Assessing the knowledge and skill needs of community-based health promoters

Community-based health promoters require a range of complexskills. As part of its ongoing support to five community-basedhealth promotion programs, the Health Promotion Branch of theOntario (Canada) Ministry of Health, commissioned a study toidentify knowledge and skills needs in these programs and assesswhether resources were available to meet these needs. A NeedsAnalysis Questionnaire was developed and administered to coordinators,staff board members, and volunteers at 23 health promotion sites.Key informant interviews with site coordinators and focus groupinterviews of site staff board members and volunteers were carriedout. The needs analysis process is presented, as are illustrativefindings. Potential applications of the needs analysis proceduresare considered.     

Tachycardia Sensing Failure of an Implantable Cardioverter Defibrillator in a Patient with Hypertrophic Cardiomyopathy

A 17-year-old white male was found to have nonobstructive hypertrophic cardiomyopathy after suffering three severe syncopal episodes. He experienced an episode of sustained polymorphic ventricular tachycardia during exercise tolerance testing that required cardioversion. Electrophysiological studies were able to reproduce sustained polymorphic ventricular tachycardia that was unresponsive to standard pharmacotherapy. An automatic implantable defibrillator was placed. However, during implantation with the rate sensing electrodes on the left ventricle, it was found that the extremely polymorphic nature of the tachycardia caused such rapid fluctuations in the sensed R wave signal that the device could not properly detect the tachycardia. This was felt to be due to the automatic gain control circuit of the Ventak 1550. The problem was solved by moving the rate sensing electrodes to the lateral right ventricle. This case suggests that the unique arrhythmic substrate of hypertrophic cardiomyopathy may present sensing difficulties during automatic implantable defibrillator insertion.     

Alcohol and the physiological detection of deception: Arousal and memory influences

Eighty male volunteers participated in an analogue study of the effects of alcohol intoxication at the time of a crime on the physiological detection of deception using control question and guilty knowledge techniques. Sixty-four of the subjects committed a mock crime and half of these were intoxicated during the crime. Sixteen subjects committed no crime and served as innocent controls. We found that intoxication at the time of the crime had no significant effect on polygraph test outcomes, although it did affect anticipatory arousal before the crime and subsequent memory for crime details. Manipulations designed to influence memory for crime details and arousal during the crime had differential effects for the two polygraph tests. On the guilty knowledge test, primed subjects who rehearsed specific details following the crime were more detectable than unprimed subjects. On the control question test, primed subjects were also more detectable, but only when arousal during the crime was high.     

Hepatic Glycogen Storage Disease: CLINICAL AND LABORATORY FINDINGS IN 23 CASES

Clinical and laboratory findings and the results of enzyme studiesmade on tissue samples from 23 children with hepatic glycogenstorage disease are described. Two-thirds of the patients had glycogenosis associated withdeficiency of glucose-6-phosphatase, amylo 1,6-glucosidase,or hepatic phosphorylase. No enzyme defect could be found toaccount for excessive glycogen deposition in the others, whowould have been incorrectly diagnosed as suffering from oneof the recognized enzyme deficiencies, if samples of affectedtissue had not been examined for specific enzyme activities. The treatment of glycogen storage disease has been limited toregulating the blood sugar level and preventing hypoglycaemia.In most patients this was achieved by simple dietary management.Two children who did not respond to dietary control have beentreated with diazoxide.     

Xeroradiography of the Pharynx

Seventy-five cases of pharyngeal malignancy were reviewed to determine the place of xeroradiography in their management. Comparison was made with plain radiography, conventional tomography and barium studies. Nasopharyngeal lesions and lesions in the midline were most conveniently demonstrated with a plain lateral xerograph. Laterally placed tumours were best shown with conventional AP tomography and with a barium examination.     

Lead Absorption in Police Small-arms Instructors

An investigation was made into the degree of exposure to leadin small-arms instructors on a police firing range. The resultsof the blood-lead examinations and of air samples taken duringfiring are shown. Although no hazard was present on this range,there is a definite risk, and the need for adequate ventilationand continued monitoring of indoor ranges in general, and onthose who work on them regularly, is shown. Dr D.L. Smith, EMA, Health and Safety Executive, Auchinleck House, 152 Broad Street, Birmingham, B15 1DL.     

Age related changes in the clearance and oral absorption of sodium cromoglycate in the developing albino rat

A dual radioisotope method was used to investigate the clearance and oral abso***rption of sodium cromoglycate. Radiolabelled sodium cromoglycate was administered orally at a dose of 100 mg kg ¹ (¹⁴ C-labelled) and simultaneously subcutaneously at a dose of 2 mg kg^?1 (³ H-labelled) to rat pups 5, 9, 14, 20, 29 and 75 days old. Blood concentrations of ¹⁴ C and ³ H were measured at intervals for 24 h after dosing. Since the compound is not metabolized the blood concentrations of ¹⁴ C were taken as a measure of the sodium cromoglycate absorbed orally and the blood concentrations of ³ H as a measure of the subcutaneously administered material. Using the area under the oral ¹⁴ C blood curve (AUC) as an index of bioavailability, the calculated bioavailability of sodium cromoglycate (692·9?945·9 min μg ml^?1) in 5, 9 and 14 day old pups was 4–8 times greater than that observed (61·0-118·8 min μg ml^?1) in 20, 29 and 75 day old pups. The blood clearance of sodium cromoglycate was increased four-fold in 75 day old animals (43·9 ml min^?1 kg^?1) and three-fold in 20 and 29 day old pups when compared to the clearance in 5, 9 and 14 day old pups. The clearance in 5, 9 and 14 day old pups was relatively constant (10·8 ? 9·9 ml min^?1 kg^?1). In rats less than 14 days old the systemic absorption of sodium cromoglycate after oral administration was 2–3 times greater (6·8-9·2%) than in rats aged 20, 29 or 75 days old (2·7-3·3%). The reduction in oral bioavailability of sodium cromoglycate as the pups grew older was, therefore, due to both an increased blood clearance and a decreased absorption of the compound.     

Teratology Studies of Compound Lyn 171883 Administered Orally to Rats and Rabbits

Teratology Studies of Compound LY171883 Administered Orallyto Rats and Rabbits. HA-GOPIAN, G. S., HOOVER, D. M., AND MARKHAM,J. K. (1988). Fundam Appl Toxicol. 10, 672–681. The teratogenicpotential of the leukotriene antagonist LY171883, a novel antiasthmaagent, was investigated in CD rats and Dutch Belted rabbits.Mated female rats were dosed with 0, 10, 65, or 425 mg/kg/dayon gestation days 6 through 15 and killed on gestation day 20.Mated female rabbits were dosed with 0, 20, 65, or 200 mg/kg/dayon gestation days 6 through 18 and killed on gestation day 28.Maternal toxicity was indicated at 425 mg/kg in rats and 200mg/kg in rabbits by depressed body weight gain and food consumption.In the rabbit study four abortions occurred at 200 mg/kg, mostlikely secondarily to maternal toxicity. LY171883 did not causeembryo/fetal toxicity or teratogenicity in rats or rabbits atdoses up to and including those that were maternally toxic.