Structure of the VHS domain of human Tom1 (target of myb 1): insights into interactions with proteins and membranes.

VHS domains are found at the N-termini of select proteins involved in intracellular membrane trafficking. We have determined the crystal structure of the VHS domain of the human Tom1 (target of myb 1) protein to 1.5 A resolution. The domain consists of eight helices arranged in a superhelix. The surface of the domain has two main features: (1) a basic patch on one side due to several conserved positively charged residues on helix 3 and (2) a negatively charged ridge on the opposite side, formed by residues on helix 2. We compare our structure to the recently obtained structure of tandem VHS-FYVE domains from Hrs [Mao, Y., Nickitenko, A., Duan, X., Lloyd, T. E., Wu, M. N., Bellen, H., and Quiocho, F. A. (2000) Cell 100, 447-456]. Key features of the interaction surface between the FYVE and VHS domains of Hrs, involving helices 2 and 4 of the VHS domain, are conserved in the VHS domain of Tom1, even though Tom1 does not have a FYVE domain. We also compare the structures of the VHS domains of Tom1 and Hrs to the recently obtained structure of the ENTH domain of epsin-1 [Hyman, J., Chen, H., Di Fiore, P. P., De Camilli, P., and Brünger, A. T. (2000) J. Cell Biol. 149, 537-546]. Comparison of the two VHS domains and the ENTH domain reveals a conserved surface, composed of helices 2 and 4, that is utilized for protein-protein interactions. In addition, VHS domain-containing proteins are often localized to membranes. We suggest that the conserved positively charged surface of helix 3 in VHS and ENTH domains plays a role in membrane binding.

Long-term effects of language intensity in preventive messages on planned family solar protection.

A series of sun safety messages containing highly intense language and deductive logical style achieved the most immediate compliance by parents, particularly when they intended to improve protection. Inductive messages were more successful when no intentions existed (D. B. Buller, Borland, & Burgoon, 1998; D. B. Buller et al., 2000). Interviewers recontacted 568 parents during the winter following message dissemination and assessed solar protection. A 2 (language intensity) x 2 (logical style) x 3 (behavioral intention) x 2 (person) mixed-model analysis of variance showed that parents receiving high-intensity, deductive messages reported the most improved solar protection and improvement was greatest when parents intended to improve protection. Over the long term, high language intensity may reinforce decisions to take preventive action and does not appear to provoke psychological reactance or resistance to these highly directive messages.

Using language intensity to increase the success of a family intervention to protect children from ultraviolet radiation: predictions from language expectancy theory.

BACKGROUND: Even though people are informed about skin cancer prevention, they do not always comply with prevention advice. From Language Expectancy Theory, it was predicted that messages with high language intensity would improve compliance with sun safety recommendations and that this effect would be enhanced with deductive argument style. METHODS: Parents (N = 841) from a pediatric clinic and elementary schools received sun safety messages (newsletters, brochures, tip cards) by mail that varied in language intensity and logical style. Effects on attitudes and behavior were tested in a pretest-posttest factorial design. RESULTS: As hypothesized, parents receiving messages with high- as opposed to low-intensity language complied more with sun safety advice. Messages with highly intense language were more persuasive when the arguments were formatted in a deductive style; low language intensity was more persuasive in inductively styled messages. CONCLUSIONS: By carefully adjusting messages features, health professionals can obtain further compliance beyond that produced by educating people about health risks and creating favorable attitudes and self-efficacy expectations. Highly intense language may be a good general strategy in prevention messages and works better when conclusions and recommendations are offered explicitly to recipients, especially when advice is aimed at reducing their personal risk.

Evaluation of the "Sunny Days, Healthy Ways" sun safety CD-ROM program for children in grades 4 and 5.

