The geometry of triple-balloon dilation

Triple-balloon dilation (TBD) of a variety of luminal structures has been successfully, though infrequently, used. A mathematical model is presented for the selection of balloon sizes, and equations and tables are derived that allow the user to estimate more accurately the size of balloons needed for TBD of structures with large lumina. With TBD, an approximately circular lumen can be formed. Also, TBD allows smaller, higher-pressure balloons to be used instead of single, low-pressure, large balloons. However, multiple puncture sites may be required for TBD.     

The effect of substantia nigra stimulation and morphine on α-motoneurones and the tail-flick response

Rats were used to study the effect of unilateral stimulation of the substantia nigra on the reflex discharge of α-motoneurones and on the reaction time of the tail-flick response. In preparations with prenigral decerebration, nigral stimulation facilitated monosynaptic α-reflex activity ehilst γ-reflex activity remained unchanged. The facilitation of monosynaptic α-reflex activity was reduced by naloxone (1 mg/kg); morphine (2 mg/kg) did not change the number of α-reflex discharges, but it reduced the α-reflex latency, enhanced the effect of nigral stimulation on the latency and abolished the effect of naloxone on nigral facilatation. Nigral stimulation prolonged the reaction time of the tail-flick response in rats with an intact brain and after prenigral decerebration. Naloxone did not influence the anti-nociceptive effect of nigral stimulation, whilst morphine enhanced it in rats with an intact brain. The anti-nociceptive effect exerted by morphine in animals with an intact brain was abolished by prenigral decerebration, and an additional spinalization restored it. Inactivating the nigral neurones by unilateral microinjections of procaine or GABA into the substantia nigra depressed the nociceptive reflex. It is concluded that (1) activation of nigral neurones influenced mono- and polysynaptic reflexes in a reciprocal fashion by a pathway descending via brain stem relays to the spinal cord, (2) inactivation of nigral neurones produced similar changes in reflex activity by altering the function of the nigro-striatal feedback system, the outlet from the system to the spinal cord not being the substantia nigra, (3) morphine influenced the nociceptive reflex by an action at different levels of the central nervous system.     

The detection of pollutant impact in marine environments: Condition index, oxidative DNA damage, and their associations with metal bioaccumulation in the Sydney rock oyster Saccostrea commercialis

Specimens of the Sydney rock oyster Saccostrea commercialis were deployed for a 3-month period at control and sewage disturbed marine locations in the Hunter Region, New South Wales, Australia. The DNA damage product, 8-hydroxyguanine, was measured by GC/MS-SIM from chromatin extracts of the gill tissues of oysters to assess oxidative damage. The levels ranged from 11.5 to 18.8 modified bases per 10⁷ guanine bases. Although the condition indices were significantly different between the Redhead control site (178.3±3.6) and the Burwood sewage disturbed location (140.4±4.4), no significant differences in 8-hydroxyguanine concentrations were detected between the sites, and the concentration of 8-hydroxyguanine was not correlated to condition index. However, levels of the DNA base modification were correlated with the concentrations of bioaccumulated lead (r=0.84, P=0.036). This association provides in vivo evidence that the bioaccumulation of lead results in oxidative damage to DNA. An additional control and sewage disturbed site were included to investigate the relationship between heavy metal bioaccumulation and the condition index of deployed oysters. After the 3-month deployment period, the condition index was negatively correlated to concentrations of bioaccumulated mercury (r=–0.80, P<0.001), cobalt (r=–0.65, P<0.01), and nickel (r=–0.69, P<0.01), suggesting a strong negative influence of these metals at relatively low concentrations on the physiological condition of the oysters.     

A feedback model for applied research on tobacco control

Although the health communication program feedback cycle is frequently referenced, the steps for moving between or within the sections of the model in a public health environment are rarely described. We detail the process by which the Texas Tobacco Research Consortium implemented the stage of "assessing effectiveness and making refinement" and expanded it to include a program assessment feedback model.

Tools were developed to move the consortium through five stages of the expanded program assessment feedback model: 1) formulate research questions using logic models to identify key evaluation items, 2) format data displays from multiple data sources to address research questions, 3) use a facilitated group process to present and review research findings, 4) prepare group recommendations, and 5) involve local partners to translate recommendations into practice.

The process allowed us to sift through a large volume of information and prepare data-based program recommendations. A Web-based reporting system provided timely access to community-based program activity data and process indicators that, when linked to logic models, provided actionable items for program improvement. Partnerships among researchers and state and local practitioners created the conditions for implementing the recommendations.

Program changes included revisions to program materials, target audiences, and evaluation instruments for a community-based tobacco-cessation campaign. The systematic approach allowed translation of research into practice and should be applicable to other areas of population-based health promotion.

     

Training community health workers to reduce health disparities in Alabama's Black Belt: the Pine Apple Heart Disease and Stroke Project

African American women have significantly higher mortality rates from heart disease and stroke than White women despite advances in treatment and the management of risk factors. Community health workers (CHWs) serve important roles in culturally relevant programs to prevent disease and promote health. This article describes the Pine Apple Heart and Stroke Project's activities to (1) revise the Women's Wellness Sourcebook Module III: Heart and Stroke to be consistent with national guidelines on heart disease and stroke and to meet the needs of African American women living in rural southern communities; (2) train CHWs using the revised curriculum; and (3) evaluate the training program. Revisions of the curriculum were based on recommendations by an expert advisory panel, the staff of a rural health clinic, and feedback from CHWs during training. Questionnaires after training revealed positive changes in CHWs' knowledge, attitudes, self-efficacy, and self-reported risk reduction behaviors related to heart disease, stroke, cancer, and patient-provider communication. This study provides a CHW training curriculum that may be useful to others in establishing heart disease and stroke programs in rural underserved communities.