (P = .002 and P = .005, respectively) and Group IV (P = .024 and P = .012, respectively) in 24-hour ambulatory electrocardiograms. CONCLUSION: The initial onset of accessory pathway-mediated tachycardia after age 65 may be caused by changes of electrophysiologic properties (greater D-ERP) as well as increased supraventricular and ventricular ectopic activity. Influence of the autonomic nervous system, rather than changes of conduction properties in the AV node, and increase in ectopic activity may contribute to the new onset of AV node reentrant tachycardia in older adults. The choice of antiarrhythmic drugs and radiofrequency ablation require attention to the clinical profile and facilitating factors of reentrant tachycardia in this group of patients.

Adult↗
PubMed1998

Proteolysis of factor V by cathepsin G and elastase indicates that cleavage at Arg1545 optimizes cofactor function by facilitating factor Xa binding.

The single-chain procofactor factor V is cleaved by thrombin (FVaIIa) at Arg709, Arg1018, and Arg1545 and by a variety of other proteases to generate a cofactor species with various levels of cofactor function. Having demonstrated previously that monocyte-bound forms of cathepsin G and elastase cleave and activate factor V, studies were initiated here using purified proteins to probe factor V structure/function. Electrophoretic, Western blotting, and amino-terminal sequence analyses revealed that cathepsin G cleaves factor V at several sites (Phe1031, Leu1447, Tyr1518, and potentially Tyr696), ultimately generating an amino-terminal 103 kDa heavy chain and a carboxy-terminal 80 kDa light chain (FVaCG). Elastase also cleaves factor V at several sites (Ile708, Ile819, Ile1484, and potentially Thr678), generating a cofactor species, FVaHNE, with an amino-terminal 102 kDa heavy chain and a carboxy-terminal 90 kDa light chain. Incubation of FVaIIa with either cathepsin G or elastase resulted in cleavage within the heavy chain, releasing peptides of approximately 2000 and approximately 3000 Da, respectively, generating FVaIIa/CG and FVaIIa/HNE. The functional activity of each cofactor species was assessed either by clotting assay or by employing a purified prothrombinase assay using saturating amounts of factor Xa. Significant differences in cofactor function were observed between the two assay systems. Whereas FVaIIa, FVaCG, FVaIIa/CG, FVaHNE, and FVaIIa/HNE all had similar cofactor activities in the purified prothrombinase assay, FVaCG and FVaHNE had no cofactor activity in the clotting-based assay, and FVaIIa/CG and FVaIIa/HNE had approximately 30-35% clotting activity relative to FVaIIa. These disparate results led us to examine the binding interactions of these cofactors with the various prothrombinase components. Kinetic analyses indicated that FVaIIa (Kd(app) = 0.096 nM), FVaIIa/CG (Kd(app) = 0.244 nM), and FVaIIa/HNE (Kd(app) = 0.137 nM) bound to membrane-bound factor Xa much more effectively than FVaCG (Kd(app) = 1.46 nM) and FVaHNE (Kd(app) = 0.818 nM). In contrast, studies of the activated protein C (APC)-catalyzed inactivation of each of the factor V(a) species indicated that they were all equivalent substrates for APC with no differences observed in the rate of inactivation or the cleavage mechanism, suggesting that APC interacts with the light chain at a site distinct from factor Xa. The Km values for prothrombin, as well as the kcat values for each of the FV(a) species, were all similar (approximately 0.25 microM and approximately 1900 min-1). In addition, kinetic analyses indicated that whereas FVaCG and FVaHNE exhibited a slightly reduced ability to interact with phospholipid vesicles (approximately 2-3-fold), the remaining FV(a) species assembled equally well on this surface. Collectively, these data indicate that FVaCG and FVaHNE have a diminished capacity to support factor Xa binding; however, cleavage at Arg1545 and removal of the extended B-domain in these cofactors restore near-total factor Xa binding. Thus, cleavage at Arg1545 optimizes cofactor function within prothrombinase by facilitating factor Xa binding to membrane-bound FVa.

Arginine↗
PubMed1997

Computed tomographic analysis of hemifacial spasm: narrowing of the posterior fossa as a possible facilitating factor for neurovascular compression.

