The effectiveness of education for family management of asthma in children: a preliminary report

This paper reports preliminary findings in a convenience sample of one half the population enrolled in a study of self-management in low income families where a child has asthma. In initial evaluation data, parents participating in self-management education reported significantly less fear and anxiety associated with their children's wheezing episodes than did control families. They also reported that their children exhibited fewer signs of stress during wheezing episode. A trend toward reduced school absences and emergency room visits was noted among participating families. The actions taken by a family to manage the illness increased with the number of sessions attended.

Intellectual development and nutrition

One newborn child was selected from 14 families in which kwashiorkor had occurred. Undernutrition in this test group was prevented for the first two years of life by the provision of supplementary feeding. Controls who were the siblings directly preceding each of the 14 test children received no supplementary feeding, but received medical attention and management. In each family an older child who previously had kwashiorkor (kwashiorkor group), and the nearest sibling who had received neither extra feeding nor medical management (kwasiorkor control group) were also available for comparison. A battery of psychologic tests was administered when the mean age of the test group was 8.9 years. The mean full-scale IQ of the supplementary feeding group at an average age of 8.9 years was significantly higher than that of any of the other three groups. There was no significant difference between test and control groups on nonverbal IQ. Measures of "brain damage" did not discriminate between any of the four groups. The results suggest that nutritional factors contribute especially to the elevation of verbal intelligence. Environmental stimulation (daily contact with a more alert child) apparently contributed to the elevation of the nonverbal scores of the controls.

Long-term outcome of smoking cessation workshops

Three hundred seventy-two (63%) of 590 enrollees in nine smoking cessation workshops held over a five-year period responded to a follow-up survey. Outcome data were collected retrospectively for six-month intervals from workshop to follow-up. Forty nine per cent of all enrollees graduated, and 56% of the respondents quit smoking during the program. Nonsmoking rates declined to an average of 25% by the first year post-workshop and remained relatively stable thereafter for periods up to five years.

Retirement and coronary mortality

Information on several variables, including occupational history and various coronary risk factors, was collected from the wives of 568 married men who died of coronary heart-disease (CHD) and an equal number of matched control subjects. The crude matched-pair relative risk of fatal CHD among men who retired compared with non-retirees was 2.9 (95% confidence limits from 1.9 to 4.9). After adjustment for age and history of hospitalisation for myocardial infarction by means of a paired multiple-logistic regression analysis the relative risk was reduced to 1.8 (range 1.0 to 3.3). These data suggest that retirement and subsequent coronary mortality may be linked.

In vitro investigation of autoantibody-secreting peritoneal cells and their regulation

A high proportion of peritoneal cells from untreated mice, after 4--5 days in culture, develop into plaque-forming cells against bromelain-treated mouse red blood cells. The number of plaque-forming cells was increased significantly by exposing the peritoneal cells to ammonium chloride to lyse red blood cells before culture. Conversely, the increase was significantly inhibited by adding before culture untreated or bromelain-treated sheep or mouse red blood cells. Treated or untreated horse or rat red blood cells did not inhibit the increase. Treating peritoneal cells or subpopulations of peritoneal cells with anti-theta serum and complement before culture caused a significant increase in the number of plaque-forming cells against bromelain-treated red blood cells after 3--4 days of culture. Various procedures were used to fractionate peritoneal cells into B-cell enriched and B-cell depleted subpopulations before culture and after culture, to investigate whether some of the plaque-forming cells could be attributed to phagocytic cells. Generally, changes in the number of plaque-forming cells against bromelain-treated mouse red blood cells paralleled changes in B-cells. In some experiments the proportion of plaque-forming cells observed represented up to 85% of the B-cells present. The results suggest that the high level of autoreactivity is due to antibody production by B-cells and that phagocytic cells are not forming spurious plaques. Further, it appears that the autoimmunity is regulated by T-cells and can also be inhibited by mouse RBC.

Temperature-sensitive mutants of complementation group E of vesicular stomatitis virus New Jersey serotype possess altered NS polypeptides

