An investigation into nurses' understanding of health education and health promotion within a neuro-rehabilitation setting*

This qualitative study was undertaken at two neuro-rehabihtation centres in England, with the aim of exploring the nurses' understanding of health education and health promotion and their role within it, and their perception of illness and wellness related to disability The principle of methodical triangulation was employed using questionnaires, group interviews and content analysis of client care plans Although the nurses had difficulty distinguishing between health promotion and health education, differences did emerge which were supported by the literature The nurses generally identified their role as being one of health promotion However, they tended to equate wellness with physical independence As a result of the study a health promotion model based on the principles of self-empowerment is suggested, which could be used as a framework for rehabilitation nurses and other professionals to enable them to focus on health and wellness rather than illness and disability     

Access to Health Promotion, Protection, and Disease Prevention among Impoverished Individuals

Abstract Health care access was surveyed in a sample of 182 northern Texas individuals (57% Hispanic) who provided information on 658 family members in northern Texas. Barriers were evaluated using the Institute of Medicine (Millman, 1993) and the L.A. Aday and R. M. Anderson (1981) conceptual framework and a survey research design. Eighty-eight percent of the 182 respondents were 54 years old or younger, yet the majority reported fair health status with currently unmet needs and untreated health problems. Forty-nine percent used an emergency room within the last year. Forty-two percent of the respondents always worry about their future health and 40% perceived little or no influence over their family's future health status. Forty-one percent of the variance in chronic health problems was accounted for by barriers, mental health needs, educational needs, and use of social services. Seventeen percent of the variance in health status was explained by mutable barriers to access. Unmet needs negatively affected physical and mental health. This study demonstrated that this relatively young sample (77% <44 years old) was experiencing health care access needs. These data aid evaluation of the Healthy People 2000 goal of reducing disparities that exist among Americans in health promotion, protection and prevention.     

Macrophage activation and Fcgamma receptor-mediated signaling do not require expression of the SLP-76 and SLP-65 adaptors

The Src-homology 2 domain-containing, leukocyte-specific phosphoprotein of 76 kDa (SLP-76) is a hematopoietic adaptor that plays a central role during immunoreceptor-mediated activation of T lymphocytes and mast cells and collagen receptor-induced activation of platelets. Despite similar levels of expression in macrophages, SLP-76 is not required for Fc receptor for immunoglobulin G (IgG; FcgammaR)-mediated activation. We hypothesized that the related adaptor SLP-65, which is also expressed in macrophages, may compensate for the loss of SLP-76 during FcgammaR-mediated signaling and functional events. To address this hypothesis, we examined bone marrow-derived macrophages (BMM) from wild-type (WT) mice or mice lacking both of these adaptors. Contrary to our expectations, SLP-76(-/-) SLP-65(-/-) BMM demonstrated normal FcgammaR-mediated activation, including internalization of Ig-coated sheep red blood cells and production of reactive oxygen intermediates. FcgammaR-induced biochemical events were normal in SLP-76(-/-) SLP-65(-/-) BMM, including phosphorylation of phospholipase C and the extracellular signaling-regulated kinases 1 and 2. To determine whether macrophages functioned normally in vivo, we infected WT and SLP-76(-/-) SLP-65(-/-) mice with sublethal doses of Listeria monocytogenes (LM), a bacterium against which the initial host defense is provided by activated macrophages. WT and SLP-76(-/-) SLP-65(-/-) mice survived acute, low-dose infection and showed no difference in the number of liver or spleen LM colony-forming units, a measure of the total body burden of this organism. Taken together, these data suggest that neither SLP-76 nor SLP-65 is required during FcgammaR-dependent signaling and functional events in macrophages.     

Effects of a Single Hit from the Alpha Hemolysin Produced by Escherichia coli on the Morphology of Sheep Erythrocytes

Scanning electron micrographs of sheep erythrocytes showed that attachment of the alpha hemolysin produced by Escherichia coli resulted in the formation of spherocytes, with 10 to 20 small projections spaced relatively evenly over the surface of the erythrocyte membrane. This shape change was induced within 5 min after treatment. If the hemolysin concentration was reduced to a level which would lyse only a fraction of the total erythrocytes, the affected cells were easily identified against a background of normal, unaffected cells. Unlike sodium lauryl sulfate and other amphipathic agents which enter cell membranes and increase their flexibility, low concentrations of hemolysin did not provide protection against hypotonic hemolysis. These findings indicate that the surface projections were not the result of membrane expansion caused by incorporation of hemolysin into the outer portion of the lipid bilayer. The ability of a given amount of hemolysin to release a constant amount of hemoglobin in the presence of increasing concentrations of red cells confirmed that a single hit is sufficient for lysis. These results suggest that a single hemolysin molecule can bind to a sheep erythrocyte and trigger internal reactions which result in the derangement of membrane integrity at multiple sites on the surface. Confirmation of one-hit kinetics indicates that measurement of E. coli hemolysin activity should be carried out at low ratios of hemolysin to erythrocyte to decrease the possibility of multiple hits on a single cell.     

Maternal pituitary-adrenal responsiveness as a function of differential treatment of rat pups

The effects of litter separation and pup treatment on the maternal pituitary-adrenal system were investigated in 3 experiments. Lactating females did not show a pituitary-adrenal response to separation from their pups. However, the lactating females showed an increase in plasma corticosterone when their pups had been briefly removed and then returned. If, in addition, the pups were subjected to a noxious stimulus (electric shock) during the 2-min separation, mothers showed a further increase in corticosterone. When pups were returned after 3 hr of separation, mothers again showed a differential pattern of corticoid responsiveness. The magnitude of the mother's pituitary adrenocortical response depended upon the intensity of treatment given to the pups. These data lend physiological support to behavioral studies which have shown that maternal behavior is differentially influenced by pup-produced stimuli.