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PubMed1996

Neurographic assessment of intramedullary motoneurone lesions in cervical spinal cord injury: consequences for hand function.

Examination of hand function and neurography of the median- and ulnar nerves was performed in 15 patients with acute and 26 patients with chronic tetraplegia due to cervical spinal cord injury (SCI). 30% of patients showed a mild and 20% a severe axonal lesion of motor fibres of both nerves. The latter is caused by intramedullary damage of ventral horn cells and anterior nerve roots as neurographic examination of sensory nerve fibres was normal in these patients. The most frequent and severe nerve lesion was present in those with lower cervical spinal cord injuries (C6/7-Th1) where the median and ulnar nerves originate. In the latter patients the development of active hand function, which enables the patient to perform active grasping movements, was closely related to the result of neurography, already early after trauma. The results of median and ulnar neurography in tetraplegia due to cervical SCI allow to differentiate between intramedullary damage of motoneurones and the anterior nerve roots (peripheral nervous system) or the pyramidal tract fibres (central nervous system) within the spinal cord responsible for the paresis of the intrinsic hand muscles. Neurography is of prognostic value in cervical SCI to predict the outcome of hand function and therefore influences the appropriate occupational therapy and the program and aims of rehabilitation.

Action Potentials↗
PubMed2002

Pressure assisted chelating extraction: a novel technique for digesting metals in solid matrices.

This work describes a novel technique for the digestion of metals in solid matrices. The technique is called pressure assisted chelating extraction (PACE). In a typical procedure, a solid sample is placed in a stainless steel cell and is mixed with appropriate chelating agents. Using a programmed sequence of temperature, static time, pressure and thermal equilibration available in ASE 200, the metal is removed under moderate temperature (up to 200 degrees C) and pressure (up to 3000 psi). PACE achieves metal recovery that is equivalent to that of wet digestion techniques and also provides for a clean and safe operation by substituting the strong acids commonly used during wet digestion with chelating agents. It uses less solvents and significantly less time (minutes vs. hours) for metal digestion. PACE has been validated using certified standard reference materials (SRMs) including industrial sludge, buffalo river sediments and coal fly ash. The total time required to remove metals was approximately 20 min. Results show that the PACE system provides an ideal platform for efficient, rapid, and safe metal digestion. Good agreement between measured and reference values for Pb, Mn, and Cu were found with recoveries averaging between 80 and 101% and a relative standard deviation of less than 5%. This approach may provide an alternative digestion technique for environmental samples, alloys, biological materials and samples of geological importance. The potential advantage offered lies in non-destruction of the sample, automation and the exclusion of concentrated mineral acids during the digestion procedure.

Chelating Agents↗
PubMed2005

Di-2-pyridyl ketone oxime [(py)2CNOH] in manganese carboxylate chemistry: mononuclear, dinuclear and tetranuclear complexes, and partial transformation of (py)2CNOH to the gem-diolate(2-) derivative of di-2-pyridyl ketone leading to the formation of NO3-.

The use of di-2-pyridyl ketone oxime, (py)2CNOH, in manganese carboxylate chemistry has been investigated. Using a variety of synthetic routes complexes [Mn(O2CPh)2{(py)2CNOH}2].0.25H2O (1.0.25H2O), Mn4(O2CPh)2{(py)2CO2}2{(py)2CNO}2Br2].MeCN (2.MeCN), [Mn4(O2CPh)2{(py)2CO2}2{(py)2CNO}2Cl(2)].2MeCN (3.2MeCN), [Mn4(O2CMe)2{(py)2CO2}2{(py)2CNO}2Br2].2MeCN (4.2MeCN), [Mn4(O2CMe)2{(py)2CO2}2{(py)2CNO}2(NO3)2].MeCN.H2O (5.MeCN.H2O) and [Mn2(O2CCF3)2(hfac)2{(py)2CNOH}2] (6) have been isolated in good yields. Remarkable features of the reactions are the in situ transformation of an amount of (py)2CNOH to yield the coordination dianion, (py)2CO2(2-), of the gem-diol derivative of di-2-pyridyl ketone in 2-5, the coordination of nitrate ligands in 5 although the starting materials are nitrate-free and the incorporation of CF3CO2- ligands 6 in which was prepared from Mn(hfac)(2).3H2O (hfac(-)= hexafluoroacetylacetonate). Complexes 2-4 have completely analogous molecular structures. The centrosymmetric tetranuclear molecule contains two MnII and two MnIII six-coordinate ions held together by four mu-oxygen atoms from the two 3.2211 (py)2CO2(2-) ligands to give the unprecedented [MnII(mu-OR)MnIII(mu-OR)2MnIII(mu-OR)MnII]6+ core consisting of a planar zig-zag array of the four metal ions. Peripheral ligation is provided by two 2.111 (py)2CNO-, two 2.11 PhCO2- and two terminal Br- ligands. The overall molecular structure 5 of is very similar to that of 2-4 except for the X- being chelating NO3-. A tentative reaction scheme was proposed that explains the observed oxime transformation and nitrate generation. The CF3CO2- ligand is one of the decomposition products of the hfac- ligand. The two Mn(II) ions are bridged by two neutral (py)2CNOH ligands which adopt the 2.0111 coordination mode. A chelating hfac- ligand and a terminal CF3CO2- ion complete a distorted octahedral geometry at each metal ion. The CV of complex reveals irreversible reduction and oxidation processes. Variable-temperature magnetic susceptibility studies in the 2-300 K range for the representative tetranuclear clusters 2 and 4 reveal weak antiferromagnetic exchange interactions, leading to non-magnetic ST = 0 ground states. Best-fit parameters obtained by means of the program CLUMAG and applying the appropriate Hamiltonian are J(Mn(II)Mn((III))=-1.7 (2), -1.5 (4) cm(-1) and J(Mn(III)Mn(III))=-3.0 (2, 4) cm(-1).