In vesicular stomatitis virus New Jersey serotype polyacrylamide gel electrophoresis was unable to distinguish the polypeptides of the temperature-sensitive (ts) mutants of complementation groups A, B, C, and F from those of the wild-type virus. However, the NS polypeptide of the representative mutant of group E, ts E1, had a significantly greater electrophoretic mobility than that of the wild-type virus NS polypeptide. The electrophoretic mobilities of the NS polypeptides of the three mutants of complementation group E varied, being greatest in the case of ts E1, slightly less for ts E2, and only a little greater than that of wild-type virus NS polypeptide in the case of ts E3. Since the NS polypeptides of the revertant clones ts E1/R1 and ts E3/R1 have mobilities identical to that of wild-type NS polypeptide, the observed altered mobilities of the group E mutants are almost certainly the direct result of the ts mutations in the E locus. The electrophoretic mobilities of the intracellular NS polypeptides of the group E mutants were indistinguishable from those of their virion NS polypeptides. The electrophoretic mobilities of the NS polypeptides of the group E mutants synthesized in vitro using mRNA synthesized in vitro by TNP were identical to those of the NS polypeptides of their purified virions. The NS polypeptides of all three mutants were labeled with (32)P(i) to approximately the same extent as wild-type virus NS polypeptide, indicating that gross differences in phosphorylation of this polypeptide are unlikely to account for the altered mobilities. We propose a model in which the NS polypeptide consists of at least three loops held in this configuration by hydrophobic or ionic forces or both and stabilized by phosphodiester bridges. If a mutation affects one of the amino acids to which the phosphate is covalently linked, the phosphodiester bridge cannot be formed, and, as a result, in the presence of sodium dodecyl sulfate the affected loop opens and thus the NS polypeptide migrates further into the gel. Such a configuration may also explain the multifunctional nature of the NS polypeptide.

Measures and methods in evaluating patient education programs for chronic illness

Patient education provides a vehicle for increasing the self-management of chronic illness and promoting modifications of life styles, which are considered important strategies for prevention. Evaluating the impact of such programs is complex and poses a number of methodologic and technical problems. Outcome measures of patient education programs are defined and reviewed in terms of the existing evaluation literature and our own studies utilizing diabetes as a prototype condition. Important dimensions of adaptation are outlined and indices to measure it discussed in an effort to examine aspects of educational programs directed at facilitating coping and maintaining quality of life. Factors which influence outcome variables are identified and include: patient factors (e.g., age, ethnic, socioeconomic, cultural, personality, and emotional), disease factors (e.g., severity of illness, age of onset, length of illness, mode of therapy), system factors (e.g., patient's location in the health care system, relation of teaching program to other health care providers). The effects of these factors are described including their implications for research design.

Acidic Precipitation in South-Central Ontario: Recent Observations

Precipitation in south-central Ontario, with mean pH between 3.95 and 4.38 and frequent event pH's of < 4.0, is more acidic than that in the Sudbury, Ontario, region and in Scandinavia, and as acidic as that in the northeastern USA. As in New England, a major component of the total acidity is strong mineral acid. Because most lakes in south-central Ontario have very low buffering capacities (10–200 μeq∙L−1), high acid loadings are likely to lead to acidification of many lakes and streams in the forseeable future. Although it is not yet possible to estimate the time required for this to happen, there is already some evidence of declining buffering capacity in a few lakes. Key words: acidic rain, buffering capacity, acidic lakes, precipitation, alkalinity

Limitations of a single extra-amniotic injection of prostaglandins in viscous gel to induce midtrimester abortion

A dose-response study using PGE2 in a viscous gel has been undertaken for induction of midtrimester abortion. A direct relationship was found between the time to abortion and the dose administered. However, even using PGE2 3.5 mg induced uterine activity was noticed to subside in a significant number of women after approximately 6 h. For routine management it is suggested that PGE2 3.5 mg be injected and followed by repeat doses 6 h later with removal of the injecting catheter on each occasion.

Synthesis and antiinflammatory activity of some 2-aryl-6-benzoxazoleacetic acid derivatives

Various approaches to the synthesis of 2-aryl-6-substituted benzoxazoles are described. The products, which included the 6-methyl derivative 4a, ethylamines 10 and 19, ethanols 12 and 14, the acetic and alpha-methylacetic acids 9 and 16a--f, and the acetic ester 11, were screened for antiinflammatory activity on the carrageenan-induced rat paw edema test. Some of the compounds possessed activity superior to that of phenylbutazone and of the same order as that of benoxaprofen.

Blood pressure effects of lower abdominal aortic surgery with particular reference to the use of morphine and droperidol in modifying the responses

Hypertensive responses during operations on the abdominal aorta are common. We have shown that hypertensive changes occur before cross-clamping of the aorta. We have also shown that droperidol modifies the hypertensive changes in operations on the lower aorta. Although further studies are required, our preliminary results show a higher rise of serum epinephrine and norepinephrine levels in one patient receiving morphine, as compared to one patient receiving the same dose per unit body weight of morphine plus droperidol. With maintenance of adequate pre-operative hydration and intra-operative fluid and blood replacement, declamping hypotension was transient in both groups of our patients.