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Erwin J, Burns L, Devalia U, Witton R, Shawe J, Wheat H, Axford N, Doughty J, Kaddour S, Nelder A, Brocklehurst P, Boswell S, Paisi M. Co-production of health and social science research with vulnerable children and young people: A rapid review. Health Expect 2024; 27:e13991. [PMID: 38403901 PMCID: PMC10895074 DOI: 10.1111/hex.13991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/23/2024] [Accepted: 02/03/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The term 'care-experienced' refers to anyone who is currently in care or has been in care at any stage in their life. A complex interplay of factors leads to care-experienced children and young people (CECYP) experiencing poorer oral health and access to dental care than their peers. A rapid review of the co-production of health and social care research with vulnerable children and young people (CYP) was carried out to inform the development of a co-produced research project exploring the oral health behaviours and access to dental services of CECYP. Here, 'co-production' refers to the involvement of CYP in the planning or conduct of research with explicit roles in which they generate ideas, evidence and research outputs. AIM To learn how to meaningfully involve vulnerable CYP in the co-production of health and social science research. OBJECTIVES To identify: Different approaches to facilitating the engagement of vulnerable CYP in co-production of health and social science research; different activities carried out in such approaches, challenges to engaging vulnerable CYP in co-production of health and social science research and ways to overcome them and areas of best practice in relation to research co-production with vulnerable CYP. SEARCH STRATEGY A rapid review of peer-reviewed articles was conducted in six databases (MEDLINE, Embase, SocINDEX, CINAHL, PsycINFO and Web of Science) and grey literature to identify studies that engaged vulnerable CYP in co-approaches to health and social research. MAIN RESULTS Of 1394 documents identified in the search, 40 were included and analysed. A number of different approaches to co-production were used in the studies. The CYP was involved in a range of activities, chiefly the development of data collection tools, data collection and dissemination. Individual challenges for CYP and researchers, practical and institutional factors and ethical considerations impacted the success of co-production. DISCUSSION AND CONCLUSION Co-production of health and social science with vulnerable CYP presents challenges to researchers and CYP calling for all to demonstrate reflexivity and awareness of biases, strengths and limitations. Used appropriately and well, co-production offers benefits to researchers and CYP and can contribute to research that reflects the needs of vulnerable CYP. Adherence to the key principles of inclusion, safeguarding, respect and well-being facilitates this approach. PATIENT AND PUBLIC CONTRIBUTION Members of our patient and public involvement and stakeholder groups contributed to the interpretation of the review findings. This manuscript was written together with a young care leaver, Skye Boswell, who is one of the authors. She contributed to the preparation of the manuscript, reviewing the findings and their interpretation.
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Affiliation(s)
- Jo Erwin
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Lorna Burns
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Urshla Devalia
- Royal National ENT and Eastman Dental Hospital, London, UK
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Jill Shawe
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Hannah Wheat
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Nick Axford
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Janine Doughty
- School of Dentistry, Royal Liverpool University Dental Hospital, Liverpool, UK
| | | | | | | | | | - Martha Paisi
- Peninsula Dental School, University of Plymouth, Plymouth, UK
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
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Booth J, Erwin J, Burns L, Axford N, Horrell J, Wheat H, Witton R, Shawe J, Doughty J, Kaddour S, Boswell S, Devalia U, Nelder A, Paisi M. A Scoping Review of the Oral Health Status, Oral Health Behaviours and Interventions to Improve the Oral Health of Children and Young People in Care and Care Leavers. Dent J (Basel) 2024; 12:38. [PMID: 38392242 PMCID: PMC10887692 DOI: 10.3390/dj12020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/07/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Children and young people (CYP) in care experience poorer physical health and overall wellbeing in comparison to their peers. Despite this, relatively little is known about what their oral health needs and behaviours are. The aim of this scoping review was to provide a global perspective on the oral health status and behaviours of CYP in care and care leavers. It also aimed to synthesise interventions that have been trialled in this population to improve oral health. METHODS Five databases were searched, Ovid Embase, Ovid MEDLINE, CINAHL (EBSCOhost), SocINDEX (EBSCOhost) and Dentistry and Oral Sciences Source (EBSCOhost), alongside grey literature sources up to January 2023. Eligibility criteria were studies that (i) reported on children and adolescents aged 25 years or younger who are currently in formal/informal foster or residential care and care leavers, (ii) pertained to oral health profile, behaviours or oral health promotion interventions (iii) and were published in the English language. Thematic analysis was used to develop the domains for oral health behaviours and interventions. RESULTS Seventy-one papers were included. Most papers were published from very high or medium Human Development Index countries. CYP in care were found to experience high levels of decay, dental trauma, periodontal disease and poorer oral health-related quality of life. Oral health behaviours included limited oral health self-care behaviours and a lack of oral health-based knowledge. The trialled interventions involved oral health education, supervised brushing and treatment or preventative dental care. CONCLUSIONS This scoping review reveals that CYP in care experience poorer oral health in comparison to their peers. They are also less likely to carry out oral health self-care behaviours. This review highlights a scarcity of interventions to improve the oral health of this population and a paucity of evidence surrounding the oral health needs of care leavers.
