Attitudes and career experiences of male and female healthcare executives

While the expression "battle between the sexes" may be a cliche, the question being asked in business and healthcare management circles focuses on who is rising to the top of the management hierarchy--the male or the female executive. Previous research has shown a smaller percentage of women than men make it to the senior levels of management in business.

Health care executives look at rationing

In summary, executives want change. They want it done openly and they reaffirm their guiding principle of underwriting effective health care services. They are more circumspect on more specific methods, such as basing decisions on minorities' needs or the results of a public opinion poll. They do agree, however, that developing a plan to reduce the root causes of poor health would work to begin change.

Cloning of the Schizosaccharomyces pombe TFIID gene reveals a strong conservation of functional domains present in Saccharomyces cerevisiae TFIID

The gene encoding the Schizosaccharomyces pombe TATA box-binding factor (TFIID) was cloned and sequenced. The gene contains three introns and codes for a polypeptide of 231 amino acids. The cDNA-expressed protein showed both TATA box-binding and basal transcription activities. The carboxy-terminal three-quarters of S. pombe TFIID shares an extraordinary degree of amino acid sequence homology with a corresponding region of Saccharomyces cerevisiae TFIID that has been shown to be necessary and sufficient for TATA box-binding and basal transcription activities. In contrast, the amino-terminal regions of the S. pombe and S. cerevisiae TFIIDs differ markedly in amino acid sequence and composition. Structure and function relationships of TFIID are discussed in light of these data.

Analysis of structure-function relationships of yeast TATA box binding factor TFIID

A systematic series of N-terminal, C-terminal, and internal deletion mutants of S. cerevisiae TFIID were expressed in vitro and tested for TATA box binding and basal level transcription activities using, respectively, DNA mobility shift and in vitro transcription assays. The domains responsible for these activities were colocalized to a surprisingly large region containing C-terminal residues 63-240. This region was noted previously to contain potentially interesting structural motifs (central basic core, direct repeats, and sigma factor homology) and, more recently, to be highly conserved among TFIID from different species. Deletion mutant cotranslation studies revealed that TFIID binds DNA as a monomer. The implications of these results for TFIID structure and function are discussed.

Hospital administrators' response to AIDS. Results of a national survey

Executives are just beginning to adapt to the presence of the epidemic. Two-thirds have been involved in AIDS care and these hospitals appear to be in the forefront in developing structural responses and initiating procedures to deal with the disease. Through the use of rating scale analysis, we were able to show a continuum of responses by which hospitals cope with the disease. First, educational efforts are begun, then human resource departments begin to refer employees with AIDS to caregivers. And the most developed response is for hospitals to establish specific policies for employees, ultimately requiring them to report whether or not they have the disease to their supervisor. Executives' attitudes also seem to be affected by whether or not their hospitals have cared for any AIDS patients. In contrast to the contact hypothesis used to explain prejudice, experienced administrators are more authoritarian in reacting to the crisis. For example, more experienced than inexperienced hospital administrators agree that all patients should be routinely tested for AIDS. Our findings are corroborated in a recently reported study of house staff who had been exposed to patients with AIDS. House officers who had cared for a greater number of AIDS patients showed a greater level of concern about acquiring the disease than those with less exposure. Just as experience among house officers serves to produce increasing concern for their personal safety, so too experience on the part of the executives appears to intensify anxiety in their attitudes. Experienced administrators are more likely to advocate specialized facilities for the care of AIDS patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Transcription factor requirements for in vitro formation of transcriptionally competent 5S rRNA gene chromatin

The Saccharomyces cerevisiae 5S rRNA gene was used as a model system to study the requirements for assembling transcriptionally active chromatin in vitro with purified components. When a plasmid containing yeast 5S rDNA was assembled into chromatin with purified core histones, the gene was inaccessible to the yeast class III gene transcription machinery. Preformation of a 5S rRNA gene-TFIIIA complex was not sufficient for the formation of active chromatin in this in vitro system. Instead, a complete transcription factor complex consisting of TFIIIA, TFIIIB, and TFIIIC needed to be formed before the addition of histones in order for the 5S chromatin to subsequently be transcribed by RNA polymerase III. Various 5S rRNA maxigenes were constructed and used for chromatin assembly studies. In vitro transcription from these assembled 5S maxigenes revealed that RNA polymerase III was readily able to transcribe through one, two, or four nucleosomes. However, we found that RNA polymerase III was not able to efficiently transcribe a chromatin template containing a more extended array of nucleosomes. In vivo expression experiments indicated that all in vitro-constructed maxigenes were transcriptionally competent. Analyses of protein-DNA interactions formed on these maxigenes in vivo by indirect end labeling indicated that there are extensive interactions throughout the length of these maxigenes. The patterns of protein-DNA interactions formed on these genes are consistent with these DNAs being assembled into extensive nucleosomal arrays.

