International Program to Monitor Cat Flea Populations for Susceptibility to Imidacloprid

An international team of scientists and veterinarians was assembled in 1999 to develop a monitoring program to determine the susceptibility of cat fleas, Ctenocephalides felis felis (Bouché) (Siphonaptera: Pulicidae), to imidacloprid. Cat flea eggs were collected, shipped to laboratories, and tested for their susceptibility to imidacloprid. Over 3,000 C. felis populations were collected from 2002 to 2017 from 10 different countries. Of these, 66.3% were collected from cats and 33.7% from dogs. C. f. felis populations (n = 2,200) were bioassayed by exposing cat flea eggs and the emerging larvae to a Diagnostic Dose (DD) of 3 ppm imidacloprid in larval rearing medium. Flea eggs hatched and developed in the untreated controls in 1,837 of the isolates (83.5%) bioassayed. Flea isolates (n = 61) that had ≥5% survival at the DD of 3 ppm were retested with a second DD of 3 ppm. None of them had ≥5% survival to the second dose of 3 ppm. Of the 1,837 valid C. felis isolates tested, there has been no evidence of a decreased susceptibility to imidacloprid over the past 17 yr. The methods outlined in this article should provide an acceptable protocol for testing many of the new active ingredients that have been registered for cat flea control.

Finite-difference solution of the Poisson-Boltzmann equation: Complete elimination of self-energy

A new procedure to solve the Poisson-Boltzmann equation is proposed and shown to be efficient. The electrostatic potential due to the reaction field is calculated directly. Self-interactions among the charges are completely eliminated. Therefore, the reference calculation to cancel out the self-energy is not needed. © 1996 by John Wiley & Sons, Inc.

TRIAD: The Translational Research Informatics and Data Management Grid

OBJECTIVE

Multi-disciplinary and multi-site biomedical research programs frequently require infrastructures capable of enabling the collection, management, analysis, and dissemination of heterogeneous, multi-dimensional, and distributed data and knowledge collections spanning organizational boundaries. We report on the design and initial deployment of an extensible biomedical informatics platform that is intended to address such requirements.

METHODS

A common approach to distributed data, information, and knowledge management needs in the healthcare and life science settings is the deployment and use of a service-oriented architecture (SOA). Such SOA technologies provide for strongly-typed, semantically annotated, and stateful data and analytical services that can be combined into data and knowledge integration and analysis "pipelines." Using this overall design pattern, we have implemented and evaluated an extensible SOA platform for clinical and translational science applications known as the Translational Research Informatics and Data-management grid (TRIAD). TRIAD is a derivative and extension of the caGrid middleware and has an emphasis on supporting agile "working interoperability" between data, information, and knowledge resources.

RESULTS

Based upon initial verification and validation studies conducted in the context of a collection of driving clinical and translational research problems, we have been able to demonstrate that TRIAD achieves agile "working interoperability" between distributed data and knowledge sources.

CONCLUSION

Informed by our initial verification and validation studies, we believe TRIAD provides an example instance of a lightweight and readily adoptable approach to the use of SOA technologies in the clinical and translational research setting. Furthermore, our initial use cases illustrate the importance and efficacy of enabling "working interoperability" in heterogeneous biomedical environments.

Large-scale monitoring of imidacloprid susceptibility in the cat flea, Ctenocephalides felis

Although on-animal topical treatment with compounds such as imidacloprid has revolutionized the control of the cat flea, Ctenocephalides felis (Bouché) (Siphonaptera: Pulicidae), the development of insecticide resistance is a continuing threat. As part of a highly co-ordinated and unprecedented resistance monitoring programme for C. felis, 1437 flea isolates were collected by veterinary clinics in Australia, Germany, France, the U.K. and 29 states in the U.S.A. from 2002 to 2009. About 65% of the collections were made from June to October each year and 71% of the collections were from cats. Collections of flea eggs were sent to one of five different laboratories, where they were tested with a diagnostic dose of imidacloprid (3 p.p.m.) applied to larval flea-rearing medium. Of the 1437 collections received, 1064 contained adequate numbers of eggs for testing. Of these isolates, untreated eggs failed to hatch in 22.7% and were not considered valid bioassays. Survival rates >5% and development of adult fleas (a threshold for further testing) occurred in only 22 isolates. They were re-tested with the same diagnostic dose and none produced >5% adult emergence. Complete dose-response bioassays were performed on three of the isolates that had triggered a second test and produced slopes, intercepts and LC(50) values similar to those for existing susceptible laboratory strains. Results confirmed sustained susceptibility of C. felis to imidacloprid, despite its widespread use for over a decade.

