Nutrition and health of population in the North: priority guidelines

Studies covered nutrition of immigrants in Far North and revealed considerable disturbances and shortage in vitamin supply. The authors necessitate general efforts to maintain balanced nutrition with consideration of Far Northern conditions.     

Cultural competence: a priority for performance improvement action

An increase in diversity that has been accompanied by a sharp decrease in white Caucasian "mainstream" culture has made cultural competence a priority in nursing performance improvement. Each culturally diverse group defines health and illness differently. Most have a long and well-established tradition of folk health beliefs and practices, which strongly impact members' reactions to American standards of care--an influence on both patient satisfaction and treatment compliance. This article describes the culture--health care relationship and lists 10 indicators for measuring cultural competency. It presents a practical, systemwide model for the improvement of nursing care quality through enhanced cultural competency and lists resources, which can be used to both support and improve cultural competency throughout an integrated health care system.     

Weightlessness: a matter of gravity

Circular dichroism (CD) and infrared spectroscopy (IRS) studies of aqueous solutions of fourth N-terminal peptides of histone H4 with different chain length were carried out under various conditions. It was shown that all studied peptides had conformation of extended left-handed helix as well as poly-1-proline II at the acidic and neutral pH, in moderate ionic strength (0,15), in 80% ethanol, 0,2 M sodium dodecylsulphate, in 8 M urea and 5 M guanidinum hydrochloride. This conformation was changed by raising temperature, under transition to the range of basic pH and in the concentrated solutions of CaCl2 (5M).     

Children's access to mental health care: does insurance matter?

Using data from a 1992 community survey of children and their parents (or guardians), we found major gaps in mental health insurance coverage. Interestingly, private insurance had no statistically significant effect on use of mental health services. Youth without insurance coverage and those with public insurance had higher rates of serious emotional disorder than did those with private insurance. The analysis is based on the National Institute of Mental Health's Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, conducted in three mainland U.S. sites and in Puerto Rico.     

Extraterrestrial organic matter: a review

We review the nature of the widespread organic material present in the Milky Way Galaxy and in the Solar System. Attention is given to the links between these environments and between primitive Solar System objects and the early Earth, indicating the preservation of organic material as an interstellar cloud collapsed to form the Solar System and as the Earth accreted such material from asteroids, comets and interplanetary dust particles. In the interstellar medium of the Milky Way Galaxy more than 100 molecular species, the bulk of them organic, have been securely identified, primarily through spectroscopy at the highest radio frequencies. There is considerable evidence for significantly heavier organic molecules, particularly polycyclic aromatics, although precise identification of individual species has not yet been obtained. The so-called diffuse interstellar bands are probably important in this context. The low temperature kinetics in interstellar clouds leads to very large isotopic fractionation, particularly for hydrogen, and this signature is present in organic components preserved in carbonaceous chondritic meteorites. Outer belt asteroids are the probable parent bodies of the carbonaceous chondrites, which may contain as much as 5% organic material, including a rich variety of amino acids, purines, pyrimidines, and other species of potential prebiotic interest. Richer in volatiles and hence less thermally processed are the comets, whose organic matter is abundant and poorly characterized. Cometary volatiles, observed after sublimation into the coma, include many species also present in the interstellar medium. There is evidence that most of the Earth's volatiles may have been supplied by a 'late' bombardment of comets and carbonaceous meteorites, scattered into the inner Solar System following the formation of the giant planets. How much in the way of intact organic molecules of potential prebiotic interest survived delivery to the Earth has become an increasingly debated topic over the last several years. The principal source for such intact organics was probably accretion of interplanetary dust particles of cometary origin.     

Can bilharziasis be considered a health priority in western Africa, justifying control programs of large scope?

INTRODUCTION: The aim of the study was the evaluation of the usefulness of transesophageal atrial pacing in predicting chronic oral treatment efficacy of symptomatic reciprocating supraventricular tachycardia in infants and in avoiding the risk of very dangerous recurrences at home. METHODS: We studied 13 infants (11 males, 2 females, mean age 43 +/- 31 days) with symptomatic reciprocating supraventricular tachycardia and no structural heart disease. All patients had chronic oral therapy, using the drug effective in acute i.v. somministration. Each patient was discharged when supraventricular tachycardia was not inducible with transesophageal atrial pacing after 5 half-lives of the drug used in chronic oral treatment. All patients, every 6 months, were retested with transesophageal atrial pacing alternatively during chronic oral therapy and after complete wash out. Oral therapy was stopped in each patient when supraventricular tachycardia was not inducible after the wash out. RESULTS: The number of oral treatments tested for each patient were 2 +/- 1 (range 1-5). The number of transesophageal studies performed for each patient were 4 +/- 2 (range 3-7). No patient had symptomatic episodes of supraventricular tachycardia or needed to change therapy during the follow-up. The oral treatment was stopped after the twelfth month of life in 8 patients and after the twenty-fourth in 2 others without recurrences. CONCLUSION: Transesophageal atrial pacing seems to be useful in predicting accurately and rapidly the oral treatment efficacy of supraventricular tachycardia in infants. Our protocol seems to be effective to avoid dangerous recurrences of tachycardia and to decide when we can stop therapy without risk.     

Prison inmates with a history of inpatient psychiatric treatment

Radiation enteric disorders are rare and difficult to treat. A case of radiation duodenitis treated by hyperbaric oxygen is reported. A sixty-year-old man underwent right nephroureterectomy, chemotherapy (platin and 5 fluorouracil) and radiation therapy (54 Gy) for excretory urinary carcinoma. Six months later, even though he was under omeprazole therapy for reflux oesophagitis, he experienced antroduodenitis, duodenal ulceration, and duodenal telangiectasia. Symptoms and duodenal ulcer disappeared 2 months later with hyperbaric oxygen (10 one hour sessions at 2 ATA). Most likely, hyperbaric oxygen can reduce the consequences of obliterative endarteritis due to irradiation, responsible for ischaemia and fibrosis later on.     

PHLS overview of communicable diseases 1997: results of a priority setting exercise

In early 1997, the PHLS Overview of Communicable Diseases (OVCD) Committee carried out a consultation exercise to inform the development of PHLS priorities in communicable diseases for the years 1997 to 1999. The views of PHLS senior staff and scientific committees and consultants in communicable disease control in district health authorities were sought by postal questionnaire, and several organisations of health professionals were asked for their views on the initial findings. The main findings of the exercise are summarised in three areas of priority. Priority 1 diseases--those of major importance to public health--included food poisoning, meningitis, tuberculosis, sexually transmitted diseases, vaccine preventable diseases, hospital acquired infections, and antimicrobial resistance. Priority 2 diseases--those of moderate importance to public health--included respiratory syncytial virus and varicella zoster virus infections and emerging problems such as travel associated infections. Priority 3 diseases included those whose prevalence is declining as a result of public health action, such as listeriosis, and diseases of low prevalence and/or associated morbidity. The exercise identified four areas of possible future work for the PHLS: activities in prion diseases, helping to tackle inequalities in health, taking a more active approach to documenting the socioeconomic burden of disease, and engaging more with those consulted. The PHLS has used the results of the priority setting exercise to guide major programme initiatives in tuberculosis, measles, mumps, and rubella, meningococcal and pneumococcal diseases, and in antibiotic resistance. In addition, they have helped to shape agenda in service delivery and research in hospital acquired infections, sexually transmitted diseases, and gastrointestinal diseases. This exercise of engaging corporately with key professionals in communicable disease has paved the way for a wider engagement with stakeholders in the setting of future priorities.