Service users' experiences of participation in decision making in mental health services.

ACCESSIBLE SUMMARY: Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. ABSTRACT: Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.

Functional activity of HERV-K-T47D-related long terminal repeats.

The human genome contains a family of endogenous retroviruses, HERV-K(HML-4), that comprises the full-length provirus HERV-K-T47D, five related elements, and hundreds of solitary long terminal repeats (LTRs). We here show that HERV-K-T47D-related LTRs are dispersed over all human chromosomes and have arisen after the divergence of Old and New World monkeys. By screening a cDNA library derived from the human mammary carcinoma cell line T47D with a HERV-K-T47D LTR probe, we isolated several clones containing LTR/cellular gene chimeras and assessed the transcriptional activity of these LTRs in transient transfection experiments. All LTRs were able to drive the expression of a reporter gene, thereby displaying distinct activities in different cell lines. We found that sequences located downstream of the LTR-U3 region modulate the level of gene expression. Based on the impact of the R region we distinguished between three different LTR types; the activity of type I LTRs was enhanced in the presence of the LTR-R region in all cell lines tested, whereas a type II LTR was downregulated. Type III LTRs are characterized by lacking or having a varying influence of the R region that was dependent on the cell line used. Finally, our results attribute to LTR-U5-gag sequences a role in determining LTR activity.

Cell type-specific expression and promoter activity of human endogenous retroviral long terminal repeats.

Evolution over millions of years has adapted several thousand copies of retrovirus-like elements and over 10 times as many solitary long terminal repeats (LTRs) to their present location in the human genome. Transcription of these human endogenous retroviruses (HERVs) has been detected in various cells and tissues, and in some cases their transcriptional control elements have been recruited by cellular genes. We used a retroviral pol-specific expression array to obtain a HERV transcription profile in a variety of human cells such as epidermal keratinocytes, liver cells, kidney cells, pancreatic cells, lymphocytes, and lung fibroblasts. This rapid screening test revealed a distinct HERV pol-expression pattern in each cell type tested so far. About 40 different U3/R regulatory sequences from the HERV-H and HERV-W families were then amplified from actively transcribed 3'HERV LTRs of various cell lines and tissues. Their promoter activities were compared with LTR sequences of other known HERV families in 12 human cell lines using a transient luciferase reporter system. Expression of the isolated HERV LTRs varied significantly in these cell lines, in some cases showing strict cell type specificity. These results suggest that endogenous retroviral LTRs may be a valuable source of transcriptional regulatory elements for the construction of targeted retroviral expression vectors.

HERV-IP-T47D, a novel type C-related human endogenous retroviral sequence derived from T47D particles.

A new type C retrovirus-related endogenous pol sequence (ERV-FTD) found to be occasionally copackaged in retrovirus-like particles released by the human mammary carcinoma cell line T47D was used to screen a human genomic library (Seifarth W, Skladny H, Krieg-Schneider F, Reichert A, Hehlmann R, and Leib-Mösch C: J Virol 1995;69:6408-6416). The DNA sequence of one full-length clone now reveals a human endogenous proviral sequence (HERV) of 4190 bp in length comprising a 5' LTR (489 bp) and regions with 37 and 74% overall amino acid homology to RTVL-Ia gag and pol genes, respectively. About 35 related elements were found to be distributed on all human chromosomes except 16, 17, and Y. Sequence comparisons with Mo-MuLV and various type C-related HERVs suggest that despite a proline primer-binding site this novel HERV element, now named HERV-IP-T47D, can be assigned to one family together with known HERV-I elements. Phylogenetic analyses of 5 proviral and 25 solitary LTR sequences confirmed the existence of two distinct but closely related subgroups of the HERV-IP superfamily in the primate genome. In contrast to most known HERV-families, the evolutionary age of HERV-IP elements dates back prior to the divergence of New and Old World monkeys. Despite their old age, members of the HERV-IP family are still transcriptionally active and were found to be highly expressed in specific human tissues such as liver and kidney.

[Sun protection by optimally designed fabrics]. / Sonnenschutz durch optimierte Stoffe.

A rising incidence worldwide of skin cancer has been observed for years. A high cumulative exposure to UV radiation is a major factor in the development of such neoplasms. Suitable protective measures are therefore becoming increasingly important. Textiles provide simple, effective and medically safe protection against UV radiation. At present, however, in Europe--in contrast to Australia--the UV protection factor (UPF) for summer textiles is not stated. It is a largely unknown fact that by far not all textiles offer sufficient protection. Our goal was to study the factors which determine the UV transmission of fabrics and, based on these findings, to design materials which provide enhanced protection. A spectrophotometric method was used to determine the UV transmission by fabrics made of cotton, silk, polyester and viscose. The UV protection factors of the fabrics were computed on the basis of the transmission data. The UV protection factor is dependent on the type of fibre, yarn and surface design, weight per square metre, moisture content, colour, finishing method and degree of wear. To optimize the UV protection via textiles, a viscose yarn with a low UV transmission was used. This yarn makes it possible to design light-weight summer fabrics with optimized UV protection. This development will make it possible to offer clothing with high UV protection on the European marked. This clothing will not be more expensive than normal products, so that effective prevention should be more available.