A new model for collaborative continuing professional development

For collaborative patient-centered practice models to develop, improved collaboration in the workplace is needed. In this project we aimed to create a model of continuing professional development (CPD) using a case based approach that would allow the exchange of information between primary health care providers in the community. Over 60 participants from community care sectors including physicians, nurses and administrators participated in a planning group and two consultation workshops. Using participatory action research methods, themes contributing to and inhibiting communication, collaboration and coordination of care in the community were identified. Recommendations for solutions were prioritized and implemented. Evaluations suggest that the case scenario and consultation approach successfully focused participants to address relevant local issues to improve collaboration among community providers.

Public-health education at Kansas State University

What are veterinary medical and public-health professionals doing to remedy the immediate and impending shortages of veterinarians in population health and public practice? This question was addressed at the joint symposium of the Association of American Veterinary Medical Colleges and the Association of Schools of Public Health, held in April 2007. Thinking locally, faculty and students at Kansas State University (KSU) asked similar questions after attending the symposium: What are we doing within the College of Veterinary Medicine to tackle this problem? What can we do better with new collaborators? Both the professional veterinary curriculum and the Master of Public Health (MPH) at KSU provide exceptional opportunities to address these questions. Students are exposed to public health as a possible career choice early in veterinary school, and this exposure is repeated several times in different venues throughout their professional education. Students also have opportunities to pursue interests in population medicine and public health through certificate programs, summer research programs, study abroad, and collaborations with contributing organizations unique to KSU, such as its Food Science Institute, National Agricultural Biosecurity Center, and Biosecurity Research Institute. Moreover, students may take advantage of the interdisciplinary nature of public-health education at KSU, where collaborations with several different colleges and departments within the university have been established. We are pleased to be able to offer these opportunities to our students and hope that our experience may be instructive for the development of similar programs at other institutions, to the eventual benefit of the profession at large.

Efficacy of a topically applied formulation of metaflumizone on cats against the adult cat flea, flea egg production and hatch, and adult flea emergence

A spot-on metaflumizone formulation was evaluated to determine its adulticidal efficacy, effect upon egg production, and ovicidal activity when applied to flea infested cats. Eight male and eight female adult domestic shorthair cats were randomly assigned to either serve as non-treated controls or were treated topically with a minimum of 40mg/kg metaflumizone in single spot-on Day 0. On Days -2, 7, 14, 21, 28, 35, 42, 49, and 56, each cat was infested with approximately 100 unfed cat fleas, Ctenocephalides felis felis. On Days 1, 2, and 3, and at 48 and 72h after each post-treatment reinfestation, flea eggs were collected and counted. At approximately 72h after treatment or infestation, each cat was combed to remove and count live fleas. Egg viability was determined by examining hatched eggs after 5 days and adult emergence was determined 28 days after egg collection. Metaflumizone provided >/=99.6% efficacy against adult fleas from Days 3 to 45 following a single application. Following treatment, egg production fell by 51.6% within 24h and 99.2% within 48h. Following subsequent weekly infestations egg production from treated cats was negligible out to Day 38, with >/=99.5% reduction relative to non-treated cats. Where there were eggs to evaluate, metaflumizone treatment did not have any apparent effect on the hatching of eggs or on the development and emergence of adult fleas from the eggs produced by fleas from treated animals.

Best Practice Smoking Cessation Intervention and Resource Needs of Prenatal Care Providers

OBJECTIVE

To describe smoking cessation interventions by prenatal care providers and to identify factors associated with best practice.

METHODS

A mailed survey assessed implementation of the "5 A's" of best practice (Ask about smoking; Advise patients to quit; Assess willingness to quit; Assist with a cessation plan; and Arrange follow-up), practice characteristics, intervention training, resources, barriers, and attitudes toward reimbursement. Each factor in association with provider type and best practice implementation was analyzed.