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Affiliation(s)
- Joelle Booth
- Centre for Dental Public Health and Primary Care, Queen Mary University of London, Turner Street, London E1 2AD, UK
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Jo Erwin
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Lorna Burns
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Nick Axford
- Peninsula Medical School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Jane Horrell
- Peninsula Medical School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Hannah Wheat
- Peninsula Medical School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Jill Shawe
- School of Nursing and Midwifery, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Janine Doughty
- School of Dentistry, Royal Liverpool University Dental Hospital, Pembroke Place, Liverpool L3 5PS, UK
| | - Sarah Kaddour
- Pathway Oral Health Fellow, Pathway, 250 Euston Road, London NW1 2PG, UK
| | - Skye Boswell
- Patient and Public Involvement Member, Plymouth County Council, Plymouth PL1 3BJ, UK
| | - Urshla Devalia
- Royal National ENT and Eastman Dental Hospitals, University College London Hospitals, London NW1 2BU, UK
| | - Abigail Nelder
- Peninsula Dental Social Enterprise, Plymouth PL6 8BT, UK
| | - Martha Paisi
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
- School of Nursing and Midwifery, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
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Erwin J, Horrell J, Wheat H, Axford N, Burns L, Booth J, Witton R, Shawe J, Doughty J, Kaddour S, Boswell S, Devalia U, Nelder A, Paisi M. Access to Dental Care for Children and Young People in Care and Care Leavers: A Global Scoping Review. Dent J (Basel) 2024; 12:37. [PMID: 38392241 PMCID: PMC10887801 DOI: 10.3390/dj12020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/22/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
AIMS This scoping review aimed to explore three research questions: 1. What is the dental care access for children and young people (CYP) in care and care leavers? 2. What factors influence CYP in care and care leavers' access to dental care? 3. What pathways have been developed to improve access to oral health care for CYP in care and care leavers? METHODS Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, SocINDEX and Dentistry and Oral Sciences Source) and grey literature sources were systematically searched. Articles relating to CYP in care or care leavers aged 0-25 years old, published up to January 2023 were included. Abstracts, posters and publications not in the English language were excluded. The data relating to dental care access were analysed using thematic analysis. RESULTS The search identified 942 articles, of which 247 were excluded as duplicates. A review of the titles and abstracts yielded 149 studies. Thirty-eight were eligible for inclusion in the review: thirty-three peer-reviewed articles, one PhD thesis and four grey literature sources. All papers were published from very high or medium Human Development Index countries. The studies indicate that despite having higher treatment needs, CYP in care and care leavers experience greater difficulty in accessing dental services than those not care-experienced. Organisational, psycho-social and logistical factors influence their access to dental care. Their experience of dental care may be impacted by adverse childhood events. Pathways to dental care have been developed, but little is known of their impact on access. There are very few studies that include care leavers. The voices of care-experienced CYP are missing from dental access research. CONCLUSIONS care-experienced CYP are disadvantaged in their access to dental care, and there are significant barriers to their treatment needs being met.
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Affiliation(s)
- Jo Erwin
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Jane Horrell
- Peninsula Medical School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Hannah Wheat
- Peninsula Medical School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Nick Axford
- Peninsula Medical School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Lorna Burns
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Joelle Booth
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
- Centre for Dental Public Health and Primary Care, Queen Mary University of London, Turner Street, London E1 2AD, UK
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
- Peninsula Dental Social Enterprise, Plymouth PL6 8BT, UK
| | - Jill Shawe
- School of Nursing and Midwifery, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Janine Doughty
- School of Dentistry, Royal Liverpool University Dental Hospital, Pembroke Place, Liverpool L3 5PS, UK
| | - Sarah Kaddour
- Pathway Oral Health Fellow, Pathway, 250 Euston Road, London NW1 2PG, UK
| | - Skye Boswell
- Patient and Public Involvement Member, Plymouth County Council, Plymouth PL1 3BJ, UK
| | - Urshla Devalia
- Royal National ENT and Eastman Dental Hospitals, University College London Hospitals, London NW1 2BU, UK
| | - Abigail Nelder
- Peninsula Dental Social Enterprise, Plymouth PL6 8BT, UK
| | - Martha Paisi
- Peninsula Dental School, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
- School of Nursing and Midwifery, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
- Patient and Public Involvement Member, Plymouth County Council, Plymouth PL1 3BJ, UK
