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Inpatient Understanding of Their Care Team and Receipt of Mixed Messages: a Two-Site Cross-Sectional Study. J Gen Intern Med 2023; 38:2703-2709. [PMID: 36973573 PMCID: PMC10042424 DOI: 10.1007/s11606-023-08178-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Patient understanding of their care, supported by physician involvement and consistent communication, is key to positive health outcomes. However, patient and care team characteristics can hinder this understanding. OBJECTIVE We aimed to assess inpatients' understanding of their care and their perceived receipt of mixed messages, as well as the associated patient, care team, and hospitalization characteristics. DESIGN We administered a 30-item survey to inpatients between February 2020 and November 2021 and incorporated other hospitalization data from patients' health records. PARTICIPANTS Randomly selected inpatients at two urban academic hospitals in the USA who were (1) admitted to general medicine services and (2) on or past the third day of their hospitalization. MAIN MEASURES Outcome measures include (1) knowledge of main doctor and (2) frequency of mixed messages. Potential predictors included mean notes per day, number of consultants involved in the patient's care, number of unit transfers, number of attending physicians, length of stay, age, sex, insurance type, and primary race. KEY RESULTS A total of 172 patients participated in our survey. Most patients were unaware of their main doctor, an issue related to more daily interactions with care team members. Twenty-three percent of patients reported receiving mixed messages at least sometimes, most often between doctors on the primary team and consulting doctors. However, the likelihood of receiving mixed messages decreased with more daily interactions with care team members. CONCLUSIONS Patients were often unaware of their main doctor, and almost a quarter perceived receiving mixed messages about their care. Future research should examine patients' understanding of different aspects of their care, and the nature of interactions that might improve clarity around who's in charge while simultaneously reducing the receipt of mixed messages.
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Communicative appeals and messaging frames in visual media for HIV pre-exposure prophylaxis promotion to cisgender and transgender women. CULTURE, HEALTH & SEXUALITY 2023; 25:1007-1023. [PMID: 36074902 PMCID: PMC9992445 DOI: 10.1080/13691058.2022.2116111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Women in the USA represent 15% of new HIV diagnoses but only 5% of pre-exposure prophylaxis (PrEP) users. We sought to characterise communicative appeals and messaging frames used in US visual media to cultivate PrEP demand among cisgender and transgender women using content analysis methodology. We catalogued and coded media items (images and videos) from US PrEP marketing campaigns featuring women. Production and content characteristics were abstracted, and communicative appeals from media items were qualitatively coded in duplicate. We then descriptively summarised production and content characteristics and identified discrete subgroups of media items, clustering around specific messaging frames, through qualitative thematic analysis. Racial/ethnic minorities and sexual/gender minority women were heavily featured, and numerous media items leveraged cognitive and social communicative appeals to promote PrEP. We identified three unique messaging frames emerging from coded media items, portraying PrEP as: (1) necessary prevention (protection frame), (2) a desirable yet accessible commodity (aspiration frame), and (3) a conduit to sexual autonomy (empowerment frame). To effectively communicate PrEP information and promote PrEP to women, PrEP marketing should leverage alternative appeals (subjective norms, self-efficacy), address anticipated barriers to uptake (stigma, cost, medication interactions), and deconstruct misconceptions of PrEP use(rs).