Synthesis, pharmacological characterization, and quantitative structure-activity relationship analyses of 3,7,9,9-tetraalkylbispidines: derivatives with specific bradycardic activity.

A series of 3,7,9,9-tetraalkyl-3,7-diazabicyclo[3.3.1]nonane derivatives (bispidines) was synthesized and identified as potential antiischemic agents. Pharmacological experiments in vitro as well as in vivo are described, and the results are listed. For selection of those compounds fitting best to the desired profile of a specific bradycardic antianginal agent--decrease in heart rate without affecting contractility and blood pressure--these results were scored and ranked. Quantitative structure--activity relationship (QSAR) analyses were performed and discussed a posteriori by means of Hansch, nonelementary discriminant and factor analysis to get insight into the molecular features determining the biological profile. Highly significant equations were obtained, indicating hydrophobic and steric effects. Both pharmacological ranking and QSAR considerations showed compound 6 as the optimum within the structural class under investigation. Compound 6 (tedisamil, KC8857) has been selected as the most promising compound and was chosen for further pharmacological and clinical investigations as an antiischemic drug.

Design and synthesis of an orally active GPIIb/IIIa antagonist based on a phenylpiperazine scaffold.

The design and synthesis of an orally active LMW non-peptide GPIIb/IIIa antagonist, based on a N,N'-bisphenylpiperazine scaffold, is described. The optimal compound showed a high in vitro binding potency (pIC50 = 8.7) in combination with potent oral antithrombotic activity (30-40% inhibition of thrombus growth at 0.3-3 mg/kg) with a duration of action of > 90 min. in a hamster cheek pouch model.

Cloning and sequencing of the dnaK operon of Bacillus stearothermophilus.

Here, we report the cloning of a 5.8-kb PstI fragment of chromosomal DNA from Bacillus stearothermophilus (Bt) carrying the three genes, grpE, dnaK and dnaJ. This fragment contains, in addition, the 3'-end of an open reading frame which has been shown to be part of the dnaK operon in three bacterial species. The dnaJ gene could complement an Escherichia coli dnaJts mutant for growth at high temperature. Sequencing and hybridization data strongly suggest that the Bt chromosome contains an analog of dnaJ.

Overproduction, purification and characterization of GroES and GroEL from thermophilic Bacillus stearothermophilus.

To facilitate purification of the two chaperonins GroES and GroEL encoded by the thermophilic Bacillus stearothermophilus, an Escherichia coli strain was constructed in which the geoESL operon was replaced by that of B. stearothermophilus. This strain is perfectly viable, demonstrating that the B. stearothermophilus operon is functionally interchangeable with that of E. coli. To increase the amount of GroES, the groES gene was fused to an IPTG-inducible promoter. Both proteins GroES and GroEL, were purified from E. coli using the standard protocol with some modifications. This method should be applicable in all cases where a foreign groE operon can substitute that of E. coli. A preliminary characterization of GroEL, revealed that it has the same secondary structural elements as the E. coli homologue, but its thermodynamic stability is significantly increased.

Construction of His6-tagging vectors allowing single-step purification of GroES and other polypeptides produced in Bacillus subtilis.

Two plasmid expression vectors for Bacillus subtilis have been constructed that direct the synthesis of fusion proteins containing a stretch of six histidine residues (His6) at either the N or C terminus. The His6 tag allows the rapid enrichment of proteins by metal chelate affinity chromatography in a denatured or native state. As an example of the general utility of one of these expression vectors, we produced the GroES protein encoded by the groESL operon of B. stearothermophilus.

Molecular cloning, sequencing, and transcriptional analysis of the groESL operon from Bacillus stearothermophilus.

Using a gene probe of the Bacillus subtilis groEL gene, a 7.3-kb HindIII fragment of chromosomal DNA of Bacillus stearothermophilus was cloned. Sequencing of 2,309 bp led to the detection of two open reading frames in the order groES groEL. Primer extension studies revealed one potential transcription start site preceding the groESL operon, which was activated upon temperature upshift. Northern blot (RNA) analysis resolved two mRNA species with lengths of 2.2 and 1.5 kb; RNA slot-blot experiments revealed an at least 10-fold increase in the amount of specific mRNA from 0 to 7 min postinduction followed by a decrease. The 9-bp inverted repeat characteristic of many gram-positive bacteria was found within the 5' leader region of the mRNA. The groESL operon of B. stearothermophilus could complement E. coli groES(Ts) and groEL(Ts) mutants for growth at high temperature and for propagation of phage lambda.