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Boswell S, Gusowski K, Kaiser A, Flachenecker P. Hippotherapie bei Multipler Sklerose – eine prospektive, kontrollierte, randomisierte und einfachblinde Studie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Berg MB, Safren SA, Mimiaga MJ, Grasso C, Boswell S, Mayer KH. Nonadherence to medical appointments is associated with increased plasma HIV RNA and decreased CD4 cell counts in a community-based HIV primary care clinic. AIDS Care 2007; 17:902-7. [PMID: 16120506 DOI: 10.1080/09540120500101658] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined the association of appointment nonadherence to markers of disease severity using one year of demographic and health information on 995 individuals with HIV in primary care at an urban community health centre. At the latest visit, 106 of 946 valid cases (11.2%) had a CD4 less than or equal to 200, and 454 of 936 valid cases (48.5%) had detectable plasma HIV RNA (greater than 50 copies/ml). Using logistic regression, appointment nonadherence (number of missed appointments) was a significant predictor (p < .03) of having an AIDS-defining CD4 count over and above the effects of number of kept appointments (p < .0001), and whether or not the patient was taking HAART (p < .002). Appointment nonadherence was also a significant predictor (p < .05) of having a detectable viral load over and above the effects of number of kept appointments (p < .003), HAART (p < .0001) and age (p < .004). Looking only at individuals with a detectable viral load at the earliest visit, the only significant unique predictor of improvement to an undetectable viral load at the latest visit was being on HAART (p < .05). Looking at those only with an undetectable viral load at the earliest visit, the only predictor of declining to a detectable viral load was number of kept appointments (p < 003), and being on HAART (p < .05).
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Affiliation(s)
- M B Berg
- Wheaton College, Norton, MA, USA
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Russon K, Sardesai AM, Ridgway S, Whitear J, Sildown D, Boswell S, Chakrabarti A, Denny NM. Postoperative shoulder surgery initiative (POSSI): an interim report of major shoulder surgery as a day case procedure. Br J Anaesth 2006; 97:869-73. [PMID: 17065168 DOI: 10.1093/bja/ael281] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There are logistical and financial advantages to undertaking shoulder surgery in a day case setting. However, this approach is limited by postoperative pain being inadequately controlled by oral medication alone. We describe a pilot study investigating the feasibility and acceptance of community based continuous interscalene brachial plexus blockade (CIBPB) to provide effective analgesia for day case shoulder surgery. METHODS Phase 1 consisted of five patients who received CIBPB for shoulder surgery. Following an overnight hospital stay they were assessed for discharge home with the interscalene catheter in situ. Once the safety and feasibility of the approach was documented, five more patients were recruited to Phase 2. These patients had the adequacy of analgesia assessed in the postoperative period and were discharged home on the same day as surgery. A district nurse visited twice daily and removed the catheter on the third day. Patient satisfaction was assessed using a discovery interview. RESULTS Nine of the 10 patients experienced good analgesia. One patient was re-admitted because the catheter fell out. No patient experienced complications and the discovery interviews showed that the patients were satisfied with their management and pleased to be treated as a day case. CONCLUSIONS POSSI proved that it was feasible to manage these patients in the community with support and training of the district nurses. Although extra community nursing hours are required, this technique has the potential for significant cost benefits with at least three bed days saved per patient.
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Affiliation(s)
- K Russon
- Department of Anaesthesia, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.
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Boswell S, Tome W, Jaradat H, Mackie T. Comparison of Automatic Tomotherapy CT Setup Verification vs. an Optically Guided Patient Positioning System. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kissick M, Boswell S, Jeraj R, Mackie T. SU-FF-J-124: The Unappreciated Benefits of Randomness and Slow Delivery with Organ Motion. Med Phys 2005. [DOI: 10.1118/1.1997670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Safren SA, Otto MW, Worth JL, Salomon E, Johnson W, Mayer K, Boswell S. Two strategies to increase adherence to HIV antiretroviral medication: life-steps and medication monitoring. Behav Res Ther 2001; 39:1151-62. [PMID: 11579986 DOI: 10.1016/s0005-7967(00)00091-7] [Citation(s) in RCA: 239] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Advances in the medical treatment of HIV have made it clear that adherence to highly active antiretroviral treatment is a crucial feature for treatment success. The present paper had two goals: (1) to examine psychosocial predictors of adherence in persons receiving HIV antiretroviral therapy; (2) to compared two minimal-treatment interventions to increase HIV medication adherence in a subset of persons who self-reported less than perfect adherence. One of the interventions, Life-Steps, is a single-session intervention utilizing cognitive-behavioral, motivational interviewing, and problem-solving techniques. The other intervention, self-monitoring, utilizes a pill-diary and an adherence questionnaire alone. Significant correlates of adherence included depression, social support, adherence self-efficacy, and punishment beliefs about HIV. Depression was a significant unique predictor of adherence over and above the other variables. Both interventions yielded improvement in adherence from baseline, and the Life-Steps intervention showed faster improvements in adherence for persons with extant adherence problems.
