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 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper discusses the origins and experiences of the Community Medical Alliance (CMA), a Boston-based clinical care system that contracts with the Massachusetts Medicaid program on a fully capitated basis to pay for and deliver a comprehensive set of benefits to individuals with advanced AIDS and individuals with severe disability. Since 1992, the program has enrolled 818 individuals with either severe disability, AIDS, mental retardation, or general SSI-qualifying disability. Under a fee-for-service system, these two groups had received fragmented care. The capitated CMA program emphasizes patient education and self-management strategies, social support and mental health services, and a team approach to healthcare delivery that has reoriented care to primary care physicians, homes, and communities.
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PMID:Massachusetts Medicaid and the Community Medical Alliance: a new approach to contracting and care delivery for Medicaid-eligible populations with AIDS and severe physical disability. 1018 Dec 93

Very little is known about the characteristics of people with mental retardation who are infected with HIV. Using a datafile created by a match between the New Jersey HIV and AIDS Registry file through March 1996 and the New Jersey Medicaid eligibility file for the period August 1993 to March 1996, we identified the largest group of HIV-infected persons with mental retardation (N = 119) that has been reported to date. Compared to other HIV-infected New Jersey Medicaid recipients, individuals in this subgroup were more likely to be female, Black, and have injection drug use as a route of infection. Implications for delivery of appropriate services are discussed.
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PMID:Characteristics of persons with mental retardation and HIV/AIDS infection in a statewide Medicaid population. 1045 Apr 62

In this, the 11th Annual Research Review, I have been pleased to work with an outstanding group of contributors. As in past issues of the Annual Research Review the aim is to provide our readers with reviews that update both current knowledge and research findings. Authors are asked to be selective, rather than comprehensive, in their coverage as they identify the issues that they feel are particularly important for future research. I am grateful not only to the authors but to the numerous referees who provided critiques of each paper. In the first paper in this issue David Skuse provides an update on the relevance of behavioural neuroscience to child psychopathology. This paper provides a thoughtful review of the findings of the past decade and outlines possible directions for future research developments; it appears that we are poised for a major explosion of knowledge in this area. In the second paper Robin Chapman provides a very useful review of recent research on language development. This paper provides an update of Dorothy Bishop's earlier review of the topic and illustrates the considerable progress made since the time of that review. In the third paper Eilish Gilvarry summarises recent research on substance abuse in young people. This review covers recent changes in trends and patterns of substance abuse, aspects of risk and comorbidity, and treatment. Brown and colleagues then review recent work on children and adolescents with HIV and AIDS; this global health problem presents unique issues relative both to research and intervention. Danya Glaser then provides an overview of recent work on child abuse and neglect and the brain; the attempt to bring the various perspectives of neuroscience together on this topic is particularly timely and appropriate. Finally, Sparrow and Davis provide an overview of recent advances in the assessment of intelligence. This paper provides a helpful summary of current perspectives on the assessment of intelligence; the review of instruments will be of particular interest to our readers. For the 12th edition of the Annual Research Review we anticipate coverage of the following topics: intersubjectivity, reading disability, longitudinal approaches to developmental data, mental retardation, conduct disorder, and psychopharmacology.
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PMID:Editorial. 1126 Aug 27

The effects of three strategies for changing stigmatizing attitudes--education (which replaces myths about mental illness with accurate conceptions), contact (which challenges public attitudes about mental illness through direct interactions with persons who have these disorders), and protest (which seeks to suppress stigmatizing attitudes about mental illness)--were examined on attributions about schizophrenia and other severe mental illnesses. One hundred and fifty-two students at a community college were randomly assigned to one of the three strategies or a control condition. They completed a questionnaire about attributions toward six groups--depression, psychosis, cocaine addiction, mental retardation, cancer, and AIDS--prior to and after completing the assigned condition. As expected, results showed that education had no effect on attributions about physical disabilities but led to improved attributions in all four psychiatric groups. Contact produced positive changes that exceeded education effects in attributions about targeted psychiatric disabilities: depression and psychosis. Protest yielded no significant changes in attributions about any group. This study also examined the effects of these strategies on processing information about mental illness.
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PMID:Three strategies for changing attributions about severe mental illness. 1135 86

Guam has a Children with Special Health Needs (CSHN) Systems Management Project to coordinate different programs and services and to identify and enroll 4 year old children with special health care needs. It also streamlines service linkages and ongoing tracking activities. Children with special health needs include those with actual or potential disabilities and handicaps, actual or potential chronic diseases, actual or potential conditions that do not always cause disability or handicap, and health related educational and behavioral problems. Poverty plays a contributing role to some of these children's special needs. In fact, 25% of Guam's families are at or below the poverty level. Other children have special health care needs due to parental or psychological factors. Further inadequate prenatal care, parental mental retardation, AIDS, parental substance abuse, maternal age, and the inability to parent can all result in special need circumstances. Despite the many and varied needs, services and resources that can best help them are scarce in Guam. Even with optimal use of Guam's resources, many families of such children either do not receive proper care or leave the island to receive the proper care at a sizable cost. Moreover some children are not eligible for public assistance like the Medically Indigent Program, the Catastrophic Illness Program, and Medicaid or for local health insurance plans. The CSHN Systems Management Project uses a collaborative approach involving family, community, and professionals from a variety of disciplines. Parents voice several issues which revolve around health insurance, public assistance, case management, scarcity of professional resources, child care services, information and education, and early identification. The Project hopes to hold a training conference for parents and professionals in January 1992.
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PMID:New care coordination project targets special needs children under age 4. 1228 32

