Two new species of Acanthobothrium Beneden, 1849 (Tetraphyllidea: Onchobothriidae) from horn sharks in the Gulf of California, Mexico.

Between 1993 and 1996, 26 individuals of two species of horn sharks were collected from the upper Gulf of California and their spiral intestines examined for onchobothriid tapeworms. Heterodontus francisci was found to host Acanthobothrium puertecitense n. sp. Based on the criteria of Ghoshroy & Caira (2001), this is a Category 4 species (with >15 mm total length, >50 proglottids, >80 testes and a symmetrical ovary). It differs from the four Category 4 species previously reported from either the western Atlantic or eastern Pacific Oceans, including A. bajaense (emend.) which was described from H. francisci, in hook-shape, total length, number of proglottids, number of testes and number of columns of vitelline follicles. H. mexicanus was found to host Acanthobothrium santarosaliense n. sp., which, based on the criteria of Ghoshroy & Caira (2001) is a Category 3 species (with >15 mm total length, >50 proglottids, >80 testes and an asymmetrical ovary). A. santarosaliense differs from the five Category 3 species previously reported from either the western Atlantic or eastern Pacific Oceans in its size, euapolytic nature, lack of dark matrix from the bases of the hooks, hook-shape, and distribution and number of testes. In addition to the difference in ovarian symmetry, A. puertecitense possesses fewer testes, fewer proglottids, is a shorter worm, possesses a more anterior genital pore and vitelline follicles which extend further forward anteriorly than in A. santarosaliense. This represents the first report of onchobothriids from H. mexicanus and the first report of onchobothriids from H. francisci in the Gulf of California. The apparent host-specificity of both new species should be viewed with caution until a greater sample of host individuals of both species can be examined. The fact that both new tapeworm species are known only from the Gulf is also considered to be a preliminary result, given the small sample of host individuals examined from these regions to date. This brings the total number of species of Heterodontus known to host Acanthobothrium to four and the total number of Acanthobothrium species described from heterodontiform sharks to five.

Memoranda of understanding between Medicaid MCOs and public health departments.

PURPOSE: This evaluation research project was conducted to describe local perspectives on creating and implementing mandated memoranda of understanding (MOU) between Medicaid managed care organizations and local health departments (LHD), to provide insights into the strengths and limitations of MOU, and to share information on their use as tools for interorganizational service coordination. DESIGN AND METHODOLOGY: A cross-sectional, qualitative and quantitative, self-administered, mailback survey was conducted with employees of MCOs and LHDs in California having experience in creating and/or implementing state-mandated MOU in nine service areas. Descriptive and qualitative results are reported. PRINCIPAL FINDINGS: The creation of MOU was facilitated by supportive leadership, previous collaborative experience, and the state mandate. The majority of respondents believed the MOU worked well to achieve coordination of services. MOU strengths and limitations were identified. The MOU were reported to have contributed to an increase in participation in four of six types of collaborative activities. Perceived quality of health care services for Medicaid participants improved with the MOU, but no impact on quality of public health services was reported. A majority (78 percent) supported a continuation of the mandated policy. Some organizations reported expanding the use of MOU beyond mandated areas. CONCLUSIONS: Study respondents held generally positive perceptions of the strengths of MOU and supported continuation of the mandated MOU policy in California. Their experience demonstrates a capacity for MCOs and LHDs to work together on health care coordination issues despite the difficulties inherent in interorganizational collaboration.

Ethics content in community health nursing textbooks.

Nurses learn ethics content and ethical decision-making strategies through textbooks, basic curricula, continuing education, and professional experience. The author describes an ethics content analysis of community health nursing textbooks, offers suggestions for the improvement of ethics content for textbooks, and raises awareness of the need for more emphasis on public health ethics in nursing and public health professional education.

Public health nursing and immunization surveillance.

Public health nurses (PHNs) play critical roles in public health surveillance systems in the United States. Increased understanding of public health surveillance systems can help PHNs appreciate their role in surveillance and improve the quality and usefulness of surveillance data. This paper describes the National Immunization Survey, the public health surveillance system currently in place for tracking immunizations, as well as immunization registries and HEDIS performance indicators, two emerging approaches to immunization surveillance. The contributions of public health nursing to these systems and implications for public health nursing practice are discussed. High quality public health surveillance information is essential for monitoring the progress of disease trends and program effectiveness. PHNs can help assure the quality of surveillance data.