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Affiliation(s)
- S A Safren
- Massachusetts General Hospital and Harvard Medical School, Boston MA 02114, USA
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Chiara O, Pelosi P, Segala M, Turconi MG, Brazzi L, Bottino N, Taccone P, Zambelli M, Tiberio G, Boswell S, Scalea TM. Mesenteric and renal oxygen transport during hemorrhage and reperfusion: evaluation of optimal goals for resuscitation. J Trauma 2001; 51:356-62. [PMID: 11493800 DOI: 10.1097/00005373-200108000-00023] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Changes in flow to the gut and the kidney during hemorrhage and resuscitation contribute to organ dysfunction and outcome. We evaluated regional and splanchnic oxygen (O2) flow distribution and calculated oxygen supply distribution during hemorrhage and reperfusion and compared them with global measures. METHODS Seven anesthetized pigs were instrumented to evaluate global hemodynamics, visceral blood flow, and oxygen transport. Tonometric pH probes were positioned in the stomach and jejunum. Animals were bled to 45 mm Hg for 1 hour. Crystalloids and blood were infused during the following 2 hours to normalize blood pressure, heart rate, urine output, and hemo- globin. RESULTS During hemorrhage, mesenteric flow and O2 consumption were significantly decreased, whereas systemic consumption remained normal. Renal flow was reduced, but renal O2 consumption remained normal. After resuscitation, despite normal hemodynamics, neither systemic, mesenteric, nor renal O2 delivery returned to baseline. Lactate remained significantly increased. Arterial pH, base excess, and gastric and jejunal pH were all decreased. CONCLUSION During hemorrhage, the gut is more prone than other regions to O2 consumption supply dependency. After resuscitation, standard clinical parameters do not detect residual O2 debt. Lactate, arterial pH, base excess, and intramucosal gut pH are all markers of residual tissue hypoperfusion.
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Affiliation(s)
- O Chiara
- Istituto di Chirurgia d'Urgenza, Universita' degli Studi di Milano, Ospedale Maggiore IRCCS, Milano, Italy
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Abstract
Fenway Community Health was founded by community activists in 1971 in the Fenway neighborhood of Boston, Mass, and within a decade had rapidly expanded its medical services for gay men in response to the AIDS epidemic. Increased expertise and cultural competence in lesbian, gay, bisexual, and transgender (LGBT) care led to expansion of medical services to address broader community concerns, ranging from substance use to parenting issues to domestic and homophobic violence, as well as specialized programs for lesbians, bisexuals, and transgendered individuals. Fenway began as a grassroots neighborhood clinic. In 1975, the center recorded 5000 patient care visits; in 2000, Fenway's clinical departments recorded 50,850 visits by 8361 individuals, including more than 1100 individuals receiving HIV-associated care. The center now has more than 170 staff people responsible for clinical programs, community education, research, administration, planning, and development. Over the past few years, Fenway's annual budget has exceeded $10 million. Fenway has established standards for improved cultural competence about LGBT health issues for other health providers and has developed programs to educate the general community about specific LGBT health concerns. This health center may provide a model of comprehensive LGBT health services that have a local impact.
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Affiliation(s)
- K Mayer
- Infectious Disease Division, Memorial Hospital of Rhode Island, 111 Brewster St, Pawtucket, RI 02860, USA.
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Altfeld MA, Livingston B, Reshamwala N, Nguyen PT, Addo MM, Shea A, Newman M, Fikes J, Sidney J, Wentworth P, Chesnut R, Eldridge RL, Rosenberg ES, Robbins GK, Brander C, Sax PE, Boswell S, Flynn T, Buchbinder S, Goulder PJ, Walker BD, Sette A, Kalams SA. Identification of novel HLA-A2-restricted human immunodeficiency virus type 1-specific cytotoxic T-lymphocyte epitopes predicted by the HLA-A2 supertype peptide-binding motif. J Virol 2001; 75:1301-11. [PMID: 11152503 PMCID: PMC114036 DOI: 10.1128/jvi.75.3.1301-1311.2001] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2000] [Accepted: 10/30/2000] [Indexed: 01/01/2023] Open
Abstract
Virus-specific cytotoxic T-lymphocyte (CTL) responses are critical in the control of human immunodeficiency virus type 1 (HIV-1) infection and will play an important part in therapeutic and prophylactic HIV-1 vaccines. The identification of virus-specific epitopes that are efficiently recognized by CTL is the first step in the development of future vaccines. Here we describe the immunological characterization of a number of novel HIV-1-specific, HLA-A2-restricted CTL epitopes that share a high degree of conservation within HIV-1 and a strong binding to different alleles of the HLA-A2 superfamily. These novel epitopes include the first reported CTL epitope in the Vpr protein. Two of the novel epitopes were immunodominant among the HLA-A2-restricted CTL responses of individuals with acute and chronic HIV-1 infection. The novel CTL epitopes identified here should be included in future vaccines designed to induce HIV-1-specific CTL responses restricted by the HLA-A2 superfamily and will be important to assess in immunogenicity studies in infected persons and in uninfected recipients of candidate HIV-1 vaccines.
