Curli production and genetic relationships among Escherichia coli from cases of bovine mastitis

Curli are adhesive surface structures produced by some Escherichia coli and Salmonella strains that bind host proteins and activate inflammatory mediators. In this study, 61 E. coli isolates from 36 clinical cases of bovine mastitis were characterized using enterobacterial repetitive intergenic consensus-PCR and screened for their ability to produce curli. Effect of curli production on case recovery, based on a return to precase milk yield, was investigated for a subset of 43 isolates from 20 quarters of 19 cows. Thirty-five (57%) of 61 isolates were curli positive. Fifty-eight of the 61 isolates clustered into 2 clonal groups at 52% genetic similarity. Genetically diverse E. coli isolates were simultaneously cultured from individual cases. Twenty-three isolates from 13 cows were clustered in clonal group I, of which 5 cases (38%) were curli positive; 35 isolates from 22 cows were clustered in clonal group II, of which 15 cases (68%) were curli positive. No association was found between genetic similarity and phenotypic curli expression of isolates from cows with clinical E. coli mastitis cases. Phenotypic curli expression in isolates did not affect recovery of cows' milk yield to premastitis production levels.

Update on early intervention in schizophrenia

Early intervention is a popular idea for helping people with schizophrenia. There are two major approaches: intervening when the first symptoms of psychosis are expressed during adolescence and treating individuals at high risk during adolescence before psychotic symptoms become apparent. The risks and benefits of each approach are discussed.

Catchers in the Rye: Treatment Foster Parents as a System of Care

PROBLEM

Similar to the children in J. D. Salinger's novel, The Catcher in the Rye, youth in foster care face the specter of "going over the cliff."

METHODS

The empirical basis for "treatment foster care" is reviewed, concluding that treatment foster care is both a clinically and cost-effective form of community-based treatment.

FINDINGS

Treatment foster parents prevent the fall of foster youth into the chasm of school failure, involvement with juvenile justice, and dependent living as adults.

CONCLUSION

Treatment foster care is an evidence-based approach that is less restrictive and offers troubled youth an opportunity to engage and grow within a family setting.

Triple jeopardy for HIV: substance using Severely Mentally Ill Adults

Severely Mentally Ill (SMI) adults have disproportionately high HIV seroprevalence rates. Abuse of alcohol and other substances (AOD) and lifetime exposure to trauma by others are particularly potent risk factors, which, in combination with psychiatric disabilities, create triple jeopardy for HIV infection. This study examined the predictive utility of demographic characteristics; history of physical, emotional, or sexual abuse; extent of drug and alcohol abuse; knowledge about HIV/AIDS; sexual self-efficacy; and condom attitudes toward explaining the variance in a composite of HIV high-risk behavior among 188 SMI women and 158 SMI men. History of sexual abuse, engaging in sexual activities while high on substances, and lower cannabis use were the most significant predictors of HIV sexual risk behaviors. Given the triple jeopardy for HIV risk in this population, a triple barreled approach that simultaneously addresses multiple health risks within an integrated treatment setting is warranted.

International adoption as a natural experiment

International adoption research has been called a natural experiment by many child development researchers. How do studies of severe early deprivation inform us about risk factors experienced by many of these children and their impact on developmental outcomes? Three longitudinal studies conducted by British and American researchers in the 1990s are reviewed. Each year, over 20,000 children are adopted from overseas, and a significant number are now entering adolescence; the impact of their prenatal risk factors, early institutionalization, and ameliorative postadoptive environments is also reviewed. The feasibility of generalizing findings to other children in foster care is also addressed.

Integrated HIV care: HIV risk outcomes of pregnant substance abusers

Identifying contextual factors that may influence the effects of HIV risk-reduction strategies aimed at inner-city, minority female populations may be critical to interrupting the alarming trends in seroprevalence in the United States, especially among pregnant women with substance use-related problems. The objective of this Phase I, NIDA-funded project was to determine which contextual and cognitive factors were most predictive of HIV outcomes in this population. Eighty-one HIV-negative women were enrolled in a maternal addiction program with a cognitive-behavioral HIV risk-reduction component. Measures were administered between 1996 and 1998, one week post-admission, and follow-up assessments were conducted on 69 participants at 6 months post-discharge Paired t-tests were conducted to assess changes in sex risk behaviors, HIV/AIDS-related knowledge, and HIV risk-related attitudes/behaviors. Hierarchical regression analyses were conducted to investigate the relationship between attitudes/knowledge with contextual variables. At six months follow-up, there were significant increases in favorable condom attitudes (t = 3.36, p = .01) and in factual knowledge regarding HIV (t = 3.20, p = .01), with a significant decrease in the number of sexual partners (t = 2.21, p = .05). Hierarchical regression analysis revealed that the strongest predictors of the number of partners--a key outcome variable--were alcohol use, intentions to engage in safer sex behaviors, psychiatric symptoms, and a history of physical abuse (F[11, 57] = 6.58, p < .001). This study also reinforces the strategic importance of utilizing substance user treatment programs as crucial vehicles for integrating HIV risk-reduction strategies. Additionally, it will further guide the design of effective procedures to test the feasibility of an integrated HIV risk-reduction intervention for a larger randomized controlled study. The study's limitations are noted.

Family history as a tool for psychiatric nurses

In the current age of genomic health care, family history is an essential tool for health assessment, especially for those with chronic mental illness. Three methods of family history assessment (genograms, ecomaps, and pedigree analysis) are described and illustrated. Examples from the family history literature demonstrate each method's usefulness. These approaches improve both consumers' and psychiatric nurses' abilities to comprehend overall health status as well as risks at the individual, family, and community levels.

