A qualitative account of young people's experiences of alcohol screening and brief interventions in schools: SIPS Jr-HIGH trial findings.

BACKGROUND: The United Kingdom (UK) has seen a decrease in the number of young people drinking alcohol. However, the UK prevalence of underage drinking still ranks amongst the highest in Western Europe. Whilst there is a wealth of evidence reporting on the effectiveness of both primary, and secondary interventions, there are few reports of the experiences of young people who receive them. METHODS: The present study reports findings from interviews with 33 young people who were involved in an alcohol screening and brief intervention randomized controlled trial in schools in England. All interviews were analysed using inductive applied thematic analysis. RESULTS: Three major themes were identified following the analysis process: 1) drinking identities and awareness of risk; 2) access to support and advice in relation to alcohol use; and 3) appraisal of the intervention and potential impact on alcohol use. CONCLUSIONS: There appeared to be a reluctance from participants to describe themselves as someone who drinks alcohol. Furthermore, those who did drink alcohol often did so with parental permission. There was variation amongst participants as to how comfortable they felt talking about alcohol issues with school staff. Overall participants felt the intervention was useful, but would be better suited to 'heavier' drinkers.

Myxobolus neurophilus Guilford 1963 (Myxosporea: Myxobolidae): a common parasite infecting yellow perch Perca flavescens (Mitchell, 1814) in Saskatchewan, Canada.

The goal of this study was to identify a myxosporidian parasite infecting the central nervous system of yellow perch Perca flavescens (Mitchell, 1814) observed while investigating a fish kill in Saskatchewan, Canada. Fish were collected from seven different lakes, from two distinct watersheds. Sixty-four per cent (54/86) of yellow perch contained myxozoan pseudocysts located throughout the spinal cord and brain. Myxospores measured 16.5 µm (range 16.2-16.8) long and 8.2 µm (range 7.9-8.4) wide and contained two pyriform, mildly dissymmetrical, polar capsules measuring 7.7 µm (range 7.3-8.1) long and 2.7 µm (range 2.4-3.0) wide. The polar capsules each contained a single polar filament, with 7-9 turns per polar filament coil. Sequencing of the 18S SSU rDNA gene demonstrated >99% similarity to Myxobolus neurophilus. In 60% of infected fish, there was a mild to moderate, non-suppurative myelitis or encephalitis, or both, associated with myxospores. Axonal degeneration was present in rare cases. These findings extend the geographical distribution of M. neurophilus and suggest it may be widespread in yellow perch populations in Saskatchewan.

The effect of leg length discrepancy upon load distribution in the static phase (standing).

Leg length discrepancy (LLD) is commonly recognised as a complication of total hip arthroplasty. Some patients with only minor LLD complain of major difficulties. The effect of LLD has been described in the dynamic phase, but not static phase. The aim of this project was to investigate the effect of leg length discrepancy on static limb loading (i.e. Standing). A pedobarograph was used to measure the limb loading of 20 normal volunteers whilst changing the height of the other foot thus simulating a LLD. With both feet at the same level, the left limb took 54% of the load. When the right foot was lower, (simulating a long left leg), the left leg took 39% of the load. When the right foot was higher, (simulating a long right leg), the left leg took 65% of the load. A paired t-test comparison of the simulation with the level load showed a significant difference with P=0.002. Our results show that weight distribution increased in the shorter limb when LLD was simulated. This uneven distribution is likely to lead to premature fatigue when standing and may explain why some patients with LLD post hip arthroplasty have poorer outcomes.

Immunoneutralization of growth differentiation factor 9 reveals it partially accounts for mouse oocyte mitogenic activity.