Human cytomegalovirus (HCMV) represents one of the most medically important human viruses and causes a wide spectrum of human diseases, including birth defects and mental retardation in newborns, common opportunistic infections in acquired immunodeficiency syndrome (AIDS) patients (e.g., CMV-associated retinitis and pneumonia), and possibly cardiovascular diseases such as atherosclerosis. This chapter describes the utilization of RNase P ribozyme-specifically, M1GS ribozyme, as a gene-targeting agent for blocking HCMV gene expression and growth. The target for the RNase P ribozyme is the overlapping region of the mRNAs that code for HCMV major transcription factors IE1 and IE2, which are essential for viral gene expression and replication. The methods described in this chapter focus primarily on i) construction of the retroviral vector for expression of M1GS ribozymes in cultured cells, ii) generation of stable cell lines expressing ribozymes, iii) determination of the expression of M1GS RNAs in human cells, and iv) evaluation of the efficacy of ribozymes in inhibiting HCMV IE1/IE2 expression and viral growth. Using these methods, we successfully constructed M1GS RNAs against the IE1/IE2 mRNA sequence and recently showed that a reduction of up to 150- to 3000-fold in HCMV growth is found in cells that express the ribozymes.
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PMID:RNase P ribozyme as an antiviral agent against human cytomegalovirus. 1501 69

The aim is to analyze the stigma associated with severe and persistent mental illness in the general population of the community of Madrid, Spain, as a first step to promote strategies to fight against it. Participants (n = 439) showed adequate general knowledge about mental illness, but a high degree of confusion with mental retardation. Stigmatizing attitudes focusing mainly on the disposition to help and on pity. Moreover, there were some perception of contamination and pity toward other family members. Psychosis seems to shows more stigma attitudes than cancer and depression, but less than cocaine addiction and AIDS.
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PMID:Descriptive study of stigma associated with severe and persistent mental illness among the general population of Madrid (Spain). 1843 69

Human cytomegalovirus (HCMV), a ubiquitous herpesvirus, is the main cause of congenital abnormalities and mental retardation in newborns and is also responsible for severe life-threatening complications in immunocompromised individuals, including AIDS patients and transplant recipients. The disorders generated by cytomegalovirus are closely associated with the competence of the host immune system and both humoral and cell-mediated mechanisms are involved in the response to viral infection. To identify viral proteins recognized by host antibody responses, a cytomegalovirus genome library was created and displayed on lambda bacteriophage. The challenge of such a library with sera from individuals with congenital or acquired infection allowed the identification of a wide panel of recombinant bacteriophages carrying cytomegalovirus B cell epitopes. Epitope-containing fragments within the families of tegument proteins (pUL25, pUL32), structural proteins (pUL48, pUL56) and glycoproteins (pUL55) were identified. Moreover, library screening permitted isolation of phage clones carrying an antigenic region of an uncharacterized HCMV protein encoded by the UL71 open reading frame (ORF), highlighting the potential of lambda display technology in antigen and epitope discovery.
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PMID:Molecular dissection of the human B cell response against cytomegalovirus infection by lambda display. 1849 73

Cytomegalovirus (CMV) is a significant health problem among immunosuppressed individuals. In particular, transplant and AIDS patients and the developing fetus in utero are highly susceptible to CMV. In these vulnerable populations, infection leads to life threatening end organ viral disease or in surviving newborn babies to deafness or to mental retardation. Currently, the most effective way to control CMV infection, given the lack of an effective vaccine, is by antiviral therapy. However, available antivirals suffer from complications associated with prolonged use, such as drug toxicity as well as the emergence of resistant strains of virus. Additionally, since CMV has multiple complex immune evasion strategies, to avoid innate and adaptive immune responses, there is a need for new antiviral development. Any antiviral should be tested in a controlled animal model but species specificity of HCMV precludes the direct study of the virus in an animal model. Consequently, animal CMV in their respective animal host are used to study intervention strategies. In this review, both current and new antiviral strategies are discussed as are the various animal models and strategies to improve existing antiviral animal models by humanizing animal CMV.
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PMID:Current and new cytomegalovirus antivirals and novel animal model strategies. 2086 May 47

Human cytomegalovirus (HCMV), a double-stranded DNA virus in the herpesvirus family, is a ubiquitous virus that infects greater than 40-60% of the general population and up to 100% within some subpopulations and/or geographic areas (1). HCMV has a complex pathobiology because infection of immunocompetent individuals is rarely associated with severe clinical symptoms and in most cases is simply asymptomatic, whereas HCMV infections can cause a wide range of severe diseases, including mononucleosis, mental retardation, deafness, chorioretinitis, and fatal diseases, such as interstitial pneumonia and disseminated virus infections in immunocom-promised hosts (1). As with other herpesviruses, HCMV is thought to establish latent or persistent infections. Reactivation of this infection is frequently encountered during pregnancy and in organ transplant and acquired immune deficiency syndrome (AIDS) patients (1). In addition, HCMV has been implicated as a co-etiological agent in cervical cancer (2) and has been found associated with a wide range of other tumors (1). More recently, HCMV has also been shown to be epidemiologically linked to restenosis (3-5) and atherosclerosis (5,6). The severity of these HCMV-associated diseases warrants an accurate ability to detect and diagnose persons with HCMV, especially because of the clinical availability of the anti-HCMV agents, ganciclovir and foscarnet, which have been used successfully to treat patients with HCMV viremia.
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PMID:Immunological methods for the detection of human cytomegalovirus. 2134 Sep 49


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