Weight-bearing asymmetry and vertical activity differences in a rat model of post-traumatic knee osteoarthritis.

OBJECTIVE: This study used a rat model of post-traumatic knee osteoarthritis (OA) created by anterior cruciate ligament transection with partial medial meniscectomy (ACLT + pMMx). In this model, mild to moderate structural changes that are typical of knee OA have been observed within 2 and 8 weeks post-surgery. We aimed to determine whether pain-related behaviours can distinguish between an ACLT + pMMx and a sham surgery group. DESIGN: Three-month old male Sprague-Dawley rats underwent ACLT + pMMx on their right hindlimb within two groups of n = 6 each, and sham surgery within two groups of n = 5 each. Assessments evaluated percent ipsilateral weight-bearing for static weight-bearing and 18 different variables of exploratory motor behaviour at multiple time points between 1 and 8 weeks post-surgery. Histology was performed on the right hindlimbs at 4 and 8 weeks post-surgery. RESULTS: Histology confirmed mild to moderate knee OA changes in the ACLT + pMMx group and the absence of knee OA changes in the sham group. Compared to the sham group, the ACLT + pMMx group had significantly lower percent ipsilateral weight-bearing from 1 through 8 weeks post-surgery. Compared to the sham group, the ACLT + pMMx group had significantly lower vertical activity (episode count, time, and count) values. CONCLUSIONS: These findings suggest that ipsilateral weight-bearing deficit and vertical activity limitations resulted from the presence of knee OA-like changes in this model. When using the ACLT + pMMx-induced rat model of knee OA, percent ipsilateral weight-bearing and vertical activity distinguished between rats with and without knee OA changes. These variables may be useful outcome measures in preclinical research performed with this experimental post-traumatic knee OA model.

Interdisciplinary student health teams: combining medical education and service in a rural community-based experience.

Several initiatives have been introduced over the years to address the maldistribution of health care professionals and to improve access to care for underserved rural populations. One of these is the sponsorship of community-based, service-oriented teams comprised of students from various health disciplines. This study investigated extramural training as a complement to traditional hospital-based experiences. The specific objective of the study was to determine the extent to which the nation's medical schools combine training with a rural community-based experience in the form of an interdisciplinary student health team program. In the fall of 1994, a 32-item questionnaire was mailed to the chief academic or clinical affairs administrators of the nation's 126 allopathic medical schools. A total of 104 (82.5%) medical schools responded to the survey. Eighty-six of the respondents (82.7%) reported some type of rural training or public service activity; 22 (21.2%) acknowledged the sponsorship of an interdisciplinary student health team program. Small rural communities, those with populations of 5,000 or fewer, were the focus of 76 percent of the reporting programs. Nearly two-thirds of the reporting programs were located in the South, the region with the nation's lowest physician-to-population ratio. The nursing and medical professions were most frequently represented, although a wide range of disciplines were identified as participating on the student health teams. Activities of the teams included both ambulatory care and community outreach services. The majority of the programs used team-building exercises to enhance team effectiveness. Extramural training programs offer students a realistic examination of the social, cultural, economic, and political forces that influence both individual and community health. Rural community-based programs, such as interdisciplinary student health teams, should be valued because they can strengthen the link between the sponsoring institution's educational mission and its public service obligation.

Identification of sentinel health events as indicators of environmental contamination.

The consensus process was applied to addressing a public health topic; this was a novel endeavor. The following question was addressed: What role, if any, should sentinel health events play in the decision-making process for identifying the effects of environmental exposure? The panel developed three levels of sentinel health events lists: those that are clearly identifiable, those that are potential signs, and those that are indicators of body burdens. Additionally, the panel developed several salient statements regarding the principles of environmental health surveillance and, especially, recommendations for future research.

Nurses as a key PHC link in Papua New Guinea.

While many developing countries have endorsed primary health care (PHC) as a means of reaching Alma Ata's goal of health for all, effective implementation has been difficult. The major obstacle has been the historic emphasis on curative medicine in the training, licensing and job responsibilities of health care personnel and in the distribution of scarce resources. Moreover, few programmes have been geared to preparing the rural villager and the health delivery team--the two essential components of PHC--to work together to identify and solve problems. Too often health workers fear that the unrealistic expectations of community members will mean losing control of scarce resources. Clearly, central to any PHC programme is deciding where and how to begin developing the trust and interaction necessary to implement PHC beyound its curative aspects. In East New Britain, Papua New Guinea, nurses were the logical resource to reorient the rural health extension changeover to the noncurative aspects of PHC. Below, a report on this successful project.