RESULTS

Of 1,138 eligible North Carolina health professionals, 844 responded (74%); 549 were providing prenatal care and returned completed surveys. Most asked about smoking (98%) and advised cessation (100%). Across provider type, one third (31%) consistently implemented all "5 A's" of best practice. Most providers (90%) had at least one material resource (eg, pamphlets), which correlated with nearly 10 times the adjusted odds of best practice (odds ratio [OR] 9.6, 95% confidence interval [CI] 1.3-72.9). Seventy percent had at least one counseling resource. Having a counseling resource (OR 2.5, 95% CI 1.4-4.4) and a written protocol to identify staff responsibilities (OR 2.5, 95% CI 1.5-4.3) were equally associated with best practice. More than one half of providers endorsed reimbursement as influential on best practice.

CONCLUSION

Best practice is well-established to promote prenatal smoking cessation yet implemented by only one third of prenatal care providers in North Carolina. In this study, best practice was associated with resources, practice organization, and reimbursement. Augmented use of available resources (eg, toll-free hotlines) and adequate reimbursement may promote best practice implementation.

Efficacy of selamectin and fipronil-(S)-methoprene spot-on formulations applied to cats against adult cat fleas (Ctenocephalides felis), flea eggs, and adult flea emergence

A study was conducted to evaluate the efficacy of selamectin and fipronil-(S)-methoprene against adult cat fleas (Ctenocephalides felis), flea egg production, and the viability of flea eggs collected from treated cats. Cats were infested with approximately 50 adult fleas 2 days before treatment and weekly thereafter; flea eggs were collected and counted on days 0, 1, 2, and 3 and 48 and 72 hours after each weekly flea infestation. Live fleas were collected approximately 72 hours after treatment or infestation. Compared with fipronil-(S)-methoprene, selamectin provided significantly greater control of adult fleas from days 24 to 31 and significantly greater reduction in egg production from days 16 to 45. For the most part, both products significantly impacted larval and adult emergence for the entire 6-week study, with fipronil-(S)-methoprene providing significantly greater reduction in larval and adult emergence at week 6.

Reusable learning units: an innovative teaching strategy for online nursing education

Constructivist and adult learning theory provided the theoretical framework for reusable learning units (RLUs) developed for a Southeastern University's family nurse-practitioner and nurse-midwifery distance educational programs. Reusable learning units are an organized series of learning events that satisfy one or more interrelated learning objectives that cannot be broken down to component parts without losing semantic and pragmatic meaning. This paper describes the conceptual framework, background and history of RLUs, and collaborative efforts for development and implementation.

New methods and strategies for monitoring susceptibility of fleas to current flea control products

A flea larval bioassay was developed by an international team of scientists to monitor the susceptibility of fleas (Ctenocephalides felis) to imidacloprid (Advantage, Bayer HealthCare). The assay was validated using laboratory and field isolates of C. felis. Flea eggs representing different field isolates of C. felis were collected by veterinarians in the United States, United Kingdom, and Germany. Of the 972 flea isolates obtained during the 5-year study, 768 contained sufficient numbers of eggs to conduct the larval bioassay. Greater than 5% survival occurred for only six of the field isolates evaluated. Further evaluation and analysis of these isolates demonstrated that they did not differ significantly in their susceptibility to imidacloprid from the reference strains used to develop the assay. Collections of field flea isolates will continue in an attempt to detect and document any change in the susceptibility of field flea populations to imidacloprid.

Determining a diagnostic dose for imidacloprid susceptibility testing of field-collected isolates of cat fleas (Siphonaptera: Pulicidae)

The susceptibility of four laboratory strains of cat fleas, Ctenocephalides felis (Bouche), to imidacloprid was determined by three different laboratories, by using a standardized bioassay protocol. The probit lines generated by the different laboratories were very similar, with LC50 values ranging from 0.32 to 0.81 ppm. Based on these data, a diagnostic dose (DD) of 3 ppm imidacloprid in larval rearing media was provisionally identified for detecting shifts in tolerance, possibly as a consequence of incipient imidacloprid resistance. None of the larvae from the susceptible laboratory strains survived the DD. Eighteen field-collected isolates were evaluated for their susceptibility to imidacloprid and to validate a DD of 3 ppm. Probit lines from 18 field-collected isolates were very similar, with LC50 values ranging from 0.14 to 1.52 ppm. When exposed to the DD, between 3 and 10% of the exposed larvae emerged as adults from only three of the 18 isolates. All other field isolates gave 100% mortality at the DD. Under the criteria established (>5% survivorship at 3 ppm), two isolates would be established on mammalian hosts and more extensive tests conducted to exclude or confirm the presence of resistance. The DD of 3 ppm is robust enough to eliminate most of the susceptible isolates collected until today, yet low enough to identify possible isolates for further testing.