Hemifacial spasm can be caused by vascular compression of the facial nerve at the root exit zone from the brainstem. Several case reports suggest that narrowing of the cerebellopontine angle cistern caused by Paget's disease, abnormal elevation of the petrous bone caused by hyperplasia, or contralateral acoustic neurinoma may increase the chance of vascular compression of the facial nerve. Therefore, posterior fossa narrowness has been evaluated in 34 patients with hemifacial spasm by measuring the petrous angle and pons diameter index to elucidate whether narrowing of the posterior fossa can act as a facilitating factor for neurovascular compression. The petrous angle in the hemifacial spasm group was significantly smaller than that in the control group, which consisted of 33 patients with an unruptured supratentorial aneurysm, and the pons diameter index in the hemifacial spasm group was significantly greater than that in the control group. These results indicate that the cerebellopontine angle cistern of patients with hemifacial spasm is narrower resulting in more crowded cranial nerves and vascular structures compared with patients without hemifacial spasm. The narrowness of the cerebellopontine angle cistern may be a possible factor in facilitating neurovascular compression in hemifacial spasm.

Adult↗
PubMed1998

A study of factors facilitating and inhibiting the willingness of the institutionalized disabled elderly for rehabilitation: a United States-Japanese comparison.

The high prevalence of 'bedridden elderly' in Japan is at least three times higher than that of any other industrialized country. To decrease likelihood of being bedridden, it is important to cultivate and maintain the willingness of older disabled patients for rehabilitation, and to preserve functioning in activities of daily living (ADL). The purpose of this study was to identify the factors facilitating and inhibiting the willingness of institutionalized disabled older adults for rehabilitation with respect to physical, goal-attainment, psychological and cultural aspects. The convenience sample consisted of 71 disabled older adults (45 in Japan and 26 in the USA). 46 subjects (64.8%) were identified as 'willing for rehabilitation', whereas 25 (35.2%) were 'unwilling for rehabilitation'. The data were gathered using structured interviews to subjects and administering questionnaires to the nurses. The data were compared between the 'willing' and the 'unwilling', and between those from Japan and from the USA by cross-tabular and correlational analyses. The major findings in this study were as follows: (1) Factors found to facilitate willingness of older persons for rehabilitation included: high independence level in ADL, generalized endurance/stamina, lack of pain, mutual goal agreement between old people and care staff, and no presence of regressive behavior. (2) Factors found to inhibit willingness of older persons for rehabilitation included: lower independence in ADL, presence of pain, generalized little stamina, depression, presence of regressive behavior, and dementia, and expectation of another person's help all the time. Healthcare workers need to be aware of patients who are subject to factors inhibiting willingness, and to promote factors facilitating willingness, in order to prevent the elderly with disabilities from becoming bedridden. In addition, the implications of this study are for a multidimensional functional assessment to be part of the rehabilitation intake in order to better understand each individual and motivate his/her optimum level of functional ability.

Journal Article↗
PubMed1983

The effects of tumor facilitating factor of B16 melanoma on the macrophage.

B16 cells produce a tumor facilitating factor (TFF) that increases B16 tumor incidence in mice injected with a small number of B16 cells. TFF was derived from serum-free culture supernatant concentrated on an Amicon PM10 membrane. One milliliter of concentrated material represented the product 10(8) B16 cells during a 6-h incubation. We report data that indicate TFF may act by altering macrophage function. In the nude mouse deficient in T cell, but not macrophage function, the injection of 0.8 ml of TFF facilitated tumor development. Subcutaneous injection of 0.7 ml of TFF induced mouse peritoneal macrophages to spread when removed and plated on glass coverslips. This effect peaked 3 days after injection of TFF and was abrogated by heating the TFF to 70 degrees C for 1 h. The injection of TFF was also able to induce macrophage spreading in nude mice. Injection of viable B16 cells induced spreading, as would be predicted if TFF is produced by B16 cells in vivo. In vitro incubation of peritoneal cells with TFF was also able to induce macrophage spreading. Finally, subcutaneous injection of TFF reduced by 80% the accumulation of peritoneal cells in response to intraperitoneal injection of phytohemagglutinin. We suggest that one mode by which TFF facilitates tumor growth is by reducing the numbers of macrophages chemotaxing to the tumor site.

Animals↗
PubMed2000

Reviewing audit: barriers and facilitating factors for effective clinical audit.