Paracrine factors secreted by oocytes play a pivotal role in promoting early ovarian follicle growth and in defining a morphogenic gradient in antral follicles, yet the exact identities of these oocyte factors remain unknown. This study was conducted to determine the extent to which the mitogenic activity of mouse oocytes can be attributed to growth differentiation factor 9 (GDF9). To do this, specific anti-human GDF9 monoclonal antibodies were generated. Based on epitope mapping and bioassays, a GDF9 neutralizing antibody, mAb-GDF9-53, was characterized with very low cross-reactivity with related transforming growth factor (TGF)beta superfamily members, including BMP15 (also called GDF9B). Pep-SPOT epitope mapping showed that mAb-GDF9-53 recognizes a short 4-aa sequence, and three-dimensional peptide modeling suggested that this binding motif lies at the C-terminal fingertip of mGDF9. As predicted by sequence alignments and modeling, the antibody detected recombinant GDF9, but not BMP15 in a Western blot and GDF9 protein in oocyte extract and oocyte-conditioned medium. In a mouse mural granulosa cell (MGC) bioassay, mAb-GDF9-53 completely abolished the mitogenic effects of GDF9, but had no effect on TGFbeta1 or activin A-stimulated MGC proliferation. An unrelated IgG at the same dose had no effect on GDF9 activity. This GDF9 neutralizing antibody was then tested in an established oocyte-secreted mitogen bioassay, where denuded oocytes cocultured with granulosa cells promote cell proliferation in a dose-dependent manner. The mAb-GDF9-53 dose dependently (0-160 microg/ml) decreased the mitogenic activity of oocytes but only by approximately 45% at the maximum dose of mAb. Just 5 microg/ml of mAb-GDF9-53 neutralized 90% of recombinant mGDF9 mitogenic activity, but only 15% of oocyte activity. Unlike mAb-GDF9-53, a TGFbeta pan-specific neutralizing antibody did not affect the mitogenic capacity of the oocyte, but completely neutralized TGF beta 1-induced DNA synthesis. This study has characterized a specific GDF9 neutralizing antibody. Our data provide the first direct evidence that the endogenous GDF9 protein is an important oocyte-secreted mitogen, but also show that GDF9 accounts for only part of total oocyte bioactivity.

Long-term outcome of the 'Beefburger' procedure in patients unsuitable for two-stage revision following infected total knee replacement.

A 5-year review of a group of 13 patients with infected total knee replacements deemed unsuitable for two-stage revision is presented. The 'Beefburger' procedure was initially performed in all the patients as a 'definitive' procedure. Eight patients had no further procedure performed, three patients were deemed suitable for a subsequent arthrodesis, and two went on to above-knee amputation. Three patients died within the first 6 weeks, but infection was successfully eradicated in eight of the remaining 10 patients (80%) at the time of death or latest review. At follow-up, all traceable subjects had Hospital for Special Surgery Knee Scores and SF-36 scores of below average. No significant difference was found between the 'Beefburger' or arthrodesis groups. In conclusion, the 'Beefburger' procedure gives results similar to arthrodesis and amputation in patients deemed unsuitable for two-stage revision surgery and should perhaps be considered as an option in these medically compromised patients.

The relationship between atopic status and IL-10 nasal lavage levels in the acute and persistent inflammatory response to upper respiratory tract infection.

We examined the influence of atopy on virus-induced airway inflammation by comparing the nasal response to naturally acquired upper respiratory tract infection in atopic and nonatopic subjects by measurement of cytokine, chemokine, and mediator levels in nasal lavage from 44 adults (23 atopic) taken during the acute and the convalescent phases of the common cold. Nasal aspirates were examined for the presence of upper respiratory viruses by RT-PCR. In atopic and nonatopic subjects there were increased levels of IL-1beta, IL-6, IL-8, TNF-alpha, RANTES, sICAM-1, MPO, ECP, IL-10, and IFN-gamma in nasal lavage during the acute compared with the convalescent phase (p < 0.001). During the acute phase histamine levels were significantly higher in the atopic than in the nonatopic subjects (p < 0.05), whereas IL-10 levels were significantly greater in the nonatopic than in the atopic subjects (p < 0.05). At convalescence levels of IL-1beta, IL-6, sICAM-1, ECP, RANTES and albumin were significantly higher in the atopic group (p < 0.05). An upper respiratory tract virus was found in 27 volunteers (61%) during the acute stage and in two volunteers (4%) at convalescence. We conclude that virus-induced inflammatory changes within the nose are more prolonged in atopic than in nonatopic subjects and that this is associated with reduced IL-10 levels in atopic compared with nonatopic subjects during the acute phase of upper respiratory tract infection.

Quantification of the depressive effects of diazepam on the guinea pig righting reflex.

