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Studiens syfte var att ta reda på hur socialarbetare upplever anhörigas betydelse i klientarbetet samt hur socialarbetare förhåller sig till de anhöriga. Som grund för studien utfördes en narrativ intervju med en anhörig, samt kvalitativa intervjuer med fyra socialsekreterare och en beroendeterapeut. Empirin från studien analyserades med evidensbaserad praktik som teoretiskt perspektiv samt med socialt kapital/socialt stöd och rollteori som teoretiska verktyg. Resultatet visar att informanterna upplevde anhöriga som en viktig del i klientens kontext, vilket kunde ha effekt på behandlingsresultatet. Forskningsresultat pekar på att socialt stöd är en viktig komponent för en lyckad behandling samt att det har stöd i evidensbaserad forskning. Resultatet visar ett tydligt mönster som framkom i intervjuerna, dessa är: Att se anhöriga som resurser, Anhöriga exkluderas från behandlingsprocessen, Anhöriga klientifieras. De anhöriga skulle kunna vara en tillgång för klienten och då speciellt vid hemkomst från behandling samtidigt som de professionella exkluderar de anhöriga från klientens behandlingsprocess. Om anhöriga initierar kontakt med de professionella blir fokus på den anhöriges behov och en klientifiering blir följden. I analysen framkom att de professionella uppträder med två roller mot de anhöriga, den ena där de behåller samma professionella roll som de har i mötet med missbrukarna och då klientifierar de anhöriga samt en personlig roll där de möter anhöriga utifrån ett mer medmänskligt perspektiv. / The study's purpose was to find out how social workers feel that the relatives are important in client work and how the social workers relates to the relatives. A narrative interview as a basis for the study was conducted with a relative, five qualitative interviews with social workers and one addiction therapist. The empiricism from the study was analyzed using EBP, social capital / social support and role-theory. The result shows that the informants felt that the relatives were an important part of the client's context, which could have an effect on the treatment-result. Research findings indicate that social support is an important component for successful treatment, while also being backed by evidence-based research. The result shows an explicit pattern: That having access to relatives was considered an asset, The relatives were excluded from the work with the client, That the relatives were clientified. The relatives could be an asset to the client, especially when the client returns home from treatment while the social workers exclude the relatives from the client’s treatment process. If the relatives initiated contact with the social workers, the focus turned to the relative’s needs, thus leading to clientification. The social workers were found in the analysis to act out two roles towards the relatives; one were they keep the same professional role that they have when meeting with the addicts, which clientifies the relatives; the second being a more personal role where they handle the relatives from a more humane perspective.

This thesis explores how basic region/leucine zipper (bZIP) transcription factors target gene regulatory sequences. The GCN4 bZIP binds to more than one target site [CRE (TGACGTCA) and cognate AP-1 (TGACTCA)] and exhibits flexibility in -helical structure. These observations suggest that the GCN4 bZIP can establish sequence-selective DNA binding at noncognate target sites. Studies on such noncognate but sequence-selective binding can provide insights into how bZIP proteins search for and localize to their cognate target sites. This thesis investigates DNA binding by the GCN4 bZIP and its structural and functional mimic, the wild-type (wt) bZIP, at noncognate gene regulatory sequences C/EBP (TTGCGCAA), E-box (CACGTG), HRE (GCACGTAG), XRE1 (TTGCGTGA), and related DNA sequences. These DNA-binding activities are sequence-selective, as confirmed by DNase I footprinting and electrophoretic mobility shift assay (EMSA). Full- and half-site DNA-binding affinities, determined by EMSA titrations, decrease from cognate to noncognate binding. At noncognate target sites, the bZIP proteins form a dimer of -helices, as indicated by circular dichroism (CD) spectroscopy and EMSA. These results demonstrate that the bZIP proteins can establish noncognate but sequence-selective DNA binding, and suggest such DNA binding potentially contributes to structure preorganization and rapid translocation of the bZIP proteins when they search for their cognate target sites, to which they then bind with high affinity. This thesis also indicates a highly dynamic DNA-binding model for the bZIP proteins to establish strong and sequence-selective DNA binding. The C/EBP site includes two 5H-LR (TTGCG) half-sites, each of which comprises two 4-bp subsites. The in vitro and in silico results together demonstrate that the basic region at 5H-LR recognizes the 4-bp subsites alternately as distinct units, which requires it to translocate between the subsites, potentially by sliding or hopping. Taken as a whole, this thesis provides further insights into how bZIP transcription factors accomplish sequence-selective DNA binding.

