Building social capital with women in a socially disadvantaged community

Individual and community health outcomes are strengthened by friendships and social support networks. Community interventions aimed at improving the social factors that influence the health of individuals and communities increasingly include strategies to develop resilience through building networks and social capital. The study reported here used a cross-sectional survey design, administered at two time points, to measure the effect of a community capacity-building programme implemented by Women's Health Nurses. Data described and where possible measured women's perceptions of their physical and mental well-being, friendships and support networks, community connectedness and participation, safety, and knowledge of and access to local community services. The follow-up survey also measured the impact of specific community development initiatives. Overall, findings of both surveys were consistent, with some notable exceptions. For example, at follow up there was a significant improvement in mental health indicators and fewer women believed their physical or emotional problems imposed a considerable burden on their daily activities. They also believed people from other cultures were more likely to be accepted by neighbours and reported increased involvement in community activities as a direct result of the Villawood Icebreakers Project.     

Detection of a common mutation in factor V gene responsible for resistance to activated protein C causing predisposition to thrombosis

Hereditary predisposition to thrombosis due to activated protein C resistance (APCR) has been attributed to a missense mutation in the factor V gene at nucleotide 1691 (G to A), causing replacement of arginine at codon 506 with glutamine. Using an RFLP-PCR assay to detect this mutation, we measured a prevalence of 3.3% in healthy Caucasians and 1.25% in healthy African-Americans. In addition, we evaluated a total of 90 consecutive specimens submitted to the coagulation laboratory at the Medical College of Virginia for the presence of this mutation. We compared our results for 78 of these specimens with the values measured by a modified partial thromboplastin assay, the COATEST. Twelve of the 90 samples could not be tested using the COATEST because the patients were undergoing anticoagulant therapy. One of the latter 12 specimens was positive by the RFLP-PCR test. Using the genetic test as the definitive assay and the cutoff value established for distinguishing between normal and abnormal results by the COATEST, the COATEST had a sensitivity of 50% and specificity of 93% for the detection of factor V mutation. Analysis of the 90 samples stratified by ethnic groups revealed a frequency of mutation of 13.3% for Caucasians and 6.88% for African-Americans, although with the present sample size, the difference was not statistically significant. Although the COATEST is technically simpler to perform than the genetic test for diagnosing the presence of the factor V mutation, its use for this purpose is limited due to low sensitivity. Thus where this disorder is clinically suspected, submission of the specimen directly for genetic testing by RFLP-PCR or equivalent assay should be considered. J. Clin. Lab. Anal. 11:328–335, 1997. © 1997 Wiley-Liss, Inc.     

脑栓塞患者主动脉斑块的临床意义

目的 探讨脑栓塞患者的主动脉弓动脉粥样硬化（ＡＡＡ）严重程度及其有关的危险因素,方法 对１００例脑梗塞患者进行了ＴＣＤ,经食道超声心动图（ＴＥＥ）,颈动脉超声心动图,ＣＴ及ＭＲＩ等检查。结果 ７５例患者伴有ＡＡＡ,其中３４例为中－重度ＡＡＡ,年龄,吸烟,冠心病,糖尿病,颈内动脉阻塞性痴呆病以及栓塞源性心脏病与ＡＡＡ呈明显的正相关;１２例在病变侧发现有高度的颈内动脉狭窄,２８例伴有栓塞性的心脏疾病,     

Adult mammalian forebrain ependymal and subependymal cells demonstrate proliferative potential, but only subependymal cells have neural stem cell characteristics

The adult derivatives of the embryonic forebrain germinal zones consist of two morphologically distinct cell layers surrounding the lateral ventricles: the ependyma and the subependyma. Cell cycle analyses have revealed that at least two proliferating populations exist in this region, one that is constitutively proliferating and one that is relatively quiescent and thought to include the endogenous adult neural stem cells. Earlier studies demonstrated that specific dissection of the region surrounding the lateral ventricles was necessary for the in vitro isolation of multipotent, self-renewing neural stem cells. However, in these studies, the ependymal layer was not physically separated from the subependymal layer to identify the specific adult laminar localization of the neural stem cells around the lateral ventricles. To determine which cellular compartment in the adult forebrain contained the neural stem cells, we isolated and cultured the ependyma separately from the subependyma and tested for the presence of neural stem cells using the in vitro neurosphere assay. We demonstrate that the ependymal cells can proliferate in vitro to form sphere-like structures. However, the ependymal cells generating spheres do not have the ability to self-renew (proliferate to form secondary spheres after dissociation) nor to produce neurons, but rather only seem to generate glial fibrillary acidic protein-positive ependymal cells when plated under differentiation conditions in culture. On the other hand, a subpopulation of subependymal cells do possess the self-renewing and multipotential characteristics of neural stem cells. Therefore, the adult forebrain neural stem cell resides within the subependymal compartment.     

Managing ventilatory insufficiency and failure in a patient with kyphoscoliosis: a case study

This article reports a case study of ‘Sue’, a 37 year old female who was transferred to a metropolitan hospital's intensive care unit in acute respiratory failure secondary to severe kyphoscoliosis (KS). KS is defined as a deformity of the spine involving both lateral displacement (scoliosis) and anteroposterior angulation (kyphosis). Over time, this anatomical distortion results in ventilatory insufficiency due to muscle weakness. Sue displayed a restrictive lung pattern, evidenced by a decreased vital capacity and tidal volume with severe nocturnal dyspnoea, resulting in raised carbon dioxide levels in arterial blood and decreased oxygenation.

This paper reviews Sue's progress throughout her hospitalisation and examines the key issues involved in her care. Particular attention is given to specific problems encountered on the acute care ward related to oxygen delivery, tracheostomy care, non-invasive ventilation and rehabilitation. The paper highlights the increased acuity of respiratory ward patients who require the use of substantial technological support to optimise their management. Nurses working in these wards need specialised knowledge, excellent patient communication ability and well-developed technical skills. The trend is to treat patients with respiratory failure, either chronic or acute, on wards rather than in critical care units which has promoted the development of a specialised role in respiratory nursing.     

四种黄芪注射液中黄芪甲苷含量比较

目的：考察不同厂家黄芪注射液的内在质量。方法：用高效液相色谱法测定黄芪甲苷的含量。结果：建立的方法适用于黄芪注射液中黄芪甲苷的含量测定、快速,灵敏,重 现性好。结论：不同厂家产品差异显著。