The effects of 5 mg/kg/day diazepam (IP for 21-39 days) on righting reflex latency (RRL) and neuronal activity in the medial vestibular nucleus (MVN) were investigated in guinea pigs. Diazepam treatment increased the RRL relative to vehicle-injected controls (p < 0.05, ANOVA); although the average RRL in the diazepam-treated animals did decrease over time, this decrease was not statistically significant and therefore evidence of tolerance was not obtained. MVN slices were removed from diazepam-treated animals and recordings were made from MVN neurons in vitro. The average resting activities for MVN neurons in slices from diazepam-treated animals and uninjected animals from a previous study were not significantly different.

Understanding cultural obstacles to HIV/AIDS prevention in Africa.

Global efforts to prevent further spread of the human immunodeficiency virus (HIV) are faced with tremendous obstacles, and limited understanding of the cultural and social context of HIV and AIDS is an important factor hindering prevention efforts to date. Examples from the authors' experience in providing technical support to 7 nongovernmental projects for HIV/AIDS prevention in Africa illustrate the importance of including qualitative data in initial baseline studies for projects responding to the problem. Qualitative data are needed to provide a deeper understanding of the meanings of behavior and other phenomena that are identified through quantitative methods. Runyoka is discussed as an example of a traditionally-defined illness in Zimbabwe that appears to affect local understanding of HIV/AIDS. The authors suggest approaches that would assist HIV/AIDS projects to better understand and respond to the social and cultural context of AIDS in local settings.

Simple device for quantifying drug effects on the righting reflex.

A simple, inexpensive device is described that allows quantification of the effects of drugs on the righting reflex. This device consists of a modified set of kitchen scales connected to a digital timer. Two moveable Hall effect switches are positioned around the pointer, which registers the weight of the animal on the scales; when the animal is placed on the scales in the supine position, the initiation of a righting reflex causes the pointer to cross one of the switches, stopping the digital timer and providing a measure of righting reflex latency (RRL). We describe an efficient protocol for using this device that provides quantification of drug effects on the RRL, which can then be subjected to analysis using parametric statistics such as analysis of variance.

Induction of FMLP-mediated calcium mobilization requires crosslinking of surface immunoglobulin in Daudi cells.

We have explored the requirements for the induction of the N-formyl-methionyl-leucyl-phenylalanine (FMLP) response in Daudi cells after anti-immunoglobulin treatment. Our results indicate that (a) induction of responsiveness to FMLP was observed in Daudi only after crosslinking of surface immunoglobulin by anti-immunoglobulin; (b) this induced responsiveness was not observed in Ramos or Wil-2 cells; (c) the F(ab')2 fragment was sufficient for the induction of the FMLP response, but the Fab fragment and the Fc fragment were ineffective; (d) of the many agents active in B lymphocyte regulation which were tested, none were as effective as anti-immunoglobulin in the induction of the FMLP response; and (e) three inhibitors of calcium mobilization (W-7 (N-(6-aminohexyl)-5-chloro-1-naphthalene sulfonamide), PMA (phorbol 12-myristate 13-acetate), and colchicine), acting on distinct mechanisms, inhibited both the calcium mobilization due to anti-immunoglobulin and the induction of responsiveness to FMLP. Our results suggest important determinants in the induction of a calcium-mobilizing FMLP response in cells of B lymphocyte lineage include (a) the cell type, (b) a selective requirement for activation via surface immunoglobulin, and (c) crosslinking of the surface immunoglobulin.

G-proteins and the role of second messengers in the regulation of the human neutrophil.