Molecular phylogeny of isolates of Ctenocephalides felis and related species based on analysis of ITS1, ITS2 and mitochondrial 16S rDNA sequences and random binding primers

The phylogenetic relationships among 31 different flea isolates representing seven different species were studied by nucleotide sequence comparison of the internal transcribed spacer 1 (ITS1), internal transcribed spacer 2 (ITS2) and/or mitochondrial 16S ribosomal RNA gene (mt16S-rDNA) to examine the patterns of variation. Results show that all regions are useful in discriminating among flea species. In Ctenocephalides felis and Tunga penetrans, some differences in these gene regions occurred among different isolates within the same species. In the latter case, the differences are in the mt16S-rDNA region, with one isolate showing 48% divergence in nucleotide sequence. The taxonomic implications of this result are unclear at present. The gene regions revealed differences between C. felis isolates only after DNA sequencing the PCR products. Further differentiation among C. felis isolates was obtained using four different random binding primers (decamers) and primers for mammalian aldolase to amplify narrow differences in the genome. Using these primers we were able to discriminate between different C. felis isolates and determine that some of the genetic variation coincided with minor differences in response to the control agent imidacloprid. However, overall findings do not support the existence of subspecies of C. felis.

Applying motivational interviewing to contraceptive counseling: ESP for clinicians

Healthcare providers are in a unique position to address women's risk of unintended pregnancy and sexually transmitted infections (STIs), yet evidence for effective counseling strategies is limited. One approach to developing effective contraceptive counseling methods may be the application of theory-based behavior counseling models. One such model, motivational interviewing (MI), is a promising approach for addressing risk-taking behaviors of many kinds. We propose application of MI to contraceptive counseling. This process, ESP, involves Exploring discrepancies between pregnancy intention and contraceptive use and between risk of STIs and condom use, Sharing information and Promoting behaviors to reduce risk. This model emphasizes the importance of identifying discrepancies between goals and behaviors and supporting women's confidence in using appropriate contraceptive methods

Development of a larval bioassay for susceptibility of cat fleas (Siphonaptera: Pulicidae) to imidacloprid

Strategies for controlling cat fleas, Ctenocephalidesfelisfelis (Bouché), have undergone dramatic changes in the past 5 yr. With the advent of on-animal treatments with residual activity the potential for the development of insecticide resistance increases. A larval bioassay was developed to determine the baseline susceptibility of field-collected strains of cat fleas to imidacloprid. All four laboratory strains tested showed a similar level of susceptibility to imidacloprid. Advantages of this bioassay are that smaller numbers of fleas are required because flea eggs are collected for the test. Insect growth regulators and other novel insecticides can also be evaluated. Using a discriminating dose, the detection of reduced susceptibility in field strains can be determined with as few as 40 eggs.

What does the Ashworth scale really measure and are instrumented measures more valid and precise?

This study aimed to explore the limitations of the Ashworth scale for measuring spasticity. An isokinetic dynamometer to quantify resistance to passive stretch and surface EMG was used to verify if a stretch response occurred and, if so, at what joint angle. The authors sought to determine which components of passive resistance (magnitude, rate of change, onset angle of stretch, or velocity dependence) were most related to Ashworth scores and which were related to motor function in cerebral palsy (CP). Twenty-two individuals with spastic CP (11 males, 11 females; mean age 11.9 years, SD 4.3) and a comparison group of nine children without CP (four males, five females; mean age 11.3 years, SD 2.5) participated in the study. The group with CP included those with a diagnosis of spastic diplegia, hemiplegia, or quadriplegia, distributed across Gross Motor Functional Classification Levels. Procedures included: (1) clinical assessment at the knee joint, (2) functional assessments, and (3) isokinetic assessment of passive resistance torque in hamstrings and quadriceps at three velocities. EMG data were recorded simultaneously to identify stretch responses. Detecting stretch responses using the Ashworth scale compared with instrumented measures showed near complete agreement at extremes of the scale, with marked inconsistencies in mid-range values. Ashworth scores were correlated with instrumented measures, particularly for the quadriceps, with higher correlations to the rate of change in resistance (stiffness) and onset angle of stretch than to peak resistance torque. Those with greater resistance tended to have poorer function with isokinetic relations typically stronger.