OBJECTIVE: To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. DESIGN: A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. RESULTS: Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. CONCLUSIONS: Clinical audit can be a valuable assistance to any programme which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at nurturing effective audits, valuable opportunities will be lost. Paying careful attention to the professional attitudes highlighted in this review may help audit to deliver on some of its promise.

Attitude of Health Personnel↗
PubMed2005

Identifying barriers and facilitating factors to improve screening mammography rates in women diagnosed with mental illness and substance use disorders.

Little is known about screening mammography rates among women diagnosed with mental illness-even though some studies have suggested that this population might be particularly vulnerable to breast cancer. The purpose of this pilot study was to identify facilitators and barriers to mammography among women diagnosed with mental illness and/or substance use disorders. Four focus groups were conducted, with a total of 26 women, ages 40-65 years, with mental illness and/ or substance use disorders. Analysis was performed using the grounded-theory editing approach. Several major themes emerged from the transcripts: (1) motivators for obtaining mammograms, (2) fears and concerns, (3) shame and embarrassment, (4) the clinical environment, (5) provider-patient communication, and (6) the need for increased patient education. A family history of breast cancer and/or cancer was the most powerful motivator among focus group participants for obtaining a mammogram. Doctor recommendations and referrals were also identified as key facilitating factors. The overall knowledge of mammography and breast cancer among these women suggested educational deficiencies-despite extensive breast cancer screening and awareness campaigns. The findings highlight the importance of patient education as well as the positive effects of physician recommendations to encourage patients to receive breast cancer screening.

Adult↗
PubMed2006

Challenges and facilitating factors in sustaining community-based participatory research partnerships: lessons learned from the Detroit, New York City and Seattle Urban Research Centers.

In order to address the social, physical and economic determinants of urban health, researchers, public health practitioners, and community members have turned to more comprehensive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received considerable attention over the past decade, and numerous publications have described theoretical underpinnings, values, principles and practice. Issues related to the long-term sustainability of partnerships and activities have received limited attention. The purpose of this article is to examine the experiences and lessons learned from three Urban Research Centers (URCs) in Detroit, New York City, and Seattle, which were initially established in 1995 with core support from the Centers for Disease Control and Prevention (CDC). The experience of these Centers after core funding ceased in 2003 provides a case study to identify the challenges and facilitating factors for sustaining partnerships. We examine three broad dimensions of CBPR partnerships that we consider important for sustainability: (1) sustaining relationships and commitments among the partners involved; (2) sustaining the knowledge, capacity and values generated from the partnership; and (3) sustaining funding, staff, programs, policy changes and the partnership itself. We discuss the challenges faced by the URCs in sustaining these dimensions and the strategies used to overcome these challenges. Based on these experiences, we offer recommendations for: strategies that partnerships may find useful in sustaining their CBPR efforts; ways in which a Center mechanism can be useful for promoting sustainability; and considerations for funders of CBPR to increase sustainability.

Centers for Disease Control and Prevention, U.S.↗
PubMed2002

Implementation of a teacher-delivered sex education programme: obstacles and facilitating factors.

Interventions are unlikely to achieve their desired aims unless they are implemented as intended. This paper focuses on factors that impeded or facilitated the implementation of a specially designed sex education programme, SHARE, which 13 Scottish schools were allocated to deliver in a randomized trial. Drawing on qualitative and quantitative data provided by teachers, we describe how this intervention was not fully implemented by all teachers or in all schools. Fidelity to the programme was aided by intensive teacher training, compatibility with existing Personal and Social Education (PSE) provision, and senior management support. It was hindered by competition for curriculum time, brevity of lessons, low priority accorded to PSE by senior management, particularly in relation to timetabling, and teachers' limited experience and ability in use of role-play. The nature of the adoption process, staff absence and turnover, theoretical understanding of the package, and commitment to the research were also factors influencing the extent of implementation across and within schools. The lessons learned may be useful for those involved in designing and/or implementing other teacher-delivered school-based health promotion initiatives.

Adolescent↗
PubMed2002

The establishment of a brain bank for the study of late-life depression: a feasibility study of factors facilitating consent.