2,2'-Dipyridyl↗
PubMedDate not supplied

The role of the World Health Organization on pharmaceuticals in Europe.

The World Health Organization (WHO) is the specialized agency of the UN on public health. It gives worldwide guidance in the field of health, sets global standards for health, cooperates with governments to strengthen national health care programs, and develops and transfers appropriate health technology, information, and standards. Within the WHO European region, health status and health expenditures vary greatly. In this paper, disparities between health status, health services, and health care expenditures between countries of the WHO European region are presented. The objectives, performance, and dilemmas facing health care systems are discussed, including the recent performance ranking published by the WHO. The paper focuses particularly on access to medicines, their appropriate use, and rising drug expenditures. Strategies used by European countries to improve drug use and contain health care expenditures are outlined. Finally, the future of pharmaceuticals and public health is explored.

Delivery of Health Care↗
PubMed2001

Cardiovascular disease risk factors among older black, Mexican-American, and white women and men: an analysis of NHANES III, 1988-1994. Third National Health and Nutrition Examination Survey.

CONTEXT: There are few studies of ethnic differences in cardiovascular disease (CVD) risk factors in older populations. OBJECTIVES: To examine the association of ethnicity on CVD risk factors, after accounting for socioeconomic status (SES), and to examine health behaviors among those with CVD risk factors. DESIGN: Third National Health and Nutrition Examination Survey, 1988-1994. SETTING: Eighty-nine mobile examination centers. PARTICIPANTS: 700 black, 628 Mexican-American, and 2192 white women and men age 65 to 84 years. MEASUREMENTS: Ethnicity in relation to type II diabetes mellitus, physical inactivity, abdominal obesity, hypertension, cigarette smoking and non-high-density lipoprotein cholesterol (non-HDL-C). RESULTS: After accounting for age and SES, both black and Mexican-American women had significantly higher prevalences of type II diabetes than white women. In addition, black women were significantly more likely to have abdominal obesity and hypertension and to be physically inactive than white women. Black men had significantly higher prevalences of hypertension and physical inactivity than white men. However, black men had lower prevalences of abdominal obesity than white men, and black women had lower prevalences of high non-HDL-C than white women. Among those with CVD risk factors, health behaviors were in need of improvement, especially among Mexican-American women whose primary language was Spanish. CONCLUSIONS: In this national sample of older women and men, black and Mexican American women and black men were at the greatest risk for CVD. These findings parallel the heightened risk of CVD among younger ethnic minority populations and argue for appropriate primary and secondary prevention programs, modified for the language, cultural, and medical needs of older ethnic minorities.

Black or African American↗
PubMed2003

A standardized quality assessment system to evaluate incontinence care in the nursing home.