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Dark Energy Survey year 3 results: Constraints on cosmological parameters and galaxy-bias models from galaxy clustering and galaxy-galaxy lensing using the redMaGiC sample. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.043520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Provider Perspectives on HIV Pre-Exposure Prophylaxis Service Disruptions and Adaptations During the COVID-19 Pandemic in Baltimore, Maryland: A Qualitative Study. AIDS Patient Care STDS 2022; 36:313-320. [PMID: 35951445 PMCID: PMC9419971 DOI: 10.1089/apc.2022.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The COVID-19 pandemic continues driving unprecedented disruptions to health care provision, including HIV pre-exposure prophylaxis (PrEP) services. We explored service provider experiences promoting and prescribing PrEP to marginalized populations during the COVID-19 pandemic in Baltimore, Maryland. In February to April 2021, we facilitated four virtual focus group discussions with 20 PrEP providers, representing various professional cadres and practice settings. Employing an iterative, team-based thematic analysis, we identified salient enablers and constraints to PrEP promotion, initiation, and maintenance in the COVID-19 era, along with innovative adaptations to PrEP service delivery. Discussants described attenuated demands for PrEP early in the pandemic, exemplified by high PrEP discontinuation rates. This was attributed to changes in clients' sexual behaviors and shifting priorities, including caregiving responsibilities, during the pandemic. Substantial systems-level disruptions impacting PrEP provision were identified, including outreach service suspension, personnel shortages, and facility restrictions on face-to-face visits. Providers emphasized that these disruptions, though occurring early in the pandemic, had protracted impacts on PrEP accessibility. The transition to telemedicine rendered health care services, including PrEP, more accessible/convenient to some clients and expeditious to providers. However, structural barriers to telehealth engagement (telephone/internet access), coupled with limitations of the virtual care environment (difficulty establishing rapport), impeded efforts to equitably promote and prescribe PrEP. Expanding the PrEP outreach workforce and availing alternatives to telemedicine (e.g., community-based PrEP provision, specimen self-collection) could facilitate PrEP care continuity, especially as COVID-19 transitions from an acute to a protracted health crisis.
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National trends in post-launch cancer prescription drug prices and the impact of generic entry, 2014-2020. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.6598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6598 Background: The high prices of branded ‘on patent’ cancer prescription drugs and the impact of competition on them is of importance to patients, physicians, payers and policymakers. The objective of this study is to quantify trends in the prices of all currently approved cancer drugs and to evaluate the impact of loss of exclusivity and generic entry on prices using national and contemporaneous data. Methods: Observational study of cancer drug prices from the IQVIA National Sales Perspectives from January 2014 to December 2020. The compound annual growth rate (CAGR) of drug prices was calculated for branded and generic drugs by therapeutic class (chemotherapy, targeted therapy, and supportive therapy). An event study empirical strategy and ordinary least squares regression was used to determine the relationship between the natural logarithm of prices and loss of exclusivity and generic entry. Results: The study cohort included 184 cancer drugs (37% chemotherapy, 51% targeted therapy, and 12% supportive therapy), of which 105 were always branded, 18 were always generic and 18 underwent loss of exclusivity and generic entry during the study period. Prices of branded chemotherapies and targeted therapies increased by 2.24% (0.79% CPI-adjusted) and 2.83% (1.07% CPI-adjusted) annually, whereas generics decreased by 12.63% (-14.14% CPI-adjusted) and 20.15% (-21.57% CPI-adjusted), respectively. Prices of branded supportive therapies decreased by 0.73% (-2.40% CPI-adjusted), while generics increased by 1.28% but decreased with CPI-adjustment (-0.45). Loss of exclusivity and generic entry was associated with statistically significant decreases in generic drug prices, but increases in branded drug prices after CPI-adjustment; these effects are concentrated in chemotherapies and targeted therapies. Conclusions: We found that cancer drug prices increased, after adjusting for inflation, particularly among branded chemotherapies and targeted therapies. Generic entry mitigates these price increases, but only a handful of cancer drugs experienced competition in the study period. Drug prices are key determinants of cancer-related spending, and many cancer patients remain underinsured. Although this data reflects net prices before discounts to providers and pharmacies, patient out-of-pocket costs are based on the list price. Our findings are critical to informing current efforts to improve cancer treatment affordability.
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Dark Energy Survey Year 3 results: Cosmological constraints from galaxy clustering and weak lensing. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.023520] [Citation(s) in RCA: 106] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Dark Energy Survey Year 3 results: Cosmology from cosmic shear and robustness to data calibration. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.023514] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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1346 Hardware Complications in Cephalomedullary Nailing for Intertrochanteric Hip Fractures: A Retrospective Cohort Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Intertrochanteric hip fractures are common injuries in elderly patients and can result in significant morbidity. The use of cephalomedullary femoral nailing (CMN) has gained popularity, particularly for unstable fracture patterns. We investigated hardware complications and mortality of patients undergoing long and short CMN for intertrochanteric hip fractures.