Reagentless biosensing using electrochemical impedance spectroscopy

The use of electrochemical impedance spectroscopy (EIS) and the conducting polymer, poly (pyrrole), as an integrated recognition and transduction system for reagentless biosensor systems was demonstrated with two different systems. The first system being an immunoassay for detection of luteinising hormone (LH) with the antibody being entrapped with in the poly (pyrrole) matrix and the second, a construct for DNA hybridisation discrimination able to differentiate single- and double-stranded DNA based on the interaction of the DNA with poly (pyrrole).

Malignancy associated changes in bronchial epithelial cells and clinical application as a biomarker

A total of 74 bronchial brushing specimens, 24 from patients with advanced stage cancer, eight from patients with CIS, 31 from patients with atypical metaplasia and 11 from normal subjects were examined for the existence of malignancy associated changes (MAC). Conventional fiberoptic bronchoscopy and fluorescence endoscopy was carried out on every case. Each case was classified according to the highest grade of abnormality diagnosed by bronchial biopsy of the suspect areas. During the endoscopy examination, a bronchial brushing specimen was obtained from a visually normal area very remote from the abnormal area as possible such as the opposite lung or another lobe. The bronchial brushing specimens were fixed, mounted and stained by a DNA specific method and approximately 1500 images of individual nuclei per case were captured by an automated high resolution image cytometry. For each of these images, more than 100 nuclear features such as size, shape and chromatin spatial organization were calculated. Discriminant function analysis revealed nuclear features which differentiated between normal bronchial cell nuclei from the normal subjects and ostensively normal nuclei (MAC cell nuclei) from the lung cancer patients. The best discrimination was achieved when the frequency of individual cells expressing MAC was 50% or greater. With this threshold, 75% of the patients with invasive cancer and CIS were correctly classified. Fifty percent of those with severe or moderate atypia and 35% with mild atypia were also MAC positive. The frequency of cells expressing MAC also increased as the degree of abnormality of the groups increased. MAC may be a useful criterium to determine biological behavior of the intra-epithelial (pre-invasive) neoplasia.

Molecular follow-up of a preinvasive bronchial lesion treated by 13-cis-retinoic acid

We report the result of the follow-up molecular analysis of a bronchial carcinoma in situ treated by 13-cis-retinoic acid, which relapsed 9 months after cessation of drug therapy. Loss of heterozygosity at 3p21 and 9p22 genomic sequences were assessed by polymerase chain reaction (PCR) after microdissection of the dysplastic epithelia. Despite a transient regression of the lesion to a lower grade with treatment, molecular analysis showed the persistence of a 3p and 9p deletion in all the bronchial biopsies taken in the same area during a 1 year follow-up, preceding by 9 months the recurrence of the carcinoma in situ. Our findings suggest that molecular follow-up analysis can help to assess the persistence of a malignant clone within a bronchial epithelium that displays a more benign phenotype under retinoid treatment on follow-up. Molecular analysis may be of great importance to evaluate the effects of chemoprevention and to determine the duration of such intervention in responder patients.

Evidence of cumulative gene losses with progression of premalignant epithelial lesions to carcinoma of the bronchus

Human bronchial carcinoma is thought to develop through progressive stages from basal cell hyperplasia to squamous metaplasia, dysplasia, carcinoma in situ, and finally invasive cancer. In this study, we used tissue microdissection to examine loss of heterozygosity of chromosomes 3p21, 5q21, and 9p21 at each stage of the epithelial progression to invasive cancers. Forty-eight premalignant/malignant bronchial sites were biopsied from 13 patients (including 9 subjects without cancer) using fluorescence bronchoscopy. Eighteen sites with moderate/severe dysplasia in 6 patients were subjected to bronchoscopic and molecular follow-up during a 3-month to 2-year period. Seven separate cases of advanced non-small cell bronchial cancers were also analyzed. From the baseline biopsies, the prevalence of 3p and 9p deletions increased significantly from no deletion in the hyperplasia/metaplasia samples (n = 9) to 37 and 31% of the informative cases, respectively, in the dysplasia samples (n = 29), to 100 and 83%, respectively, for the carcinomas in situ (n = 6), and 100% in the invasive cancers (n = 11). Chromosome 5q deletion was significantly more frequent in invasive cancers (70% of the informative cases) as compared to carcinoma in situ (40%), dysplasias (33%), and hyperplasia/metaplasia samples (11%). The number of chromosome alterations also increased significantly from the lowest to the highest grade lesions, showing evidence of accumulation of genetic damage from one group to another. The molecular follow-up analysis showed that the same genomic alteration can persist in a given dysplastic bronchial area for several months or years, and that the persistence or the regression of the molecular abnormality is well correlated with the evolution of the disease on follow-up. Our results suggest that molecular analysis of bronchial biopsies obtained by fluorescence bronchoscopy may be a very useful means to study the natural history of preinvasive bronchial lesions and the outcome of interventions, such as with chemopreventive treatment.