OBJECTIVES: To demonstrate the reliability and feasibility of a standardized protocol to assess and score urinary incontinence care in nursing homes. DESIGN: Descriptive. SETTING: Eighteen nursing homes (NHs). PARTICIPANTS: Four hundred twenty-six incontinent residents. MEASUREMENTS: Resident interview data were used to score three quality indicators, and usable data were retrieved from 117 (27%) of 426 incontinent residents in 18 homes who were selected for interview based on evidence that they could accurately describe the care they received. Medical record data were used to score six quality indicators for a subset of 58 participants in five homes. RESULTS: Zero to 98% of the participants were scored as receiving care consistent with the intent of the indicator across the nine indicators. All NHs failed to provide chart documentation of an assessment to determine an incontinent resident's appropriateness for a scheduled toileting program (0% passed). The absence of an assessment to determine a resident's potential responsiveness to toileting assistance may explain why 103 incontinent residents who were documented on the Minimum Data Set as being on a scheduled toileting program reported that they received the same number of toileting assists per day (1.3) as the group of 114 incontinent residents who were not on a scheduled toileting program (1.0). The received toileting assistance frequencies reported by both groups were too low to maintain continence. CONCLUSION: The standardized quality assessment system generated scores for nine incontinence quality indicators with good interrater reliability and provided explicit scoring rules that can facilitate replication. The focus of the indicators on care processes that are under the control of NH staff make the protocol useful for external survey and internal quality improvement purposes.

Aged↗
PubMed1997

A national clinical indicator database: issues of reliability and validity.

The introduction of performance (clinical) indicators into the accreditation process by the Australian Council on Healthcare Standards is in keeping with global trends and has enabled the establishment of a National Aggregate Database reflecting standards of care in acute health care organisations. The database contains both quantitative and qualitative information on the processes and outcomes of patient care and changes in practice induced through indicator monitoring. Of fundamental importance to the integrity of the database are the issues of indicator validity, responsiveness and reliability. This paper considers these issues, drawing parallels, as appropriate, to other performance indicator programs and studies.

Australia↗
PubMed1986

Osteoarthritis. Aggravating factors and therapeutic measures.

Clinical criteria for diagnosis of osteoarthritis are not yet formally established; at present, diagnosis is usually made through physical and radiologic examination and evaluation of synovial fluid. Severe trauma and possibly repeated microtrauma, excessive activity, inactivity, and obesity are believed to aggravate symptoms. Treatment objectives are to reduce pain and improve, or at least preserve, function. Antiinflammatory agents provide relief for many patients, although gastrointestinal reactions may accompany their use. Antispasmodics may be helpful for pain caused by muscle spasm, and intraarticular injections of depocorticosteroids are useful for inflammation. Agents that provide analgesia are an appropriate part of the therapeutic program. Patients should be taught to protect weakened joints through use of orthotics, strengthening exercises, and proper body movement and posture. A supportive physician who encourages a healthy life-style and positive outlook will see better physical as well as emotional results with these patients.

Adrenal Cortex Hormones↗
PubMed2005

Having a "safe delivery": conflicting views from Tibet.

In the Tibetan Autonomous Region (TAR) of the People's Republic of China (PRC) maternal mortality ratios remain among the highest in the world. Although traditional Tibetan medical theory, practice, and pharmacology include information on maternal and child health care, Tibet is one of the few societies in the world that does not have traditional birth attendants or midwives. Using ethnographic methods, we gathered data from individual interviews with rural Tibetan women (N=38) about their beliefs and behaviors surrounding pregnancy and childbirth. Additional data were gathered through interviews with prefecture, county, and township health care providers. These data were used to develop a culturally appropriate village birth attendant training program in rural Tibet. We describe Tibetan women's perspectives of "having a safe delivery" in relation to concepts about "safe delivery" according to evidence-based medicine in the West. Our work also provides an example of the benefits and challenges that arise when ethnographic research methods are used to design and implement health care interventions.

Adult↗
PubMed2005

Using curriculum design principles to improve health education for adolescent girls.

Learning and teaching are main concepts within health contexts, but curriculum theory is generally overlooked in the design of health education. In this paper, we describe the curriculum development component of a health research study designed to develop and present educational interventions for adolescent girls. Through the use of these interventions, we encouraged the girls to recognize and address potential health compromises in their dating relationships. By blending our disciplinary approaches of nursing and education to address the challenges of this research, we developed a curriculum that would effectively meet the needs of the participants. To do this, we assessed humanistic, social reconstructionist, technological, and academic curriculum approaches to determine that our approach is one of social reconstruction. We then considered teacher-centered, learner-centered, and problem-centered curriculum designs, choosing both learner and problem centered, and analyzed six dimensions of these designs. We describe these approaches, designs, and dimensions of curriculum considering pedagogical issues, criteria for evaluation, and appropriateness to educational health intervention programs.

Adolescent↗
PubMed1995

Caregiver discourse: perceptions of illness-related dialogue.

