Revegetation of an abandoned uranium millsite on the Colorado Plateau, Arizona.

We attempted to restore native plants on disturbed sites at a former uranium mill on the Colorado Plateau near Tuba City, AZ. Four-wing saltbush [Atriplex canescens (Pursh) Nutt.] was successfully established in compacted caliche soil and in unconsolidated dune soil when transplants were irrigated through the first summer with 20 L/plant/wk. The caliche soil was ripped before planting to improve water-holding capacity. The diploid saltbush variety, angustifolia, had higher survival and growth than the common tetraploid variety, occidentalis, especially on dune soil. The angustifolia variety grew to 0.3 to 0.4 m3 per plant over 3 yr even though irrigation was provided only during the establishment year. By contrast, direct seeding of a variety of native forbs, grasses, and shrubs yielded poor results, despite supplemental irrigation throughout the first summer. In this arid environment (precipitation = 100 to 200 mm/yr), the most effective revegetation strategy is to establish keystone native shrubs, such as four-wing saltbush, using transplants and irrigation during the establishment year, rather than attempting to establish a diverse plant community all at once.

A survey of asthma care in managed care organizations: results from the Chicago Asthma Surveillance Initiative.

INTRODUCTION: Managed care, both via staff model health maintenance plans and nonstaff model plans, has become a major source of health-care funding in the United States. However, very little is known about the asthma-specific products and services offered by these plans. The purpose of this study is to examine the asthma-specific products and services offered by managed care within the Chicago area. METHODS: Between December 1997 and February 1998, a self-administered survey was mailed to the medical directors of the 19 managed care organizations (MCOs) in the Chicago area. The survey covered the following content areas: general characteristics of the MCOs, asthma-related services, monitoring of asthma care, and asthma-related quality improvement efforts. The medical directors were asked to respond separately for staff model capitated plans, nonstaff model capitated plans, and noncapitated plans. RESULTS: Responses were received from 13 of the 19 eligible Chicago-area MCOs (a response rate of 68.4%). Three of the responding MCOs (23.1%) offered a staff model plan, 11 (84.6%) offered a nonstaff model capitated plan, and 6 offered some type of noncapitated plan. Asthma education programs, although available in all plan types, were offered much less frequently in the nonstaff model capitated and noncapitated plans, 36.4% and 33.3%, respectively. Asthma case management programs were also available in some, but not all of the health plans. Only 54.5% of the nonstaff model capitated health plans promoted the use of asthma practice guidelines. Among the responding MCOs, asthma quality improvement efforts related to National Committee on Quality Assurance accreditation were infrequent in 1995. Sixty-one percent of the MCOs reported that program development for improving asthma care was a very high priority relative to programs for other health conditions. CONCLUSION: The results of this study suggest that many, but not all, of the basic elements of asthma care services are offered by the MCOs in the Chicago area. Findings from this study also suggest ways in which asthma-related product and service delivery might be changed to improve outcomes for asthma in this community.

Prevalence and burden of illness for asthma and related symptoms among kindergartners in Chicago public schools.

BACKGROUND: Asthma mortality rates in poor communities of Chicago are among the highest in the country. Possible explanations include increased asthma prevalence, increased severity, and suboptimal health care. OBJECTIVE: To estimate the prevalence of asthma and asthma-related symptoms among inner-city kindergarten children, and to characterize their burden of illness, asthma-related health care access, and pharmacologic treatment. METHODS: Cross-sectional survey of parents of kindergartners was conducted in 11 randomly selected Chicago elementary schools. A self-administered 16-item questionnaire was given to parents of kindergartners. Parents who reported doctor-diagnosed asthma or at least one of several key asthma-related symptoms were then interviewed with a supplemental questionnaire examining asthma-related health care and medication use. RESULTS: Based on data from 638 children [mean age 5.7 (SD = 0.6) years], the prevalence of diagnosed asthma was 10.8%. Sixteen percent of the respondents reported that their child had wheezed in the past year. The prevalence of asthma-related symptoms unassociated with a diagnosis of asthma was 30.1%. The children with diagnosed asthma had evidence of a high burden of illness: over 40% were reported to have had sleep disturbance due to wheezing > or =1 to 2 nights/week and 86.6% reported acute care visits for respiratory symptoms in the past year. Self-reported access to medical care was high. Over 40% of the children with doctor diagnosed asthma were reported to have used a beta2-agonist in the preceding 2 weeks, and 12.2% used an inhaled anti-inflammatory. CONCLUSIONS: These data suggest that asthma prevalence in school-aged children in inner-city communities may be higher than US estimates. The burden of illness experienced by these children is substantial. Also, a large proportion of children were reported to have respiratory symptoms consistent with asthma, and no asthma diagnosis, suggesting possible undiagnosed asthma. While measures of health care access appear to indicate that the majority of children with asthma experience no identified barriers to health care, there is evidence to suggest undertreatment.

Examination of the neuroendocrine basis for the social conflict-induced enhancement of immunity in mice.

