[Photo stories instead of leaflets: support for people with low health literacy]. / Fotostrips in plaats van folders.

In the Netherlands, almost 30 percent of adults have limited levels of health literacy. They have difficulties finding, understanding and using health information. Comprehensible health information is extra important for people with low health literacy. A systematic review revealed that narrative health communication is a promising strategy to increase comprehension. We have investigated which interventions may improve comprehensibility of health-related documents for older adults with different levels of health literacy. We are currently exploring if and how photo stories on care and health topics can support people with low health literacy.

How peer conversations about HIV/AIDS media messages affect comprehension and beliefs of young South African women.

Most existent research on the effects of interpersonal discussions about health campaign messages is based on surveys. In this study, we analysed actual conversations about an HIV/AIDS poster to find out possible effects. Young South African women in 59 dyads (n = 118) participated in conversations about a deliberately puzzling HIV and AIDS poster that cautioned the target group to be faithful to one sexual partner. We measured their comprehension of the poster and beliefs about the message, before and after the conversations. Overall, actual comprehension (AC) was low, and we observed a large discrepancy between actual and perceived comprehension. In general, conversations did not improve AC. It proved to be even more probable that a correct interpretation before a conversation turned into an incorrect interpretation than the other way around. However, having a well-informed conversation partner increased the chance of acquiring adequate subsequent comprehension. We found, in general, that conversations did not decrease undesirable beliefs. One important undesirable belief even became reinforced after the conversations. Conversations among peers might be valuable in health campaigns, but our study shows that intended positive effects do not automatically follow.

TRPV4 channels in the human urogenital tract play a role in cell junction formation and epithelial barrier.

AIM: The molecular interactions between transient receptor potential vanilloid subtype 4 channels (TRPV4) and cell junction formation were investigated in the human and mouse urogenital tract. MATERIALS AND METHODS: A qualitative study was performed to investigate TRPV4 channels, adherence junctions (AJs) and tight junctions (TJs) in kidney, ureter and bladder tissues from humans and wild-type and transgenic TRPV4 knockout (-/-) mice with immunohistochemistry, Western blotting, immunoprecipitation and reverse trasnscription-PCR. Cell junction formation in the wild-type and TRPV4 knockout (-/-) mouse was evaluated with immunohistochemistry and transmission electron microscope (TEM) techniques. RESULTS: TRPV4 channels are predominantly located in membranes of epithelial cells of the bladder, ureter and the collecting ducts of the kidney. There is a molecular interaction between the TRPV4 channel and the AJ. TEM evaluation showed that AJ formation is disrupted in the TRPV4 -/- mouse resulting in deficient intercellular connections and integrity of the epithelium. CONCLUSIONS: TRPV4 is believed to be a mechanoreceptor in the bladder. This study demonstrates that TRPV4 is also involved in intercellular connectivity and structural integrity of the epithelium.

Analysis of observed behaviors displayed by depressed patients during a clinical interview: relationships between behavioral factors and clinical concepts of activation.

In 61 drug-free depressed patients, relationships were studied between observed behaviors and measures of common clinical concepts of activation. The behaviors were observed during a clinical interview and analyzed with ethological methods. Activation was assessed by means of self-ratings (Thayer, AD-ACL) and global judgement (Hamilton, retardation, agitation). Various aspects of patients' speaking and listening behaviors were recorded and analyzed, such as looking, head movements, yes-nodding and no-shaking, leg movements, gesturing, and body and object touching. A factor analysis was applied, enabling grouping of behaviors without using a priori concepts. Five factors reflected different aspects of a conversation: restlessness (leg and hand movements), speech, active listening (head movements and intensive body touching, during listening), speaking effort (looking, gesticulating, head movements, during speaking), and eagerness (yes-nodding and no-shaking). Significant positive relationships were found between the speech factor, the speaking effort factor and the restlessness factor on the one hand, and activation on the other. The eagerness factor was related negatively with activation. The results give insight into the organization of behavior during an interview, and show how this is related to clinical concepts of activation.

Esophageal reflux and secondary malignant neoplasia at laryngoesophagectomy.

Pathologic evidence of gastroesophageal reflux demonstrated by either Barrett's esophagus or esophagitis was present in 33% of patients undergoing laryngopharynoesophagectomy, while secondary esophageal squamous cell carcinomas were present in 25% of the specimens. Overall, 54% of all the patients undergoing laryngopharyngoesophagectomy had esophageal disease. This incidence of reflux and secondary esophageal malignant neoplasia is higher than in the general population. Careful assessment of the patient's preoperative history for gastroesophageal reflux, contrast swallowing studies, and esophagoscopies correctly diagnosed most but not all of the esophageal lesions found on pathologic examination. Interestingly, all of the esophageal carcinomas removed in the laryngopharyngoesophagectomy specimens were small and sometimes not evident clinically. Although gastroesophageal reflux has been postulated as an additional etiologic agent in the development of laryngeal carcinoma, all the patients in our study had heavy alcohol and tobacco consumption, and therefore reflux could not be evaluated separately as a risk factor.

Ultrastructural changes in the placenta of the ewe after fetal pituitary stalk section.

Binucleate cells are a normal component of the ovine chorionic epithelium, but are usually separated from the fetal-maternal interface by a thin layer of cytoplasm derived from the principal or uni-nucleate cells of the trophoblast. They are distinguished not only by two distinct and separate nuclei, but also by conspicuous membrane-bound cytoplasmic inclusions in the form of haloed droplets. After fetal pituitary stalk section binucleate cells move up to and participate in the formation of the fetal-maternal interface; furthermore they extend clear blunt-ended pseudopodia into the maternal epithelial syncytium. These activities do not appear to be supppressed by fetal infusion of cortisol or ACTH. The apparent motility of binucleate cells, together with the presence of haloed droplets within the maternal epithelial syncytium, suggests that after fetal pituitary stalk section binucleate cells invade the uterine syncytium, lose their limiting membranes and discharge their contents into the syncytial cytoplasm. Large molecules such as ovine placental lactogen may be transported from fetal to maternal tissues by this mechanism.