Bible times and characters : from the creation to Jacob

by Louis Ginzberg ; translated from the German manuscript by Henrietta Szold

Notes to Volumes I and II : from the creation to the exodus

by Louis Ginzberg

Homeless access to dental health care: Creation of a dental service model

This project involved developing a model for planning a dental emergency treatment center that could function as an embedded component of a shelter for the homeless population. The dental services provided by such a clinic should include treatment for tooth pain, dental caries or cavities, chipped or broken teeth, broken partials, abscessed teeth, emergency cleanings, periodontal disease or gum disease and fillings. These are the dental services that are most often sought by homeless people in hospital emergency rooms.^ The underlying assumption for this project was that the oral health needs of the homeless community can most effectively be addressed by implementing small dental clinics in existing facilities that provide shelter and other services for this population. The model described in this project identifies oral health care services that would be provided by the clinic, facility (physical plant) requirements and associated infrastructure to operate an embedded dental clinic, methods for obtaining funding, strategies of recruiting dental professionals to staff the facility, and methods to assess the outcomes of the embedded clinic strategy. As an example, this project describes a strategy for developing such an embedded clinic at San Antonio Metropolitan Ministries SAMM shelter based on recommendations from community health care leaders, managers of homeless shelters, members of the homeless community and dental professionals^

Attitudes and other barriers to the utilization of clinical research findings by American physicians: A systematic review

Background: The Institute of Medicine estimates that only a maximum of 25% of clinical research findings are incorporated into practice by physicians. To improve clinical practice, efforts have been made to promote evidence-based medicine and the use of clinical guidelines. Despite these efforts, the gap between research and clinical practice remains wide.^ Objective: To systematically review the literature describing the factors which influence the use of clinical research recommendations by American physicians.^ Hypothesis: Barriers exist in the application of clinical research into clinical practice, and are multifactorial. The establishment of the Clinical and Translational Awards (CTSA; special federal grants awarded to selected institutions to support clinical and translational research) has reduced the effect of these barriers and improved the process of clinical research translation into practice among American physicians.^ Aims: Identify barriers and facilitators of the use of research findings in clinical practice by American physicians. Contrast studies published six years before and after the creation of the CTSA.^ Methods: The sources of data include published literature from Medline, PubMed and PsycINFO. Selected studies must be qualitative, a survey of American clinicians, based on evidence-based medicine practice, clinical guidelines or treatment pathways. Systematic reviews and reports were excluded, as well as studies with less than 100 respondents.^ Results: In total, 1036 abstracts were reviewed; 115 full text potential articles were identified and reviewed, and a total of 31 studies met all criteria for inclusion in the final review.^ Conclusions: The barriers against the application of clinical research findings, in the forms of clinical guidelines, evidence-based medicine guides and clinical pathways, can be divided broadly into physician barriers, practice/system barriers and patient barriers. Physician barriers are the most common barriers, especially the lack of familiarity with guidelines and the lack of time. Of the factors which improve the use of research based guidelines, physician factors such as younger age, lower duration of clinical practice, specialty training, and practice in large group Health Maintenance Organization (HMO) settings with fewer patients seen were the most commonly cited.^

Creation of a retinoblastoma mutant with dominant -negative activity

The Retinoblastoma tumor suppressor gene (RB) plays a role in a variety of human cancers. Experimental analyses have indicated that the protein product of the RB gene (pRb) plays a role in cell cycle regulation, and that this protein is required in cellular differentiation, senescence, and cell survival. pRb function is dependent on its ability to bind to cellular factors. There are multiple protein binding domains within pRb. Mutations within these domains which eliminate the ability of pRb to bind its targets result in loss of function. Loss of pRb function leads to tumorigenesis, although uncontrolled cellular proliferation is not a universal response to pRb inactivation. The ultimate response to the loss of pRb is influenced by both the genetic and epigenetic environments. Targeted disruption of RB in mice results in embryonic lethality, demonstrating the requirement for functional pRb in development. Close examination of various tissues from the embryos which lack wildtype RB shows problems in differentiation as well as showing induction of apoptosis. Although disruption of RB has provided useful information, complete inactivation of a gene precludes the possibility of discovering the functions that separate domains may have within the system. Creation of a dominant negative mutant by domain deletion whose phenotype is expressed in the presence of the wildtype may provide information about the intermediate functions of the protein. In addition, tissue specific targeting of a dominant negative mutant of pRb allows for comprehensive analysis of pRb function in organogenesis. In this thesis, a series of RB deletion mutants were created and tested for dominant negative activity as well as cellular localization. A tissue culture assay for dominant negative activity was developed which screens for the phenotype of apoptosis due to loss of pRb function. Two mutants from this series scored positive for dominant negative activity in this assay. The effect of these mutants within the assay environment can be explained by a model in which pRb acts as a facilitator of cell fate pathway decisions. ^

Instituciones y recursos hídricos : Aportes conceptuales para una práctica política congruente con las necesidades locales

Las instituciones para la gestión hídrica tienen serias dificultades para asir la realidad a intervenir porque parten de supuestos abstractos y homogéneos que poco se asemejan a las complejas problemáticas locales, conflictivas y heterogéneas que estarían destinadas a mejorar. Se genera así una problemática brecha entre las políticas públicas y los problemas concretos. El trabajo propone discutir los marcos teóricos institucionales dominantes señalando limitaciones e implicaciones. A partir de una revisión crítica de bibliografía sobre el tema, el artículo establece líneas de base así como un conjunto de dimensiones de análisis que -desde una mirada diferente- aporte a la conformación de un régimen institucional que contribuya a la reproducción sustentable de los recursos hídricos

Instituciones y recursos hídricos : Aportes conceptuales para una práctica política congruente con las necesidades locales

Las instituciones para la gestión hídrica tienen serias dificultades para asir la realidad a intervenir porque parten de supuestos abstractos y homogéneos que poco se asemejan a las complejas problemáticas locales, conflictivas y heterogéneas que estarían destinadas a mejorar. Se genera así una problemática brecha entre las políticas públicas y los problemas concretos. El trabajo propone discutir los marcos teóricos institucionales dominantes señalando limitaciones e implicaciones. A partir de una revisión crítica de bibliografía sobre el tema, el artículo establece líneas de base así como un conjunto de dimensiones de análisis que -desde una mirada diferente- aporte a la conformación de un régimen institucional que contribuya a la reproducción sustentable de los recursos hídricos

Instituciones y recursos hídricos : Aportes conceptuales para una práctica política congruente con las necesidades locales

Las instituciones para la gestión hídrica tienen serias dificultades para asir la realidad a intervenir porque parten de supuestos abstractos y homogéneos que poco se asemejan a las complejas problemáticas locales, conflictivas y heterogéneas que estarían destinadas a mejorar. Se genera así una problemática brecha entre las políticas públicas y los problemas concretos. El trabajo propone discutir los marcos teóricos institucionales dominantes señalando limitaciones e implicaciones. A partir de una revisión crítica de bibliografía sobre el tema, el artículo establece líneas de base así como un conjunto de dimensiones de análisis que -desde una mirada diferente- aporte a la conformación de un régimen institucional que contribuya a la reproducción sustentable de los recursos hídricos