Interacting with terminally-ill patients is significantly stressful for caregiving families. To date, few studies have examined how caregivers perceive their communication with dying family members. As such, the present investigation was undertaken. A sample of 10 family caregivers was utilized for the study; informants had to be the spouse or child of the patient, having provided the majority of care during the illness period. Semi-structured interviews were employed by the investigator to collect data on the communicative experiences of these caregivers; they were asked to describe their thoughts and interactional experiences with specific reference to the following: (1) the inevitability of the patient's death, (2) the patient's preferred courses of action, (3) levels of family interaction, (4) patient denial, (5) previous patterns of discourse, and (6) bereavement. All interviews were audio-recorded, transcribed verbatim, and analyzed using a two-tier system incorporating aspects of content analysis methodology. Results indicate that caregivers experience difficulty communicating with their patients and with other family members. Suggestions for developing effective, appropriate, and sensitive communication training programs for terminally-ill patients and their caregiving families are provided.

Aged↗
PubMed2006

Suicide among Guaraní Kaiowá and Nandeva youth in Mato Grosso do Sul, Brazil.

Information on morbidity and mortality are critical for developing appropriate prevention and health promotion programs. This study summarizes data on the Guaraní (Kaiowá and Nandeva) communities in Mato Grosso do Sul, Brazil, about which little addressing suicide has been documented. Epidemiologic and anthropological data were used to examine suicidal behavior in these indigenous communities. Several findings in this report about the Guaraní Kaiowá and Nandeva communities were remarkable: the rates of suicide among these communities appear higher than the national average; suicide deaths disproportionately affect adolescents and young adults; and suicide rates among young males appear to be increasing. Data in this report highlight the need for health information data specific to a community in order to identify emerging health problems.

Adolescent↗
PubMed2002

Challenges and opportunities for humanitarian relief in Afghanistan.

Afghanistan is in the midst of a profound humanitarian crisis resulting primarily from long-standing armed conflict, a devastating drought, and massive population migration. The economy, government, and health care system are in shambles. Currently, as many as 5 million Afghans are in camps either as refugees in neighboring countries or as internally displaced persons within Afghanistan. Much of the rest of the population is in dire need of basic essentials such as food, water, shelter, and basic medical care. Those attempting to carry out humanitarian relief face many daunting challenges, such as reaching remote locations, coping with a dangerous security situation, and working with limited resources. However, there are opportunities in the short run to save many lives and substantially improve the plight of Afghans by carrying out appropriate and effective emergency relief programs. Over the long term, effective medical and public health relief efforts will be an essential part of rehabilitating and rebuilding this devastated country.

Afghanistan↗
PubMed1987

Inverse problem solution in cardiomagnetism using a current multipole expansion of the primary sources.

The equivalent current dipole (ECD) model is only the first-order approximation in modelling the primary sources of the magnetic field of the heart. From the experimental point of view this fact is particularly evident during the onset of ventricular depolarisation. In this paper we have tried to explain the departures of the experimental maps from the dipolar pattern in terms of the second-order component of the current multipole expansion for the primary source density. The antisymmetric part of this second-order component produces the external magnetic field and is equivalent to a magnetic dipole. To a first approximation it could represent circular currents flowing within the heart. We have derived the analytical expression for the magnetic field normal to the frontal plane produced by an equivalent current dipole and by an equivalent magnetic dipole (EMD) lying in a homogeneous conducting half-space. Using this expression in a least-squares fit computer program we have obtained the appropriate set of ECD and EMD parameters producing the best matching between theoretical and experimental field distributions in normal subjects. The results are in good agreement with the anatomical features of the heart and with the electrophysiology of ventricular activation. With previous theoretical considerations they strongly suggest the presence of divergence-free circular current sources within the heart.

Electric Conductivity↗
PubMed1978

Psychotropic drug use among institutionalized and noninstitutionalized Medicaid aged in California.

Previous research has shown that prescription drug use is higher for the aged than for the general population. The present study uses the California Medicaid data base to compare the amount and pattern of prescription drug use among the aged to that of the general population and then compares, within the aged population, drug use by the institutionalized and noninstitutionalized. It was found that prescription drug use was higher for the aged as compared to the general population; among the aged, however, prescription drug expenditures were almost three times as high for the institutionalized as compared to the noninstitutionalized. The bulk of the difference in prescription drug expenditure among the aged subgroup was found to be due to a much higher level of psychotropic drug use among the institutionalized. Data from a sample of aged in a day health program raises questions about the appropriateness of this level of psychotropic drug use.