BACKGROUND: Studies of postmortem brain tissue are advancing the understanding of the pathophysiology of major depressive disorder (MDD). The nature and quality of subject samples, however, limit their applicability to late-life MDD. OBJECTIVE: To examine the feasibility of establishing a brain bank for late-life MDD, and identify clinical, demographic, and procedural factors that might facilitate subject enrollment. METHODS: Elderly subjects participating in clinical trials associated with the Mental Health Intervention Research Center for Late-Life Mood Disorders (MHIRC/LLMD) at the University of Pittsburgh were approached by clinical research staff for consent to future brain-only autopsy. Subjects who consented to participation were compared with those who refused participation on demographic and clinical variables. MHIRC/LLMD clinical research staff were interviewed to determine factors that may have facilitated or hindered the consent process and reasons for subject consent or refusal. RESULTS: Eighty out of 242 subjects (33%) subjects approached for participation in the brain bank provided consent. Consent to participate was associated with higher level of education and with lower Mini-Mental State Examination score. Several factors facilitating and hindering the consent process were identified. CONCLUSION: We provide preliminary evidence for the feasibility of establishing a brain bank for the study of late-life MDD. Future efforts may be guided by the factors identified as facilitating the consent process, especially the inclusion of family in the consent process.

Journal Article↗
PubMed2005

A four-country investigation of factors facilitating student internet use.

Education and national culture may influence Internet use. The present study explored factors that might facilitate college students' use of the Internet across samples in four countries: India, Mauritius, Reunion Island (an overseas Department of France), and the United States. Questionnaire data was collected on students' extent and frequency of Internet use. Also, structured items asked about the factors that would help them to use the Internet more. Data was analyzed using dummy-coded multiple regression so as to compare responses across the country groups. The U.S. sample was coded as the reference group so that the regression coefficients in the equation provided a comparison between the U.S. sample and each other country represented. Further country comparisons were made using t-tests for differences between the regression coefficients. Results suggested that there was more Internet use in the U.S. sample compared to the others. The Non-Western samples also reported greater desire for Internet access and non-English web sites. Training on how to use the Internet and course requirements for Internet use were reported as helpful by the India and Mauritius groups to a greater extent than by those in Reunion and the United States. Implications of the present exploratory results are discussed for applications of theoretical models across cultures.

Adult↗
PubMed2005

Recent developments in factor-facilitated ribosome assembly.

Escherichia coli ribosomal subunits can be reconstituted in vitro under highly optimized conditions. These reconstitution systems have proven invaluable for the study of ribosomal subunit assembly. While E. coli ribosomal subunits can self-assemble in vitro there has been much speculation regarding the existence of extra-ribosomal assembly factors that act in functional subunit formation in vivo. Recently, a biochemical assay has been implemented to identify factors that facilitate a single, critical step in 30S subunit assembly in vitro. These studies have revealed that the DnaK (heat shock protein 70) chaperone system can facilitate 30S subunit assembly in vitro. The 30S subunits, formed in the presence of the chaperones under otherwise non-permissive conditions, are highly similar to 30S subunits formed under standard reconstitution conditions. It has become evident that the manner in which the "factor-assembled" 30S subunits are purified is critical for monitoring formation of functional ribosomal particles. Given that methodologies for in vitro reconstitution and functional analysis of ribosomal subunits have been described in detail previously, this manuscript will focus on isolation of functional 30S subunits that have been assembled in the presence of exogenous factors in vitro. Also, recent efforts toward understanding the roles of exogenous factors in 50S subunit and eukaryotic ribosome assembly will be briefly discussed.

Escherichia coli↗
PubMed1993

Increasing steps in recall of events: factors facilitating immediate and long-term memory in 13.5- and 16.5-month-old children.

Children late in the second year of life show patterns of event recall similar to those of older children: (a) well-ordered immediate and delayed recall, and (b) facilitation of recall by familiarity and by enabling relations. We used elicited imitation to test whether the patterns extend to children early in the second year. In Experiment 1, 13.5- and 16.5-month-olds accurately recalled familiar and novel 2-act sequences immediately and after a 1-week delay. For 16.5-month-olds, recall was facilitated by familiarity and by enabling relations; for 13.5-month-olds, only enabling relations facilitated recall. In Experiment 2, verbal cues were used to test immediate and 1-week delayed recall of 3-act sequences. For both ages, recall was facilitated by familiarity and by enabling relations. Experiment 3 verified that the verbal information served to cue recall of previously experienced events, not to "suggest" sequences that could be performed. Together the results demonstrate that children as young as 13 months can recall specific events after a delay. They also suggest development in sensitivity to factors that facilitate recall.

Attention↗