Method
We conducted a retrospective cohort study of consecutive cases in a single UK-based trauma unit between 01 July 2016 – 31 Dec 2019. Primary outcome measures were implant failure and revision surgery. The secondary outcome measure was mortality.
Results
335 patients were included, mean age 82.9 years. 176 long (LN) and 167 short (SN) CMNs were performed. 25/335 (7.5%) hardware complications occurred resulting in 19 (5.7%) revision surgeries. Overall implant survivorship was 94.3%. There was no statistically significant difference in implant survivorship between LN and SN (p = 0.93), or between proximal screw configuration (p = 0.20). Cox regression analysis did not identify any independent predisposing factors leading to hardware complications. 30-day, 90-day and 1-year mortality rates were 7.9%, 15.2% and 26.5% respectively. There was no significant difference in mortality between LN and SN (p = 0.53). Regression analysis identified age and male gender as statistically significant independent factors of increased mortality.
Conclusions
For intertrochanteric fractures, there is no difference in hardware complications or mortality between long and short cephalomedullary nails. We highlight the risk of implant fracture at the lag screw-nail interface; accounting for one-quarter of failures. The revision rate of 5.7% due to hardware failure should be a consideration for surgeons undertaking CMN for intertrochanteric fractures.
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Dark Energy Survey Year 1 Results: Cosmological Constraints from Cluster Abundances, Weak Lensing, and Galaxy Correlations. PHYSICAL REVIEW LETTERS 2021; 126:141301. [PMID: 33891448 DOI: 10.1103/physrevlett.126.141301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/07/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
We present the first joint analysis of cluster abundances and auto or cross-correlations of three cosmic tracer fields: galaxy density, weak gravitational lensing shear, and cluster density split by optical richness. From a joint analysis (4×2pt+N) of cluster abundances, three cluster cross-correlations, and the auto correlations of the galaxy density measured from the first year data of the Dark Energy Survey, we obtain Ω_{m}=0.305_{-0.038}^{+0.055} and σ_{8}=0.783_{-0.054}^{+0.064}. This result is consistent with constraints from the DES-Y1 galaxy clustering and weak lensing two-point correlation functions for the flat νΛCDM model. Consequently, we combine cluster abundances and all two-point correlations from across all three cosmic tracer fields (6×2pt+N) and find improved constraints on cosmological parameters as well as on the cluster observable-mass scaling relation. This analysis is an important advance in both optical cluster cosmology and multiprobe analyses of upcoming wide imaging surveys.
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Abstract
INTRODUCTION The COVID-19 pandemic has had a huge impact on all our lives, both personally and professionally, and in many ways has been a catalyst for change. Limitations on social gathering have called the wisdom of a conventional trauma meeting into question. We have initiated our virtual trauma meeting and report our early results. MATERIALS AND METHODS Daily morning trauma meetings are now conducted online. Following instigation, we collated the results of a feedback form completed online to assess the relative merits of a virtual trauma meeting. RESULTS There were 27 responses received to the electronically administered virtual trauma meeting evaluation survey, from a range of trauma and orthopaedic department personnel. There were no concerns regarding patient safety or decision making and, apart from the quality of the audio (63% dissatisfied or very dissatisfied) positive feedback outweighed negative feedback in every category. At 74%, the majority of respondents were satisfied or very satisfied overall with the virtual trauma meeting. CONCLUSION Trauma meetings can be safely conducted in a virtual environment with high standards of patient care maintained. Virtual trauma meeting offers service enhancements such as early subspecialty input and enhanced cross-site communication and rapid solution development to logistical difficulties. Adapting to conference call etiquette will enhance user experience and opportunity for training opportunities, but adequate investment in high-quality equipment is essential.