[Acute vestibular syndrome in cerebellar infarct of the posterior inferior cerebellar artery (PICA infarct)]. / Akutes vestibuläres Syndrom beim Kleinhirninfarkt der Arteria cerebellaris posterior inferior (PICA-Infarkt).

The differential diagnosis of an acute peripheral vestibulopathy ("vestibular neuritis") and of an ischemic lesion in the cerebellar territory of the posterior-inferior cerebellar artery (PICA) is important. Both present with acute vertigo, vomiting, spontaneous nystagmus and difficulties in walking. We analyze the clinical, oculographic and NMR findings as well as the outcome in 10 patients with an ischemic stroke in the cerebellar territory of the PICA. On clinical grounds alone, it is not always possible to attribute the acute vestibular syndrome to a peripheral vestibular lesion or to a PICA insult. In our experience an important feature of a PICA insult is a discrepancy between the amount of vertigo, the severity of the walking difficulties, and the often weak and rapidly resolving spontaneous nystagmus. In contrast to a peripheral vestibulopathy, the vestibuloocular reflex is only minimally or not decreased in PICA insults, and gain asymmetries are accounted for by the presence of spontaneous nystagmus. However, only neuroimaging can finally differentiate between the two entities.

Evaluation of public health nursing home visits to pregnant women on WIC.

Selected pregnant women participating in the Special Supplemental Food Program for Women, Infants and Children (WIC) were receiving public health nursing (PHN) home visiting services. The purposes of this study were to describe PHN services provided to pregnant women on WIC; and to compare birth outcomes and prenatal care (PNC) utilization between two groups, women with WIC services only and women with WIC plus PHN services. In this retrospective cross-sectional study, the sample consisted of all women on WIC (N = 398) at the Madison Department of Health who delivered singleton births during 1991, divided into the WIC-only group (n = 301) and the WIC + PHN group (n = 97). Three instruments were used for data collection: birth certificates, the WIC record, and the antepartal nursing record. Data were described; differences between groups were tested. Primary PHN activities included: assessment of physical and behavioral indicators, parenting skills, and support systems; teaching about nutrition, use of drugs, danger signs, labor signs, and stress management; and referrals to a variety of community resources. No difference in adequacy of PNC or in birth outcomes was found between the two groups. Findings have been used to plan the agency's future PNC coordination services.

Normal development of cardiac beta adrenoceptors in mice exposed to ethanol in utero.

Abnormalities of cardiac physiology and anatomy may occur in children with the fetal alcohol syndrome. To understand the basis of these abnormalities, research has been performed which shows that in mice exposed to ethanol from gestation day 8 to birth via a liquid diet regime with pairfed controls there are ultrastructural changes in the cardiac myocytes. To determine if the exposure to ethanol also affects the development of the cardiac noradrenergic system, which in turn could cause developmental abnormalities, beta adrenoreceptor binding was characterized by Scatchard analyses of concentration dependent binding curves in newborn mice exposed to ethanol in utero. Although body and heart weight were lower in newborns from both the pairfed and ethanol groups compared to a normally fed group, no differences in the densities of the beta adrenoceptors or in the Kd values for binding were seen due to the ethanol or the liquid diet regime. Therefore, at least one component of the development of the cardiac sympathetic system was not altered by ethanol exposure or a reduced caloric intake.

Regulation of ODC activity in the thymus and liver of rats by adrenal hormones.

The activity of L-ornithine decarboxylase (EC 4.1.1.17, ODC) has become a useful indicator of hormone responsiveness. Various regimens of dexamethasone, aldosterone and epinephrine, alone or in combination, were administered to adrenalectomized rats either in acute or chronic doses. In addition, adrenalectomized rats, which were chronically treated with aldosterone and epinephrine, were given a single injection of 50 micrograms dexamethasone and sacrificed at various time intervals after hormone treatment. Hepatic and thymic ODC activity was measured. The expected dexamethasone effect, an increase in hepatic and a decrease in thymic ODC, was observed. This study also revealed that aldosterone induced similar responses in these tissues. Epinephrine had the opposite effect since chronic administration of dexamethasone or aldosterone with epinephrine resulted in control levels of ODC. Furthermore, when aldosterone and epinephrine were chronically administered to adrenalectomized rats, to study the acute effects of dexamethasone on rat thymus and liver, the time course of the response in each tissue was found to be distinct. The influence of the adrenal gland on rat thymus and liver is not restricted only to glucocorticoids, but may also involve other hormones which it secretes.