Cervicography: an intermediate triage test for the evaluation of cervical atypia

BACKGROUND

A substantial number of abnormal Papanicolaou (Pap) smears are reported as demonstrating "cytologic atypia." This finding may actually represent premalignant cervical disease. Some of these patients may not be able to afford definitive colposcopic examinations, and simply repeating cytologic testing may result in missed treatable disease. The purpose of this study was to evaluate the use of cervicography as an intermediate triage test for women with atypical cervical cytology.

METHODS

Women with a recent smear demonstrating cytologic atypia were evaluated using colposcopy, biopsy, and cervicography.

RESULTS

Colposcopically directed cervical biopsies were obtained from 224 of 685 women with cytologic atypia. The histologic specimens confirmed evidence of cervical dysplasia for 166 women. Of these women, cervicography detected 74.7% of those who had mild dysplasia, 87.5% of those who had moderate dysplasia, 75% of those who had severe dysplasia, and the one patient who had cervical cancer. Most (93%) of the women with dysplasia that was undetected by cervicography had mild dysplasia.

CONCLUSIONS

Cervicography may be an effective intermediate triage test for the evaluation of young women with Pap smears demonstrating cytologic atypia.

Cervicography: adjunctive cervical cancer screening by primary care clinicians

BACKGROUND

Cervicography is an adjunct method of cervical cancer screening intended to complement cervical cytologic sampling, ie, Papanicolaou (Pap) smear. Cervicography involves obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the screening use of cervicography as an adjunct to clinical cytologic screening.

METHODS

Women presenting at four clinical sites for annual cervical cytologic screening or for follow-up evaluation after receiving an abnormal Pap smear result were enrolled in the study. Each patient received a Pap smear and a cervigram. Those women in whom abnormalities were detected by either test subsequently underwent colposcopy, and when appropriate, histologic specimens were obtained.

RESULTS

Pap smear and cervigram data were obtained for 1449 women. When premalignant or malignant histologic test results were considered as a true positive, the Pap smear correctly identified 25.6% of subjects with dysplasia and 37.5% with severe dysplasia. The Pap smear failed to identify the one patient with invasive cancer. The cervigram detected 50.5% of the subjects with dysplasia and 77.8% of the subjects with severe dysplasia, and it identified the one patient with invasive cancer when a positive cervigram was considered a true positive. When the results were combined, the two tests identified 62.9% of subjects with histologically confirmed dysplasia, 81.3% of subjects with severe dysplasia, and 100% (one patient) with cancer.

CONCLUSIONS

The cervigram detected twice the number of patients with premalignant disease as the Pap smear alone, and correctly identified the invasive cancer. Cervicography improved the detection of cervical disease.

Effect of a CVIS Instructional Program Regarding Therapeutic Communication on Student Learning and Anxiety

This quasi-experimental, pretest-posttest design study explored the effect of a computer video-interactive system (CVIS) instructional program regarding therapeutic communication on senior baccalaureate nursing students' learning and anxiety as they anticipated interaction with patients in psychiatric settings. The 75 subjects were randomly divided into two groups. Group I received a basic lecture and a supplementary CVIS instructional program on therapeutic communication, while Group II received the same lecture discussion on therapeutic communication and a videotape. Two hypotheses were tested, using analyses of covariance. Hypothesis I, that Group I would score significantly higher on a therapeutic communication posttest than would Group II, was supported (P less than .001). This finding validates previous observations that computer-video interaction programs do enhance learners' application of knowledge. Hypothesis II, that Group I would evidence significantly less state anxiety at posttest than would Group II, was not supported. Although there were no significant differences for state anxiety scores between the groups at either pretest or posttest, these scores remained higher than reported normative state anxiety scores. This finding suggests that anticipated interaction with psychiatric patients is an anxiety-inducing situation for nursing students.

