The Uniqueness of Child and Youth Care: A Personal Perspective

The author draws upon 30 years of experience in the child and youth care field, personally carrying a dual diagnosis as a professional child and youth care worker and a professional social worker for most of that time. A definition of child and youth care is offered, and differences in focus and emphasis within the two disciplines are explored. Two underlying paradigms are suggested as contributing to the tensions apparent between the professions internationally, and the author concludes that the continuing struggle to develop a free-standing profession of child and youth care needs to be vigorously pursued because competent child and youth care workers are good for children and play a unique role in their lives.     

Smoking: attitudes of Costa Rican physicians and opportunities for intervention.

The aim of this study was to obtain information, using a written questionnaire, on the knowledge, smoking behaviour, and attitudes of Costa Rican physicians about smoking as a health issue. A random sample of 650 physicians was chosen from a list of active physicians; 287 of them were covered by survey between August 1993 and October 1994, and 217 (76%) responded with data for the study. While 40% of the physicians who participated were ex-smokers, 19% were current smokers; 67% of these two groups combined reported smoking in the workplace. Only 49% believed that physicians could be a nonsmoking role model; the majority (87%) had asked patients about their smoking status. The only cessation technique consistently used (90%) was counselling about the dangers of smoking. Measures such as setting a date to quit smoking and nicotine replacement were rarely recommended (< or = 2%). Nearly all the physicians (99%) considered smoking to be a major health issue. These results showed a high prevalence of smoking among Costa Rican physicians, with little recognition of the need for them to set an example as a role model. While they were knowledgeable about the health risks of smoking, they did not recommend any of the proven techniques to help their patients to quit smoking. A clear consensus for more strict tobacco regulation exists, but to date little has been done to act on this.     

Interaction of ivermectin with γ-aminobutyric acid receptors in Trichinella spiralis muscle larvae

The value of the γ-aminobutyric acid (GABA) receptor of nematodes as a target for ivermectin's mode of action remains unclear. Using binding assays, we examined extracts from Trichinella spiralis muscle larvae for the presence of [³H]-ivermectin and [³H]-GABA binding sites. Tissue preparations displayed affinity binding sites for [³H]-ivermectin with a dissociation constant (K _d) of 83 nM and a receptor density (B_max) of 145 fmol/mg protein. We also identified a specific [³H]-GABA binding activity with a K _d of 1.2 μM and a B_max of 4.78 pmol/mg protein. In competition studies, ivermectin was found to be a competitive inhibitor of specific [³H]-GABA binding activity with an inhibition constant (K _i) of 3.39 nM, suggesting that GABA receptors could be implicated in the mechanism of action of ivermectin in nematodes. Received: 7 August 1998 / Accepted: 22 September 1998     

Infravesical obstructive uropathy secondary to extreme vulval atrophy

Lower urinary tract obstruction in women is an uncommon condition resulting from multiple either organic or functional disorders. This paper contributes one case of obstructive uropathy secondary to presence of almost complete vulvar synechia due to extreme genital atrophy, a rare entity that may appear in postmenopausal women. Partial and incomplete vulvar fusion usually occurs in significant postmenopausal atrophies, sometimes associated to urethral meatus stricture; this, however, has no significant repercussion on urination dynamics. No other comparable case was found in the reviewed literature.