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Revision total knee arthroplasty longer term outcome and comparison between infection and aseptic loosening at mean follow-up of 10 years. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720971839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Although the majority of total knee arthroplasty cases have good outcome and survival, some arthroplasty eventually required revision. While early outcomes of revision knee arthroplasty are well reported, there is relatively fewer literatures reporting on the longer term outcome of revision knee arthroplasty. This study aims to review the outcome of revision knee arthroplasty for a longer term, and also make comparison between the two common indications for revision arthroplasty of infection and aseptic loosening. Methods: This study reviews all total knee arthroplasty revision performed at a single center over a 11 year period. Of the 48 cases found, 35 cases not lost to follow-up had a mean follow-up duration of 10.6 years (SD 2.9) for aseptic loosening, and 10.1 years (SD 2.6) for infection. Data of initial arthroplasty, revision arthroplasty, demographics, follow-up outcome were obtained, analyzed and compared. Results: Revision arthroplasty due to infection had more cases that required use of varus/valgus constraints (p ∼ 0.008) and extensile surgical exposure of quadriceps snip (p ∼ 0.005) compared to aseptic loosening. The survival at 10 years for this study is 91% overall (aseptic loosening 93.3%, infection 89.3%). Infection cases had significant initial improvement for range of motion (p ∼ 0.001) and use of walking aid (p ∼ 0.04) at post-operation 1 year, but no significant differences between the infection and aseptic loosening cases at 5 years and 10 years follow-up. Comparison between the two groups on other factors including initial arthroplasty, operative details, demographics, post-operative details and X-rays showed no statistically significant difference.
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Dark Energy Survey Year 1 Results: Cosmological constraints from cluster abundances and weak lensing. Int J Clin Exp Med 2020. [DOI: 10.1103/physrevd.102.023509] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Comparison of facet joint violation in lumbar posterior spinal instrumentation using different techniques including cortical bone trajectory. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720903471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Study background: A retrospective study to compare the rate of facet joint violation (FJV) in lumbar posterior spinal instrumentation using open pedicle screw, percutaneous pedicle screw, and cortical bone trajectory (CBT) technique. CBT is a new posterior spinal instrumentation technique in which a more caudal entry point can minimize iatrogenic damage to the cranial facet joint. Only one recent study reports incidence of FJV of 11%; however, no previous reports comment on radiological outcomes comparing to traditional open and percutaneous screws. Methods: We reviewed 90 patients who underwent lumbar posterior spinal instrumentation from January 2016 to June 2017. Postoperative computer tomography scans were performed to evaluate FJV. Incidence of FJV was graded by three reviewers according to Seo classification. Results: Totally, 446 screws (open 43.4%, percutaneous 37.8%, CBT 18.9%) were inserted. Among these, 6.3% (28/446) had screw head or rod in contact with facet joint and 0.9% (4/446) had screws directly invaded the facet joint. Overall, FJV was 7.2% (CTB = 3.4%, open = 10.4%, and percutaneous = 4.5%, p = 0.075). Conclusion: CBT technique has potential advantage in reducing FJV. It has a unique entry site at lateral aspect of pars interarticular with a caudomedial to craniolateral pathway. It is a reasonable alternative to open or percutaneous techniques in lumbar posterior spinal instrumentation.
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Abstract
We introduce Pepper (Protein complex Expansion using Protein–Protein intERactions), a Cytoscape app designed to identify protein complexes as densely connected subnetworks from seed lists of proteins derived from proteomic studies. Pepper identifies connected subgraph by using multi-objective optimization involving two functions: (i) the coverage, a solution must contain as many proteins from the seed as possible, (ii) the density, the proteins of a solution must be as connected as possible, using only interactions from a proteome-wide interaction network. Comparisons based on gold standard yeast and human datasets showed Pepper’s integrative approach as superior to standard protein complex discovery methods. The visualization and interpretation of the results are facilitated by an automated post-processing pipeline based on topological analysis and data integration about the predicted complex proteins. Pepper is a user-friendly tool that can be used to analyse any list of proteins. Availability: Pepper is available from the Cytoscape plug-in manager or online (http://apps.cytoscape.org/apps/pepper) and released under GNU General Public License version 3. Contact: mohamed.elati@issb.genopole.fr Supplementary information:Supplementary data are available at Bioinformatics online.