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Affiliation(s)
- M A Altfeld
- Partners AIDS Research Center and Infectious Disease Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Boswell S. Building the dental dream team: behavioral styles in the practice. J Contemp Dent Pract 2000; 1:76-85. [PMID: 12167884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
There are four different behavioral styles evident in a dental team and in patients. The styles are based on observable behaviors relating to degrees of "assertiveness" and "responsiveness." The Behavioral Style model helps to clarify why some people relate positively with each other and why others may conflict. Using finely tuned observational skills and an understanding of these styles, interpersonal transactions can be more effective, dental teams become more cohesive, and patients will be more satisfied with service provided in the dental practice. Each member of the team should understand his/her own personal style and those of teammates. Once that understanding is gained by all, it may be effectively applied to understanding patients. Behavior modification is at the heart of this concept. Adjusting your own behavior to the needs of others enables a patient to achieve more comfort with the dental team, and they are more likely to hear your verbal messages.
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Mayer KH, Kwong J, Singal R, Boswell S. Non-occupational postexposure HIV prophylaxis: clinical issues and public health questions. Med Health R I 2000; 83:210-3. [PMID: 10934823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Affiliation(s)
- K H Mayer
- Infectious Disease Division, Memorial Hopsital of RI, Pawtucket 02960, USA.
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Mayer KH, Boswell S, Goldstein R, Lo W, Xu C, Tucker L, DePasquale MP, D'Aquila R, Anderson DJ. Persistence of human immunodeficiency virus in semen after adding indinavir to combination antiretroviral therapy. Clin Infect Dis 1999; 28:1252-9. [PMID: 10451162 DOI: 10.1086/514775] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Changes in human immunodeficiency virus (HIV) type 1 concentration and protease genotype were evaluated in semen specimens from 22 HIV-positive men before and 6 months after the addition of indinavir to dual nucleoside therapy. Seminal HIV was detected by polymerase chain reaction analysis for DNA or RNA for 59% of men before combination treatment and persisted at 6 months for 31% of the men who initially had seminal HIV detected (P = .026). The maximum levels of cell-free RNA, cell-associated RNA, and proviral DNA in semen before treatment and at 6 months were 400,000 and 10,000 copies/mL, 70,000 and 27,000 copies/mL, and 80,000 and 3,000 copies/mL, respectively. Three of the four men with persistent seminal DNA had plasma viral loads of > 10,000 copies/mL before treatment. One patient who became intolerant to indinavir had seminal HIV RNA detected by PCR analysis after 6 months. Although none of the cultures of semen specimens from the four men with PCR analysis-detectable seminal DNA after 6 months yielded HIV, indinavir resistance mutations were identified in a seminal leukocyte DNA specimen from one patient, and a second patient whose therapy was switched to saquinavir had different protease inhibitor resistance mutations in seminal and blood leukocyte DNA specimens. HIV-1 protease inhibitor resistance mutants may emerge in the semen of patients receiving combination therapy.
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Affiliation(s)
- K H Mayer
- Fenway Community Health Center, Brigham and Women's Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston, USA.
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Boswell S. Unmasking patient attitudes: the case for patient immersion. J Gt Houst Dent Soc 1998; 70:21-2. [PMID: 9855843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Stone VE, Clarke J, Lovell J, Steger KA, Hirschhorn LR, Boswell S, Monroe AD, Stein MD, Tyree TJ, Mayer KH. HIV/AIDS patients' perspectives on adhering to regimens containing protease inhibitors. J Gen Intern Med 1998; 13:586-93. [PMID: 9754513 PMCID: PMC1497015 DOI: 10.1046/j.1525-1497.1998.00180.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To gather qualitative data regarding HIV/AIDS patients' perspectives about HIV-1 protease inhibitors (PIs), and about their experiences taking and adhering to regimens containing PIs. DESIGN Six focus groups of persons under care for HIV were conducted between September and November 1996 regarding participants' knowledge, awareness, experiences when taking, and adherence to antiretroviral regimens containing PIs. An identical discussion guide was used to facilitate all six groups. Focus group proceedings were audiotaped, transcribed, coded for themes, and analyzed qualitatively. SETTING HIV/AIDS practices of three teaching hospitals and two community health centers. PATIENTS/PARTICIPANTS Fifty-six patients with HIV disease: 28 men and 28 women. MEASUREMENTS AND MAIN RESULTS Knowledge and positive impressions of PIs were prevalent among this diverse group of persons with HIV, and did not differ by race/ethnicity or gender. Most knew that these were new, potent medications for treating HIV/AIDS. Networks of persons with HIV and medical providers were the most important information sources. Those taking PIs were aware that adherence to the regimen is important, and most were using special strategies to maximize their own adherence, but expressed considerable frustration about the central role these medication regimens had assumed in their life. A subset who did not believe they would adhere to these regimens had declined treatment with them. Motivating factors for taking and adhering to these complex regimens were improving CD4 counts and viral loads and the patient-provider relationship. CONCLUSIONS Among those with HIV/AIDS, awareness of PIs and their effectiveness is substantial, owing to the impact of informal networks and medical providers. This early positive "reputation" of PIs may enhance motivation for adherence. Those who are taking PIs invest substantial effort adhering to these complex regimens, but resent the need to make medications the focus of their lives.