Context and common ground: cultural adaptation of an intervention for minority HIV infected individuals

Understanding social contextual mediators of risk in HIV/AIDS prevention and promoting cultural adaptation of clinical interventions have evolved from new priorities set forth by the National Institutes of Health (NIH) on ecological validity and translational research (NIH, 2001). Thus, emphasis is placed on linguistically and culturally translating promising interventions "for and with" new populations to serve the realities of the particular group. The purpose of this paper is to describe the process involved in developing culturally sensitive interventions to strengthen the ecological validity of a cognitive behavioral stress management (CBSM) intervention for HIV+ individuals.

The black cloud over the Sunshine State: health disparities in south Florida

Florida, the "Sunshine State", is paradise for international tourists and has been adopted as seasonal or permanent home by many wealthy individuals and celebrities. However, Florida is not paradise for the growing number of residents who suffer from poverty, health problems, and a lack of access to health care and social services. The purpose of this paper is to present data on health care problems and disparities throughout the state of Florida and in select south Florida counties. Flaskerud and Winslow (1998) have provided a framework which can be used to analyze disparities in resource availability, relative risk, and health status indicators and suggests areas in which nursing and other health professionals can ethically intervene through research, practice, and political action.

Risk and protective factors in children adopted from the former Soviet Union

INTRODUCTION

The former Soviet Union (including the present independent republics of Russia, Ukraine, Latvia, Belarus, Lithuania, and Georgia) is the leading source of children adopted from overseas by persons in the United States (US Department of State, 1998). This study sought to (a) characterize the current social, academic, and conduct competencies of 6- to 9-year-old children adopted from the former Soviet Union who have resided in the United States for at least 2 years and (b) evaluate both risks and protective influences of adoptive families and their relationships to competence via a structural equation model.

METHOD

Telephone interviews and a postal survey of children were drawn from a US community sample of 105 children. Measures included (a) Child Behavior Checklist, (b) Teacher Report Form, (c) Vineland Adaptive Behavior Scales, (c) Family Environment Scale, and (d) demographic information.

RESULTS

Many children had experienced abuse, abandonment, or neglect between birth and entry to the institution. Their mean birth weight was 2637 g, and alcohol abuse by the birth mother was common (41%). Although the children scored below average in competence, adoptive family environments were positive and served as buffers between the risks experienced by the children and the subsequent development of competence within the adoptive family.

CONCLUSION

Children's abilities ranged from severely challenged to developmentally normal. The high rate of fetal alcohol exposure in the children may portend future challenges for families.

The psychiatric-primary care nurse practitioner: a futuristic model for advanced practice psychiatric-mental health nursing

A new paradigm for delivering comprehensive mental and general health services has been born out of the necessity to integrate all aspects of health care. Because of issues of cost-effectiveness and capitation, fragmentation of services is no longer viable. Graduate programs in nursing will need to: (1) effectively prepare its practitioners to manage the complexity of both medical and psychiatric problems of clients, (2) promote health and prevent disease, and (3) counsel and refer clients. The psychiatric nurse practitioner is uniquely suited to provide comprehensive health care to both clients in psychiatric settings as well as primary care environments. An overview of the Psychiatric-Primary Care Nurse Practitioner program at the University of Pittsburgh is described.

Resilience: analysis of the concept

Resilience describes a process whereby people bounce back from adversity and go on with their lives. It is a dynamic process highly influenced by protective factors. Protective factors are specific competencies that are necessary for the process of resilience to occur. Competencies are those healthy skills and abilities that the individual can access and may occur within the individual or the interpersonal or family environment. Psychiatric-mental health nursing has always focused on mental-health promotion and attempted to discern positive outcomes from adversity and states of wellness amidst difficult circumstances or severe illness. Defining specific protective factors that facilitate mental health in high-risk groups would enhance our position in today's health care climate.

Familial influence in unipolar depression: effects of parental cognitions and social adjustment on adult offspring

As part of an ongoing study of risk factors for unipolar depression in adult first-degree relatives of depressed probands, we have evaluated the relationship between cognitions and social adjustment in parents and adult offspring. Asymptomatic relatives of families with at least one parent with major depression, of families with no affected parent, and of normal control families were assessed. Maternal social adjustment was associated with both negative thinking and social adjustment in adult offspring. These effects were independent of the influence of personal history of depression in offspring, an effect that also influenced offspring thinking and social adjustment. These findings suggest that impairments in social adjustment in mothers may persist well beyond an episode and influence the adjustment and thinking of at least some of their offspring. Within the context of parent-child interaction, increased vulnerability for depression in offspring of depressed parents may be mediated in part by the enduring impact of these factors.

Effects of loratadine (SCH 29851) in suppression of histamine-induced skin wheals

The efficacy and safety of single oral doses (10, 20, 40, and 80 mg) of loratadine (SCH 29851) in suppressing formation of histamine-induced wheals were assessed in a crossover study in 29 healthy male subjects. One hour prior to dosing and 1, 2, 3, 4, 6, 8, 12, 16, 24, 28, 32, 36, 40, and 48 hours after dosing, histamine and saline were injected intradermally into opposite arms. Measurements of resulting wheal areas showed loratadine suppressed wheal formation significantly better than placebo; suppression was dose related. The mean suppression over 48 hours was 16% in placebo-treated subjects and 35%, 45%, 51%, and 67% in the 10, 20, 40, and 80 mg loratadine-treated subjects, respectively. The onset of action occurred within the first hour. Duration of suppression was dose related, ranging from 12 hours with the lowest dose (10 mg) to 48 hours with the higher doses (40 and 80 mg). Incidence of sedation and other side effects were comparable among all doses of loratadine and placebo.