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PubMed2000

Impaired Fas-independent apoptosis of T lymphocytes in patients with multiple sclerosis.

The homeostasis of the immune system is maintained by apoptotic (programmed cell death) elimination of potentially pathogenic, autoreactive mononuclear cells. There is emerging evidence that apoptosis mediated by the cell death receptor Fas is impaired in activated lymphocytes from patients with multiple sclerosis (MS), but other forms of apoptosis have not yet been fully evaluated. To further explore the dynamics of programmed cell death in MS, spontaneous and induced apoptosis of both peripheral and intrathecal mononuclear cells was investigated in clinically active MS patients and appropriate controls. In the MS group, spontaneous apoptosis of unfractionated mononuclear cells was significantly reduced, and activated intrathecal and peripheral T cells were found to be predominantly resistant to Fas-independent apoptosis. These results indicate that in clinically active MS, the reduced susceptibility of mononuclear cells to apoptosis is partly due to impairment of Fas-independent apoptotic pathways.

Adult↗
PubMedDate not supplied

Effective child welfare practice with immigrant and refugee children and their families.

This article presents a multistage migration framework to broaden the lens through which child welfare personnel can view immigrant and refugee families and their children. By better understanding the family's experiences in both emigration and immigration, including reasons for leaving their home country, experiences in transit, and reception and resettlement experiences in the United States, child welfare personnel are better equipped to assess their needs and provide effective prevention, protection, permanency, and family preservation services. Case examples illustrating the application of the framework and guidelines for program and practice are included.

Child↗
PubMed1992

Teenage conception and contraception in the English regions.

Nationally available data on teenage fertility, family planning care and mortality were analysed to determine the relationship between teenage conception, availability of abortion and family planning care, and an indicator of socioeconomic disadvantage--the Standardized Mortality Ratio (SMR). In the 14 regions of England the strongest correlate of teenage conception and of the proportion of teenage conceptions aborted was female all-causes SMR. High levels of provision of NHS abortion services and uptake of family planning clinic care did not significantly reduce teenage fertility. Provision of traditional family planning services obviously plays an important role in preventing teenage pregnancy, but innovation in this service coupled with a concerted effort to reduce social disadvantage might have a greater impact on teenage fertility in England.

Abortion, Induced↗
PubMedDate not supplied

Breastfeeding practices in Indonesia.

UNLABELLED: Breastfeeding promotion program was started by the paediatricians and others in 1977, and is becoming a strong activity since 1990 it was declared by the President of the Republic of Indonesia as a National Movement. One year later the First Lady stated the importance of every Indonesian mother to breast-feed her baby, and thereafter many hospitals created the so called "Baby Friendly Hospital". In this occasion we only limit with eminent topics, i.e., "Exclusive Breast-feeding" in Indonesia, and "Breastfeeding amongst Working Mothers." In fact, until now the percentage of mothers who breastfeed exclusively is very low. Although the ever breastfed babies in Indonesia is 97% (Kodyat, 1996) but the data of the "Exclusive Breastfeeding" of Indonesia is just like Pakistan and Thailand, i.e. nearly 2 months, whereas the Philippines and Ceylon showed a figure of 4 months, and India 5 months. The Home Health Survey (SKRT) data in 1992 showed that 63.7% of the babies were exclusively breast-fed until 3 months. Three quarter of the quality of the exclusive breastmilk is quite good, enough or excellent, whereas the other one quarter is poor and this should be interfered by increasing the quality of the breastmilk and/or adding other formula, to prevent the baby of getting "failure to thrive" (Suharyono, 1996). Working mothers use to do "Early Weaning Practices" with very high mixed feeding practices (Matulessy et al, 1996). Mothers have to go to work because they have to support their family income, but unfortunately most of them ignore their main task of care their children. IN CONCLUSION: the experience in Indonesia proves that a very hard work should still be continued on the effort of promoting breastfeeding, especially regarding the two issues, i.e. "Exclusive breastfeeding" (we do hope at least until 4 months) and the other issue is regarding the "Working Mothers".

Breast Feeding↗
PubMed2006

Combined functional task practice and dynamic high intensity resistance training promotes recovery of upper-extremity motor function in post-stroke hemiparesis: a case study.