Identification and purification of a yeast transcriptional trans-activator. The yeast homolog of the Rous sarcoma virus internal enhancer binding factor

A cis-acting transcriptional activation sequence (IES2) from the Rous sarcoma virus internal enhancer was found to stimulate transcription of a heterologous gene in Saccharomyces cerevisiae. A hamster protein (termed IBF) which binds to IES2 and stimulates transcription in vitro has previously been purified and was found to have a subunit molecular mass of 40,000 (Karnitz, L., Poon, D., Weil, P.A., and Chalkley, R. (1989) Mol. Cell. Biol. 9, 1929-1939). The identification and purification of the yeast homolog of IBF (yIBF) is reported here. Purified yIBF has a subunit molecular mass of 92,000. This protein functions as a trans-activator of transcription in a heterologous HeLa transcription extract in a cis-element sequence-dependent manner in vitro.

Identification of a pancreatic beta-cell insulin gene transcription factor that binds to and appears to activate cell-type-specific expression: its possible relationship to other cellular factors that bind to a common insulin gene sequence

The insulin gene is expressed almost exclusively in pancreatic beta-cells. Previous work in our laboratory has shown that pancreatic beta-cell-specific expression of the rat insulin II gene is controlled by a number of positive and negative cis-acting DNA elements within the enhancer. We have shown that one element within the enhancer, located between nucleotides -100 and -91 (GCCATCTGCT; referred to as the insulin control element [ICE]) relative to the transcription start site, is controlled by both positive- and negative-acting cellular transcription factors. The positive-acting factor appears to be uniquely active in beta-cells. To identify the nucleotides within the ICE that mediate positive cell-type-specific regulation, point mutations within this element were generated and assayed for their effects on expression. Base pairs -97, -94, -93, and -92 were found to be crucial for the activator function of this region, while mutations at base pairs -100, -96, and -91 had little or no effect on activity. The gel mobility shift assay was used to determine whether specific cellular factors associated directly with the ICE. Several specific protein-DNA complexes were detected in extracts prepared from insulin-producing and non-insulin-producing cells, including a complex unique to beta-cell extracts. The ability of unlabeled wild-type and point mutant versions of the ICE to compete for binding to these cellular factors demonstrated that the beta-cell-specific complex appears to contain the insulin gene activator protein(s). Interestingly, the adenovirus type 2 major late promoter upstream element (USE; GCCACGTGAC) also competed in the gel mobility shift assay for binding of cellular proteins to the ICE. These results suggested that the cellular factor that binds to the USE (i.e., USF) also interacts with the ICE. This was directly demonstrated by showing that ICE and USE sequences completed for the USF required for adenovirus type 2 major late promoter transcription in vitro and by showing that reticulocyte lysate-translated human USF products bound to the ICE. However, the USE sequences were unable to stimulate beta-cell-type-specific activity in vivo. We discuss the possible relationship of these observations to positive and negative control mediated by the ICE.

Purification and characterization of Saccharomyces cerevisiae transcription factor TFIIIC. Polypeptide composition defined with polyclonal antibodies

The class III gene transcription factor termed TFIIIC has been extensively purified from Saccharomyces cerevisiae. Three polypeptides of 138, 131, and 95 kDa consistently copurified with TFIIIC transcription factor activity. These polypeptides were present in approximately equimolar quantities in all TFIIIC preparations. To determine which, if any, of these polypeptides were involved in TFIIIC activity, rabbit polyclonal antibodies were generated against each of these three polypeptides purified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Immunoblot analyses showed that each of the three antiserum preparations reacted uniquely with the respective polypeptide to which they had been elicited. This lack of cross-reactivity by any of the antiserum preparations suggested that these three polypeptides represented distinct unrelated gene products. Each of the three specific antiserum preparations decreased the mobility of TFIIIC-tDNA complexes in a DNA mobility shift assay. More importantly, all three antiserum preparations directly inhibited the transcription factor activity of TFIIIC. In addition, all three antiserum preparations depleted a solution of TFIIIC transcription factor activity. These results indicated that each of these three polypeptides of Mr = 138,000, 131,000, and 95,000 was a distinct and necessary component of yeast TFIIIC. Immunoblot analyses of immunoaffinity-purified TFIIIC fractions indicated that each of the three antiserum preparations alone could deplete the solution of all three polypeptides. These results suggested that these three polypeptides were tightly associated with one another in solution.

