Disseminating weaning messages: an intervention trial.

This article reports a non-randomized intervention study conducted in two market towns to find out whether participant-centred health education discussions improve parents' knowledge and actions concerning infant feeding. Following an initial quiz, parents of 8-week-old infants attended a discussion on weaning (intervention) or home safety (control). They were then asked to complete a questionnaire about their knowledge and actions concerning weaning when their infants were 7-9 months old. A total of 61 parents took part in the intervention and 49 in the control. In the post-intervention questionnaire, the intervention group reported using more home-cooked foods and less commercially-prepared foods and knew the optimum time to register their infants with the dentist. These results suggest that participant-centred discussions are an effective way of disseminating public health messages concerning infant feeding.

Comparing three patient-controlled analgesia methods.

Among 301 patients randomly assigned to use one of three methods for patient-controlled analgesia (PCA), no statistically significant differences were found for self-reported pain or acceptability of PCA method. Methods yielded differences in on-demand bolus analgesia use and number of symptoms.

Exploring indicators of telephone nursing quality.

To explore whether documentation, use of clinical guidelines, and nurse competency are the best indicators of quality telephone nursing, this study examined the relationship between these commonly cited indicators and the characteristics of a telephone nursing call. This study, done at a large health maintenance organization (HMO), found: accompanying symptoms played a major role in telephone nursing assessment; call length was related to documentation process and to number of visits to a health care facility after a call; nurses' interpersonal skills and ability to determine urgency of a call are related to the documentation process but not to outcomes of the call; time of a call is related to disposition; and disposition is related to number of visits after a call.

Effective health education in rural Gambia.

We aimed to measure the impact of a structured health education programme on the incidence of infectious disease in young children of a rural Gambian village. In a prospective intervention study, mothers of children under 3 years living in a rural West African village without running water (population 1600) were divided into two groups by site of residence. Group 1 (n = 70) received a fortnightly education talk on hand-washing and skin hygiene, and group 2 (n = 84) on family planning. The incidence of infectious skin and diarrhoeal, eye, and respiratory diseases were recorded at the clinics attended by all children. The mean incidence of skin infections in the children of mothers of group 1 (1.07) was significantly lower (p < 0.05) than that of group 2 (1.59) during the rainy season. Between 1981 and 1994 the incidence of skin, diarrhoeal, and eye disease showed a statistically significant (p < 0.0001) decline following the implementation of the health education programme. There was no statistical significance in the trend for respiratory disease, the incidence of which would not be expected to be affected by hygiene education. Focused health education had a sustained beneficial effect on the health of young children living in conditions where infectious diseases and poor hygiene are common.

Tackling infant malnutrition in The Gambia.

Malnutrition is common among young children in developing countries. Often it is caused by poor infant weaning practices. Karen Hoare describes a community-based infant weaning programme in The Gambia which adapted local foods to improve nutritional content. The project also resulted in the development of a simple but effective demonstration kit.

PIP: The Gambia in 1988 had an infant mortality rate of 16-17% with an estimated 25% of under five year old children malnourished as defined by the World Health Organization. The author describes a community-based infant weaning program introduced in 1990 to the West Kiang district town of Keneba as part of a wider health education initiative. Weaning foods, as traditionally prepared, tend to be low in energy and protein and high in bacterial content. Weaning food demonstrations were therefore introduced to develop health education acceptable to the recipients, to improve the nutritional status of infants, to make use of local foods, and to dispel food taboos. The program used village women as teachers in their home compounds, invited women with babies aged 4-9 months to attend the demonstrations, adapted traditional Gambian dishes to increase their protein and energy content and make them palatable to the infant, and used the demonstrations as a forum for health education. The project also resulted in the development of a simple, effective demonstration kit. The fortnightly demonstrations were popular and well-attended. The neighboring village of Kantong Kunda also became involved and started its own demonstrations. Dietary assessment forms revealed that milk and eggs were being used in infants' foods. Potentially conducted by any health worker, literate or illiterate, in any developing country, the demonstrations are a low-cost, low-technology way of reducing the prevalence of childhood malnutrition around the world.

Ras-transformed cells express both CD44 and RHAMM hyaluronan receptors: only RHAMM is essential for hyaluronan-promoted locomotion.

Hyaluronan (HA) is an important regulator of cell locomotion. We show that ras-transformed cells, termed 245 cells, respond to HA with an increase in random locomotion. We show that two HA receptors, RHAMM (receptor for hyaluronan-mediated motility) and CD44, are present on these ras-transformed fibroblasts. RHAMM is expressed as a 58-kDa protein and is distributed primarily as patches over lamellae. CD44 occurs largely as an 85- to 90-kDa protein that is distributed more or less evenly over the cell surface with small amounts concentrated at the tips of lamellae. CD44 and RHAMM both bind biotinylated HA in a transblot assay, indicating that they are both potential fibroblast HA receptors. CD44 binds approximately five times more HA than RHAMM as determined by densitometric analysis of transblots, indicating that this protein is the major HA receptor on fibroblasts. We assessed the role of these receptors in mediating the stimulatory effects of HA on cell motility by using antibody neutralization. Several antibodies to CD44 were used that inhibit HA/CD44 interactions. None of these had an effect on locomotory responses to HA, indicating that CD44 is not directly involved in mediating locomotion in response to HA on ras-transformed cells. In contrast, antibodies specific to RHAMM completely inhibited locomotion, indicating that RHAMM is the primary mediator of HA-promoted locomotion of ras-transformed cells.