Computer-based sun safety instruction has many advantages that may be attractive to health educators in schools. An educational multimedia computer program on sun safety was produced on CD-ROM for children in grades 4 and 5, which was based on the "Sunny Days, Healthy Ways" sun safety curriculum (SDHW). Its effects on children's sun safety knowledge, attitudes and behaviour were evaluated with 162 students in 8 fourth and fifth grade classes in a randomized pretest-posttest 2 x 2 factorial design. Children interacting with the CD-ROM program showed significant improvements in knowledge (p = 0.007). The effect on knowledge may have indirectly improved children's sun protection (r = 0.201, p = 0.013), even though the CD-ROM program did not directly increase sun protection (p > .05) or improve attitudes (p > .05). The CD-ROM program may be a cost-effective and administratively acceptable sun safety instructional strategy, however, like many short prevention strategies, it will be most successful at conveying information on sun safety to children.

Tetrasomy 8 detected by interphase cytogenetics in a child with acute lymphocytic leukemia.

Tetrasomy 8 is a rare clonal anomaly in human acute leukemia. Here we present a case of a 7-year-old boy with acute lymphoblastic leukemia (ALL) displaying a tetrasomy 8 clone that could not be detected by conventional cytogenetics. In this study, bone marrow and peripheral blood cells were collected at five different diagnostic stages and analyzed by double targeted fluorescence in situ hybridization (FISH) with centromeric DNA probes for chromosomes 7, 8, 9, and 12. FISH analysis revealed a significant increase in tetrasomy 8 frequency, but not in other chromosomes examined. A smaller increase in trisomy 8 was also detected. At one stage over 60% of the cells were hyperdiploid with 40% being tetrasomic. The size of the tetrasomic clone changed during the course of the disease. The hyperdiploid frequencies of chromosome 8 detected by interphase FISH analysis in bone marrow and peripheral blood were similar. Our findings indicate the utility of FISH analysis in cytogenetic monitoring of leukemia patients and further show that tetrasomy 8 may play a specific role in a subtype of ALL.

Sunny days, healthy ways: evaluation of a skin cancer prevention curriculum for elementary school-aged children.

BACKGROUND: Primary prevention of skin cancer must start early in life to reduce total life-time sun exposure and severe overexposure in childhood. Childhood is an excellent time to form life-long prevention habits. A school-based curriculum can be an effective prevention strategy. OBJECTIVE: Our purpose was to determine the effectiveness of a skin cancer prevention curriculum at increasing knowledge and attitudes supporting prevention and decreasing sun exposure by children in grades four, five, and six. METHODS: Twenty-four classes (N = 447 students) from four public elementary schools in southern Arizona participated. Half received a pretest, half were tested at the conclusion of the 5-week curriculum in early spring, and half were tested 8 weeks later in late spring. Objective measures of suntanning were obtained. RESULTS: The curriculum increased knowledge about skin cancer prevention and attitudes supporting prevention and decreased suntanning. Self-reported preventive behavior was inconsistent and only weakly associated with measures of suntanning. CONCLUSION: The curriculum was effective at increasing skin cancer prevention. Resulting reduction in sun exposure was superior to that achieved with previous prevention curricula. Change in attitude needed time to emerge, appearing after 8 weeks. Self-reported preventive behavior by children in elementary school may lack validity. Pretesting did not alter effectiveness. Sixth-graders may be ready for more advanced content, but the curriculum is probably too advanced for kindergarten through third grade.

Predictors of oral health behaviors among elderly Japanese Americans.

As part of a series of studies on oral health behaviors of older persons, 81 elderly Japanese Americans were interviewed regarding their dental service utilization patterns, oral health attitudes, and dental status. The sample consisted of 35 Issei (first generation) and 46 Nisei (second generation) Japanese Americans. Because of the significant age difference between the Issei and Nisei, it was difficult to examine generational differences between the two groups. When age differences were controlled, there was no difference between the two generations in interval since their last dental visit. However, reasons for dental visits differed between the two groups, with the Issei more likely to seek help with dentures or general restorative work while the Nisei were more likely to schedule appointments for dental check-ups and cleaning. The best predictors of dental service utilization for the entire sample were the use of complete dentures, age, and education (R2 = .38), but when the respondent's perceived importance of oral health was entered into the equation, this variable accounted for more variance than age or education. The combination of complete dentures, importance, and age accounted for 41% of the variance in recency of dental service utilization. Locus of control, the belief component of attitudes, and overall attitude scores did not add significantly to the prediction of dental utilization.

Psychological impact of osseointegrated dental implants.

