DNA immunization with HIV early genes in HIV type 1-infected patients on highly active antiretroviral therapy.

The aim of this study was to evaluate the immunological responses induced by DNA plasmids containing HIV regulatory genes administered in combination in HIV-1-infected patients with pretreatment with highly active antiretroviral treatment (HAART). The study is a double-blind, randomized, and placebo-controlled study, including 15 asymptomatic HIV-1-infected patients on stable HAART for at least 6 months and with plasma HIV RNA levels below 50 copies/ml. Ten patients received a combination of rev, tat, and nef intramuscularly (im) at weeks 0, 4, and 16 at increasing doses giving totals of 300 (100 x 3), 900 (300 x 3), and 1800 (600 x 3) micrograms DNA. Five patients received saline in the same amounts im. Antigen-specific cytotoxic T lymphocyte (CTL) levels were preserved or increased and new T lymphocyte proliferative responses were induced in the group immunized with the HIV DNA genes. No increase in antibody levels was noted. Despite a 10-fold higher vaccine dose, patients on HAART did not respond better to vaccination compared to non-HAART patients included in a previous study where the genes were administered separately. Combining the regulatory genes rev, tat, and nef in increasing doses may reduce the anticipated augmentation of HIV-specific T cell proliferative and CTL responses. Viral suppression did not seem to further improve the initial vaccine responses of patients with comparable CD4 levels.

Development of an academic consortium for nurse-managed primary care.

This article describes the development of an academic consortium comprised of four universities and their schools and colleges of nursing. The initial efforts at collaboration arose from the need to obtain funding and address policy issues related to advanced practice issues at the state level. The developmental stages of the Michigan Academic Consortium are described within a framework developed by Bailey and Koney (I).

Trauma patient outcomes: six-month follow-up.

One hundred forty-six trauma patients discharged from an acute care setting to home were followed during a 6-month period after discharge to determine functional problems they experienced and the time required to return to normal activity levels. At 1 week, 58% were unable to drive a care, 59% experienced difficulty with lifting, and 76% were unable to return to work. At 1 month, 27% continued to have trouble driving, 32% had trouble lifting, and 37% had not returned to work yet. Head injury patients and those with orthopedic injuries of the extremities or pelvis experienced problems returning to work. The head injury group also experienced vocational problems. By 6 months, 89% of the patients reported a return to normal activities. Findings suggest that a return to normal functioning level is a long-term process, and that certain injury types are at high risk for experiencing specific identifiable problems.

Validation of tardive dyskinesia as measured on the Dyskinesia Identification System--Coldwater.

Identification and description of tardive dyskinesia have been hampered by the absence of systematic studies assessing the psychometric properties of existing instruments. The purpose of this study was to establish construct validation of one of these instruments, the Dyskinesia Identification System--Coldwater. Cross-sectional prevalence assessment data of 519 institutionalized mentally retarded persons were used. The 34 items of this instrument were subjected to exploratory factor analysis. A six-factor orthogonal solution was selected. Multiple regression analyses supported the established relationships of demographic variables, such as age and sex, with the tardive dyskinesia scores generated by the instrument.

Staff nurses' attitudes toward nursing research: a descriptive survey.

Staff nurse involvement in clinical nursing research is dependent on the attitudes nurses hold toward research. An exploration of these attitudes was undertaken in a 464-bed midwestern teaching hospital as it developed its nursing research procedures. A questionnaire was developed which incorporated the Boothe Attitudes on Nursing Research Scale. All registered nurses (n = 925) at the facility were surveyed with a response rate of 77.8% (n = 720). Findings indicated that many nurses were interested in research and believed that the institution would support research activities and the implementation of research findings. Some deterrences to conducting research included: time, lack of knowledge, and the nurses's perception of the supervisory support and the research support services.