Tobacco cessation skills certification in Arizona: application of a state wide, community based model for diffusion of evidence based practice guidelines

OBJECTIVE: To describe the development and preliminary results from a community based certification model for training in tobacco cessation skills in Arizona. DESIGN: A programme evaluation using both quantitative pre-post measures and qualitative methods. SETTING: Arizona's comprehensive tobacco control programme of state funded, community based local projects and their community partners providing tobacco treatment services for geographically, socioeconomically, and ethnically diverse communities. INTERVENTION: A three tiered model of skills based training emphasising Agency for Health Care Policy and Research guidelines, and utilising a training of trainers approach to build community capacity. Certification roles addressed basic tobacco cessation skills, tobacco cessation specialist, and tobacco treatment services manager. PARTICIPANTS: Initial target audience was community based local project personnel and their community partners, with later adoption by community organisations unaffiliated with local projects, and the general public. MAIN EVALUATION MEASURES: Process measures: participant satisfaction, knowledge, skills, and self-efficacy. Outcome: participant demographics, community organisations represented, post-training, cessation related activities. RESULTS: During the model's implementation year, 1075 participants attended certification training, 947 participants received basic skills certificates and 82 received specialist certificates. Pre, post, and three month measures of self efficacy showed significant and durable increases. Analysis of participant characteristics demonstrated broad community representation. At post-training follow up, 80.9% of basic skills trainees had performed at least one brief intervention and 74.8% had made a referral to intensive services. Among cessation specialists, 48.8% were delivering intensive services and 69.5% were teaching basic skills classes. CONCLUSIONS: Initial experience with Arizona's state wide, community based model for certification of tobacco cessation skills training suggests this model may be a promising method for broad, population based diffusion of evidence based tobacco cessation guidelines.     

Cloning of the cDNA and expression of moubatin, an inhibitor of platelet aggregation

Moubatin, a new type of specific inhibitor of collagen-induced platelet aggregation, has been isolated from the soft tick Ornithodoros moubata (Waxman, L., and Connolly, T. M. (1993) J. Biol. Chem. 268, 5445-5449). A polymerase chain reaction-generated hybridization probe, produced using primers based on moubatin protein sequence, identified phage containing the entire cDNA sequence of moubatin. Analysis of the predicted amino acid sequence yielded a mature protein of 156 amino acids with a putative prepeptide of 15 amino acids. Comparison of the sequence of moubatin to that of other proteins in the Swiss PROT data base revealed no significant homology. The cDNA sequence was cloned into the yeast expression vector pKH4 alpha 2, producing a biologically active protein which inhibited collagen-stimulated aggregation of washed human platelets with an IC50 of about 100 nM, which is similar to the potency of native tick moubatin. A concentration of recombinant moubatin that fully inhibited collagen-stimulated aggregation did not inhibit aggregation induced by a variety of other platelet agonists, again demonstrating comparable properties of the recombinant and native proteins. Moubatin did not inhibit platelet adhesion to collagen even at a concentration up to 16 times its IC50 for the inhibition of aggregation. This specificity for inhibiting collagen-stimulated aggregation and not adhesion to collagen indicates that moubatin is unique among the natural product inhibitors of collagen stimulation of platelets. Further examination of the mechanism of moubatin-mediated inhibition of collagen-stimulated aggregation revealed that 1-6 microM moubatin diminished the second phase of aggregation induced by ADP, inhibited aggregation in response to submaximal concentrations of the thromboxane A2 mimetic U46619, and competed for the binding of a thromboxane A2 receptor antagonist to platelet membranes. Therefore, at higher concentrations, moubatin may affect more than one aspect of platelet signal transduction including the thromboxane A2 receptor. The availability of recombinant moubatin will allow further investigation of its unique activities in vitro and in vivo.     

Social self-efficacy in adolescence: Relations with self-concept, social adjustment, and mental health.

An examination of social self-efficacy in 163 high school students (aged 13–19 yrs) and 79 emotionally disturbed adolescents (aged 12–18 yrs) is reported. The Adolescent Social Self-Efficacy Scale, a 25-item scale which elicits self-ratings of behavioral effectiveness in problematic peer contexts, was developed. Scale homogeneity and test–retest reliability were evident in the samples tested. Validity of the social self-efficacy construct was demonstrated by correlations with indices of social self-concept and ratings of social adjustment. Clinical utility of the scale was also evident. Emotionally disturbed adolescent Ss rated themselves more poorly than did their well-functioning peers. Findings support the conceptualization of social self-efficacy as a component of social competence and as a contributor to mental health. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Locally recurrent prostate tumors following either radiation therapy or radical prostatectomy have changes in Ki-67 labeling index, p53 and bcl-2 immunoreactivity