Aged↗
PubMedDate not supplied

Mapping the d1 and d2 dwarfing genes and the purple foliage color locus P in pearl millet.

The d(1) and d(2) dwarfing genes and the P purple foliage color gene were placed on the restriction fragment length polymorphism (RFLP)-based molecular marker linkage map of pearl millet [Pennisetum glaucum (L.) R. Br.] using a mapping population based on a cross of inbred lines IP 18293 (D(1)/D(1), d(2)/d(2), P/P) and Tift 238D1 (d(1)/d(1) D(2)/D(2) p/p). A skeleton genetic linkage map of 562 cM (Haldane function) was constructed using 33 RFLP markers and these three morphological markers. The D(1)/d(1) plant height locus mapped to pearl millet linkage group 1, while the D(2)/d(2) plant height locus and the P/p foliage color locus mapped to pearl millet linkage group 4. Loose genetic linkage was observed between the D(2)/d(2) and P/p loci, with 42% repulsion-phase recombination corresponding to 92 cM (Haldane). This loose linkage of morphological marker loci detected on pearl millet LG4 can likely find use in applied pearl millet breeding programs, as host plant resistances to both downy mildew and rust have previously been identified in this genomic region. Such exploitation of these morphological markers in an applied disease resistance breeding program would require development of appropriate genetic stocks, but the relatively loose genetic linkage between d(2) and P suggests that this should not be difficult.

Chromosome Mapping↗
PubMed2003

3DNA: a software package for the analysis, rebuilding and visualization of three-dimensional nucleic acid structures.

We present a comprehensive software package, 3DNA, for the analysis, reconstruction and visualization of three-dimensional nucleic acid structures. Starting from a coordinate file in Protein Data Bank (PDB) format, 3DNA can handle antiparallel and parallel double helices, single-stranded structures, triplexes, quadruplexes and other complex tertiary folding motifs found in both DNA and RNA structures. The analysis routines identify and categorize all base interactions and classify the double helical character of appropriate base pair steps. The program makes use of a recently recommended reference frame for the description of nucleic acid base pair geometry and a rigorous matrix-based scheme to calculate local conformational parameters and rebuild the structure from these parameters. The rebuilding routines produce rectangular block representations of nucleic acids as well as full atomic models with the sugar-phosphate backbone and publication quality 'standardized' base stacking diagrams. Utilities are provided to locate the base pairs and helical regions in a structure and to reorient structures for effective visualization. Regular helical models based on X-ray diffraction measurements of various repeating sequences can also be generated within the program.

Base Pairing↗
PubMed1986

Cyclic endocytic activity and kinetics of lysosomes in Sertoli cells of the rat: a morphometric analysis.

Native ferritin was injected into the rete testis of rats, and seminiferous tubules infused with the tracer were collected 6 h later and prepared for electron microscopic analysis. As a result of internalization of the tracer by Sertoli cells, label was found within 12-66% of the secondary lysosomes, depending on the stage of the cycle of the seminiferous epithelium. The Zeiss MOP-3 instrument was used on selected electron microscope photographs to measure a number of morphometric parameters. Applying appropriate formulae and a computerized program, it was possible to determine the absolute numbers of labeled and unlabeled secondary lysosomes per Sertoli cell for each one of the 14 stages of the cycle. Knowing the duration of these stages, it was also possible to evaluate the turnover kinetics and life span of lysosomes for each stage of the cycle. The percentage of ferritin-labeled lysosomes, regarded as an index of the endocytic activity of Sertoli cells, remained low in stages II to VIII, increased abruptly during stage IX, stayed high during stages X to XIV, and decreased to a low level during stage I of the following cycle. Correspondingly, the turnover of secondary lysosomes was relatively slow and their life span relatively long during stages II through VIII, while the turnover of lysosomes was faster and their life span shorter during stages X through XIV-I of the cycle. During stage IX, there was a sharp drop in the number of lysosomes per Sertoli cell associated with a fast rate of disappearance and a remarkably short life span of less than 4 h for the lysosomes. These features, characteristic of stage IX, are explained by the rapid fusion of lysosomes with residual bodies, which are phagocytosed by Sertoli cells at this particular stage of the cycle. The accelerated endocytosis taking place during stages IX through XIV of the cycle may explain the reduction of the surface area of the adluminal plasma membrane of Sertoli cells as well as the reduction in volume of the tubular lumen observed during these stages. Thus, the demonstrated cyclic endocytic activity of Sertoli cells and several other cyclical events taking place within seminiferous tubules correlate well.

Animals↗

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