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Programmed cell death in plants: effect of protein synthesis inhibitors and structural changes in pea guard cells.

Pea leaf epidermis incubated with cyanide displayed ultrastructural changes in guard cells that are typical of apoptosis. Cycloheximide, an inhibitor of cytoplasmic protein synthesis, and lincomycin, an inhibitor of protein synthesis in chloroplasts and mitochondria, produced different effects on the dynamics of programmed death of guard cells. According to light microscopy data, cycloheximide reinforced and lincomycin suppressed the CN(-)-induced destruction of cell nuclei. Lincomycin lowered the effect of cycloheximide in the light and prevented it in the dark. According to electron microscopy data, the most pronounced effects of cycloheximide in the presence of cyanide were autophagy and a lack of apoptotic condensation of nuclear chromatin, the prevention of chloroplast envelope rupturing and its invagination inside the stroma, and the appearance of particular compartments with granular inclusions in mitochondria. Lincomycin inhibited the CN(-)-induced ultrastructural changes in guard cell nuclei. The data show that programmed death of guard cells may have a combined scenario involving both apoptosis and autophagy and may depend on the action of both cytoplasm synthesized and chloroplast and mitochondrion synthesized proteins.

Apoptosis↗

Association between contraceptive method accepted and perception of information received: a comparison of Norplant and IUD acceptors.

In the present study Norplant(R) and IUD acceptors who attended the same counseling sessions have been compared on their perception of the information received at the family planning clinic. The study covered 100 acceptors of each method quota matched by parity and years of schooling. Data were obtained through home interviews. The two groups presented no significant differences when selected socio-demographic characteristics were analyzed. Norplant users recalled more information on this method than did IUD acceptors, and the content of what they remembered was different. This included concepts as important as risk of pregnancy, menstrual and health effects, and method of removal. The results suggest that the intrinsic qualities of the new method and the presence of a group of women motivated to use one with its general characteristics, are not sufficient conditions for its acceptance.

Contraception↗

Medical student attitudes to computer-assisted learning in anaesthesia.

Two methods of data entry for computer-assisted learning (CAL) programs were assessed and the acceptability of two forms of CAL to 100 medical students determined. Sixty-two per cent preferred keyboard entry of data compared with 26% who preferred the light-pen. There was not preference for dynamic simulation programs over patient management programs. The majority of the students preferred using CAL in groups with a supervisor to provide further explanation when required. Ninety-three per cent of students favoured more teaching using this method.

Anesthesiology↗

Adolescent contraception. Review and recommendations.

In the light of the increase in teenage sexual activity over the past decade, the authors review current social, psychological, and educational attitudes. Together with a summary of the legal ramifications, they provide recommendations for treatment of this patient group.

Adolescent↗

Building institutional and faculty capacity in higher education gerontology academic programs.

Directors of California State University (CSU) gerontology, geriatrics, and aging studies (GGA) academic programs were surveyed regarding CSU capacity to fulfill demographic and legislative mandates to prepare professional personnel for work with the state's aging population. Program directors affirmed the importance of providing GGA education and training to meet these needs which will require GGA program growth in core and breadth courses, students, faculty, and scope. National guidelines for GGA program development and possible future accreditation and licensure were noted. The CSU currently does not support such growth. The number of GGA programs remained at 1997 levels and unevenly distributed across the state. Faculty time assigned to GGA was less than half of that presently required. Program directors rated GGAprogram and curriculum strength as modest, and CSU fiscal and administrative support as low. Program directors strongly supported faculty development innovations to prepare more present and future GGA faculty for building the capacity of higher education GGA programs.

Aged↗

Problems and help seeking in high-risk adolescent patients of health clinics.

In this study, 2787 adolescents between the ages of 13 and 18 years living in inner-city communities were interviewed about their mental and physical health and their clinic use. The patients used consolidated mental and physical health clinics located in neighborhoods, hospitals, or schools; or traditional neighborhood or hospital health clinics. Analyses of selected patient problems reveal that less than one third of adolescent patients with suicide ideation, conduct disorder, and substance abuse or dependency sought or received care for those problems. Only half of the adolescents with major depression sought or received care for depression, and only two thirds of the sexually active females sought or received help with birth control. A special effort needs to be made to attract troubled youth to clinics and to identify and treat their problems, particularly when those problems involve mental health concerns.

Adolescent↗

Dynamic training versus relaxation training as home exercise for patients with inflammatory rheumatic diseases. A randomized controlled study.

The aim of the study was to evaluate the effects of a dynamic training program versus a muscle relaxation training program as home exercise in patients with inflammatory rheumatic diseases. Fifty-four patients (mean age 54 years, mean symptom duration 14 years) were randomized to one of the two programs. After personal instructions every patient exercised at home for half an hour, 5 days a week during 3 months. Before and after the interventions, all patients were assessed for health-related quality of life, joint tenderness and physical capacities. The dynamic training group had improved in perceived exertion at the walking test (p < or = 0.05), while the relaxation training group had improved their total Nottingham Health Profile (p < or = 0.01), its subscale for lack of energy (p < or = 0.05), Ritchie's articular index (p < or = 0.05), muscle function of the lower extremities (p < or = 0.01), and arm endurance (p < or = 0.01). Regarding changes in muscle function of the lower extremities during the intervention period, there was a significant difference (p < or = 0.05) between the groups in favour of the relaxation training group. The results of the study thus indicated that progressive muscle relaxation training might improve health related quality of life, reduce joint tenderness and be superior to dynamic muscle training in improving the muscle function of the lower extremities in patients with inflammatory rheumatic diseases. The clinical effects were small and the results have to be interpreted with caution.

