A comparative study in Alzheimer's and normal brains of trace element distribution using PIXE and INA analyses and glucose metabolism by positron emission tomography.

The onset of Alzheimer's disease has been shown to affect trace element concentrations in the brain when compared to "normal" subjects in ex vivo samples. The techniques used to determine trace element concentrations were proton-induced X-ray emission and instrumental neutron activation analysis. With these methods, significant differences are seen between lobes within a hemisphere and between the same lobes of opposing hemispheres for "normal" brains. The change observed in trace element concentrations may indicate a possible alteration in the function of the blood-brain barrier, the effect of which can be investigated in vivo using the imaging technique of positron emission tomography (PET). A PET study was performed on nine female and nine male subjects to determine whether the regional metabolic rate of glucose (rCMRGlu) varied between hemispheres and sex in the Alzheimer diseased brain as was seen in the trace element study. Glucose metabolism was measured using [F-18]-fluorodeoxyglucose (18F-FDG). Hemispherical differences were observed for the frontal, occipital, parietal lobes, and the temporolateral region in both males and females for rCMRGlu. Variation was also seen between sexes, where the frontal lobe had a lower rCMRGlu in females compared to that of males.

Hunger in midwestern inner-city young children.

OBJECTIVE: To determine the characteristics of hunger in young children who attend ambulatory pediatric clinics in a midwestern city. DESIGN: Consecutive sample. SETTING: Ambulatory pediatric clinics of an inner-city teaching hospital. PARTICIPANTS: English-speaking caregivers of 2578 children younger than 5 years. MAIN OUTCOME MEASURE: Structured survey measures of hunger, family characteristics, assistance program use, child feeding practices, and anthropometrics. RESULTS: In this population, 171 (6.6%) were hungry, and 842 (32.7%) were at risk for hunger. Hunger status was associated with increased age (P<.001), decreased maternal education level (P=.013), maternal nonwhite race (P<.002), a history of homelessness (P<.001), and parental unemployment (P<.001). Hunger status was associated with use of Aid to Families with Dependent Children (P<.001) and food stamps (P<.001) but not with participation in The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Results of anthropometrics indicated that mean growth percentiles were no different between hunger categories. CONCLUSIONS: Housing, dietary, and family characteristics are identifiable risk factors for early childhood hunger. Hunger cannot be identified, however, using anthropometrics. It is disconcerting that fewer hungry children and children at risk for hunger participate in WIC compared with other programs. These data suggest the potential for more aggressive identification and intervention at the primary care and social service levels to benefit hungry children.

Affective care: rhetoric or reality.

Midwives say they are "with women", and philosophies of midwifery espouse "holistic care". A study into the counselling role of midwives revealed that midwives are "physically with women", and adopt a reductionist model of midwifery care. A combination of quantitative and qualitative research methods was used to explore the counselling attitudes, intention, and behaviour of midwives practising in a large Melbourne metropolitan obstetric and midwifery teaching hospital. This sample of midwives revealed positive attitudes towards the counselling of childbearing women and a high counselling behavioural intention. Reflection on their midwifery practice and support of propositions relating to the affective role of the midwife, highlighted further their claims of attending to the psychosocial needs of childbearing women. However, when observed in practice, the midwives engaged in minimal communication with the women and demonstrated few counselling behaviours. In fact, the focus of midwife care was clearly physical and task oriented, with an emphasis on the giving of practical advice and a lack of attention to the affective needs of their midwifery clients. It is argued that a number of factors are responsible for the discrepancy between midwives' intention and practice. Firstly, midwives adopt self-defence techniques in response to the requirement to deal with the psychosocial needs of childbearing women. Secondly, this mode of self-protection is precipitated by feelings of uncertainty in not knowing what to do, compounded by inadequate role preparation through nursing and midwifery education. Finally, socialisation of midwives within the work culture is a powerful determinant of the model of care they adopt.

Measles immunization and its effectiveness in the southern Highlands.

Measles immunization was introduced in the Southern Highlands Province in 1982. Since then immunization coverage of children aged under 1 year has increased from 12% in 1982 to 52% in 1986. The number of reported measles cases has declined, despite an increase in the number of health facilities reporting and an increase in maternal child clinic visits where most sick children are seen. The incidence of measles and the incidence of diarrhoea are compared with the cumulative measles immunizations given. Problems with the Expanded Programme on Immunization (EPI) campaign and means to improve measles vaccine coverage are discussed.