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Michelle Currin Sarah Patterson Hannah McGhee Pim Kuipers 《Physical & occupational therapy in geriatrics》2016,34(2-3):141-154
Background: Paradigms which emphasize the social determinants of health and client self-management, and approaches which promote health behavior change, are rarely operationalized within rehabilitation settings. The aim of this study was to investigate the processes required for this model of care change within an existing allied health community rehabilitation service. Methods: The service change program consisted of training elements in the areas of the social determinants of health, client self-management and health behavior change techniques as well as associated operational changes to reflect this paradigm shift. Results: The training packages implemented appear to have improved staff knowledge and skills within these socio-behavioral areas. Clinicians self-reported improvement with client care; however, these changes were not reflected in the chart audit. Conclusions: Clinician training is required to build both knowledge and skills in the areas of the social determinants of health, client self-management and health behavior change principles. In addition, clinicians should be equipped with frameworks to assist with operationalizing these principles. 相似文献
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55.
The epidemiology of hyperuricaemia and gout in Taiwan aborigines 总被引:4,自引:1,他引:4
To determine the prevalence of hyperuricaemia, gout and gout-related
factors in Central Taiwan Atayal aborigines, 342 subjects over 18 yr old
were interviewed and examined. A questionnaire was designed to screen for
signs and symptoms of gout and gout-related risk factors. Serum uric acid,
triglyceride and creatinine were measured in all subjects. The prevalence
of hyperuricaemia was 41.4% and that of gout 11.7% in aborigines. The uric
acid level was 7.9+/-1.7 mg/dl in males and 5.7+/-1.5 in females, and
differed significantly under age 70 yr (P < 0.001). Significantly
increased triglyceride, creatinine and alcoholism was found in gouty
patients compared with non-gouty patients. In 40 cases with gout, 54% had
tophi and 35% of their first- degree relatives had gout. The high
prevalence of hyperuricaemia and gout in Taiwan Atayal aborigines, a
significant family predisposition, increased creatinine level and
alcoholism suggest multiple factors affecting the hyperuricaemia.
相似文献
56.
The primary role of lymphoreticular cells in the mediation of host responses to bacterial endotoxim 总被引:19,自引:0,他引:19
S M Michalek R N Moore J R McGhee D L Rosenstreich S E Mergenhagen 《The Journal of infectious diseases》1980,141(1):55-63
Mice that are unresponsive to lipopolysaccharide (LPS) (strain C3H/HeJ) can be rendered LPS-sensitive by the adoptive transfer of bone marrow cells from LPS-sensitive mice (strain C3H/HeN). This model of adoptive transfer was used to evaluate the contribution of lymphoreticular cells to five effects of endotoxin on the host: immunogenicity, adjuvanticity, lethality, induction of interferon, and induction of colony-stimulated factor. C3H//HeJ mice became sensitive to each of these effects after adoptive transfer of bone marrow cells from C3H/HeN mice. The efficacy of transfer was directly proportional to the dose of X-irradiation and inversely proportional to the number of surviving host stem cells. The most effective dose of radiation was 850 rad, and C3H/HeN leads to C3H/HeJx chimeras prepared at this dose were as sensitive to LPS for each parameter tested as were the C3H/HeN donors except for a threefold greater resistance to lethality than LPS-responsive C3H/HeN mice. C3H/HeN mice could also be rendered unresponsive to LPS by the adoptive transfer of C3H/HeJ bone marrow cells. C3H/HeN chimeras were resistant to all of the effects of LPS studied except for the induction of colony-stimulating factor. These results demonstrate that lymphocytes and/or macrophages play a primary role in mediating a number of diverse and seemingly unrelated host responses to endotoxin. 相似文献
57.
Ortiz-Alvarez O; Cabral D; Prendiville JS; Stringer D; Petty RE; Malleson PN 《Rheumatology (Oxford, England)》1997,36(2):280-284
Two children are reported in whom intestinal pseudo-obstruction was the
initial manifestation of systemic sclerosis. Gastrointestinal symptoms and
skin changes resolved or improved in both children following treatment with
prednisone and penicillamine (case 1) or methotrexate (case 2), although
radiological changes of the gastrointestinal tract persisted at 3 and 2 yr
of follow-up, respectively.
相似文献
58.
59.
Coakley G; Mok CC; Hajeer AH; Ollier WE; Turner D; Sinnott PJ; Hutchinson IV; Panayi GS; Lanchbury JS 《Rheumatology (Oxford, England)》1998,37(9):988-991
OBJECTIVE: To examine whether promoter polymorphisms associated with
variation in interleukin-10 (IL-10) production are relevant to the
development of rheumatoid arthritis (RA) or Felty's syndrome (FS). METHODS:
DNA was obtained from 44 FS patients, 117 RA patients and 295 controls. The
promoter region between -533 and - 1120 was amplified by polymerase chain
reaction, and polymorphisms detected by restriction enzyme digest or
sequence-specific oligonucleotide probing. RESULTS: We found no significant
difference in allele or haplotype frequencies between the groups.
CONCLUSION: There is no association between FS or RA and these recently
identified IL-10 promoter polymorphisms. Other genetic or environmental
factors could explain the alterations in IL-10 levels seen in these
conditions.
相似文献
60.
Marco Gerlinger Sergio A Quezada Karl S Peggs Andrew JS Furness Rosalie Fisher Teresa Marafioti Vishvesh H Shende Nicholas McGranahan Andrew J Rowan Steven Hazell David Hamm Harlan S Robins Lisa Pickering Martin Gore David L Nicol James Larkin Charles Swanton 《The Journal of pathology》2013,231(4):424-432
The recognition of cancer cells by T cells can impact upon prognosis and be exploited for immunotherapeutic approaches. This recognition depends on the specific interaction between antigens displayed on the surface of cancer cells and the T cell receptor (TCR), which is generated by somatic rearrangements of TCR α‐ and β‐chains (TCRb). Our aim was to assess whether ultra‐deep sequencing of the rearranged TCRb in DNA extracted from unfractionated clear cell renal cell carcinoma (ccRCC) samples can provide insights into the clonality and heterogeneity of intratumoural T cells in ccRCCs, a tumour type that can display extensive genetic intratumour heterogeneity (ITH). For this purpose, DNA was extracted from two to four tumour regions from each of four primary ccRCCs and was analysed by ultra‐deep TCR sequencing. In parallel, tumour infiltration by CD4, CD8 and Foxp3 regulatory T cells was evaluated by immunohistochemistry and correlated with TCR‐sequencing data. A polyclonal T cell repertoire with 367–16 289 (median 2394) unique TCRb sequences was identified per tumour region. The frequencies of the 100 most abundant T cell clones/tumour were poorly correlated between most regions (Pearson correlation coefficient, –0.218 to 0.465). 3–93% of these T cell clones were not detectable across all regions. Thus, the clonal composition of T cell populations can be heterogeneous across different regions of the same ccRCC. T cell ITH was higher in tumours pretreated with an mTOR inhibitor, which could suggest that therapy can influence adaptive tumour immunity. These data show that ultra‐deep TCR‐sequencing technology can be applied directly to DNA extracted from unfractionated tumour samples, allowing novel insights into the clonality of T cell populations in cancers. These were polyclonal and displayed ITH in ccRCC. TCRb sequencing may shed light on mechanisms of cancer immunity and the efficacy of immunotherapy approaches. Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. 相似文献