Mast cells participate in the host defense against parasites. Mast cells release leukotrienes (LTs), potent 5-lipoxygenase (LO) products of arachidonic acid well-known to be involved in the inflammatory process. After incubation with Toxoplasma gondii, mast cells were found to degranulate and release LTB4; this interaction damages the tachyzoites. This mast cell activity against the tachyzoites was inhibited by the 5-LO inhibitor A-63162 and the 5-LO-activating protein inhibitor MK-886 but not by the cyclooxygenase inhibitor indomethacin. Reactive oxygen species were not implicated in the mast cell-mediated toxoplasmacidal activity. The generation of LTs is important for mast cell secretion, and LTB4 released by mast cells and other inflammatory cells may be a key factor in the host defense against T. gondii.     

The safety of intraoperative lumbar subarachnoid drainage for acutely ruptured intracranial aneurysm: technical note

Recently, some concern has arisen regarding the safety of intraoperative spinal drainage for brain relaxation in aneurysm surgery, due to anecdotal association with both aneurysmal rebleeding and increases in symptomatic vasospasm. To address these concerns, we reviewed our experience with frequent spinal drainage and early surgery in 432 consecutive cases of surgically treated aneurysmal subarachnoid hemorrhage. Unless contraindicated by mass effect or associated pathology, all grade I-III patients referred within 14 days were treated with spinal drainage at surgery. In this cohort (n = 314), there were no cases of meningitis or nerve root injury. Only one case of intraoperative rebleeding could be associated with spinal drain placement (0.3%). In grade IV-V patients, 47% required preoperative ventriculostomy, and 11% were ineligible for spinal drainage due to mass effect. There were, however, no complications related to spinal drainage in the remaining 23 patients. Permanently-shunted hydrocephalus (8%) and symptomatic vasospasm (19%) were infrequent overall. When analyzed by grade, spinal drains were generally associated with equal or reduced incidence of these developments when compared to patients without spinal drainage. We conclude that brain relaxation can be safely and effectively obtained using intraoperative spinal drains during early aneurysm surgery.     

Programming methodology and performance issues for advanced computer architectures

This paper will describe some recent attempts to construct transportable numerical software for high-performance computers. Restructuring algorithms in terms of simple linear algebra modules is reviewed. This technique has proved very succesful in obtaining a high level of transportability without severe loss of performance on a wide variety of both vector and parallel computers. The use of modules to encapsulate parallelism and reduce the ratio of data movement to floating-point operations has been demonstrably effective for regular problems such as those found in dense linear algebra. In other situations it may be necessary to express explicitly parallel algorithms. We also present a programming methodology that is useful for constructing new parallel algorithms which require sophisticated synchronization at a large grain level. We describe the SCHEDULE package which provides an environment for developing and analyzing explicitly parallel programs in FORTRAN which are portable. This package now includes a preprocessor to achieve complete portability of user level code and also a graphics post processor for performance analysis and debugging. We discuss details of porting both the SCHEDULE package and user code. Examples from linear algebra, and partial differential equations are used to illustrate the utility of this approach.     

Schizophrenia is associated with altered orienting activity: Depression with electrodermal (cholinergic?) deficit and normal orienting response.

The import of a recent consensus that a distinctive subgroup of schizophrenics is marked by nonreactivity of the orienting response (OR) to innocuous stimuli has been made ambiguous by reports of similar nonreactivity among depressives. To test this, we studied 50 schizophrenics (14 drug free), 50 depressives (20 drug free), and 50 normal controls. Stimuli were 1000 Hz (60 dB) or 2000 Hz (58 dB) 1-s tones delivered either to the left or right ear. A subsample of each group was told they need do nothing during tone presentations (habituation series); other subsamples had to press a pedal for each designated target signal (left ear, right ear, 1000 Hz, 2000 Hz), ignoring all nontarget tones. Skin conductance response (SCR) and finger pulse volume (FPV) analyses are reported. As in previous work, schizophrenics showed high nonresponding in the habituation series, consistent in both SCR and FPV, and they showed normalizing in both to target signals. Depressives were equally nonresponsive during the habituation series in SCR, but did not normalize to target signals and showed normal FPV response during both the habituation and target series. Whereas schizophrenic dysfunction reflected OR change, that of depressives seemed to reflect cholinergic deficit but intact OR. This was associated with high retardation and low agitation ratings, but not with degree of depression on Hamilton or Zung scales. In addition, 10 largely remitted depressives showed the same pattern as did patients currently in a major depressive episode. (PsycINFO Database Record (c) 2010 APA, all rights reserved)