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O-029 The Importance of Core Infarct Volume in the Number Needed to Treat in Endovascular Therapy for Acute Ischemic Stroke. J Neurointerv Surg 2014. [DOI: 10.1136/neurintsurg-2014-011343.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Teaching and Learning Guide for: The Chinese Personality Assessment Inventory as a Culturally Relevant Personality Measure in Applied Settings. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2009. [DOI: 10.1111/j.1751-9004.2009.00215.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Necrotic Cells Induce Systemic Autoimmune Disease in vivo by Activation of Dendritic Cells (DCs). J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2005.01.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A comprehensive "Healthy Schools Programme" to promote school health: the Hong Kong experience in joining the efforts of health and education sectors. J Epidemiol Community Health 2003; 57:174-7. [PMID: 12594193 PMCID: PMC1732409 DOI: 10.1136/jech.57.3.174] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Both health and education are linked to economic performance. The success of education depends on good health, and vice versa. Modern education should help young people to determine values, and accept responsibility for their health and social behaviour. The success of health promotion in schools requires the joint efforts of both the health and education sectors. A comprehensive programme is needed to include teachers' training, curriculum development, community participation, changing policies and practices, and research. All these components are needed to build up a successful model of a health promoting school. The "Healthy Schools Programme" in Hong Kong gives a good example of close partnership between the health and education sectors, and moves towards a multidisciplinary approach and active learning towards health promotion.
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Abstract
The advantages of using 1, 96, or 384 precision glass syringes in automated high-throughput microdispensers in creating highly uniform and reproducible DNA, protein, and organic compound array filters and slides are described. Using the Hydra Microdispenser and Tango Liquid Handling system, 0.1-5 ng (in 50-300 nL) PCR-amplified, human cancer-related genes and housekeeping genes were spotted onto nylon membranes and coated slides. Protein solutions of 50 microg/mL to 1 mg/mL were spotted onto coated slides or onto MaxiSorp 96-well plates. Up to 6144 spots/membrane and up to 1000 spots/slide were printed. The size of the spots created by glass syringes was uniform and reproducible (precision variation of less than 5%) from spot to spot and membrane to membrane. Using a Tango 384 system, a total of ten 6144-spot filters can be produced in approximately 25 min, translating into a spotting speed of 2.5 min/membrane.
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Effect of renin-angiotensin system blockade on the expression of the angiotensinogen gene and induction of hypertrophy in rat kidney proximal tubular cells. EXPERIMENTAL NEPHROLOGY 2001; 9:109-17. [PMID: 11150859 DOI: 10.1159/000052601] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Studies have shown that high levels of glucose and angiotensin II (Ang II) stimulate hypertrophy and the expression of matrix protein genes in mouse proximal tubular cells in vitro. The present study tested the hypothesis that blockade of the renin-angiotensin system (RAS) inhibits the stimulatory effect of high levels of glucose on the expression of the renal angiotensinogen (ANG) gene and the formation of Ang II and subsequently attenuates the induction of hypertrophy in kidney proximal tubular cells. Immortalized rat proximal tubular cells (IRPTC) were cultured in monolayer. The levels of expression of rat ANG and ANG mRNA in the IRPTC were quantified by specific radioimmunoassays for rat ANG (RIA-rANG) and by a reverse-transcription polymerase chain reaction (RT-PCR) assay, respectively. Hypertrophy of IRPTC was analyzed by flow cytometry (FACScan) and cellular protein assay. Our studies showed that losartan (an Ang II (AT(1))-receptor blocker), perindopril and captopril (inhibitors of angiotensin-converting enzyme) blocked the stimulatory effect of a high level of glucose (i.e. 25 mM) on the expression of the rat ANG gene and hypertrophy in IRPTC but not by the Ang II (AT(2))-receptor blocker. Our studies indicate that the blockade of RAS is effective in inhibiting the stimulatory effect of hyperglycemia on the expression of the ANG gene and hypertrophy in IRPTC, supporting the notion that the local formation of intrarenal Ang II may play a role in the development of renal hypertrophy during early diabetes.
