Weight loss education: the challenge of a new paradigm

The functional effects of adenosine 5'-triphosphate (ATP), uridine 5'-triphosphate (UTP), adenosine 5'-tetraphosphate (AP4) and the diadenosine polyphosphates P1,P3-diadenosine triphosphate (Ap3A), P1,P4-diadenosine tetraphosphate (Ap4A) and P1,P5-diadenosine pentaphosphate (Ap5A) were studied in two isolated smooth muscle preparations thought to contain P2Y (P2Y1) receptors, the guinea-pig taenia caeci (which relaxes to ATP) and the rat colon muscularis mucosae (which contracts to ATP). In addition, the breakdown of these compounds by the rat colon muscularis mucosae was investigated by high pressure liquid chromatography. In the guinea-pig taenia caeci all the purine nucleotides caused relaxation with a potency order of Ap3A=Ap4A> ATP>AP4=Ap5A, and these relaxations were antagonised by suramin with apparent pA2 values in the region of 5, consistent with activation of a P2Y1 receptor. In the rat colon muscularis mucosae the nucleotides caused contraction with a potency order of Ap3A = Ap4A>ATP=AP4 =Ap5A >UTP. However, while suramin (100 microM) inhibited responses to ATP and UTP at all concentrations of agonist, it only inhibited contractions induced by the higher concentrations of AP4, Ap3A and Ap4A and had little effect on contractions induced by Ap5A. A higher concentration of suramin (1 mM) enhanced contractions induced by ATP but greatly inhibited those induced by UTP and had no effect on responses to the other agonists. The A1 adenosine receptor antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX; 10 nM) had no effect on responses to ATP or UTP but inhibited responses to Ap3A, Ap4A, Ap5A and AP4. A combination of suramin (1 mM) and DPCPX (10 nM) almost abolished responses to all the agonists. ATP and UTP were rapidly degraded by the rat colon muscularis mucosae while AP4, Ap3A, Ap4A and Ap5A were degraded more slowly, and the major product detected after breakdown of the purine nucleotides was inosine rather than adenosine. The breakdown of all the nucleotides was inhibited by suramin (1 mM), although this inhibition did not achieve statistical significance in the case of ATP. These results show that while the diadenosine polyphosphates appear to act as P2 agonists in the taenia caeci, in the rat colon muscularis mucosae their major action is via adenosine A1 receptors rather than via P2 receptors. In addition, although they are more stable than ATP or UTP, their action in this tissue is clearly affected by their degradation which complicates the effects of suramin.     

"Integrated psychotherapy": a new clinical challenge

Integrated psychotherapy according to Barolin wants to be embedded in the general health system and regards the whole "bio-psychosocial entity of man" using psychical means, which can take psychotropic as well as somatotropic effect. It should come out of an isolated ivory tower and seek coordination with each and everyone dealing with the "human entity": medical (like medication, physiotherapy, etc.), nursing, social work, administration, etc. Psychotherapeutic "schools" should serve as a solid base of learning. Practical use however should go beyond schools: patient-centered instead of school-centered. Integrated psychotherapy should reach all persons who need it, within their somatogenic and psychogenic problems, especially the physical ill, up to accompaniment of the dying, especially in rehabilitation, including social environment, old-age groups. For this it needs social integration accepting economic responsibility (in the sense of "social ethics") plus evaluation. Hence, theory and practice of integrated psychotherapy find themselves linked to a higher human-ethical postulate, with a marked communicative component.     

Health sciences as an interdisciplinary challenge: the development of a new scientific field

Health sciences in Central Europe have been established in recent years as the academic complement to public health. Unlike the situation outside Europe the link between academia, administration and practical application has become a distinct characteristic of this European philosophy. In this article the two questions are posed: 1. as to which structural problems characterize research into health and illness today and 2. how far can the establishment of an interdisciplinary sphere of "health sciences" provide adequate solutions? The authors also sketch the outlines of the new health sciences as an intergrating and "trans-paradigmatical" teaching and research field and they consider the relationships of health sciences to practice in general, and their relevance to the health services in particular. The challenges in the future for public health and therefore for the health sciences will be enormous. A breakthrough in this field will probably not be achieved until the research interests of clinical specialists and researchers oriented towards social and behavioural sciences are linked over a broad front. It is also hoped that from this connection-embeded in open scientific discourse-"health sciences" will arise, not as part of medicine, and not as part of this social sciences, but with their own claims and specific conceptions as to how the problems of our health system can be resolved.     

Conceptual models of aging: The challenge of a new frontier.