Identification of hyaluronan binding proteins using a biotinylated hyaluronan probe.

A method for detecting hyaluronan (HA)-binding proteins in transblot assays using biotinylated HA (BHA) is described. Some of the binding characteristics of a novel HA receptor termed RHAMM (Receptor for HA-Mediated Motility) are characterized using this assay. The method is also used to detect other HA-binding proteins in tissue homogenates. This method is semiquantitative, rapid, reproducible, sensitive and therefore of potential use in identifying the levels of HA-binding proteins in different cells and tissues.

Molecular cloning of a novel hyaluronan receptor that mediates tumor cell motility.

A cDNA encoding a unique hyaluronan receptor has been molecularly cloned from a lambda GT11 3T3 cDNA expression library. Immunoblot analyses of cell lysates, using antibodies to peptides encoded in the cDNA, specifically react with a 58-kD protein. This protein is regulated by the mutant H-ras gene in cells containing a metallothionein promoter H-ras hybrid gene. Further, antibodies to peptide sequences encoded in the cDNA block the increase in locomotion resulting from induction of the mutant H-ras gene in this cell line. In a transblot assay, the bacterially expressed protein binds to biotinylated hyaluronan. Antibodies to peptides encoded in the cDNA react in immunoblot assays with the 58- and 52-kD proteins of a novel hyaluronan receptor complex previously implicated in cell locomotion. Furthermore, antibodies specific to the 58- and 52-kD proteins, which block ras-induced locomotion, also cross-react with the expressed, encoded protein. The gene product described here appears to be a new type of hyaluronan receptor that is involved in cell locomotion. It is named RHAMM, an acronym for receptor for hyaluronan-mediated motility.

Health visiting in rural Gambia.

PIP: A British nurse was the 1st health visitor in the village of Keneba in the Gambia. She was at a nutritional research center which provided basic medical services. In addition to visiting mothers in their homes to talk about health education, such as oral rehydration and advice on hand washing, she would also encourage them to bring their children to the infant welfare clinic for immunizations. She told the mothers that the health staff would check the growth and nutritional status of their children and why these activities were important. Staff at the clinic aimed to see all the children 2 years 9 times the 1st year and 4 times the 2nd year. All anthropometric data were forwarded to Cambridge, England to be included in a continuing study on the growth of the population. The clinic referred children with serious illnesses to the pediatrician or, if necessary, took them to a hospital on the coast. Children that came to the clinic with a fever 37.4 degrees Celsius during the wet season had a blood film taken to check for malaria parasites. Indeed cerebral malaria contributed greatly to child deaths in the Gambia. If malaria was present, children received their 1st dose of chloroquine immediately so the staff could determine tolerance. 3 doses followed this dose. The health visitor also organized the health education component of the clinic. The clinic dresser interpreted the British nurse's presentations to eventually conduct them alone. The nurse divided the mothers and fathers into 2 groups. In the future, she would evaluate the 2 groups to determine if weekly education on hand washing and skin hygiene would reduce diarrheal and cutaneous disease incidence in children 3 years old. The other group learned about family planning. Both groups learned about immunization, detection of illness, safety, sanitation, nutritional advice, dental care, and food preparation.^ieng

Characteristics of L-alanine:4,5-dioxovaleric acid transaminase: an alternate pathway of heme biosynthesis in yeast.

The present study reports for the first time the presence of the enzyme L-alanine:4,5-dioxovaleric acid transaminase (EC 2.6.1.43), which catalyzes the irreversible synthesis of 5-aminolevulinic acid in three strains of yeast: Candida albicans 3100, Saccharomyces cerevisiae 3059, and S. cerevisiae S288C. The enzyme was predominantly present in the cytosol and was purified from C. albicans 3100 by about 200-fold with an overall yield of 23% to apparent homogeneity. The purification procedure involved heat treatment, followed by affinity chromatography on L-alanine-Sepharose CL-4B, ion-exchange chromatography on DEAE-cellulose DE-52, and chromatography on hydroxyapatite. As judged by gel filtration and sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the enzyme appeared to be a monomeric protein of relative molecular mass 59,000. The enzyme activity was stimulated by pyridoxal phosphate and was optimally active at 60 degrees C. The purified enzyme had an isoelectric point of 4.7 and a pH optimum of 7.2 Km values of the enzyme for L-alanine, pyridoxal phosphate, and 4,5-dioxovaleric acid were 2.8 X 10(-7), 5.0 X 10(-7), and 1.05 X 10(-5) M, respectively. The Vmax of the enzymatic reaction was 5 X 10(-6) mol/mg/h. Antibody raised against the purified yeast L-alanine:4,5-dioxovaleric acid transaminase did not cross-react with the same enzyme from rat liver and kidney.

Unit-based research in a service setting.

This paper describes a model for involving staff in a service setting in nursing research. The model offers suggestions for organizing nurses into research groups and implementing the research process. Success of this model depends on nursing unit size, composition of the research group, and departmental integration of nursing research.