This longitudinal study of 39 patients who underwent treatment involving osseointegrated implants examined problems in oral and psychosocial functioning, expectations and experiences of difficulties with surgery, satisfaction with surgery, body image, neuroticism, self-concept, and extroversion. Patients completed six questionnaires from before phase 1 surgery to the final recall appointment for the new prosthesis (12 to 18 months after phase 1 surgery). The most common problems reported before treatment were those associated with eating; esthetics was less of a concern. Significant improvements in all problem areas were observed immediately after phase 2 surgery. Expectations of surgery-related problems were generally consistent with experiences immediately after phase 1 surgery, but more negative than experiences following phase 2 surgery. Body image before treatment was most negative vis-à-vis teeth. Significant improvements were found not only regarding teeth, but also on facial, mouth, and even overall body image. Satisfaction scores were generally high, but showed continued improvements through the final assessment. The only group experiencing negative outcomes consisted of patients scoring high on neuroticism.

Oral hygiene instruction and health risk assessment in dental practice.

We studied oral hygiene instruction given to 109 patients in 19 Washington State dental practices to investigate the extent to which therapists targeted their efforts toward patients with high disease risk. Patients were examined prior to instruction and prophylaxes. Therapists' instructions were tape-recorded and their content analyzed: therapists' expectations were scored. There were no statistically significant associations between patients' initial plaque levels and the process/content of the oral hygiene instructions delivered. On average, therapists spent 9.4 minutes of each prophylaxis session discussing oral hygiene. Therapists were judged more genuine with those patients for whom they had higher expectations of compliance, i.e., those with less plaque and low disease risk. We conclude that dental practitioners were not employing effective risk assessment strategies in selection of patients most in need of intensive instructional efforts.

How effective is oral hygiene instruction? Results after 6 and 24 weeks.

We studied the clinical effectiveness of oral hygiene instruction given to 71 "high" plaque patients in 19 Washington State dental practices to determine the extent of plaque reduction. Patients were examined prior to instruction and prophylaxis. Therapist instructions were tape-recorded and content analyzed, and therapists' expectations were scored. Patients were surveyed as to oral health behaviors and general health habit characteristics. Only 20 of 71 (28%) initially "high" plaque patients had reduced mean plaque scores to 1.0 or less at six weeks. An additional 13 percent had deteriorated plaque levels at 24 weeks. We concluded that therapists did not consistently follow principles of effective instruction and often overestimated their effectiveness. Determinants of relapse involve the educational process, the patients' oral status, and patients' life situations.

Use of routine chest radiography in the evaluation of fever in neutropenic pediatric oncology patients.

Evaluation of febrile episodes in children who have become neutropenic during treatment for malignant disease has traditionally included radiography of the chest. It has been our impression that the yield of such examination is low. To test this hypothesis we reviewed all chest radiographs (CXRs) obtained in the above setting in our institution over the last 3 years. These radiographs were independently reviewed by two of us (R.C., J.F.). Sixty-one patients experienced 134 febrile neutropenic episodes for which a CXR was obtained. Only eight (6%) of these films revealed any abnormality. After careful review it was apparent that four of these radiographs did not represent a infectious process. Thus only four of 134 films (2.9%) indicated pulmonary infection as the probable cause of fever in the patient. All four of these patients had prominent respiratory signs or symptoms. Of patients who were febrile but without pulmonary signs/symptoms, only one of 49 had an abnormal radiograph. We feel that such a low yield (at most 2%) calls into question the routine practice of obtaining a CXR in the febrile neutropenic child who is otherwise asymptomatic.

Hypertension in neuroblastoma induced by imipramine.

Hypertension is a well-known finding in some patients with neuroblastoma. However, it has not previously been described in association with the use of Imipramine. We report the occurrence of severe hypertension (blood pressure 190/160) in a 4-year-old girl with neuroblastoma who was given Imipramine to control a behavior disorder. It was determined later that this patient's tumor was recurring at the time of her hypertensive episode. Since she had no blood pressure elevation at initial diagnosis and none following discontinuation of the Imipramine (when she was in florid relapse), we believe that this drug rather than her underlying disease alone caused her hypertension. The mechanism for this reaction is believed to be increased levels of vasoactive catecholamines due to interference of their physiologic inactivation by Imipramine. From this experience, we urge extreme caution in the use of tricyclic antidepressants in children with active neuroblastoma.

