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Chemokines induced by infection of mononuclear phagocytes with mycobacteria and present in lung alveoli during active pulmonary tuberculosis.

The capacity of Mycobacterium tuberculosis (MTB) to induce production of chemokines with known chemotactic activity for monocytes and lymphocytes, the cellular building blocks of granulomas, was investigated. These chemokines included regulated upon activation, normal T cell expressed and secreted (RANTES), monocyte chemotactic protein-1 (MCP-1), and macrophage inflammatory protein-1alpha (MIP-1alpha). MTB stimulated production of MCP-1 and MIP-1alpha by blood monocytes (MN) and alveolar macrophages (AM). MTB infection of MN and AM stimulated release but not production of RANTES. AM produced or released significantly higher levels than MN of RANTES (by 2.1-fold), MCP-1 (by 6.9-fold), and MIP-1alpha (by 5. 5-fold) (P < 0.05 for each). This study also confirmed that MTB-infected AM produce the chemokine interleukin (IL)-8. MTB infection of AM resulted in increased steady-state expression of messenger RNA (mRNA) for MCP-1 and MIP-1alpha and minimal increased expression of RANTES mRNA. Both an avirulent (H37Ra) and a virulent (H37Rv) strain of MTB and purified protein derivative of H37Rv but not latex beads induced production of chemokines. Supernatants of MTB-infected cells demonstrated chemotactic activity for both monocytes and lymphocytes partially inhibitable by neutralizing antibodies against the chemokines studied. Bronchoalveolar lavage fluid from patients with active pulmonary tuberculosis as compared with healthy control subjects contained increased levels of RANTES (by 8-fold), MCP-1 (by 2.7-fold), and IL-8 (by 8.9-fold) (P < 0.05), but not MIP-1alpha, as compared with healthy control subjects. Thus, multiple chemokines may be involved in recruitment of cells for granuloma formation in tuberculosis.

Adult↗

Understanding expanded school mental health services in Baltimore City.

This article explores the nature of expanded school mental health (ESMH) services in Baltimore City, which at the time of the study were incorporated into 40% of the city's public schools. A provider survey was distributed to ESMH clinicians to gather information on the characteristics of service providers and recipients, types of services being provided, and their proposed outcomes. Provider reports indicated an impressive service capacity, augmentation of traditional school-based services, and the continual need for increased mental health service hours in their buildings. In addition, the most frequently voiced benefits of the ESMH programs were increased mental health awareness and improved school climate. Implications of the findings for future programming development and research are discussed.

Adolescent↗

Social work and primary health care: an integrative approach.

An interinstitutional, interagency Consortium has been formed in Houston to develop an innovative service model and provide interdisciplinary primary care/mental health training. The Houston Consortium Program integrates mental health professionals and trainees into the primary care framework of a neighborhood center serving a low-income, predominatly Mexican-American population. The introduction of mental health, psychosocial, and cross-cultural perspectives to complement the long-standing physiological concerns of health professionals fosters an holistic approach to patient care. The social workers' full participation as members of primary care teams builds upon their traditional training to provide them the experience and skills required to function effectively in the expanded coordinative capacity of health/mental health manager as defined by the President's Commission on Mental Health. It is anticipated that Consortium Program can serve as a heuristic model in the development of a nationwide pattern of comprehensive care.

Community Health Centers↗

Bioterrorism: What? Why? and Who?

The former Secretary of the Department of Health and Human Services, Donna Shalala, indicated in an address in 1999 that complacency needs to be replaced with a sense of urgency in order for us to deal successfully with the threats of bioterrorism. The attack on September 11, 2001 and the anthrax threats have made our vulnerability clear. We are now living in a new and frightening world. Our complacency is gone. The victims and the survivors shall remain forever in our minds. Dr. Jeffery Koplan, Director, Centers for Disease Control and Prevention in his broadcast, Building Infrastruture to Protect the Public Health said we must look at preparedness in a new way. We need to: build a solid public health infrastructure with grant monies; rapidly address the problem of inadequately trained staff; and address the capacity of a laboratory to produce timely and accurate results for the diagnosis of agents in the investigation of outbreaks. We must take action to prepare the healthcare system to rapidly meet any challenge, overt or covert, that may emerge.

Bioterrorism↗

What is a global manager?

Riven by ideology, religion, and mistrust, the world seems more fragmented than at any time since, arguably, World War II. But however deep the political divisions, business operations continue to span the globe, and executives still have to figure out how to run them efficiently and well. In "What Is a Global Manager?" (first published in September-October 1992), business professors Christopher Bartlett and Sumantra Ghoshal lay out a model for a management structure that balances the local, regional, and global demands placed on companies operating across the world's many borders. In the volatile world of transnational corporations, there is no such thing as a "universal" global manager, the authors say. Rather, there are three groups of specialists: business managers, country managers, and functional managers. And there are the top executives at corporate headquarters who manage the complex interactions between the three--and can identify and develop the talented executives a successful transnational requires. This kind of organizational structure characterizes a transnational rather than an old-line multinational, international, or global company. Transnationals integrate assets, resources, and diverse people in operating units around the world. Through a flexible management process, in which business, country, and functional managers form a triad of different perspectives that balance one another, transnational companies can build three strategic capabilities: global-scale efficiency and competitiveness; national-level responsiveness and flexibility; and cross-market capacity to leverage learning on a worldwide basis. Through a close look at the successful careers of Leif Johansson of Electrolux, Howard Gottlieb of NEC, and Wahib Zaki of Procter & Gamble, the authors illustrate the skills that each managerial specialist requires.

Administrative Personnel↗

Material resources are not enough: good management is the key to effectiveness.

The effectiveness of a health intervention (i.e. the degree to which predetermined objectives are attained) can be viewed as its efficacy or capacity to produce results as modified by the quality of management. If management is poor the provision of additional materials, buildings and staff is unlikely to have a significant impact on effectiveness even though the efficacy may be increased.

Developing Countries↗

[Photopolymers as an immobilized matrix in biosensing].

Biosensors are perspective devices for analysis of substances in chemistry, biological chemistry, medicine, biotechnology and also for environment status monitoring. Their advantages are compact size, short time of analysis, display high response and simplicity in usage. The working characteristics of biosensors often depend on efficacy of a biological stuff immobilization on the surface of transducer. In this context there is a need for development of immobilization methods capable to provide for execution of the following demands: 1) compatibility of this process with technology of building transducer; 2) simplicity in fulfillment, cheapness and expressness at manufacture of biomembranes; 3) ability to provide the maximal safety of a biological stuff activity and its high adhesion to a surface of transducer; 4) reproducibility at serial application and capacity of standardizing. Usage of photocrosslinked and photopolymerized compound at the immobilization of a biological stuff allows to provide execution of the listed above demands. The present review is devoted to features of application of the given class of compound at building of biosensors.

Biosensing Techniques↗