Aged↗

Modern health services and health care behavior: a survey in Kathmandu, Nepal.

The most important problem regarding health service utilization in Third World countries is that established indigenous forms of health care are readily available and compete with modern health care. Thus, in addition to understanding the components of the decision to seek medical help, we must understand the conditions that affect the choice of a specific health care system. This study examines the impact of medical pluralism on the use of modern forms of health care in Nepal. The findings show that the presence of medical pluralism is a significant factor which delays use of modern health services. Policy implications are discussed, and the need for more research in this area is stressed.

Attitude to Health↗

Is Medicaid pronatalist? The effect of eligibility expansions on abortions and births.

CONTEXT: Income thresholds for Medicaid eligibility for pregnant women were raised in two phases between 1987 and 1991. During roughly the same period, the U.S. fertility rate rose and the abortion rate declined; changes were particularly marked among young women, raising the possibility that fertility increases were related to Medicaid expansions. METHODS: Pooled time-series cross-section regressions were used to examine the effects of the Medicaid eligibility expansions in 15 states on rates of abortions and births among unmarried women aged 19-27 with 12 or fewer years of schooling. Abortion data came from the National Center for Health Statistics or state health departments and were aggregated by women's age, race, marital status and schooling; data on births were from national natality tapes. RESULTS: The Medicaid expansions were associated with a 5% increase in the birthrate among white women, but did not influence the rate among black women. Overall, no effect on the abortion rate was evident, but in analyses restricted to a subsample of eight states with the most complete abortion data, the rate among white women showed a significant decline after the second phase of expansions. CONCLUSIONS: Subsidized health care for low-income pregnant women in these 15 states may have encouraged white women to have more children than they would have without coverage.

Abortion, Legal↗

Microarray analysis of trophoblast differentiation: gene expression reprogramming in key gene function categories.

Placental development results from a highly dynamic differentiation program. We used DNA microarray analysis to characterize the process by which human cytotrophoblast cells differentiate into syncytiotrophoblast cells in a purified cell culture system. Of 6,918 genes analyzed, 141 genes were induced and 256 were downregulated by more than 2-fold. Dynamically regulated genes were divided by the K-means algorithm into 9 kinetic pattern groups, then by biologic classification into 6 overall functional categories: cell and tissue structural dynamics, cell cycle and apoptosis, intercellular communication, metabolism, regulation of gene expression, and expressed sequence tag (EST) and function unknown. Gene expression changes within key functional categories were tightly coupled to morphological changes. In several key gene function categories, such as cell and tissue structure, many gene members of the category were strongly activated while others were strongly repressed. These findings suggest that differentiation is augmented by "categorical reprogramming" in which the function of induced genes is enhanced by preventing the further synthesis of categorically related gene products.

Cell Differentiation↗

Tendon excursions after flexor tendon repair in zone. II: Results with a new controlled-motion program.

Metal markers were used to study flexor digitorum profundus tendon excursions during early controlled motion with a new program combining dynamic traction and passive flexion to all four digits. The mean excursion was 2.3 mm along the middle phalanx and 11.7 mm along the proximal phalanx. This was more than twice the mean size of excursions previously achieved with a modified traditional Kleinert traction program. The mean excursion per 10 degrees of combined distal and proximal interphalangeal controlled joint motion amounted to 73% of the corresponding excursion recorded during active motion. Taken together with the findings of our previous study on tendon excursions, the results also indicate that the magnitude of excursions induced by both the distal and the proximal interphalangeal joints during controlled motion has a significant effect on adhesion formation and clinical results. However, in the region of 6 to 9 mm there appears to be a threshold beyond which the effect of a further increase in excursions becomes insignificant.

Adolescent↗

Satisfaction with health care. A predictor of adolescents' appointment keeping.

Adolescents are assuming greater responsibility for their own health care, yet have a high rate of broken appointments. The importance of satisfaction with their health care in determining appointment compliance has been demonstrated for adult patients. The purpose of the present study was to explore patient satisfaction among teenagers and its relationship to appointment keeping. A short, reliable instrument was developed to assess adolescent patients' satisfaction with their clinic care. The patient's satisfaction was highly correlated with subsequent compliance in coming for appointments. Satisfaction, hence, appointment keeping, was higher in females, older adolescents, those making their own initial clinic appointment, those with a positive body image, and those scoring high on a test of personal freedom.

Adolescent↗

Project Redirection: evaluation of a comprehensive program for disadvantaged teenage mothers.

An evaluation of Project Redirection, a two-year demonstration program designed to help pregnant teenagers and teenage mothers, shows that teenagers from a comparison group, who were not enrolled in the demonstration program, were significantly more likely than project participants to experience a repeat pregnancy after one year, but that after two years the difference was small and nonsignificant. Likewise, at 12 months into the program, the project participants proved more likely to be using contraceptives, but by 24 months the comparison group had caught up. After one year of participation, the project teenagers were more likely than the others either to be in school or to have graduated (56 and 49 percent, respectively). However, this differential also disappeared by 24 months. Nonetheless, even at that point, project teenagers who had dropped out prior to joining the program and those who had had a repeat pregnancy were more likely to be in school or to have completed school than were similar comparison teens. Project teenagers also were somewhat more likely to have held a job during the two-year period than were teenagers not enrolled in the program. All in all, the evaluation demonstrated that teenagers who participated in the project and remained in it for more than a year had consistently better outcomes in education, employment and repeat pregnancy than any other group had. Comparison teenagers who had never participated in any special program for pregnant teenagers, on the other hand, demonstrated consistently poorer outcomes than any other group.

Adolescent↗