Development of a measure of job satisfaction for dentists and dental auxiliaries.

This paper describes the development of a multidimensional, 38-item measure of job satisfaction appropriate for dentists, dental hygienists, and dental assistants. Items were grouped into the following 12 subscales: income, recognition, opportunity to develop professionally, time to develop professionally, responsibility, non-patient tasks, staff relations, quality of care, leisure time, fatigue, time pressure and general satisfaction. The measure was developed from a set of 45 items included in questionnaires administered to dentists and staff of 126 dental practices in Washington State, USA. Questionnaires were returned by 117, 121 and 106 dentists; 69, 80, and 82 hygienists; and 322, 329, and 320 assistants, respectively, in each of the 3 yr (1979, 1980, 1981). Factor analysis (principal components analysis with varimax rotation) plus categorization of items by a panel of professionals were used to initially group items into subscales. Contribution to internal consistency was the final criterion for an item's inclusion in a subscale. Internal consistency reliability of subscales ranged from 0.68 to 0.95. Statistically significant relationships were found between individual job satisfaction subscales and intent to change job for hygienists and assistants.

Development and validation of a measure of dental patient satisfaction.

As part of the Washington State Dental Auxiliaries Project, a 42-item measure of patient satisfaction with dental care was developed. The measure is comprised of 13 subscales: dentist-patient relations, technical quality of care, access, patient waiting time, cost, facilities, availability, continuity, pain, auxiliaries performing expanded duties, staff-patient relations, staff technical quality of care, and office atmosphere. The measure was developed from a set of 52 items included in a questionnaire administered to the patients of private dental practices in Washington state. Usable questionnaires were returned by 30.8% of patients receiving questionnaires in 1979, 40.1% in 1980, and 34.0% in 1981. Factor analysis plus categorization of items by a panel of professionals were used initially to group items into subscales. Contribution to internal consistency was the final criterion for an item's inclusion in a subscale. Internal consistency of subscales ranged from 0.44 to 0.80. The concurrent validity of subscales was assessed by relating patient satisfaction to characteristics of the dental practices. The following statistically significant relationships between subscales and criterion variables were observed: dentist-patient relations and percent of patients seen by the dentist; access and number of weeks appointments must be booked in advance; patient waiting time and actual patient waiting time; continuity of care and percent of patients seen by the dentist; auxiliaries performing expanded duties and delegation to auxiliaries; and staff technical quality and percent of hygienist restorations with satisfactory quality. Each relationship was in the expected direction.

The prediction of relapse in bulimia nervosa.

Thirty-nine women successfully treated for bulimia nervosa were followed up six months after the conclusion of treatment and classified as maintaining recovery or partially or completely relapsed. Clinical and psychometric variables including body image disturbance and dissatisfaction were entered into regression equations to identify predictors of relapse. Dissatisfaction with body image at the end of treatment was the most potent predictor of relapse. The finding is interpreted as underscoring the importance of addressing issues of body image in therapy if treatment gains are to be maintained.

Pulmonary function changes after acute inhalation of chlorine gas.

Four young healthy adults were studied physiologically after accidental inhalation of chlorine gas. All patients were symptomatic with cough, tightness in the chest, and shortness of breath. All had restrictive ventilatory defect with impaired diffusing capacity. There was evidence of some obstruction in small airways. There was inconsistent evidence of obstruction in large airways. All lung function impairment was temporary and cleared entirely within one month. There was no residual lung damage.

Computer-assisted instruction for decision making in food systems management.

Although effectiveness of the CAI case study simulations was not immediately made evident by the results of the objective measurements used, students and faculty members involved responded positively to the CAI experience and expressed interest in continuation and expansion of the CAI method. The use of CAI in a dietetic education program was feasible for this coordinated dietetics program. Further research is recommended on the use of CAI to meet both cognitive and affective competencies in a dietetic education program. Research in evaluation of effectiveness of CAI is essential when objectives to be met are affective in nature.