Negative and supportive social interactions and quality of life among persons diagnosed with severe mental illness.

This study examined the relative importance of negative and supportive social interactions in predicting different aspects of quality of life (QOL) in a sample of persons diagnosed with severe mental illness (n = 104). Controlling for other variables that might explain such a relationship, we found that negative social interactions were significantly related to lower QOL in three subjective domains, while supportive social interactions were related to higher QOL in four objective domains and one subjective domain. We found negative social interactions that are stigmatizing to be particularly important in predicting QOL; additional analyses suggested that perceived stigma partially mediated the relationship between negative social interactions and QOL. We discuss the implications of the present findings for the study of the link between social relationships and QOL among persons with mental illness.

Human immunodeficiency virus type 1 entry inhibitors PRO 542 and T-20 are potently synergistic in blocking virus-cell and cell-cell fusion.

Human immunodeficiency virus type 1 (HIV-1) entry proceeds via a cascade of events that afford promising targets for therapy. PRO 542 neutralizes HIV-1 by blocking its attachment to CD4 cells, and T-20 blocks gp41-mediated fusion. Both drugs have shown promise in phase 1/2 clinical trials. Here, the drugs were tested individually and in combination in preclinical models of HIV-1 infection, and inhibition data were analyzed for cooperativity by using the combination index method. Synergistic inhibition of virus-cell and cell-cell fusion was observed for phenotypically diverse viruses for a broad range of drug concentrations, often resulting in > or = 10-fold dose reductions in vitro. Additional mechanism-of-action studies probed the molecular basis of the synergies. The markedly enhanced activity observed for the PRO 542:T-20 combination indicates that the multistep nature of HIV-1 entry leaves the virus particularly vulnerable to combinations of entry inhibitors. These findings provide a strong rationale for evaluating combinations of these promising agents for therapy in vivo.

Crafting usable knowledge.

Current emphasis on evaluating interventions does not address the problems of dissemination and utilization of these interventions, particularly in complex settings such as schools. Research on interventions is of value, but its generalizability to specific contexts is limited. Further, little is known about actual use of empirically supported interventions in practice settings. These concerns suggest the following: (a) There is a need to examine the dissemination process, including practitioner education and the development of a consumer information mindset by researchers; (b) guidance about selecting interventions would benefit from a systematic problem-solving orientation; and (c) research training and methodology need to be augmented with strategies and techniques suitable for developing an empirical approach to practice. These issues are addressed with specific examples drawn from school-based practice.

A multiplex reverse transcription polymerase chain reaction method for the detection of foodborne viruses.

A multiplex reverse transcription polymerase chain reaction (RT-PCR) method was developed for the simultaneous detection of the human enteroviruses, hepatitis A virus (HAV) and Norwalk virus (NV). Poliovirus type 1 (PV1) was chosen as a model for the human enterovirus group. Three different sets of primers were used to produce three size-specific amplicons of 435 bp, 270 bp, and 192 bp for PV1, NV, and HAV, respectively. RT-PCR products were separated by agarose gel electrophoresis, and amplicon identity was confirmed by Southern transfer followed by DNA hybridization using nonradioactive, digoxigenin-labeled internal probes. When tested on mixed, purified virus suspensions, the multiplex method achieved detection limits of < or = 1 infectious unit (PV1 and HAV) or RT-PCR-amplifiable unit (NV) for all viruses. With further streamlining efforts such as single tube amplification and liquid hybridization, multiplex PCR offers advantages over cell culture methodology and monoplex PCR because it allows for rapid and cost-effective detection of several human enteric viruses in a single reaction tube.

Mammalian telomeres end in a large duplex loop.

Mammalian telomeres contain a duplex array of telomeric repeats bound to the telomeric repeat-binding factors TRF1 and TRF2. Inhibition of TRF2 results in immediate deprotection of chromosome ends, manifested by loss of the telomeric 3' overhang, activation of p53, and end-to-end chromosome fusions. Electron microscopy reported here demonstrated that TRF2 can remodel linear telomeric DNA into large duplex loops (t loops) in vitro. Electron microscopy analysis of psoralen cross-linked telomeric DNA purified from human and mouse cells revealed abundant large t loops with a size distribution consistent with their telomeric origin. Binding of TRF1 and single strand binding protein suggested that t loops are formed by invasion of the 3' telomeric overhang into the duplex telomeric repeat array. T loops may provide a general mechanism for the protection and replication of telomeres.

A crossover clinical investigation of the safety and efficacy of a new oscillating/rotating electric toothbrush and a high frequency electric toothbrush.

