ABSTRACT
The Program Environment Scale (PES) was developed for use with clients of community-based programs for the severely mentally ill. It is intended to fill the gap in available tools for assessing clients' perceptions of program functioning as it affects their "quality of life" in a program. Formal pretests were conducted with 121 clients at 12 randomly selected programs near Washington, DC. The final field test used a revised form (29 domains; 129 items) with 221 clients in 22 programs selected randomly throughout the U.S., including Clubhouse, day treatment, psychosocial rehabilitation, and social club programs. Twenty-three subscales met at least five of eight psychometric criteria for internal consistency and discriminant validity. A 24th subscale was retained because of its substantive importance. Successful subscales cover program atmosphere and interactions (program cares about me, energy level, friendliness, openness, staff-client and client-client respect, reasonable rules, availability of positive physical contact, protection from bad touch, staff investment in their jobs, and confidentiality), client empowerment/staff-client equality (program and treatment empowerment, egalitarian space use), and service components (support for paid work, work importance, emergency access, family activities, housing, public benefits, community activities, medications, substance abuse, and continuity). Subscale validity is indicated by associations of specific service offerings with scores on scales measuring client perceptions of those services, and by an ability to differentiate among program models (i.e., Clubhouses, day treatment programs, and psychosocial rehabilitation programs look different from each other). Subscale scores were not influenced by client characteristics (gender, race, age, diagnosis, number of hospitalizations, length of time in program). The final scale has 97 items and takes about 25 minutes to complete. The PES succeeds in measuring different aspects of programs as clients perceive them. In the programs we visited, directors felt the PES covers the important things they want to know about how clients perceive their program. The PES should become a useful tool both for researchers interested in how client responses to programs may influence their therapeutic outcomes, and for practitioners interested in improving their clients' program experiences and/or increasing convergence of staff and client views of their program.
Subject(s)
Environment , Mental Disorders/rehabilitation , Social Perception , Social Support , Surveys and Questionnaires , Female , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Severity of Illness IndexABSTRACT
The anti-cytomegalovirus activities of four phosphate derivatives of 9-(1,3-dihydroxy-2-propoxymethyl)guanine (DHPG) were evaluated against human, monkey and murine viruses. The 5'-mono-, 3'5'-bis(mono-), and 3',5'-cyclic monophosphate and 5'-homophosphonate forms of DHPG inhibited virus plaque formation at 1-15 microM. The cyclic phosphate and homophosphonate were more active than the other compounds against murine cytomegalovirus (MCMV) in vitro. In an in vivo MCMV infection model, DHPG homophosphonate and DHPG were equally effective at reducing mortality at greater than or equal to 10 mg/kg. The cyclic phosphate was active at 10-20 mg/kg but toxic at greater than or equal to 40 mg/kg. The phosphorylation of DHPG phosphate and DHPG phosphonate, as well as the inhibition of human cytomegalovirus DNA polymerase by their respective triphosphates, were also examined.
Subject(s)
Acyclovir/analogs & derivatives , Antiviral Agents/pharmacology , Cytomegalovirus/drug effects , Acyclovir/pharmacology , Animals , Antiviral Agents/toxicity , Cell Line , Cells, Cultured , Cytomegalovirus Infections/drug therapy , Ganciclovir , Guanine/analogs & derivatives , Guanine/pharmacology , Haplorhini , Humans , Mice , Nucleic Acid Synthesis Inhibitors , PhosphorylationABSTRACT
A series of phosphate esters of 9-[(1,3-dihydroxy-2-propoxy)methyl]guanine (DHPG, 1) were synthesized and evaluated for antiherpes virus activity. The cyclic phosphate esters were made by a new, efficient method utilizing stannic chloride as a solubilizing agent. Monophosphate 2 and bisphosphate 4 showed comparable activity to DHPG and probably acted as prodrugs of DHPG. On the other hand, the cyclic phosphate of DHPG 3 was taken up by cells and bypassed the virus-specified thymidine kinase. As a result, 3 was active against DHPG-resistant HSV mutants that lacked the viral-specified thymidine kinase and was more toxic than DHPG to uninfected cells. The phosphonate 5, the least toxic of the derivatives tested, was only marginally active against HSV but showed substantial activity against human cytomegalovirus in vitro.
Subject(s)
Acyclovir/analogs & derivatives , Ganciclovir/analogs & derivatives , Organophosphonates , Phosphates , Simplexvirus/drug effects , Acyclovir/administration & dosage , Acyclovir/chemical synthesis , Acyclovir/pharmacology , Administration, Oral , Animals , Cell Line , Cytomegalovirus/drug effects , Female , Haplorhini , Humans , In Vitro Techniques , Injections, Subcutaneous , Magnetic Resonance Spectroscopy , Mice , Microbial Sensitivity Tests , Simplexvirus/enzymology , Thymidine Kinase/metabolismABSTRACT
Treatment of chronic ground squirrel hepatitis virus infection with arabinosyladenine monophosphate at 20 mg/kg per day for 3 weeks caused marked decreases in serum virion-associated DNA polymerase concentrations in three of five squirrels. Statistically significant but less dramatic decreases in enzymatic activity were noted in two of six squirrels treated with 50 mg of 9-(1,3-dihydroxy-2-propoxymethyl)guanine per kg per day. After therapy, DNA polymerase activities rose to pretreatment levels.