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Affiliation(s)
- V E Stone
- Department of Medicine, Memorial Hospital of Rhode Island, Pawtucket 02860, USA
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Boswell S. Tailor your practice to what the customer wants. Dent Econ 1998; 88:76-8, 80-1. [PMID: 10200692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Katz M, Gerberding J, Boswell S. Post-sexual exposure prophylaxis: a roundtable discussion. AIDS Clin Care 1998; 10:9-11, 16. [PMID: 11365078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Boswell S. How did the Reader's Digest article affect patient's trust? Dent Econ 1997; 87:24-5, 63. [PMID: 9452605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- S Boswell
- Suzanne Boswell Presentations, Dallas, TX 75244-7100, USA.
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Boswell S. Make patients think, 'wow!'. Dent Econ 1997; 87:72-80. [PMID: 9452595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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23
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Boswell S. Understanding behavioral styles. The art of communicating with patients, peers. Dent Teamwork 1996; 9:22-5. [PMID: 9084243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Boswell S. Immersion: building a foundation for long-term patient relationships. J Calif Dent Assoc 1996; 24:37-43. [PMID: 9051988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The highest compliment a patient can give a dental staff is to say that they make him or her feel like part of the "family." Building this kind of positive long-term patient relationship begins with the first telephone contact. Taking the time to fully "immerse" the patient in the practice through confidence- and communication-building steps will help create a fulfilling patient-staff relationship.
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Hromas R, Boswell S, Shen RN, Burgess G, Davidson A, Cornetta K, Sutton J, Robertson K. Forced over-expression of the myeloid zinc finger gene MZF-1 inhibits apoptosis and promotes oncogenesis in interleukin-3-dependent FDCP.1 cells. Leukemia 1996; 10:1049-50. [PMID: 8667641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The myeloid zinc finger protein MZF-1 is important in hematopoiesis. Previous studies have found that reducing expression of MZF-1 inhibited G-CSF-driven human marrow colony formation assays. In this study we found that retrovirally overexpressing MZF-1 in IL-3-dependent FDCP.1 cells inhibited their apoptosis when IL-3 was withdrawn. The MZF-1-transduced FDCP.1 cells also formed tumors when injected into congenic mice, whereas control FDCP.1 cells did not.
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Affiliation(s)
- R Hromas
- Division of Hematology/Oncology, Indiana University Medical Center, Indianapolis 46202, USA
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Boswell S. Cadaver organ donation and moral distress: a staff nurse's perspective. Semin Perioper Nurs 1996; 5:98-101. [PMID: 8718402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Current advancements in medical science, such as the progress seen in the area of organ transplantation, brings with it many ethical dilemmas for which there are no precedents. Obtaining informed consent for cadaver organ donation requires perioperative nurses to confront the moral responsibility that they have to their patients, their patients' families, and to the nursing profession as a whole. The perioperative nurse must question his or her own moral and cultural beliefs, face their own fears of death, and confront societal misconceptions about brain death. This evolution is emotionally demanding and often stresses one's support systems. However, with self-discovery and education, it can also be very rewarding.