The ideas discussed above clearly point to increasingly complex and interactive transduction mechanisms for the regulation of the neutrophil. The central challenges to be met include the following: 1. Better assays are needed for the study of physiological parameters such as adherence, aggregation, shape change, and cytoskeletal rearrangements, assays which are not prohibitively complex and expensive while still allowing for more detailed physiological observations. 2. The neutrophil receptors need to be characterized in greater detail at the molecular level. Protein purification, sequencing, and cloning approaches are needed. Given the inherent shortcomings of working with the neutrophil system due to the presence of proteases and the problems of obtaining sufficient amounts of plasma membranes as source material for receptor purification, this is a difficult task. Advances in micropurification and sequencing may alleviate some of the difficulties here. 3. The size and complexity of the G-protein family continue to expand. However, as pointed out earlier, stimulus-responsive enzymes without G-protein-associated regulation, and G-proteins without clearly identified targets, remain. A better definition and description of the G-protein family will be required if cellular regulation is to be understood at the molecular level. In terms of second messengers and their role in cellular regulation, the main questions which remain to be answered concern identification of the precise pathways which are important to cellular regulation. In order to understand the complex cascades of arachidonate metabolism, phospholipid turnover, and calcium homeostasis, it is all the more important that the manner in which second messengers may regulate particular cell functions be better understood. An omission in this review is the role of kinases in cellular regulation. Activation of kinase C (through calcium and diacylglycerol) and kinase A (through cAMP) has been demonstrated. The substrates for these kinases have been described by various investigators. However, relating phosphorylation changes in a particular protein to the activity of the protein, and assignment of activity to particular physiological roles, has not been satisfactorily accomplished and remains a challenge for the future.

Successful haemodialysis via an unusually sited subclavian catheter.

A 38-year old woman with a history of congenital rubella required temporary venous access for haemodialysis. A left sided subclavian catheter was inserted percutaneously and on check radiography it was found to be on the left side of the mediastinum. Contrast radiography showed that the catheter was in a left sided superior vena cava which drained into the right atrium via the coronary sinus. Haemodialysis was performed without any difficulty.

The role of non-governmental organizations in the global response to AIDS.

PIP: This article describes the role of non-governmental organizations (NGOs)in AIDS prevention worldwide, highlights successful NGO projects, assesses NGO strengths and weaknesses, and provides recommendations for supporting the work of NGOs. While NGOs vary in their scope, all share a dedication to a set of social values that guides their organizational missions. In industrialized nations, NGOs established trends for AIDS prevention and treatment, including the targeting of educational materials to specific groups, peer education, and increasing access to experimental drugs. In the developing world, NGOs have been the first to respond to the epidemic, promoting access to counselling and healthcare to people with AIDS. The article briefly describes successful NGO projects for AIDS prevention and care in developing countries. Examples include the establishment of the Rio de Janeiro Prostitutes Association, designed to fight AIDS and STDs among prostitutes in Brazil, and the formation of the NGO Consortium in Kenya, which serves as a bridge between the AIDS Programme Secretariat and the private sector. Among their strengths, NGOs are able to respond quickly, address controversial issues, reach the community more quickly and effectively, reach marginalized groups, and mobilize local resources. Some of their disadvantages include funding difficulties, staff attrition, and lack of cooperation among organizations. Noting the enormous potential of NGOs to play a major role in AIDS prevention, the article provides 9 specific recommendations for supporting NGOs.^ieng

Desensitization of calcium mobilization and cell function in human neutrophils.

Neutrophils pretreated with the chemoattractant formylmethionyl-leucyl-phenylalanine become unresponsive when re-exposed to the same ligand, a process termed desensitization. We have examined whether desensitization of transduction (Ca2+ mobilization) or of other cell functions (superoxide generation, enzyme release, or aggregation) occurs synchronously. Simultaneous studies of Ca2+ mobilization and aggregation by using Fura-2-loaded cells indicate that, under conditions where the aggregation response is abolished, most of the Ca2+ mobilization is unaltered. Further studies were then carried out to ascertain whether desensitization of Ca2+ mobilization could in fact be induced. Desensitization was observed, and was dependent on the number of exposures of the cells to the ligand, the concentration of the ligand, and whether the ligand was left in the medium or was removed. The pattern of resensitization was dependent on the experimental design. Under conditions where ligand was continuously present, no recovery of the Ca2+-mobilization response was seen with subsequent challenges. In contrast, on removal of ligand, this response showed partial recovery. Whereas complete desensitization of aggregation was noted, enzyme release showed a markedly lesser degree of desensitization and required more frequent exposures to the ligand before it was observed. Little or no desensitization of superoxide generation was observed regardless of the conditions utilized. Studies using phorbol myristate acetate as the ligand showed that Ca2+ mobilization and aggregation could be simultaneously inhibited. Our results suggest that discrete mechanisms of desensitization are possible in human neutrophils, and that desensitization of one particular function (aggregation) does not imply concomitant desensitization of other functions.