Medicine and Health Sciences Commons^™

Bridging Conflicting Ideologies: The Origins Of American And British Occupational Therapy., Ruth L. Schemm

Department of Occupational Therapy Faculty Papers

Occupational therapy practice has bridged two contradictory value systems for more than 100 years. This article describes the origins of practice ideas in both the United States and Britain and demonstrates that founding members of the occupational therapy profession all shared a core of humanistic beliefs while embracing the emerging paradigm of scientific medicine. The result has been an intellectual tension between the biological and the psychosocial aspects of practice. For more than 75 years, occupational therapists struggled to balance the art and science of patient care; recent debates on modalities, practice domains, and research priorities indicate that the unifying …

Roc Curve Regression Analysis: The Use Of Ordinal Regression Models For Diagnostic Test Assessment, Anna N.A. Tosteson, Milton C. Weinstein, Jack Wittenberg, Colin B. Begg

Dartmouth Scholarship

Diagnostic tests commonly are characterized by their true positive (sensitivity) and true negative (specificity) classification rates, which rely on a single decision threshold to classify a test result as positive. A more complete description of test accuracy is given by the receiver operating characteristic (ROC) curve, a graph of the false positive and true positive rates obtained as the decision threshold is varied. A generalized regression methodology, which uses a class of ordinal regression models to estimate smoothed ROC curves has been described. Data from a multi-institutional study comparing the accuracy of magnetic resonance (MR) imaging with computed tomography (CT) …

The Life-Long Learning Imperative... Ends And Means, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

Regulation Of Collagenase Gene Expression By Il-1 Beta Requires Transcriptional And Post-Transcriptional Mechanisms, Matthew P. Vincenti, Charles I. Coon, Oneil Lee, Constance E. Brinckerhoff

Dartmouth Scholarship

Interleukin-1 beta is believed to contribute to the pathophysiology of rheumatoid arthritis by activating collagenase gene expression. We have used a cell culture model of rabbit synovial fibroblasts to examine the molecular mechanisms of IL-1 beta-mediated collagenase gene expression. Stimulation of rabbit synovial fibroblasts with 10 ng/ml recombinant human IL-1 beta resulted in a 20-fold increase in collagenase mRNA by 12 h. Transient transfection studies using collagenase promoter-CAT constructs demonstrated that proximal sequences responded poorly to IL-1 beta, possibly due to insufficient activation of AP-1 by this cytokine. More distal sequences were required for IL-1 beta responsiveness, with a 4700 …

A Randomized Comparison Of Coronary-Stent Placement And Balloon Angioplasty In The Treatment Of Coronary Artery Disease. Stent Restenosis Study Investigators., David L. Fischman, Martin B. Leon, Donald S. Baim, Richard A. Schatz, Michael P. Savage, Ian Penn, Katherine Detre, Lisa Veltri, Donald Ricci, Masakiyo Nobuyoshi, Michael Cleman, Richard Heuser, David Almond, Paul S. Teirstein, R. David Fish, Antonio Colombo, Jeffrey Brinker, Jeffrey Moses, Alex Shaknovich, John Hirshfeld, Stephen Bailey, Stephen Ellis, Randal Rake, Sheldon Goldberg

Department of Medicine Faculty Papers

BACKGROUND: Coronary-stent placement is a new technique in which a balloon-expandable, stainless-steel, slotted tube is implanted at the site of a coronary stenosis. The purpose of this study was to compare the effects of stent placement and standard balloon angioplasty on angiographically detected restenosis and clinical outcomes.

METHODS: We randomly assigned 410 patients with symptomatic coronary disease to elective placement of a Palmaz-Schatz stent or to standard balloon angioplasty. Coronary angiography was performed at base line, immediately after the procedure, and six months later.