BACKGROUND AND PURPOSE: Weakness is a significant impairment in persons with post-stroke hemiparesis, yet traditional clinical perspectives caution against strengthening in neurological populations. Significant correlations between weakness and functional movement have been demonstrated, however, a clear relationship between increased strength and functional improvement has been elusive. This case study describes a combined program of dynamic, high-intensity resistance training and functional task practice for the upper-extremity in adult hemiparesis. CASE DESCRIPTION: The patient was a 65-year-old, right hand dominant woman who presented to the Neural Control of Movement Laboratory at the Palo Alto VA Rehabilitation Research and Development Center 16 weeks following clipping of an unruptured aneurysm with consequent dense right hemiparesis. She received 7 weeks of acute rehabilitation according to CARF guidelines (ie, at least 3 hours of two or more disciplines, 6 days per week). Her baseline research evaluation revealed significant upperextremity deficits at the ICF body structure/function level including: weakness, shoulder pain, mild resistance to passive movement, and need for moderate to maximal assistance in many activities of daily living including bathing and dressing. The Stroke Impact Scale score reporting her perspective indicated she had recovered from her stroke only 50%. The hybrid resistance training-functional task practice intervention, detailed in this report, was delivered 3 times per week for 6 weeks with each session lasting 75:00. OUTCOMES: The subject revealed marked improvements in isometric and dynamic force production in 5 key upper-extremity actions: elbow flexion, elbow extension, shoulder flexion, shoulder abduction, and shoulder external rotation. Strength gains were accompanied by increased EMG activation immediately postintervention and by a combination of increased activation and apparent hypertrophic effects at 6 month follow up. Marked improvements were noted in all clinical and functional measures and in an elbow trajectorytracking task which served as a surrogate measure of motor control. DISCUSSION: Improvements in strength and positive outcome effects at the physiological, clinical, and functional levels were observed in this subject following the experimental hybrid upper-extremity rehabilitation intervention described. Importantly, no deleterious effects were observed including exacerbation of spasticity or musculoskeletal compromise. Observations of improved EMG activation in this case study suggest that improvements in motor activation underlie these strength gains and can likely be attributed to working at a high intensity level.

Activities of Daily Living↗
PubMed1992

Newborn screening: the miracle and the challenge.

Modern newborn screening programs are coordinated multi-disorder systems for prevention of infant death and disability, which include statewide infant screening, rapid retrieval, early intervention, and long-term follow-up. Screening programs are dynamic, with new tests being evaluated and added. Because nurses are actively involved in all phases of newborn screening, they must be knowledgeable about each disorder and changing screening requirements. This article reviews basic defects, genetics, incidence, symptoms, treatment, and specific newborn screening requirements for the eight disorders most widely incorporated into statewide newborn screening programs, and discusses practical nursing interventions.

Anemia, Sickle Cell↗
PubMedDate not supplied

The effectiveness of family planning clinics in serving adolescents.

Data from surveys conducted by The Alan Guttmacher Institute (AGI) in 1981 have been used to create three indicators of the effectiveness of family planning clinics in serving teenagers: the mean delay between first intercourse and first clinic visit (which for teenage clinic patients is 13.2 months); teenage patient retention (67 percent; and the average excess of patient satisfaction over dissatisfaction with clinic policies and services (33 percent). Clinics run by Planned Parenthood are more effective than other types of facility, according to the mean delay indicator, whereas other clinics, such as those associated with community action programs and neighborhood health centers, rank highest in levels of patient satisfaction and patient retention. All three measures indicate that clinics serving 1,000-2,499 family planning patients per year are more effective in serving teenagers than either smaller or larger clinics, and that nonmetropolitan clinics are more effective in providing services than those in cities. Regression analysis shows that clinic administrators might take a number of actions to shorten the mean delay among teenagers between first intercourse and first clinic visit. These include offering community education programs for teenagers, enlisting the support of local churches, developing relationships with local youth groups, opening the clinic during evenings and weekends, accepting more teenagers as walk-in patients and locating a clinic in or near neighborhoods where many teenagers live. Two of the same factors--developing an active relationship with youth groups and opening the clinic to teenagers on evenings and weekends--were also found to be particularly effective in keeping teenagers as clinic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Effects of exercise training on aerobic fitness in children after open heart surgery.

Graded treadmill tests to maximal exercise were given to 24 children 1 year or more after open-heart surgery and to 26 age- and sex-matched controls, before and after 9 weeks of exercise training to test whether or not they could increase their aerobic fitness levels. The corrected cardiac lesions included tetralogy of Fallot, aortic stenosis, transposition of the great arteries and atrioventricular canal (AVC). Maximal exercise variables measured were heart rate (HR), oxygen consumption (VO2), and workload (stage of exercise and time on treadmill). The results of the pretraining tests indicated that the fitness levels of the 24 patients were significantly less than those of the controls. Of the original groups, 9 controls and 12 patients satisfactorily completed the training (jogging) program. The results of the post-training tests indicated that both the patients and controls significantly improved their fitness levels. Specifically, most subjects improved their maximal workload with little or no increase in maximal HR or VO2. In conclusion, children after open-heart surgery for complex congenital heart disease can further improve their work capacity by a dynamic exercise program. After training, they are able to do more work at a given VO2.

Adolescent↗
PubMed1984

Who attends family planning clinics?

Data were obtained from 1,810 consecutive women who attended a central metropolitan (Brisbane) Family Planning Clinic during a 5 week period in 1982. Young women in particular formed the major client group with 32% being under 20 years of age. The client population was skewed towards women of upper socioeconomic status (SES). There was no SES disproportion in the use of oral contraceptives or IUD's. However, diaphragm use occurred disproportionately in women of upper SES groups; postcoital contraception was sought by and limited to, women of SES classes A and B only. The clinic satisfied a need for women with a history of failed or absent contraception and 15% had already had a termination of pregnancy by the time they first presented at the clinic.

Abortion, Induced↗