Multiple mutations of the first gene of a dimeric tRNA gene abolish in vitro tRNA gene transcription

Eukaryotic tRNA expression initiates with transcription by RNA polymerase III and requires two additional protein factors and two regions within the tRNA gene (the 5'-internal control region (ICR) or A-box and the 3'-ICR or B-box). Using a reconstituted Saccharomyces cerevisiae RNA polymerase III system, the transcription of various 5'-ICR, 3'-ICR, and double mutation alleles of the Schizosaccharomyces pombe sup3-e dimeric tRNA gene were studied. The sup3-e tRNA locus consists of an upstream serine tRNA gene and a downstream initiator methionine tRNA gene which are transcribed as a dimeric precursor and processed to give two tRNAs. Only the ICRs of the tRNA(Ser) gene are active in directing dimeric gene transcription. Mutations in the 3'-ICR of the tRNA(Ser) gene reduce transcription of the dimer more than those in the 5'-ICR. Mutations in the 5'-ICR were found which greatly increased or decreased transcription of the dimer, while base changes in the 3'-ICR were only found to decrease transcription. This suggests a modulatory role for the 5'-ICR in transcription regulation. Mutation of the methionine tRNA gene ICR has little effect on sup3-e transcription, and no detectable transcripts initiate from the methionine tRNA gene when the tRNA(Ser) gene promoter is inactivated by mutation. Comparison with transcription studies of other mutant tRNA genes suggests that nucleotides sites within the ICRs, such as nucleotides 8, 10, 13, 18, and 19 in the 5'-ICR and 48, 53, 56, 57, and 58 in the 3'-ICR, appear to have evolved universal importance for RNA polymerase III transcription in eukaryotes. Thus these ICR sequences may play a critical role in regulation of tRNA expression.

Cloning and structure of a yeast gene encoding a general transcription initiation factor TFIID that binds to the TATA box

The TATA sequence-binding factor TFIID plays a central role both in promoter activation by RNA polymerase II and other common initiation factors, and in promoter regulation by gene-specific factors. The sequence of yeast TFIID, which seems to be encoded by a single gene, contains interesting structural motifs that are possibly involved in these functions, and is similar to sequences of bacterial sigma factors.

Pancreatic beta-cell-type-specific expression of the rat insulin II gene is controlled by positive and negative cellular transcriptional elements

The insulin gene is expressed almost exclusively in pancreatic beta-cells. The DNA sequences that control cell-specific expression are located upstream of the transcription initiation site. To identify the cis-acting transcriptional control regions within the rat insulin II gene that are responsible for this tissue-specific expression pattern, we constructed a series of 5'-flanking deletion mutants and analyzed their expression in vivo in transfected insulin-producing and -nonproducing cell lines. Pancreatic beta-cell-specific expression was shown to be controlled by enhancer sequences lying between nucleotides -342 and -91 relative to the transcription start site. The rat insulin II enhancer appears to be a chimera, composed of a number of distinct cis-acting DNA elements. Both positive and negative transcriptional regulatory elements appear to be responsible for this cell-type-specific expression. We have shown that expression from one element within the enhancer, which is found between nucleotides -100 and -91, is regulated by both positive- and negative-acting cellular transcription factors. Expression from chimeras containing only the enhancer element sequences from -100 to -91 were active only in insulin-producing cells, indicating that the positive-acting factor(s) required for this activity may be active only in beta-cells. In contrast to the enhancer region, the rat insulin II gene promoter did not appear to require cell-specific transcription factors. Promoter mutants with 5'-flanking sequences extending to nucleotides -90 and -73 were constitutively active in both insulin-producing and -nonproducing cells. These results suggest that rat insulin II gene transcription in pancreatic beta-cells is imparted by a combination of both negative- and positive-acting cellular factors interacting with the gene enhancer.

Purification of a yeast TATA box-binding protein that exhibits human transcription factor IID activity

By a series of conventional chromatographic procedures we have purified from whole-cell extracts of Saccharomyces cerevisiae yeast transcription factor IID (TFIID), which functionally substitutes for human TFIID in a complementation assay comprised of the adenovirus type 2 major late promoter and HeLa cell-derived RNA polymerase II, transcription factors IIA, IIB, and IIE. Similar to its human counterpart, yeast TFIID also exhibited specific binding to the adenovirus type 2 major late promoter TATA element, as shown by both DNase I footprinting and gel mobility shift assays. NaDodSO4/PAGE analyses showed that a 27-kDa polypeptide coeluted with TFIID complementing activity through each chromatographic step. In agreement with this result and also suggesting that the native protein is a monomer, gel-filtration experiments indicated a molecular mass of 28 kDa for TFIID under nondenaturing conditions. That the 27-kDa polypeptide represented TFIID was further demonstrated by the ability of an HPLC-purified protein to bind specifically after renaturation to the adenovirus type 2 major late promoter TATA sequence.