This thesis explores how basic region/leucine zipper (bZIP) transcription factors target gene regulatory sequences. The GCN4 bZIP binds to more than one target site [CRE (TGACGTCA) and cognate AP-1 (TGACTCA)] and exhibits flexibility in -helical structure. These observations suggest that the GCN4 bZIP can establish sequence-selective DNA binding at noncognate target sites. Studies on such noncognate but sequence-selective binding can provide insights into how bZIP proteins search for and localize to their cognate target sites. This thesis investigates DNA binding by the GCN4 bZIP and its structural and functional mimic, the wild-type (wt) bZIP, at noncognate gene regulatory sequences C/EBP (TTGCGCAA), E-box (CACGTG), HRE (GCACGTAG), XRE1 (TTGCGTGA), and related DNA sequences. These DNA-binding activities are sequence-selective, as confirmed by DNase I footprinting and electrophoretic mobility shift assay (EMSA). Full- and half-site DNA-binding affinities, determined by EMSA titrations, decrease from cognate to noncognate binding. At noncognate target sites, the bZIP proteins form a dimer of -helices, as indicated by circular dichroism (CD) spectroscopy and EMSA. These results demonstrate that the bZIP proteins can establish noncognate but sequence-selective DNA binding, and suggest such DNA binding potentially contributes to structure preorganization and rapid translocation of the bZIP proteins when they search for their cognate target sites, to which they then bind with high affinity. This thesis also indicates a highly dynamic DNA-binding model for the bZIP proteins to establish strong and sequence-selective DNA binding. The C/EBP site includes two 5H-LR (TTGCG) half-sites, each of which comprises two 4-bp subsites. The in vitro and in silico results together demonstrate that the basic region at 5H-LR recognizes the 4-bp subsites alternately as distinct units, which requires it to translocate between the subsites, potentially by sliding or hopping. Taken as a whole, this thesis provides further insights into how bZIP transcription factors accomplish sequence-selective DNA binding.

This poster presents development and pilot-testing of an electronic survey evaluating behavior analysts perceptions and use of Evidence-Based Practices (EBPs). Demographic information, ratings of quality indicators (Horner et al 2005) in evaluating and choosing behavior interventions, and resources identifying EBPs were assessed. Fourteen graduate trainees in a behavior analysis certification program were participants. Test-retest intra-rater agreement was assessed approximately 2 weeks apart and varied considerably across survey items. Overall exact agreement was 71 % while agreement within 1 rating point was 91 %. The most highly rated quality indicators were clear descriptions of baseline and intervention conditions, measures of inter-observer agreement, and repeated measures of target behaviors. Lowest rated were group experimental designs, statistical analyses, and numbers of participants. Surprisingly, multiple studies with 20+ participants, integrated intervention packages, and written intervention manuals were not as highly rated. Most frequently reported EBP sources were professional society websites, university courses, practitioner journals, and professional peer-reviewed journals. Least frequently reported were webinars by private entities, non-peer-reviewed journals, and government websites (e.g., What Works Clearing House). Participants identified time constraints, difficulty finding research relevant to their current situation and technical rather than practical nature of research as impediments to keeping current with EBPs

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22728号 / 医博第4646号 / 新制||医||1045(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊達 洋至, 教授 萩原 正敏, 教授 松田 道行 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Induction of C-reactive protein (CRP) synthesis in hepatocytes by cytokines occurs at the transcriptional level. In Hep3B cells, the transcription factors C/EBPβ, STAT3, and Rel p50 have been shown to participate in this process. A C/EBP binding site centered at -53 and an overlapping nonconsensus κB site on the promoter are critical for CRP expression. We have previously found that an oligonucleotide containing a κB site diminished binding of C/EBPβ to the C/EBP site, suggesting that unidentified Rel proteins present in Hep3B nuclei facilitate the formation of C/EBPβ-complexes. The current studies were undertaken to determine which of the five Rel proteins, p50/p65/p52/c-Rel/RelB, play such a role. Mutation of the nonconsensus κB site did not abolish binding of C/EBPβ to its binding site, indicating that this site was not necessary for the formation of C/EBPβ-complexes. Depletion of Rel proteins from Hep3B nuclei led to decreased formation of C/EBPβ-complexes on a CRP promoter-derived oligonucleotide that contained only the intact C/EBP binding site but not the nonconsensus κB site. This finding indicates that Rel proteins are involved in the binding of C/EBPβ to its binding site by a κB site-independent mechanism. Electrophoretic mobility shift assays (EMSAs) revealed that it was c-Rel that facilitated formation of C/EBPβ-complexes and that c-Rel bound directly to C/EBPβ-complexes formed on the C/EBP site. Cotransfection of c-Rel enhanced the induction of CRP promoter-driven luciferase activity and enhanced endogenous CRP expression in cells transfected with C/EBPβ. We conclude that c-Rel regulates CRP expression without the requirement of binding to a κB site, and binds directly to C/EBPβ to facilitate the binding of C/EBPβ to the CRP promoter.

Evidence-based practice (EBP) is a key driver of care and advancements within nursing. It is essential to emphasize EBP early in a nurse's career to promote inquisitive minds and enthusiasm for seeking evidence. The purpose of this project was to implement an EBP mobile app into a nurse residency program (NRP) to improve the process of providing EBP information and resources to new graduate nurses. The intent of the project was to leverage mobile technology to engage new graduate nurses in evidence-based practice. Roger's diffusion of innovation framework guided the project. The target audience for the project was 16 new graduate RNs participating in a health system's NRP who attend the EBP module and were required to complete an EBP project. The EBP module was provided during a classroom lecture and the mobile application was downloaded. After using the EBP module, all attendees were sent an electronic survey with open-ended questions related to the mobile application. Responses were reviewed to identify patterns. Survey responses reflected that a 50% did not utilize the mobile application. However, those that did use the mobile application (50%) found it useful and had a positive perception of the mobile application. Continued use of the mobile application and promotion of the mobile application for new graduate nurses may help with their own personal development of an EBP project. Ultimately, allowing nurses to effectively integrate nursing research into practice and impact patient care quality. This project impacted social change by empowering new nurses with knowledge and information related to evidence based practice and allowed for increased information to be accessible to a large audience of new graduate nurses.

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