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Older school children are not necessarily healthier: analysis of medical consultation pattern of school children from a territory-wide School Health Surveillance. Public Health 2001; 115:30-7. [PMID: 11402349 DOI: 10.1038/sj/ph/1900715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2000] [Indexed: 11/09/2022]
Abstract
It is important to maintain the health of our school children as health is a major factor affecting learning. In developed countries, we assume that school children, especially in higher grades, are healthy because they are relatively free of diseases. However, many of the health problems encountered by school children are not reported in routine health data as they seek help in primary care or by self-medication. In this paper, the medical consultation pattern of school children in Hong Kong was analyzed. It was revealed that school children had a high rate of consultation and self-medication, and the health status of older school children is not better. They were not offered adequate preventive advice. The piecemeal approach to focus on curative medicine will only lead to a high rate of episodic consultation and self-medication without empowering the young people with the skills of self-care and self-help, and positive health behavior. The concept of a health-promoting school with emphasis on more extra-curricular health promotion activities, improved communication between health and education sectors, active involvement by pupils and parents, and changing policies and practices would help to make the co-ordinated school health program a greater success.
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Abstract
BACKGROUND Analysis of tear proteins is of diagnostic value for abnormal ocular conditions such as dry eye syndrome. Many studies of tear proteins have been performed on Caucasian subjects. However, little is known about these proteins in Chinese eyes. METHODS The total tear protein concentrations of 30 normal young Hong Kong Chinese were determined by the Bradford method and the modified Lowry method. Bovine serum albumin (BSA) and bovine immunoglobulin G (IgG) were both used as standards for each method. The tear protein patterns were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and the concentrations of major tear proteins were quantified by scanning densitometry after SDS-PAGE. RESULTS The mean +/- SD total tear protein concentrations determined by the Bradford method, using BSA and IgG as standards, were 6.05 +/- 1.58 mg/ml and 11.48 +/- 2.32 mg/ml respectively. The values determined by the modified Lowry method, using the same two standards, were 9.66 +/- 2.03 mg/ml and 7.53 +/- 1.80 mg/ml respectively. The mean +/- SD concentrations of major tear proteins were 2.73 +/- 0.82 mg/ml for lactoferrin, 0.021 +/- 0.028 mg/ml for human serum albumin, 2.89 +/- 0.88 mg/ml for tear-specific prealbumin and 2.46 +/- 0.44 mg/ml for lysozyme. CONCLUSION The results of total tear protein concentrations indicated that values obtained from different methods and different standards were not comparable. The tear protein patterns of our subjects were qualitatively similar to those reported for Caucasian subjects. However, the concentrations of the major proteins of our subjects were not in accordance with those reported previously. The main reason may be the large variability of method used.
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Molecular mechanism(s) of insulin action on the expression of the angiotensinogen gene in kidney proximal tubular cells. J Renin Angiotensin Aldosterone Syst 2000; 1:166-74. [PMID: 11967809 DOI: 10.3317/jraas.2000.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
To investigate the molecular mechanism(s) of insulin action on the expression of the angiotensinogen (ANG) gene in kidney proximal tubular cells, we constructed a fusion gene, pOGH (hANG N-1064/+27), containing the 5'-flanking regulatory sequence of the human ANG gene fused with the human growth hormone (hGH) gene as a reporter and stably integrated the fusion gene into the opossum kidney (OK) cell genomes. The level of expression of pOGH (hANG N-1064/+27) was quantified by the amount of immunoreactive hGH secreted into the medium. The addition of a high level of D(+)-glucose (25 mM) or phorbol 12-myristate 13-acetate (PMA, 10(-7) M) stimulated the expression of the fusion gene in OK cells. The stimulatory effect of glucose (25 mM) was blocked by insulin and tolrestat (an inhibitor of aldose reductase). Tolrestat also inhibited the increase of cellular DAG and PKC activity stimulated by 25 mM glucose. While insulin did not affect the cellular DAG and PKC activity, it did block the stimulatory effect of high glucose (25 mM) and PMA on the expression of the fusion gene. Finally, PD98059 (an inhibitor of mitogen-activated protein kinase kinase (MEK)) enhanced the stimulatory effect of high levels of glucose and blocked the inhibitory effect of insulin on the expression of the fusion gene as well as on the phosphorylation of MEK and mitogen-activated protein kinase (MAPK). In contrast, Wortmannin (an inhibitor of phosphatidylinositol-3-kinase) did not block the inhibitory effect of insulin on the ANG gene expression. These studies demonstrate that the action of insulin, blocking the stimulatory effect of a high level of D(+)-glucose (25 mM) on the ANG gene expression is mediated, at least in part, via the 5'-flanking region of the ANG gene and MAPK signal transduction pathway.
