An innovative training experience in public health at the Cheikh Anta Diop University of Dakar

The Institute for Health and Development (ISED) at the University of Dakar, was created in 1987. Its mission is to fulfill the public health training needs of Senegalese health care professionals. ISED is responsible for a training program entitled "Certificat d'études Spéciales" (CES), the equivalent of a Masters of Public Health degree. The "CES" is a two-year program comprised of six modules, which last four months each. The ISED training approach stresses trainee responsibility above all. It is based on the trainee's professional tasks and is oriented toward the problems identified by the trainees themselves. In this sense it is highly adaptive and flexible. Each module is implemented in the same way; initially there is a 15 day residential phase for intensive theoretical courses, followed by an application period of 75 days in the trainee's work place, and then a final residential phase of 15 days for writing and presenting a technical report on the work in the field. This model allows trainees to bring together the theoretical and the practical. The trainers directly supervise each of these three phases. The two residential phases are conducted in the ISED training center, located in Mbour, 80 Km south of Dakar. 103 trainees are enrolled in the program in seven different classes. Of these trainees, 93 are health care specialists (85 physicians 7 pharmacists, 1 dentist). Ninety percent of previous graduates have been civil servants who work for the Ministry of Health in Senegal and the remaining 10% were from Burkina Faso and Togo. The training program is considered by all stockholders, beneficiaries, and relevant financial institutions, to be appropriate, beneficial and successful.     

p53 protein accumulation and the presence of human papillomavirus dna in bronchiolo-alveolar carcinoma correlate with poor prognosis

Accumulation of the tumour suppressor gene p53 product due to a gene mutation is frequently seen in human carcinomas, including lung carcinoma. Another indirect mechanism involving p53 in malignant growth relates to the E6 protein of the human papillomavirus (HPV), which is able to bind and degrade wild-type p53 protein, thus eliminating its tumour suppressor activities. Bronchiolo-alveolar carcinoma (BAC) is a rare type of lung carcinoma. The aim of our study was to examine the occurrence of p53 accumulation and the presence of HPV DNA in BAC. Sections of 22 BACs were immunohistochemically stained using a p53 antibody, CM-1. The presence of HPV DNA in BACs was verified by in situ hybridisation for HPV types 6, 11, 16, 18, 31 and 33 and confirmed by PCR. Thirty-six percent of the tumours showed abnormal p53 nuclear accumulation, and HPV DNA, revealed by in situ hybridisation, was found in 36%. Unexpectedly, only 13% of the type 1 BACs were positive for p53, whereas 45% of the type 2 BACs were positive. During a follow-up of 12-176 months, only 10% of the patients with BACs negative for both p53 and HPV died of the disease, compared with 42% of the patients with either p53 or HPV positivity. No inverse relationship between abnormal p53 protein accumulation and the presence of HPV DNA was found. © 1995 Wiley-Liss, Inc.     

Neuropeptide Y-Y2 receptors mediate anxiety in the amygdala

The behavioral effects of direct injection of the neuropeptide Y (NPY) Y2 receptor agonist C2-NPY into the basolateral nucleus of the amygdala (BLA) was assessed in rats utilizing the social interaction test (SI). C2-NPY decreased SI time in a dose-dependent manner with a significant change observed at a dose of 80 pmol/100 nl. The anxiogenic effects produced by intra-amygdalar C2-NPY injections were reversed with intraperitoneal administration of alprazolam (1 mg/kg), a known anxiolytic. These findings support the hypothesis that Y2 receptors are involved in the regulation of the anxiety response.     

Epidemiology of pertussis in a West African community before and after introduction of a widespread vaccination program

The control of pertussis remains a worldwide concern. Little has been documented about its epidemiology in Africa. The authors have studied pertussis in a prospective cohort of children in a rural West African community over a 13-year period comprising time before and after introduction of a vaccination program. Children under age 15 years who were residents of the Niakhar study area in Senegal were followed prospectively between January 1984 and December 1996 for the occurrence of pertussis. Morbidity and mortality rates were extremely high before the launch of immunization. Crude incidence was 183 per 1,000 child-years at risk under age 5 years, with a 2.8% case-fatality rate. After the introduction of the vaccination program, overall incidence dropped rapidly and dramatically-by 27% after 3 years and 46% after 6 years. The decline in incidence involved all age groups but was most substantial in the group under age 5 years and was particularly pronounced in unvaccinated infants. The median age of acquisition of the disease rose steadily with population vaccine coverage. This study shows the tremendous magnitude of the disease burden in children and the rapid decline after vaccination, and it suggests a strong herd-immunity effect.     

Lack of HIV Seropositivity Among a Group of Rural Probationers: Explanatory Factors

CONTEXT: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in rural America has been described as an epidemic, and the HIV prevalence rate among criminal justice populations is higher than the general population. Thus, criminally involved populations in Southern rural areas are at elevated risk for contracting HIV because of drug and sexual practices; however, little is known about HIV/AIDS in the fastest growing criminal justice population-probationers. PURPOSE: To examine possible explanations for the lack of HIV seropositivity found in a purposive sample of rural probationers. METHODS: Data were examined from 800 felony probationers from 30 counties in Kentucky's Appalachian region. Measures included HIV prevalence within the 30 counties, migration patterns, HIV knowledge, substance use, and sexual risk behaviors. FINDINGS: These probationers had a high level of HIV knowledge, reported minimal injection drug use, practiced serial monogamy, and reported minimal engagement in transactional sex. However, these probationers also reported negligible condom use, and injection drug users shared needles and works. CONCLUSION: Findings suggest the importance of developing programs targeting safe sex practices in rural areas.     

Comparison of Florida Hispanic and non-Hispanic Caucasian women in their health beliefs related to breast cancer and health locus of control

PURPOSE/OBJECTIVES: To compare Florida Hispanic and non-Hispanic Caucasian women in their health beliefs about breast cancer and health locus of control (LOC). DESIGN: Exploratory, comparative. SETTING: A variety of healthcare settings in an urban area in Florida. SAMPLE: Hispanic (n = 113) and non-Hispanic (n = 197) Caucasian women who could read and understand either English or Spanish. METHODS: The Health Screening Questionnaire, which assesses health beliefs and health LOC, was administered in either Spanish or English, and the results were analyzed. MAIN RESEARCH VARIABLES: Attitudes about health in general, perceptions about susceptibility to cancer, beliefs about benefits of early diagnosis, and perceptions about the seriousness of cancer; LOC. FINDINGS: Florida Hispanic women are better educated than the Mexican American Hispanic women described in the literature. Hispanic and non-Hispanic women were significantly different in their health beliefs and LOC. With age and education controlled statistically, these differences remained. Hispanic women who preferred to speak/read English were more like the non-Hispanic women in their responses than were the women who preferred Spanish. CONCLUSIONS: Cultural differences exist between Hispanic and non-Hispanic women; however, differences also exist between groups of Hispanic women in Florida versus Hispanics in the southwestern United States. IMPLICATIONS FOR NURSING PRACTICE: Outreach programs for cancer screening should be culturally relevant and may need to be different for subgroups of Hispanics in the United States.