Purification and properties of the Rous sarcoma virus internal enhancer binding factor

The internal enhancer binding factor (IBF) that specifically binds sequences within the gag gene internal enhancer of Rous sarcoma virus Schmidt-Ruppin A was purified to near homogeneity from BHK cells. The polypeptides that constituted IBF DNA-binding activity were identified by sodium dodecyl sulfate-polyacrylamide gel analysis. As isolated from BHK cells, IBF consisted of two different but related polypeptides. One (IBF alpha) had a molecular weight of 40,000; the other (IBF beta) had a molecular weight of 20,000 and appeared to be a proteolytic product of IBF alpha. The site within the gag gene to which IBF bounds in vitro (internal enhancer site 2; nucleotides 856 to 878 of the Rous sarcoma virus genome) were demonstrated to function as a cis-acting transcriptional stimulatory element both in vivo and in vitro. By using HeLa cell nuclear transcription extracts, purified IBF was found to function as a trans-acting transcription factor that stimulated transcription in vitro. Purified IBF was also demonstrated to be very similar to EBP20 (K. Carlberg, T. A. Ryden, and K. Beemon, J. Virol. 62:1617-1624, 1988), and it may well belong to the same family of DNA-binding proteins.

Purification and characterization of Saccharomyces cerevisiae transcription factor IIIA

Saccharomyces cerevisiae Transcription Factor IIIA (TFIIIA) has been purified to apparent homogeneity. Two polypeptides copurified with TFIIIA activity. Yeast TFIIIA is a DNA-binding protein which exhibits a high affinity for the internal control region of the homologous 5 S ribosomal RNA gene. Characterization of the yeast protein indicates that it shares most, but not all, of the molecular properties of its Xenopus TFIIIA counterpart.

Does policy match practice? A new College survey shows where healthcare executives score hits and misses

Healthcare executives closely adhere to many of the policies of the American College of Healthcare Executives but have significant reservations about others. That's the message of a survey designed to measure how College affiliates respond to issues ranging from organ donation and ethics committees to smoking policies and voluntary credentialing.

Opinions of health care executives on access to care

A poll of the opinions of 359 health care executives (American College of Healthcare Executives affiliates) on access to care shows that they are ambivalent about entitling the entire United States population to equal access to health services. Half of the survey respondents support the concept and nearly half do not. Further results reveal that for nonemergency care, a greater number of health care executives are willing to allow the poor/uninsured to wait than if they were paying patients. Also, half of those polled approve of the poor or uninsured not having a choice of primary physician, hospital, or source of custodial care. Overall, however, 80 percent believe that system-related health outcomes should be similar for the poor and the nonpoor. The role of the government in funding health care in the U.S. is still viewed as supplementing private resources. Few condone any universal health care entitlement. However, for the poor, according to half of those polled, the government should underwrite life-sustaining surgery; it should underwrite prenatal care, according to two-fifths; and a third thought government should fund custodial care for invalids and the elderly. This hierarchy may suggest where government health care funding is crucial.

Properties of yeast class III gene transcription factor TFIIIB. Implications regarding mechanism of action

The yeast transcription factor TFIIIB has been examined with regard to its hydrodynamic properties. This protein, which is required for both tRNA and 5 S rRNA gene transcription in vitro, exhibits unusual physical properties. When analyzed by denaturing polyacrylamide gel electrophoresis TFIIIB is a single polypeptide of Mr approximately 60,000. When this transcription factor is subjected to rate zonal centrifugation on glycerol gradients, it sediments between ovalbumin (Mr = 45,000) and bovine serum albumin (Mr = 66,300). This sedimentation behavior is consistent with TFIIIB being a monomer in its native state. However, when TFIIIB was analyzed by gel filtration chromatography it was determined to have a Stokes radius of 53 A, eluting from this chromatography matrix near the position of catalase (Mr = 248,000). This anomalous behavior suggests that TFIIIB is a very asymmetric molecule. Purified TFIIIB was subjected to amino acid analyses and the resulting composition data used to calculate a partial specific volume for the intact molecule. All of these data were then used to estimate possible molecular dimensions of the native TFIIIB molecule. Results of these calculations are consistent with the idea that this transcription factor is a very elongated entity.