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A "Healthy Schools" program in Hong Kong: enhancing positive health behavior for school children and teachers. EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2000; 13:399-403. [PMID: 14742066 DOI: 10.1080/135762800750059516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Thirty-day monitoring of insulin-like growth factors and their binding proteins in intensive care unit patients. Growth Horm IGF Res 1998; 8:455-63. [PMID: 10985757 DOI: 10.1016/s1096-6374(98)80298-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study investigates the regulation of the insulin-like growth factors (IGFs) and their regulatory proteins in 14 critically ill patients during the 30-day period following admission to an intensive care unit (ICU). Levels of IGF-I, IGF-II, IGF binding protein-3 (IGFBP-3) and acid-labile subunit (ALS) were low on admission, and in the 8 patients whose serum IGF-I levels failed to increase over 30 days, levels of the other proteins also remained low, while IGFBP-3 proteolytic activity increased. Of these proteins, ALS correlated best with serum levels of nutritional indicators, particularly prealbumin. IGFBP-2 and IGFBP-6 levels tended to be high in critically ill patients, but showed little change over the 30-day period. In contrast, IGFBP-1 levels were high on admission, correlated with early changes in nitrogen balance, and fell rapidly during the first week. By demonstrating that the IGF-I response in ICU patients is related to changes in the IGF regulatory proteins, this study may be of value in planning therapeutic intervention using growth hormone or IGF-I.
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Differential expression of Met/hepatocyte growth factor receptor in subtypes of non-small cell lung cancers. Lung Cancer 1998; 20:1-16. [PMID: 9699182 DOI: 10.1016/s0169-5002(98)00007-5] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hepatocyte growth factor (HGF)/scatter factor (SF) is a multifunctional factor that stimulates epithelial cell motility, invasion and morphogenesis. Its receptor is a transmembrane tyrosine kinase encoded by the Met proto-oncogene. Several studies have suggested a possible role for HGF/Met in tumor development and progression. To investigate the potential roles of Met in human lung cancer biology, we have studied the mRNA and protein expression of Met in normal lung tissue, primary non-small cell lung carcinoma (NSCLC), and NSCLC cell lines. The results indicated a differential pattern of Met expression among various subtypes of NSCLC. The majority of squamous cell carcinoma (SQCC), either in vivo or in vitro, expressed Met mRNA and its protein product at levels much lower than or similar to normal lung tissue or bronchial epithelium. Moreover, SQCC characteristically over-expressed a variant Met mRNA which corresponds to a 5' partially deleted transcript produced by alternative splicing. In contrast, the expression of Met mRNA and its protein product in adenocarcinoma (ADC) and large cell undifferentiated carcinoma were more heterogeneous. Overexpression was demonstrated in approximately 35% and 20% of these subtypes of NSCLC, respectively. Among ADC, intermediate to high levels of Met immunoreactivity correlated with greater degree of tumor differentiation. Furthermore, an accentuation of Met immunoreactivity was often noted in cancer cells at the advancing edge of tumors. These findings support a role for Met in lung cancer cell invasion and differentiation in vivo, but its expression and functions may be modified by the differentiation phenotype of the tumor cells.
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