Explores a range of social, professional, and scientific conceptual models to examine their potential impact on the scientific and professional approach to the aging. These models include an economic/productive model, the behavioral medical model, and conceptual models of mental health care. Narrow models have led to beliefs, training, and approaches to practice that reinforce the models and perpetuate a mythology of aging to the detriment of all involved. An opportunity to broaden conceptual horizons by learning about the aged is described. It is proposed that a biopsychosocial model best conceptualizes the complexity of the situation. A commitment to a broad model must incorporate a stance by which strategies are examined in terms of how effective they are, where they are best applied and where they are appropriate, what insights they provide, what risks and benefits accrue to patient and family, and who makes decisions about care. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Amazing new discovery: Piaget was wrong!

Comments on the article by J. Macnamara and G. Austin (see record 1994-05070-001) and indicates that there is a great deal of validity in their position; however, their ideas are part of a historical tradition. For the past 60 yrs, there have been a number of individuals who have noted major inconsistencies in Piagetian theory and/or significant problems with the methodology of the studies conducted within this framework. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The challenge of environmental psychology: A proposal for a new functionalism.

Argues that the hardship conditions under which man evolved put a high premium on rapid and efficient information handling. Currently maladaptive behavior with respect to overpopulation and environmental decline may be in part the result of an inadequate conception of what the future holds. The missing knowledge is unlikely to be verbal. Substitutes for experience that enhance imagery of alternative futures may be pivotal. A few of the multitude of researchable topics that arise in this context are presented. It is concluded that a broad functional psychology could find much to learn, study, and contribute in the environmental area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification and characterization of a new splicing variant of vascular endothelial growth factor: VEGF183

The purpose of this study was to determine implant survival rates by means of life table analyses for a cohort of patients not part of a prospective efficacy trial and treated by practitioners at varying experience levels. Prognostic variables associated with implant failure were identified by means of proportional hazards models and advanced statistical methods that account for patient effects. Ninety-nine consecutive patients treated from 1987 to 1991 with follow-up to 1994 were included in this retrospective study. A total of 384 dental implants (79.7% Br?nemark, 19.3% IMZ plasma-sprayed, 1% IMZ hydroxyapatite-coated) were placed and subsequently supported 108 prostheses. Survival and proportional hazards modeling were used to generate Kaplan-Meier survival curves and to identify variables associated with implant failure. Survey data analysis was used to adjust for any patient effects for variables identified as significant through the proportional hazards models. Thirty-four implants failed over the follow-up period (median follow-up time 3.6 years), resulting in an overall failure rate of 8.9%. Seventeen of 99 patients experienced an implant failure. When prosthesis type was excluded from the modeling process, survey data analysis identified posterior location and an implant width of less than 4.0 mm as being associated with implant failure (all P < .05).     

Facial reconstruction: the history of a challenge

The temporal coordination of hand and foot actions in piano performance is an interesting instance of highly practiced, perceptually guided complex motor behavior. To gain some insight into the nature of this coordination, ten pianists were asked to play two excerpts from the piano literature that required repeated use of the damper pedal to connect successive chords. Each excerpt was played at three prescribed tempos on a Yamaha Disklavier and was recorded in MIDI format. The question of interest was whether and how changes in tempo would affect the timing of pedal releases and depressions within the periods defined by successive manual chord onsets. Theoretical possibilities ranged from absolute invariance (variable phase relationships) to relative invariance of pedal timing (constant phase relationships). The results show that, typically, the timing of pedal actions is neither absolutely nor relatively invariant: As the tempo increases, both pedal releases and depressions usually occur a little sooner and pedal changes (release-depression sequences) are executed a little more quickly, but these effects are proportionally smaller than the changes in manual (and pedal) period duration. Since this may be due to unequal changes in peripheral hand and foot kinematics with tempo, it remains possible that there is invariance of either kind at the level of central motor commands. However, it is the peripheral timing that produces the acoustic consequences musicians try to achieve.     

Hemochromatosis: new insights in pathogenesis and diagnosis following the discovery of the gene

Hemochromatosis is a common and often underdiagnosed disease. Early diagnosis and treatment results in an excellent long-term prognosis. The development of a diagnostic genetic test has improved the feasibility of the goal of prevention of morbidity and mortality from hemochromatosis.     

Continuing education: A new challenge for psychology.