RESULTS: The patients who underwent stenting had a higher rate of procedural success than those who …

Images In Clinical Medicine. Bilateral Femur Fractures., Gregory P. Conners, D W. Ochsenschlager

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Comparison Of Cytotoxic Properties Of Neonatal And Adult Neutrophils And Monocytes And Enhancement By Cytokines., E . R. Stiehm, R. L. Roberts, B. J. Ank, S. Plaeger-Marshall, N. Salman, L. Shen, M. W. Fanger

Dartmouth Scholarship

We studied cytotoxic capabilities of newborn polymorphonuclear leukocytes (PMNs) and monocytes and their enhancement by cytokines and antibodies. Umbilical cord PMNs were assessed for their ability to kill various target cells spontaneously, after activation with phorbol myristate acetate, in the presence of antiserum (antibody-dependent cellular cytotoxicity), and in the presence of dually specific antibody (heteroantibody-mediated cytotoxicity). Target cells included the K562 cell line (natural killer cell target), chicken erythrocytes (CRBCs), and herpes simplex virus-infected CEM cell lines. Newborn PMNs were equivalent to adult PMNs in their cytotoxic capacity in several cytotoxicity assays. Neither adult nor newborn PMNs lyse tumor cell …

Functional Analysis Of Human Alpha 1(I) Procollagen Gene Promoter. Differential Activity In Collagen-Producing And -Nonproducing Cells And Response To Transforming Growth Factor Beta 1., Sergio A. Jimenez, John A. Varga, Anne Olsen, Liye Li, Arturo Diaz, Janet Herhal, Julie Koch

Department of Medicine Faculty Papers

To gain a further understanding of the regulation of human type I collagen gene expression under physiologic and pathologic conditions, we characterized 5.3 kilobase pairs (kb) of the human alpha 1(I) procollagen gene promoter. A series of deletion constructs containing portions of the alpha 1(I) procollagen 5'-flanking region (with end points from -5.3 kb to -84 base pairs (bp)) ligated to the chloramphenicol acetyltransferase (CAT) reporter gene were transiently transfected into NIH/3T3 cells. Maximal CAT activity was observed with constructs having 5' end points from -804 to -174 bp. A further 5' deletion to -84 bp caused a marked reduction …

Elevated Expression Of Type Vii Collagen In The Skin Of Patients With Systemic Sclerosis. Regulation By Transforming Growth Factor-Beta., Lidia Rudnicka, John Varga, Angela M. Christiano, Renato V. Iozzo, Sergio A. Jimenez, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

A hallmark of systemic sclerosis (SSc) is the development of tissue fibrosis. Excessive production of several connective tissue components normally present in the dermis, including type I, III, V, and VI collagens as well as fibronectin and proteoglycans, is a consistent finding in the skin of SSc patients. Type VII collagen is a major constituent of anchoring fibrils, present in the skin at the dermal-epidermal basement membrane zone. TGF-beta has been shown to upregulate the expression of the type VII collagen gene. In this study, we assessed the expression of type VII collagen and TGF-beta in the skin of patients …

A Tension Between Two Cultures ... Dentistry As A Profession And Dentistry As Proprietary, David A. Nash

Oral Health Science Faculty Publications

No abstract provided.

Management Decisions Made By Caregiver Spouses Of Persons With Alzheimer's Disease., Mary A. Corcoran

Department of Occupational Therapy Faculty Papers

OBJECTIVES: As the incidence of Alzheimer's disease increases, so does the effect on families and friends who assume caregiving responsibilities. Despite the proliferation of caregiving studies reported in the literature, little is known of the day-to-day management styles and preferences of caregivers. To develop, implement, and test interventions designed to sustain caregivers in their role, more information is needed about the caregiving experience. Results of a descriptive study are presented as a first step in understanding the complex process of choosing, organizing, and implementing everyday caregiving tasks.

METHOD: Subjects of the study were 26 persons who provide care for a …

Cancer Differentials Among Us Blacks And Whites: Quantitative Estimates Of Socioeconomic-Related Risks, Kevin M. Gorey

Social Work Publications

This article analyzes 10 studies that assessed the association of socioeconomic status (SES) with cancer occurrence among blacks and whites in the United States. The following summative inferences were made: the associations of SES with cancer are similar among blacks and whites; cancers of organ sites with the most intimate environmental interfaces have the strongest SES-cancer associations (stomach, lung, cervix, and rectum); the prevalence of exposure to low socioeconomic-related risks such as poverty are approximately fourfold greater among blacks; the all-site population attributable risk percent due to low socioeconomic exposure among blacks is estimated to be four times that of …