PURPOSE: To compare the efficacy on plaque, gingivitis and calculus of an oscillating/rotating power toothbrush (Braun Oral-B Ultra Plaque Remover-D9) and a high frequency toothbrush (sonicare). MATERIALS AND METHODS: A 6-week, randomized crossover study was carried out. A total of 62 healthy adult subjects completed the study and were assessed for plaque control, gingival condition and calculus control. At the end of the study, subjects completed a questionnaire which assessed their preferences for the two devices. RESULTS: Both toothbrushes were found to be safe and effective, but a significantly lower gingival index (P = 0.002) and a lower calculus index (P = 0.022) was found in the D9 group. Assessment of patient preferences revealed that a significant majority of subjects in the study (65%) preferred the D9 to the high frequency toothbrush (27%). It is concluded that the D9 may offer greater potential for the maintenance of good gingival condition than the high frequency toothbrush, and that the greater preference for the D9 may be important with respect to long-term compliance. The implications of these findings are discussed.

Studying inpatient treatment practices in schizophrenia: an integrated methodology.

A multi-phase research project examining current inpatient psychiatric practices and the relationships between different treatments and patient outcomes is described. The study sample includes Medicaid patients with a diagnosis of schizophrenia who have been treated in inpatient units of general hospitals in New York State. The research is focused at the heart of the debate concerning the appropriate role of inpatient psychiatric care within a balanced system of mental health services. Addressed are the conceptual issues that guided the project, research strategies, instrument development, measures used and the preliminary findings that informed successive phases. Design issues are reviewed in light of the conceptual and pragmatic decisions made with a multiple site design. A compelling argument is made about the need for a long-term treatment orientation that prepares patients for what lies ahead and that assures communication and continuity between inpatient and outpatient care.

Effects of illness attribution and depression on the quality of life among persons with serious mental illness.

Attributing one's problems to a mental illness is associated with reduced subjective quality of life (QOL) among persons with schizophrenia, controlling for a broad range of socio-demographic, social, clinical, and psychosocial variables. Persons who attributed their problems to a 'physical, medical, or biological' problem in contrast to a 'mental illness' reported more positive social relations and higher overall quality of life. Much of the negative effect of mental illness attributions is explained by perceived stigma, lower self-esteem, and a higher level of depressive symptomatology. Depressive symptoms have an independent negative effect on QOL net of all other variables. These findings have important implications for the appropriate rehabilitation of persons with mental illness and require further scrutiny with prospective data.

Factors contributing to the subjective quality of life of the chronic mentally ill.

Although the deinstitutionalization of the seriously mentally ill has been severely criticized, the success of some model community programs shows that community care can enhance patients' quality of life. We lack specific knowledge, however, about the components that make these programs effective, and why. A theoretical framework for identifying these critical components is proposed. Services can enhance life satisfaction by increasing individuals' actual power through economic resources or status, thus enhancing their perceptions of mastery. An internal evaluation of a model program provides support for this hypothesis. One hundred and fifty-seven patients were interviewed about services, quality of life, and perceptions of mastery. Results show that services providing economic resources and an empowerment approach to service delivery are significantly related to overall quality of life. Furthermore, perceptions of mastery account for the impact of these components on life satisfaction. These findings suggest interventions that can be adopted by a wide range of mental health programs for the improvement of the quality of life of the chronic mentally ill.

Women and mental health: the interaction of job and family conditions.

Current research on the effects of wives' employment on their well-being focuses on the determinants of those effects. Most studies have used a gender model that concentrates on family conditions as mediators. In contrast, studies of the effects of employment on men typically use a job model and focus on work rather than family conditions as determinants. To understand fully the impact of employment on women, these models should be combined. We predict that certain work and family conditions interact, specifically, that the degree of control at work moderates the effects of demands in the family. Using two data sets on community mental health, we have found some support for this hypothesis.

The costs of sharing: wives' employment and husbands' mental health.

Although there is general concern about the psychological effects of gender stratification, we know relatively little about the particular aspects of inequality that affect men and women's mental health. This paper proposes that inequalities in power and demands associated with gender are particularly consequential for well-being. Previous analyses on married women support this perspective: wives' employment is positive for women's well-being to the extent that it increases their income relative to husbands and decreases their domestic demands, particularly through husbands sharing in domestic labor. The present analysis extends the test of this perspective to men by examining the effects of wives' employment on husbands' psychological well-being. Results show that insofar as it decreases husbands' relative income and increases their share of domestic labor, women's employment is negative for husbands' mental health.

The effects of women's employment: personal control and sex differences in mental health.

Married women have been found consistently to have higher rates of anxious and depressive symptoms than married men. Power explanations for this difference predict that employment for women, which is associated with greater power in the family, would reduce women's symptoms to approximate men's more closely. Results on the effects of women's employment, however, are inconsistent. One explanation for this inconsistency concerns role overload, or the greater demands experienced by women with employment. This paper proposes that overload creates greater symptoms for the same reason as low power; that is, through lowering individuals' sense of personal control. Thus employment for women is not consistently positive because it often trades one source of low control for another. We test a personal control explanation for the effects of women's employment, using community surveys of mental health. Results indicate that issues of personal control underlie the effects of both high demands and low power on sex differences in anxious and depressive symptoms.