Medical and Societal information from the Research Community	Number of Articles: 17,750,454 Number of Contributors: 57 Number of Queries: 12,899,077
	Save this page:  Send this page	Login  or Create a Free Account

GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (3 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Humans or Animals Humans Animals Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S. Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Results(1-25 of 25) Sort By: Publication Date Relevance Took: 1.236 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 1 1 (25 articles found) Feeding alternatives in patients with dementia: examining the evidence. Dec 2007 Donald Garrow,Pam Pride,William Moran,Jane Zapka,Elaine Amella,Mark Delegge Percutaneous endoscopic gastrostomy tubes are being placed with increasing frequency in the United States among elderly patients with dementia. Health care providers believe there may be long-term benefits for enteral feeding in this population, yet previous study of this topic has failed to yield ... ( view more )any convincing evidence to support this hypothesis. In this study, we review the evidence regarding outcomes for artificial enteral feeding in older individuals with dementia. We found that there is a lack of evidence supporting artificial feeding in the specific outcomes of survival, pressure ulcers, nutrition, and aspiration pneumonia. A brief discussion regarding hand feeding is included. The data suggest that hand feeding may be a viable alternative to tube feeding in elderly patients with dementia, although a direct comparison trial of the 2 interventions is lacking. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Presentation of illness in older adults. If you think you know what you're looking for, think again. Feb 2006 Elaine J Amella ALTHOUGH PEOPLE AGE at different rates, changes to the composition of the human body are a hallmark of aging. As a result of such changes, disease can present differently in a person over 65 years old than it would in a younger adult or child. THIS ARTICLE IDENTIFIES the critical indicators of unde... ( view more )rlying conditions, including changes in mental status, loss of function, decrease in appetite, dehydration, falls, pain, dizziness, and incontinence. It also describes the presentation of diseases common to older adults, including depression, infection, cardiac disease, gastrointestinal disorders, thyroid disease, and type 2 diabetes. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Macrophage inflammatory protein 1alpha inhibits postentry steps of human immunodeficiency virus type 1 infection via suppression of intracellular cyclic AMP. May 2005 Carol-Ann Amella,Barbara Sherry,David H Shepp,Helena Schmidtmayerova Primary isolates of human immunodeficiency virus type 1 (HIV-1) predominantly use chemokine receptor CCR5 to enter target cells. The natural ligands of CCR5, the beta-chemokines macrophage inflammatory protein 1alpha (MIP-1alpha), MIP-1beta, and RANTES, interfere with HIV-1 binding to CCR5 receptor... ( view more )s and decrease the amount of virions entering cells. Although the inhibition of HIV-1 entry by beta-chemokines is well documented, their effects on postentry steps of the viral life cycle and on host cell components that control the outcome of infection after viral entry are not well defined. Here, we show that all three beta-chemokines, and MIP-1alpha in particular, inhibit postentry steps of the HIV-1 life cycle in primary lymphocytes, presumably via suppression of intracellular levels of cyclic AMP (cAMP). Productive HIV-1 infection of primary lymphocytes requires cellular activation. Cell activation increases intracellular cAMP, which is required for efficient synthesis of proviral DNA during early steps of viral infection. Binding of MIP-1alpha to cognate receptors decreases activation-induced intracellular cAMP levels through the activation of inhibitory G proteins. Furthermore, inhibition of one of the downstream targets of cAMP, cAMP-dependent PKA, significantly inhibits synthesis of HIV-1-specific DNA without affecting virus entry. These data reveal that beta-chemokine-mediated inhibition of virus replication in primary lymphocytes combines inhibitory effects at the entry and postentry levels and imply the involvement of beta-chemokine-induced signaling in postentry inhibition of HIV-1 infection. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Nutrition in older adults. Mar 2005 Rose Ann DiMaria-Ghalili,Elaine Amella Both physiologic and psychosocial changes affect the nutritional status of adults over the age of 65. Malnutrition is, in fact, a greater threat to this population than obesity. This article reviews the intake requirements of older adults and discusses the risk factors that can lead to malnutrition... ( view more ), including diet, limited income, isolation, chronic illness, and physiologic changes. Assessment and nursing interventions are also addressed. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Presentation of illness in older adults. Oct 2004 Elaine J Amella Although people age at different rates, changes to the composition of the human body are a hallmark of aging. As a result of such changes, disease can present differently in a person over 65 years old than it would in a younger adult or child. This article identifies the critical indicators of unde... ( view more )rlying conditions, including changes in mental status, loss of function, decrease in appetite, dehydration, falls, pain, dizziness, and incontinence. It also describes the presentation of diseases common to older adults, including depression, infection, cardiac disease, gastrointestinal disorders, thyroid disease, and type 2 diabetes. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Feeding and hydration issues for older adults with dementia. Sep 2004 Elaine J Amella All cultures dictate the need to feed the hungry and create rituals for almost every life passage around the consumption of food and beverage. Yet, in old age and among those who cannot advocate for themselves, mealtime is medicalized and demoted to an insignificant event without dignity or regard ... ( view more )for individualized needs. Attention must be paid to not only what people eat, but how they eat, and how they are supported in that process. Kayser-Jones summarized the extensive findings of several ethnographic studies in nursing homes by noting the multi-factorial issues involved in delivering excellent care to all residents, especially those lacking an advocate. Her findings exposed how lack of staff education, inadequate staffing and supervision, disregard for personal and cultural preferences, lack of assessment for comorbid health problems, intake of food and fluids, dysphagia, and oral health problems all contributed to malnutrition and dehydration among the residents studied. This seminal set of studies, along with Dr. Kayser-Jones' testimony in US Congressional hearings directly affected the design of federal regulatory protocols to address malnutrition and dehydration. In an attempt to increase the number of staff available to assist at meals, the Centers for Medicare and Medicaid issued a change in regulations on Sept. 26, 2003, allowing reimbursement for staff trained for a total of 8 hours to act as feeding assistants. This change is intended to, "provide more residents with help in eating and drinking and reduce the incidence of unplanned weight loss and dehydration". Although seen as answering some of the staffing ratio issues at meal times,this rule change has been criticized for not addressing the complexities of resident needs at meal times. Although offering food and fluid is time-consuming and requires special knowledge of physiological changes and empathy for persons whose behavior might be objectionable at times, it may be one of the few times during the day that the individual with dementia receives normalized social interaction. Thus, as in the care of all vulnerable persons with dementia, whether at home or in an institution, perhaps the greatest challenge and need is for nurses and other caregivers to provide a social environment that promotes individual dignity and comfort. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Macrophages and lymphocytes differentially modulate the ability of RANTES to inhibit HIV-1 infection. Nov 2003 Eleanore Gross,Carol A Amella,Lorena Pompucci,Giovanni Franchin,Barbara Sherry,Helena Schmidtmayerova The beta-chemokines MIP-1alpha, MIP-1beta, and RANTES inhibit HIV-1 infection of CD4+ T cells by inhibiting interactions between the virus and CCR5 receptors. However, while beta-chemokine-mediated inhibition of HIV-1 infection of primary lymphocytes is well documented, conflicting results have bee... ( view more )n obtained using primary macrophages as the virus target. Here, we show that the beta-chemokine RANTES inhibits virus entry into both cellular targets of the virus, lymphocytes and macrophages. However, while virus entry is inhibited at the moment of infection in both cell types, the amount of virus progeny is lowered only in lymphocytes. In macrophages, early-entry restriction is lost during long-term cultivation, and the amount of virus produced by RANTES-treated macrophages is similar to the untreated cultures, suggesting an enhanced virus replication. We further show that at least two distinct cellular responses to RANTES treatment in primary lymphocytes and macrophages contribute to this phenomenon. In lymphocytes, exposure to RANTES significantly increases the pool of inhibitory beta-chemokines through intracellular signals that result in increased production of MIP-1alpha and MIP-1beta, thereby amplifying the antiviral effects of RANTES. In macrophages this amplification step does not occur. In fact, RANTES added to the macrophages is efficiently cleared from the culture, without inducing synthesis of beta-chemokines. Our results demonstrate dichotomous effects of RANTES on HIV-1 entry at the moment of infection, and on production and spread of virus progeny in primary macrophages. Since macrophages serve as a reservoir of HIV-1, this may contribute to the failure of endogenous chemokines to successfully eradicate the virus. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Nicotinic acetylcholine receptor alpha7 subunit is an essential regulator of inflammation. Jan 23, 2003 Hong Wang,Man Yu,Mahendar Ochani,Carol Ann Amella,Mahira Tanovic,Seenu Susarla,Jian Hua Li,Haichao Wang,Huan Yang,Luis Ulloa,Yousef Al-Abed,Christopher J Czura,Kevin J Tracey Excessive inflammation and tumour-necrosis factor (TNF) synthesis cause morbidity and mortality in diverse human diseases including endotoxaemia, sepsis, rheumatoid arthritis and inflammatory bowel disease. Highly conserved, endogenous mechanisms normally regulate the magnitude of innate immune res... ( view more )ponses and prevent excessive inflammation. The nervous system, through the vagus nerve, can inhibit significantly and rapidly the release of macrophage TNF, and attenuate systemic inflammatory responses. This physiological mechanism, termed the 'cholinergic anti-inflammatory pathway' has major implications in immunology and in therapeutics; however, the identity of the essential macrophage acetylcholine-mediated (cholinergic) receptor that responds to vagus nerve signals was previously unknown. Here we report that the nicotinic acetylcholine receptor alpha7 subunit is required for acetylcholine inhibition of macrophage TNF release. Electrical stimulation of the vagus nerve inhibits TNF synthesis in wild-type mice, but fails to inhibit TNF synthesis in alpha7-deficient mice. Thus, the nicotinic acetylcholine receptor alpha7 subunit is essential for inhibiting cytokine synthesis by the cholinergic anti-inflammatory pathway. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Resistance at mealtimes for persons with dementia. 2002 E J Amella BACKGROUND: For persons unable to feed themselves, resistance to assistance with meals may result in increased morbidity and premature mortality because of inadequate nutritional intake. Additionally, unwillingness to accept food offered has social and ethical implications in all cultures and may i... ( view more )nfluence caregiving. OBJECTIVE: As part of a larger study, this analysis sought to determine if resistance or willingness to accept assistance at meals by persons with dementia could be predicted by various personal interaction and contextual factors. DESIGN: Resistance was studied in a sample of 53 nursing home residents with late-stage dementia who were assisted at meals by CNAs. Using the EdFED-Q (Edinburgh Feeding Evaluation in Dementia Questionnaire), two groups of individuals who were being fed were identified: those who resisted assistance (n = 23) and those who accepted assistance (n = 30). Proportion of food consumed was determined by percentage of weight decrease in food offered. RESULTS: Differences between the two groups were identified. Although not differing in degree of cognitive impairment as measured by the MMSE or Body Mass Index, significant differences (p < .05) were found in level of functioning as measured by the Global Deterioration Scale, the proportion of food consumed and amount of time taken to assist with the meal. Resistors showed significantly different interaction behaviors in 8 of the 10 on the Interaction Behavior Measure-Modified when correlated with food consumed (r = .49 - .68, p < .02). CONCLUSION: When examining resistance to feeding a variety of factors must be examined, including the quality of the interaction between the caregiver and the person being fed. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Partners for NP education: the 1999 AANP preceptor and faculty survey. Nov 2001 E J Amella,L Brown,B Resnick,D B McArthur PURPOSE: To increase understanding of national trends in nurse practitioner (NP) clinical education, the Education Committee of the American Academy of Nurse Practitioners (AANP) conducted a survey at the 1999 National AANP Conference in Atlanta. DATA SOURCES: A convenience sample of preceptors (n ... ( view more )= 87) and faculty (n = 42) out of the total attendance of 1,744 responded to a written questionnaire. CONCLUSIONS: Preceptor respondents provided data concerning the number of NP students supervised, influence of student supervision on productivity, and availability of incentives for precepting. Faculty reported placement and supervision issues, the extent of precepting in their clinical practice site, and recognition and support for this role. Faculty and preceptors disagreed about the types and number of incentives offered for accepting students as well as the congruence of clinical teaching activities and national teaching guidelines. Precepting did not appear to strongly influence preceptor productivity. External funding did not influence opportunities for clinical education. IMPLICATIONS FOR PRACTICE: In 1998, the graduates of NP programs rose by 15.8% and over half of all nursing students enrolled in graduate nursing programs were seeking a NP education. This increase in students may compromise the ability of schools of nursing to insure quality clinical education of NP students by increasing faculty workload and placing greater demands on expert preceptors in the community. Clinical education is also changing in light of changes in the health care system. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The B-oligomer of pertussis toxin deactivates CC chemokine receptor 5 and blocks entry of M-tropic HIV-1 strains. Sep 6, 1999 M Alfano,H Schmidtmayerova,C A Amella,T Pushkarsky,M Bukrinsky Infection of target cells by HIV-1 requires initial binding interactions between the viral envelope glycoprotein gp120, the cell surface protein CD4, and one of the members of the seven-transmembrane G protein-coupled chemokine receptor family. Most primary isolates (R5 strains) use chemokine recep... ( view more )tor CCR5, but some primary syncytium-inducing, as well as T cell line-adapted, strains (X4 strains) use the CXCR4 receptor. Signaling from both CCR5 and CXCR4 is mediated by pertussis toxin (PTX)-sensitive G(i) proteins and is not required for HIV-1 entry. Here, we show that the PTX holotoxin as well as its binding subunit, B-oligomer, which lacks G(i)-inhibitory activity, blocked entry of R5 but not X4 strains into primary T lymphocytes. Interestingly, B-oligomer inhibited virus production by peripheral blood mononuclear cell cultures infected with either R5 or X4 strains, indicating that it can affect HIV-1 replication at both entry and post-entry levels. T cells treated with B-oligomer did not initiate signal transduction in response to macrophage inflammatory protein (MIP)-1beta or RANTES (regulated upon activation, normal T cell expressed and secreted); however, cell surface expression of CCR5 and binding of MIP-1beta or HIV-1 to such cells were not impaired. The inhibitory effect of B-oligomer on signaling from CCR5 and on entry of R5 HIV-1 strains was reversed by protein kinase C (PKC) inhibitors, indicating that B-oligomer activity is mediated by signaling events that involve PKC. B-oligomer also blocked cocapping of CCR5 and CD4 induced by R5 HIV-1 in primary T cells, but did not affect cocapping of CXCR4 and CD4 after inoculation of the cultures with X4 HIV-1. These results suggest that the B-oligomer of PTX cross-deactivates CCR5 to impair its function as a coreceptor for HIV-1. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Factors influencing the proportion of food consumed by nursing home residents with dementia. Jul 1999 E J Amella BACKGROUND: Assessment of and interventions for promoting eating in persons with late-stage dementia have primarily focused on facilitation of safe feeding and methods to promote ingestion of nutrients via several routes. Using Social Exchange Theory, this study examined how the quality of the inte... ( view more )raction between care giver and care receiver influenced the proportion of food consumed by persons with late-stage dementia. METHODS: Fifty-three dyads composed of nursing home residents with late-stage dementia and Certified Nursing Assistants (CNAs) were observed during the breakfast meal. The proportion of food consumed by the residents was measured by weight. The study included measures of the quality of interaction between the resident and the CNA (Interaction Behavior Measure-Modified (IBM-M) and the IBM), CNA empathy (Interpersonal Reactivity Index), and CNA power (Control subscale of the FIRO-B). RESULTS: Specific resident behaviors and the CNA's ability to allow another person to control a relationship were most predictive of the variance in the proportion of food consumed (R2 = .41; F(3,49) = 12.54; P < .001). The quality of the resident-CNA interaction accounted for 32% of the variance in the proportion of food consumed. One aspect of power was correlated significantly to the proportion of food consumed whereas CNA empathy was not. CONCLUSIONS: Because eating is the most social of all ADLs and is culturally bound, clinicians need to examine the interactional components of meals within the caregiving dyad when a person with late-stage dementia fails to ingest adequate nutrients. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Nutrition and health status assessment of community-residing elderly in New York City: a pilot study. May 1998 J A Gilbride,E J Amella,E B Breines,C Mariano,M Mezey Ninety-five percent of persons over the age of 65 years live in the community and benefit from community-based health and nutrition services. The purpose of this project was to evaluate diet, function, and mental health in 40 men and women aged 65 years and older who were residing in a large metrop... ( view more )olitan community. Nutritional status was assessed using two 24-hour recalls, 5 days of food records, a food frequency, and anthropometric measurements. Participants responded to standardized activities of daily living and instrumental activities of daily living instruments and an investigator-developed, performance-based appraisal of food preparation and management. Cognition and mood were assessed using the Folstein Mini-Mental Examination and the Yesavage Depression Scale. The nutrient intakes for individuals were compared with the Recommended Dietary Allowances (RDAs) and the Food Guide Pyramid. Mean energy intake was 1,625 kcal (range = 787 to 2,910 kcal); 7 persons consumed more than 2,000 kcal. The mean vitamin and mineral intake for participants met the RDAs except for calcium, vitamin D, zinc, and magnesium intakes. The average percentages of carbohydrate, protein, and fat were 53%, 16%, and 30%, respectively. Nutritional assessments of subjects with and without congregate meals were contrasted. Six of the 13 congregate-meal participants were at nutritional risk, compared with 6 of 27 not receiving congregate meals. The interrelationships of diet, functional status, and mental health factors were examined along with recommendations for future data collection in similar studies. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Mutations in the tat gene are responsible for human immunodeficiency virus type 1 postintegration latency in the U1 cell line. Feb 1998 S Emiliani,W Fischle,M Ott,C Van Lint,C A Amella,E Verdin Previous reports have demonstrated that the U1 cell line, a model for postintegration latency, is defective at the level of Tat function and can be rescued by exogenously provided Tat protein. Sequence analysis of tat cDNAs from the U1 cell line identified two distinct forms of Tat, in agreement wi... ( view more )th the fact that this cell line contains two integrated human immunodeficiency (HIV) proviruses. One Tat cDNA lacked an ATG initiation codon, while the other contained an H-to-L mutation at amino acid 13 (H13-->L). Both tat cDNAs were defective in terms of transcriptional activation of long terminal repeat-luciferase reporter gene in transient-transfection experiments. Introduction of the H13-->L mutation in a wild-type tat background caused a severe reduction in transcriptional activation. Introduction of the same mutation in an infectious HIV molecular clone caused a severely defective phenotype which could be rescued when the HIV proviral DNA was transfected in a Jurkat cell line stably expressing the Tat protein (Jurkat-Tat) or in Jurkat cells treated with tumor necrosis factor alpha. Infectious virus stocks generated in Jurkat-Tat cells were used to infect Jurkat cells and exhibited severely impaired growth which could also be rescued by infecting Jurkat-Tat cells. These observations define tat mutations as a mechanism for HIV postintegration latency. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Transcription factor binding sites downstream of the human immunodeficiency virus type 1 transcription start site are important for virus infectivity. Aug 1997 C Van Lint,C A Amella,S Emiliani,M John,T Jie,E Verdin When transcriptionally active, the human immunodeficiency virus (HIV) promoter contains a nucleosome-free region encompassing both the promoter/enhancer region and a large region (255 nucleotides [nt]) downstream of the transcription start site. We have previously identified new binding sites for t... ( view more )ranscription factors downstream of the transcription start site (nt 465 to 720): three AP-1 sites (I, II, and III), an AP3-like motif (AP3-L), a downstream binding factor (DBF) site, and juxtaposed Sp1 sites. Here, we show that the DBF site is an interferon-responsive factor (IRF) binding site and that the AP3-L motif binds the T-cell-specific factor NF-AT. Mutations that abolish the binding of each factor to its cognate site are introduced in an infectious HIV-1 molecular clone to study their effect on HIV-1 transcription and replication. Individual mutation of the DBF or AP3-L site as well as the double mutation AP-1(III)/AP3-L did not affect HIV-1 replication compared to that of the wild-type virus. In contrast, proviruses carrying mutations in the Sp1 sites were totally defective in terms of replication. Virus production occurred with slightly delayed kinetics for viruses containing combined mutations in the AP-1(III), AP3-L, and DBF sites and in the AP3-L and DBF-sites, whereas viruses mutated in the AP-1(I,II,III) and AP3-L sites and in the AP-1(I,II,III), AP3-L, and DBF sites exhibited a severely defective replicative phenotype. No RNA-packaging defect could be measured for any of the mutant viruses as determined by quantification of their HIV genomic RNA. Measurement of the transcriptional activity of the HIV-1 promoter after transient transfection of the HIV-1 provirus DNA or of long terminal repeat-luciferase constructs showed a positive correlation between the transcriptional and the replication defects for most mutants. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Educational assessment and teaching of older clients with pressure ulcers. Aug 1997 E A Ayello,M Mezey,E J Amella The importance of education in preventing and treating patients with pressure ulcers is evident by the inclusion of recommendations for educational objectives in the clinical guidelines by the Agency for Health Care Policy and Research. Both caregiver and client should be assessed for knowledge of ... ( view more )pressure ulcers. Physical changes in vision, hearing, and cognition that might affect educating older clients are described. Strategies suitable for teaching older clients about the prevention and treatment of pressure ulcers are given. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Human papillomavirus type 11 transcripts are present at low abundance in latently infected respiratory tissues. Oct 1, 1995 A Maran,C A Amella,T P Di Lorenzo,K J Auborn,L B Taichman,B M Steinberg Respiratory tract tissues containing latent human papillomavirus (HPV) 11 were analyzed by reverse transcription-polymerase chain reaction for the presence of viral-specific RNA from the early region of the genome and compared to a similar analysis of laryngeal papillomas. Latently infected tissue ... ( view more )contained low-abundance transcripts that could code for E1 and E2 proteins, but lacked evidence of spliced transcripts for the E6 and E7 proteins. Both latently infected tissue and papilloma tissue contained low-abundance antisense transcripts. Cultured cells infected with HPV 11 virions or transfected with HPV DNA, and cells derived from latently infected tissue, expressed transcripts similar to those seen in papillomas, but at a lower abundance. We postulate that latency is determined by the absence of or limiting levels of critical viral proteins. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Pressure ulcer pain: assessment and quantification. Sep 1995 L Dallam,C Smyth,B S Jackson,R Krinsky,C O'Dell,J Rooney,C Badillo,E Amella,L Ferrara,K Freeman A cross-sectional study design was used to document perception of pressure ulcer pain in 132 patients in an acute care setting. Subjects were evaluated by means of the Folstein Mini-Mental State Examination, Beck's Depression Inventory, the Faces Pain Rating Scale, and the Visual Analog Scale for p... ( view more )ain intensity. Charts were reviewed for demographic data and related medical treatments. The group comprised 44 subjects (33.3%) who were able to respond to the evaluation instruments and 88 subjects (66.7%) who were unable to respond to the evaluation tools. Forty-one percent of the respondents denied pressure ulcer pain and 59% reported pain of some type. According to the Faces Rating Scale, 32% of this group reported no pain and 68% reported some degree of pain. The respondents included 48% who scored below 24 on the Folstein Mini-Mental State Examination, indicative of cognitive impairment, and 52% who were found to be cognitively intact, with scores of 24 or above. Only 2% (n = 3) were given analgesics for pressure ulcer pain within 4 hours of the interview. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Latent infection induced with cottontail rabbit papillomavirus. A model for human papillomavirus latency. Jun 1994 C A Amella,L A Lofgren,A M Ronn,M Nouri,M J Shikowitz,B M Steinberg Latent human papillomavirus infection, a very common event, is most likely the source of primary and recurrent papillomas of the respiratory and genital tracts and might also be the source of neoplastic lesions of the female genital tract and the penis. We have developed a simple model for papillom... ( view more )avirus latency using cottontail rabbit papillomavirus. Skin of domestic rabbits was minimally scarified and inoculated with dilutions of a crude virus suspension ranging from 200 ng to 20 pg viral DNA per inoculated site. Dilution of virus to less than 10 ng/site resulted in delayed and reduced efficiency of inducing warts. After follow-up of 1 to 6 months, sites immediately adjacent to papillomas and inoculated sites where papillomas did not form were biopsied and analyzed by Southern blot and polymerase chain reaction. Inoculated tissues that were clinically and histologically normal contained viral DNA at low levels, detectable by polymerase chain reaction. Ability of the latent virus to induce warts was confirmed by activation with mild skin irritation causing wart formation. This simple model system for latent papillomavirus can be used to study mechanisms of viral activation, therapies to prevent activation, and therapies to eliminate latent virus and thus cure the infection. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Clinical effects of photodynamic therapy on recurrent laryngeal papillomas. Jan 1992 A L Abramson,M J Shikowitz,V M Mullooly,B M Steinberg,C A Amella,H R Rothstein Thirty-three patients with moderate to severe recurrent laryngeal papillomatosis underwent photodynamic therapy at our institution. All received 2.5 mg/kg of dihematoporphyrin ether intravenously either 48 or 72 hours prior to photoactivation with an argon pump dye laser system. Photosensitivity wa... ( view more )s the only side effect seen. Statistical analysis showed a significant decrease, by approximately 50%, in the average rate of laryngeal papilloma growth following treatment. The response was especially pronounced in patients with the worst disease. In addition, three patients have now remained free of disease for extended periods following photodynamic therapy. Latent infection with human papillomavirus continues to persist in clinically normal tissue following photodynamic therapy. The results and potential of this exciting new therapy for laryngeal papillomatosis are described. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Facilitating expert practice in gerontological nursing. 1990 S R Beaton,E J Amella Educators and clinical specialists can collaborate to develop experts in gerontological nursing. The authors use Loevinger's theory of ego development and Benner's model to guide their work. Their teaching strategies are designed to increase self-awareness, add conceptual contexts, broden practice ... ( view more )perspectives, and promote professional esteem. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles End-of-life communication and hospital nurses: an educational pilot. 