Consumer-professional collaboration for evaluation in neighborhood mental health programs

Neighborhood mental health programs are challenged with the scientific and fiscal necessity of evaluating their services. Since most such programs are joint endeavors of neighborhood residents (usually a consumer board) and nonneighborhood professionals, such evaluative efforts require the sanction and collaboration of both groups to be maximally effective. However, the authors point out that collaboration is often strained by lack of trust and conflicts of interest. Study design may fail to consider neighborhood values, with the result that the provision of services is impeded, consumers are frightened or coerced, the role of paraprofessionals is threatened, and the consumer board's responsibilities to the neighborhood are ignored. The authors discuss those four issues and suggest ways of resolving them.     

A simple device to obtain a pulsatile flow. Application to the vascular perfusion of dogs isolated intestinal segments

A simple device allowing a pulsatile flow to be obtained in isolated organ perfusion has been developed and applied to the vascular perfusion of isolated canine jejunal segments. The principle of the device consists of superimposing on a constant pressure produced by a roller pump, a pulsatile pressure of which the amplitude, frequency, and shape of the pulses can be adjusted separately and independently of the mean pressure value. The role of the arterial pulse in intestinal vascular perfusion has been studied by comparing the hemodynamic and metabolic behavior during alternate periods of pulsatile and nonpulsatile pumping. While no striking change in vascular resistance was observed, the O2 consumption was significantly increased under pulsatile flow. These results testify to better metabolic conditions and enhanced organ functions under pulsatile pumping and also argue for improved intestinal microcirculation despite the constancy of the vascular resistance.     

Mechanosensitive afferent units in the hypogastric nerve of the cat

1. Recordings have been made from ninety single afferent units in the hypogastric and lumbar splanchnic nerves of the cat. 2. The majority of units examined had properties similar to those previously described in the splanchnic nerve: they were slowly adapting mechanoreceptors with one to six punctate mechanosensitive sites distributed mainly along blood vessels as they approached the viscera in peritoneal ligaments; they had a wide range of mechanical thresholds and conduction velocities in the range 0.5-24 m s-1. 3. Receptive fields were found over the bladder base or its peritoneal ligaments or both, on the uterus or broad ligament or both, on the colon or mesocolon or both, and in association with the ureter, vas deferens, prostate or pelvic fat pads. 4. Discharges from afferent units associated with the bladder were investigated during spontaneous (or reflex) bladder contractions, passive distensions, and tetanic contractions induced by electrical stimulation of the sacral spinal cord. The mean spike rates of the adapted (tonic) discharges, observed during distensions and induced tetani, differed over part of the range of intravesical pressures examined. Their behaviour is discussed in relation to the concept of 'in series' tension receptors within the bladder wall.