Intruder DBA/2 and C57BL/6 mice, which display different neuroendocrine responses to social conflict, evidence a pronounced increase in splenocyte phagocytosis of opsonized zymosan particles as a consequence of social conflict-induced stress. Interruption of the hypothalamic-pituitary-adrenal axis prior to social conflict results in an abrogation of the stress-induced enhancement of phagocytosis in DBA/2, but not in C57BL/6, mice. Administration of the opiate antagonists naloxone and naltrexone resulted in a potentiation of the stress-induced enhancement of phagocytosis in both strains. Similarly, administration of the alkylating antagonist beta-chlornaltrexamine which irreversibly blocks opioid binding sites potentiated the immune-enhancing effects of social conflict stress. Mitogen-induced T and B lymphocyte proliferation was unaffected by any of the experimental procedures with the exception of beta-chlornaltrexamine which suppressed activity equally in stressed and nonstressed groups. These results demonstrate the necessity of employing inbred murine strains in the dissection of the neuroendocrine pathways which govern stress-induced modulation of the immune system.

Innate and adaptive immune responses in a social conflict paradigm.

Social conflict stress was examined for its effects on in vitro and in vivo immunity in mice. Adaptive immunity, as measured by the generation of primary IgM antibody responses to the T-dependent antigen keyhold limpet hemocyanin, was suppressed following chronic (greater than 1 day), but not acute (less than 1 day), stress periods while the IgM response to the T-independent antigen polyvinylpyrrolidone was not affected. In vitro proliferative responses of splenocytes to the T cell mitogen concanavalin A and the B cell mitogen lipopolysaccharide were unaffected. Acute (less than 1 day) stress dramatically increased innate immunity as measured by a luminol-dependent chemiluminescence assay of phagocytic cell function. DBA/2J mice averaged a 269% increase in phagocytosis as compared to a 412% increase in C57BL/6J. This differential effect of stress on immune responsiveness indicates that alterations in innate immunity in addition to adaptive immunity should also be considered when evaluating neuroendocrine and immune interactions in response to stress.

Distal sensory latencies of the ulnar nerve in long distance bicyclists: pilot study*.

* This article is adapted from a paper written in partial fulfillment of the requirement for the Master of Science Degree, Duke University, Durham, NC 27710. Ulnar neuropathy, an overuse compression syndrome injury of the ulnar nerve at the wrist, is frequently associated with bicycling. Previous studies have shown that after severe compression injury to the ulnar nerve there is a change in nerve conduction velocity. The purpose of this study was to determine if long distance bicyclists have altered nerve conduction velocities due to repeated sustained compression of the ulnar nerve. This study compares the distal sensory latency period of the ulnar nerve in 15 controls and 10 long distance cyclists. The controls bicycled less than 10 miles per week on the average and the long distance cyclists bicycled an average of more than 100 miles per week. Results showed that there was a statistically significant difference (p < 0.002) in distal sensory latencies between long distance cyclists and the control group. However, there was no significant correlation (p > 0.10) between distance bicycled and latency. Results of this study lead to the belief that there may be adaptive changes in long distance cyclists which could account for changes in sensory nerve conduction velocity of the ulnar nerve.J Orthop Sports Phys Ther 1988;9(11):370-374.

Effects of Stabilizing the Nontested Lower Extremity during lsokinetic Evaluation of the Quadriceps and Hamstrings*.

The purpose of this investigation was to determine if stabilization of the nontested lower extremity influences the peak torque generated by the knee musculature of the opposite extremity during isokinetic testing. The subjects included 15 males and 15 females, between 18 to 30 years of age, who had no history of right knee pain or pathology. A Cybex I isokinetic dynamometer was used to measure the torques generated by the quadriceps and hamstring muscles of the right lower extremity during flexion and extension. Each subject performed two trials of extension and flexion of the right knee; each trial consisted of one set of three contractions at 60 degrees /sec and one set at 180 degrees /sec. One trial was performed with the left lower extremity stabilized and the second trial was performed without stabilization. The results demonstrate that the peak torques generated by the quadriceps and hamstrings of the tested extremity are not significantly influenced by stabilization of the opposite lower extremity at the speeds tested.J Orthop Sports Phys Ther 1984;6(1):18-20.

Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident.

This study establishes intratester reliability for all components of physical performance and intertester reliability for the total scores of upper and lower extremity motor performance in a cumulative numerical scoring system devised by Fugl-Meyer et al. Intertester reliability was found to be high for the total scores of upper and lower extremity motor performance. All intratester and intertester reliability coefficients were high and statistically significant. Establishing the reliability of the Fugl-Meyer method of assessing recovery of function following cerebrovascular accident has increased the usefulness of this method for clinical assessment and as a tool for the comparative analysis of the effectiveness of various therapeutic interventions.

Selectivity in synaptic changes caudal to acute spinal cord transection.

The amplitude of monosynaptic EPSPs produced by the action of single semitendinosus (ST) Ia afferent fibers in ST motoneurons display little or no increase in amplitude within hours of a spinal cord transection performed at the thirteenth thoracic segment. This finding is in marked contrast to results obtained at the medial gastrocnemius (MG) Ia fiber-motoneuron synapse, where EPSPs have been shown to be enlarged, even in preparations with normal ST EPSPs. The increase in EPSP amplitude reported previously at the MG Ia-motoneurons synapse is selective and therefore is probably not a direct consequence of injury to the isolated segment of the spinal cord.