2006 May-Jun Jane G Zapka,Winnie Hennessy,Rickey E Carter,Elaine J Amella Heart failure is a high prevalence, high burden disease with an unpredictable trajectory. Given that approximately 50% of persons with the diagnosis die within 5 years, the implications for communication about advance planning and end of life, although simultaneously providing hope and treatment, a... ( view more )re extremely challenging. This article reports on a feasibility trial of a modest continuing education seminar to increase awareness and communication skills of inpatient nurses. Curriculum design details, including objectives and methods, are described. Needs assessment and evaluation data are reported. At the 2-month posttest, a summary communications skill score showed significant improvement. Data also illustrated that the challenge of facing issues about dying are complicated by a work force of relatively young staff and low exposure to few actual deaths during relatively short lengths of stay. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Assessment and management of eating and feeding difficulties for older people: a NICHE protocol. 1998 Sep-Oct E J Amella Adequate nutritional intake is critical to preserving the health of older people. When an elderly person requires assistance with eating, the most social of all activities of daily living, the assessment of nutritional issues becomes multidimensional and interdisciplinary. Management strategies sho... ( view more )uld involve the professional nurse's attention to dietary needs, as well as the social, cultural, and interactive components of mealtime. Additionally, special strategies need to be developed for people with cognitive and physical disabilities. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Pressure ulcer pain: assessment and quantification 1995 Dallam, L., Smyth, C., Jackson, B. S., Krinsky, R., O'Dell, C., Rooney, J., Badillo, C., Amella, E., Ferrara, L., and Freeman, K. A cross-sectional study design was used to document perception of pressure ulcer pain in 132 patients in an acute care setting. Subjects were evaluated by means of the Folstein Mini-Mental State Examination, Beck's Depression Inventory, the Faces Pain Rating Scale, and the Visual Analog Scale for p... ( view more )ain intensity. Charts were reviewed for demographic data and related medical treatments. The group comprised 44 subjects (33.3%) who were able to respond to the evaluation instruments and 88 subjects (66.7%) who were unable to respond to the evaluation tools. Forty-one percent of the respondents denied pressure ulcer pain and 59% reported pain of some type. According to the Faces Rating Scale, 32% of this group reported no pain and 68% reported some degree of pain. The respondents included 48% who scored below 24 on the Folstein Mini-Mental State Examination, indicative of cognitive impairment, and 52% who were found to be cognitively intact, with scores of 24 or above. Only 2% (n = 3) were given analgesics for pressure ulcer pain within 4 hours of the interview ( view less ) View Full Abstract View Article Details   Related Articles Resistance at mealtimes for persons with dementia 2002 Amella, E. J. BACKGROUND: For persons unable to feed themselves, resistance to assistance with meals may result in increased morbidity and premature mortality because of inadequate nutritional intake. Additionally, unwillingness to accept food offered has social and ethical implications in all cultures and may i... ( view more )nfluence caregiving. OBJECTIVE: As part of a larger study, this analysis sought to determine if resistance or willingness to accept assistance at meals by persons with dementia could be predicted by various personal interaction and contextual factors. DESIGN: Resistance was studied in a sample of 53 nursing home residents with late-stage dementia who were assisted at meals by CNAs. Using the EdFED-Q (Edinburgh Feeding Evaluation in Dementia Questionnaire), two groups of individuals who were being fed were identified: those who resisted assistance (n = 23) and those who accepted assistance (n = 30). Proportion of food consumed was determined by percentage of weight decrease in food offered. RESULTS: Differences between the two groups were identified. Although not differing in degree of cognitive impairment as measured by the MMSE or Body Mass Index, significant differences (p < .05) were found in level of functioning as measured by the Global Deterioration Scale, the proportion of food consumed and amount of time taken to assist with the meal. Resistors showed significantly different interaction behaviors in 8 of the 10 on the Interaction Behavior Measure-Modified when correlated with food consumed (r = .49 - .68, p < .02). CONCLUSION: When examining resistance to feeding a variety of factors must be examined, including the quality of the interaction between the caregiver and the person being fed ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Page 1 of 1 1 (25 articles found)

      
 ESRNexus is provided as a service by TrialStat Corporation. ESRNexus is a registered trademark of TrialStat Corporation. Copyright 2008. View a list of all articles here