Notes that pressures are mounting from within and from outside psychology for the demonstration of continued professional competence. The need for systematically available continuing education opportunities for both the practicing professional and the teacher-scientist is great. It is suggested that some services can be provided centrally by the American Psychological Association which will facilitate the development of a continuing education network for all psychologists. The following services are proposed: consultation on the development of programs, a resource center, a registration service, publication of a calendar, and a self-assessment examination system. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ecoimmunonutrition: a challenge for the third millennium

Phospholipids constitute an important part of cellular membranes, and membrane fluidity and permeability are dependent on the fatty acid composition of the phospholipid. The composition, which changes with aging and disease is, to a large degree, influenced by nutrient supply. Phospholipids have been effective in protecting cellular membranes such as those of the gastrointestinal tract to an extent not much different from that observed with external supply of established mucosa-protective drugs such as misoprostol and sucralfate. Polar lipids have also been shown to be effective in preventing microbial translocation. The effect is further potentiated by an external supply of probiotic fibers such as pectin, guar gum, and oat gum. These and many other fibers also have documented strong mucosa preventive effects. Prebiotic bacteria such as Lactobacillus plantarum have demonstrated a strong ability to preserve food and prevent spoilage. In addition, L. plantarum seems to not only preserve key nutrients such as omega-3 fatty acids, but also increases its content during storage conditions. L. plantarum alone or in combination with various fibers has demonstrated a strong ability to reduce and eliminate potentially pathogenic microorganisms both in vitro and in vivo. It has recently been shown that L. plantarum possesses the ability to adhere to and colonize intestinal mucosa. It seems unique among the lactobacilli for L. plantarum to use mannose-specific adhesins, uncommon among gram-positive, but common among gram-negative bacteria, which makes it possible that L. plantarum competes with gram-negative other potential pathogens for receptor sites at the mucosal cell surfaces. Additionally, L. plantarum seems to be effective in eliminating nitrate and producing nitric oxide. These functions of L. plantarum are among the reasons why it has been used in combination with various fibers and polar lipids to recondition the gastrointestinal mucosa. For the purpose of a L. plantarum-containing formula being produced and tried, a treatment policy is regarded as an extension of the immunonutrition program and called ecoimmunonutrition.     

Gestational diabetes: a challenge for the future

It is well established that pregnancy is associated with temporary changes in maternal metabolism which include a decrease in maternal insulin sensitivity to values similar to those associated with Type 2 diabetes. Fasting glucose concentrations fall throughout pregnancy, postprandial values rise. The maintenance of glucose tolerance in pregnancy requires a two- to three-fold increase in postprandial maternal insulin secretion. Glucose intolerance develops in women unable to compensate for the metabolic changes incurred by pregnancy. Increasing maternal hyperglycaemia is associated with increasing pregnancy morbidity and an increased likelihood of subsequent diabetes in the mother. In addition, maternal hyperglycaemia has a direct effect on the development of the fetal pancreas and is associated with an increased susceptibility to future diabetes in the infant, an effect which is independent of genetic factors. Gestational diabetes mellitus (GDM) is defined as glucose intolerance first recognized in pregnancy, and by definition includes a small number of women with previously unrecognized diabetes or impaired glucose tolerance (IGT). Figures on the prevalence of GDM vary between maternity units, depending on screening methods and the ethnic distribution of the populations. However, in a comprehensive study of a multi-ethnic antenatal population in inner London, UK it was found that only 2% of pregnant women develop significant glucose intolerance. Obstetricians and physicians debate the importance of identifying this 2% of women. The lack of agreed criteria for diagnosing gestational diabetes and the questionable obstetric benefits of treating all women with mild disturbances of glucose tolerance in pregnancy has resulted in few UK centres undertaking universal screening for GDM.(ABSTRACT TRUNCATED AT 250 WORDS)     

Multiple personality disorder: A new challenge for psychology.

Reviews recent literature on multiple personality disorder. Despite a significant increase in the number of publications on this topic during the past 10 yrs, it is noted that limited knowledge exists on issues such as prevalence rates, differential diagnosis, etiology, and treatment. Psychologists are encouraged to become actively involved in the study of this disorder, and specific research suggestions are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cryptolepis sanguinolenta: an ethnobotanical approach to drug discovery and the isolation of a potentially useful new antihyperglycaemic agent

Hypoxia induces an increase in PMN adherence to endothelial cells for which an interaction between ICAM-1 and CD18/CD11b has been demonstrated. Since PECAM-1 has been shown to be involved in PMN transmigration through the endothelium and to increase the binding capacity of leukocyte CD18/CD11b, the role of this molecule in the hypoxia-induced PMN adherence was investigated. Hypoxia did not change the total surface expression of PECAM-1 on HUVEC and did not change the cell-cell border localization of this molecule as TNF-alpha did. In addition, blocking anti-PECAM-1 antibodies could not inhibit the increased adherence of unstimulated human PMN to hypoxia-incubated HUVEC while anti-ICAM-1 partially inhibited this process. These results indicate that PECAM-1 is probably not involved in the hypoxia-induced PMN adherence to endothelial cells.     

Prostate surgery: a communication challenge

Many patients requiring prostate surgery experience a lack of interest from health-care staff in relation to their views and opinions. Information offered to patients who have undergone prostate surgery is often inadequate as a result of poor communication by health staff. Nurses need to understand the priorities of their patients and use this information to inform the way in which advice is given.