Conformational determinants of high affinity delta receptor binding of opioid peptides

Detailed conformational analysis of linear and cyclic delta-selective opioid peptides was performed in conjunction with computer-analyzed receptor binding studies with the aim of determining conformational requirements for high affinity binding of peptides to the delta-receptor. The four linear delta-selective hexapeptides included in this study were: DSLET (Tyr-D-Ser-Gly-Phe-Leu-Thr) and its D-Thr2 analog (DTLET) and two t-butyl ether analogs. In one analog an O-t-butyl group replaces the D-Ser2OH and in the other a second O-t-butyl group replaces the D-Thr6OH group as well. This study also includes seven cyclic pentapeptides of the type: Tyr-Cys(Pen-Gly-Phe-Cys(Pen) with various combinations of DL-cysteine and DL-penicillamine (beta-dimethyl cysteine) as the second and fifth residues resulting in varying delta affinities and selectivities. Four (DPLPE, DPDPE, DPLCE, and DCLPE) have both high delta affinity and selectivity; two (DCDCE and DCLCE) have high affinity at both delta- and mu-receptors, and one (LCLCE) has low affinity for both receptors. Our investigation has shown that all analogs that have high affinity at the delta receptor have a unique common low energy conformer. This compact conformer contains intramolecular H-bonds and is very different from the beta II-turn-type structure associated with high affinity mu-receptor binding deduced in our previous work.

Prematurity and the obstetrician. A regional neonatal intensive care nursery is not enough

Modern-day perinatal care has resulted in dramatically improved outcomes of premature infants, particularly those weighing 750 to 1,500 gm or of 27 to 32 weeks' gestational age. Assuming that the birth is not traumatic, the infant asphyxiated, or made hypothermic at birth, the chances of the very small premature baby developing normally are great. The delivery of an infant of less than or equal to 32 weeks' gestational age or weighing less than 1,500 gm should occur at a perinatal center when possible.

Comparison of xeroradiographic and ultrasound detection of corticosteroid induced dermal thinning

A pulsed ultrasound technique was shown to have a high degree of correlation with the established xeroradiographic method for the determination of dermal thickness both in normal skin and corticosteroid treated skin, although xeroradiography consistently gave a higher value than ultrasound. Using the pulsed ultrasound technique, an early onset of dermal thinning could be detected 2 days following treatment with creams containing 0.05% clobetasol propionate and 0.1% beta-methasone 17-valerate. The amount of dermal thinning produced by the clobetasol propionate preparation was significantly greater than that produced by cream base, clobetasone butyrate 0.05% cream and hydrocortisone 1% cream as determined by both techniques. The pulsed ultrasound technique is an accurate, noninvasive and safe method for determining dermal thickness.

Organization of an information system for food and nutrition programmes in Costa Rica

This paper discusses the information needed for multidisciplinary planning aimed at reducing nutritional deprivation in Costa Rica. In recent years, an approach has been developed for organizing data and information so as to define and described target groups of households. The development of a functional classification, a central activity of the Sistema de Información en Nutrición (SIN), is described and a preliminary description of the population groups affected by malnutrition presented. The major objectives of SIN are outlined and the possibilities of applying the same system to other countries discussed.

Stress effects on the nonverbal behavior of repressors and sensitizers

Differences between repressors and sensitizers in nonverbal behavior were found in two studies of male and female undergraduates which manipulated the amount of stress present during an interaction between an S and a confederate (C). In Study I (N = 72), sensitizers used less eye contact and more personal space than measures of personal space and eye contact, intensified the stress manipulation, and added two distinct types of stressors (interpersonal and situational). Significant differences in the same direction as in Study I were again observed between repressors and sensitizers in the use of personal space. Level of eye contact for repression-sensitization was significantly different in the second half of the interaction, though opposite in direction to found in Study I. The reversal was explained by focusing on the information-gathering versus the emotional-communication functions of eye contact. Only interpersonal stress produced significant differences in the amount of eye contact used as well as interacting significantly with stress and repression-sensitization.

Autonomic responses of paranoid, nonparanoid schizophrenic, and normal subjects to affective visual stimulation

This investigation utilized a procedure designed to determine patterns of cognitive appraisal, and autonomic reactivity which characterize groups of normals, and paranoid and nonparanoid schizophrenics. Results indicated that both groups of schizophrenics evidenced electrodermal habituation and increased finger pulse constriction. Normals indicated that stress stimuli became less disturbing over trials and displayed both electrodermal and digital vasomotor habituation. Electrodermal habituation curves for paranoids and normals were similar, with nonparanoids evidencing slower habituation. Paranoids tended to under-rate or deny their emotional reactions.