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Boswell S. Unmasking the mystery patient. Dent Teamwork 1996; 9:12-7. [PMID: 9485655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Boswell S. Back to basics: staying in touch with the patient. J Esthet Dent 1995; 7:41-3. [PMID: 8593233 DOI: 10.1111/j.1708-8240.1995.tb00559.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Boswell S. The patient's perspective. Tex Dent J 1994; 111:30-1. [PMID: 8633286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Boswell S. Managing patient perceptions: the first five minutes. J Esthet Dent 1994; 6:300-2. [PMID: 8593228 DOI: 10.1111/j.1708-8240.1994.tb00873.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Boswell S. Understanding your mystery patient. Tex Dent J 1994; 111:29-32. [PMID: 7940393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Boswell S. Building lasting relationships with your "mystery patients". J Gt Houst Dent Soc 1994; 65:8-10. [PMID: 9584732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
Cell suicide, or apoptosis, is now recognized as an essential regulatory step in such diverse developmental processes as embryogenesis, thymocyte restriction, and hematopoiesis. One of the major features of apoptosis is the activation of an endogenous nuclease that cleaves DNA into nucleosomal fragments. Little is known about the activation or specificity of the apoptotic endonuclease. In this study, we investigated signalling pathways and the specificity of the apoptotic nuclease. We found that forced over-expression of activated H-ras inhibited activation of the apoptotic endonuclease. Since a high percentage of myelodysplasias and leukemias have mutations that activate ras, this finding lends insight into how ras might be leukemogenic. In addition, the phorbol ester TPA and a cyclic AMP analogue also slowed activation of this endonuclease. Interestingly, protein synthesis inhibition stimulated the endonuclease activity. In addition, by cloning and sequencing apoptotic fragments we found that the apoptotic nuclease has no sequence specificity. Thus, the apoptotic nuclease inhibited by H-ras over-expression was random in nature.
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MESH Headings
- 8-Bromo Cyclic Adenosine Monophosphate/pharmacology
- Animals
- Apoptosis/drug effects
- Apoptosis/genetics
- Apoptosis/physiology
- Base Composition
- Blotting, Northern
- Cell Line
- Cycloheximide/pharmacology
- DNA, Neoplasm/genetics
- DNA, Neoplasm/isolation & purification
- Endodeoxyribonucleases/antagonists & inhibitors
- Gene Expression
- Genes, ras
- Leukemia, Experimental
- Leukemia, Myeloid
- Mice
- Nucleosomes/metabolism
- Point Mutation
- Poly A/genetics
- Poly A/isolation & purification
- Promoter Regions, Genetic
- RNA/genetics
- RNA/isolation & purification
- RNA, Messenger
- Repetitive Sequences, Nucleic Acid
- Sequence Homology, Nucleic Acid
- Thymidine Kinase/genetics
- Transfection
- Tumor Cells, Cultured
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Affiliation(s)
- J Moore
- Department of Medicine, Walther Oncology Center, Indiana University Medical Center, Indianapolis 46252-5121
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Boswell S. Getting and keeping your mystery patient. Tex Dent J 1993; 110:23-5. [PMID: 8332953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Girasole G, Jilka R, Passeri G, Boswell S, Boder G, Williams D, Manolagas S. 92093839 17-Estradiol inhibits interleukin-6 production by bone marrow-derived stromal cells and osteoblasts in vitro: A potential mechanism for the antiosteoporotic effect of estrogens. Maturitas 1992. [DOI: 10.1016/0378-5122(92)90260-b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Girasole G, Jilka RL, Passeri G, Boswell S, Boder G, Williams DC, Manolagas SC. 17 beta-estradiol inhibits interleukin-6 production by bone marrow-derived stromal cells and osteoblasts in vitro: a potential mechanism for the antiosteoporotic effect of estrogens. J Clin Invest 1992; 89:883-91. [PMID: 1541679 PMCID: PMC442934 DOI: 10.1172/jci115668] [Citation(s) in RCA: 434] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The effect of 17 beta-estradiol on interleukin-6 (IL-6) synthesis was examined in murine bone marrow-derived stromal cell lines, normal human bone-derived cells, and nontransformed osteoblast cell lines from mice and rats. In all these cell types IL-6 production was stimulated as much as 10,000-fold in response to the combination of recombinant interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF alpha). Addition of 17 beta-estradiol in the cultures exerted a dose-dependent inhibition of IL-1-, TNF-, and IL-1 + TNF-induced production of bioassayable IL-6. Testosterone and progesterone (but not 17 alpha-estradiol) also inhibited IL-6, but their effective concentrations were two orders of magnitude higher than 17 beta-estradiol. 17 beta-estradiol also decreased the levels of the IL-6 mRNA. In addition, estradiol inhibited both TNF-induced IL-6 production and osteoclast development in primary bone cell cultures derived from neonatal murine calvaria. The TNF-stimulated osteoclast development was also suppressed by a neutralizing monoclonal anti-IL-6 antibody. This in vitro evidence suggests, for the first time, a mechanistic paradigm by which estrogens might exert at least part of their antiresorptive influence on the skeleton.
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Affiliation(s)
- G Girasole
- Section of Endocrinology and Metabolism, Veteran's Administration Medical Center, Indianapolis, Indiana 46202
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Cantor D, Jernigan S, Cantor W, Boswell S. Assessment of brain dysfunction: Concordance of neurometric and neuropsychological findings. Arch Clin Neuropsychol 1992. [DOI: 10.1093/arclin/7.4.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lehmann JF, Boswell S, Price R, Burleigh A, deLateur BJ, Jaffe KM, Hertling D. Quantitative evaluation of sway as an indicator of functional balance in post-traumatic brain injury. Arch Phys Med Rehabil 1990; 71:955-62. [PMID: 2241541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The test of sway, using different conditions of stance with measurements of the average radial deviation of the center of pressure and its path length of sway per unit of time, has been shown to be a useful clinical tool in determining balance problems in traumatic brain injury (TBI) patients. Normative values were established to determine if an individual patient's sway values fell within the normal range (mean +/- 2SD). The tests have shown good test-retest reliability for TBI patients. In addition, it has been shown that the sensitivity of the test is sufficient to identify changes in patients' performances as their clinical conditions change. It has been demonstrated that the different stance conditions of the battery of tests become progressively more difficult to perform (from comfortable stance, eyes open and eyes closed, through narrow stance, eyes open and eyes closed, to tandem stance with right or left foot forward, eyes open and eyes closed). By using these subtests, it is easy to distinguish between the performances of able-bodied patients and TBI patients with very mild balance problems. The validity of the measure has been documented by correlating the sway performance with clinical functional performance tests. The test performance also correlates with the patient's own assessment of his or her gait difficulties. The limited data available suggest that the test of sway relates difficulties in static balance to the frequency of falls. Finally, subtests permit identification of specific problems in maintaining balance as a basis for therapeutic intervention.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J F Lehmann
- Department of Rehabilitation Medicine, University of Washington, Seattle 98195
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Boswell S. What do you say before you say hello? J Calif Dent Assoc 1990; 18:25-8. [PMID: 1708419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Thanos C, Friedman MH, Sorensen J, Winter RR, Boswell S. 1990 USC esthetic dentistry symposium. J Calif Dent Assoc 1990; 18:13-7. [PMID: 1708417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Elias L, Hoffman R, Boswell S, Tensen L, Bonnem EM. A trial of recombinant alpha 2 interferon in the myelodysplastic syndromes: I. Clinical results. Leukemia 1987; 1:105-10. [PMID: 3478534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Interferon has been reported to have differentiation promoting effects in certain model systems. Because of this and other potentially beneficial effects, a trial of recombinant alpha 2 interferon was undertaken in myelodysplastic syndromes. The study population consisted of 14 patients, subclassified as two refractory anemia (RA), one RA with ring sideroblasts (RARS), nine RA with excess blasts (RAEB), and two chronic myelomonocytic leukemia (CMMoL). The planned dosage schedule was 2.0 MU/M2 t.i.w. sc x 2 weeks q 4 weeks for at least two cycles. No patient achieved the prospective remission criteria, which included sustained blood count improvements. Transient improvements of platelet counts of greater than 50% in baseline were noted in six patients, and a transient antileukemic effect was noted in one patient with CMMoL. Myelodysplastic syndrome patients were found to be sensitive to the count suppressing effects of alpha 2 interferon with greater than 25% suppression of granulocytes, platelets, or reticulocytes transiently noted in 11 patients and decreasing bone marrow cellularity noted in two while on treatment. Because of these effects, dosage adjustments were frequently instituted in the RA, RARS, and RAEB patients. The average dosages and durations of treatment received were thus 1.48 MU/M2 x 19.4 injections for patients with RA, RARS, and RAEB and 2.25 MU/M2 x 27 injections for the CMMoL patients. Progression to acute myeloid leukemia or RAEB in transformation was noted in five patients, and increasing leukocytosis was noted in one CMMoL patient while on protocol. It cannot be determined at this time whether these transformations were accelerated by alpha 2 interferon or represent selection bias in this study population. Although some evidence of beneficial effects was noted, alpha 2 interferon in this dosage and schedule is not a useful treatment for myelodysplastic syndromes.
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Affiliation(s)
- L Elias
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque
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Katz PA, Boswell S. Flexibility and traditionality in children's gender roles. Genet Soc Gen Psychol Monogr 1986; 112:103-47. [PMID: 3732785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The present study examined the correlates of variability in children's gender-role preferences. A multidimensional test battery assessed the traditionality of preferences of 376 kindergarten and third grade children in five different gender role domains, and elicited information about three significant socialization agents (parents, peers, and media). Parents of the children (N = 358) were also interviewed with regard to their attitudes and sex role socialization practices. Predictions were generated from an existing theoretical developmental model. Boys exhibited stronger sex-typed preferences than did girls. Older girls were more flexible and older boys less flexible than were their younger counterparts. In accordance with prediction, two factors were obtained; the first relevant to current gender-related activities, the other to future expectations. Present-oriented gender preferences correlated best with peer perceptions, whereas future expectations (e.g. job aspirations) were best predicted by media choices. Parental data correlated with children's preferences but not as strongly as did the peer and media scales. Predictability of children's gender-role orientations was reasonably high when a number of factors were included, thus supporting the utility of a multidimensional approach.
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