A local congenital anomalies register: monitoring preventive interventions.

BACKGROUND: There is need for good quality data on congenital anomalies for monitoring (1) interventions for primary prevention and (2) prenatal diagnosis with advice on termination of affected pregnancies. METHOD: A register was compiled of congenital anomalies arising among births to Leeds residents in an 18 month period (13,596) and terminations (3015) in a related pregnancy cohort. Multiple sources of ascertainment were used and the full range of structural anomalies was included. RESULTS: The total incidence of anomalies (excluding spontaneous abortions) was 1.31 per cent. Incidence rates for the major categories are reported and compared with birth prevalence rates from British studies in the 1950-1960s. It was found that 31.3 per cent of the known anomalies were aborted; 2.26 per cent of the legal abortions were for a congenital anomaly. The overall birth prevalence rate was 1.10 per cent. Neural tube defects are used as an example of the use of a local congenital anomalies register in auditing preventive measures. CONCLUSION: A local congenital anomalies register is a valuable instrument in monitoring the impact of preventive measures, but it should include data on legal terminations as well as cases detected at birth and subsequently.

The need for change in nurse education: a literature review.

The implementation of the Project 2000 diploma course in 1989 meant that nurse education was moving rapidly from an apprenticeship system of preparation to an education led system in which students have student status. There is nothing new in the idea of student status for nurse learners; it had been suggested over 40 years before it actually came to fruition. This paper critically analyses the literature and looks at the reasons for the need for change in nurse education. An examination is made of the reasons why this change was not implemented earlier. The Project 2000 proposals are then explored with the benefit of hindsight, and the conclusion is reached that there is need for ongoing research to evaluate the impact of the course not that it is the established method of preparation for nurse learners.

The organisation of health care in Nepal.

The focus of this paper is to examine the organisation of health care in Nepal from the literature available. After setting the study in context and examining health care in general, a more in-depth, look is taken at Primary Health Care (PHC) and how this recent emphasis is affecting nurse education. This leads into an analysis of whether or not nurses are the most appropriate personnel to deliver PHC. The fundamental issues of improving adult female literacy rates and providing a clean water supply are suggested as means whereby Nepal's health provision could be greatly improved.

PIP: Nepal has adopted the World Health Organization concept of primary health care (PHC) in the attempt to close the gap between urban and rural health care, and improve conditions for the vast majority of the population living in isolated rural areas. The author has drawn information from relevant journal articles, UNICEF, and the World Bank, as well as International Nepal Fellowship staff, a Christian mission working to improve health care in Nepal, to examine the organization of health care in Nepal. An opening section describes background geographical, demographic, socioeconomic, political, cultural, and epidemiological factors in the country. The author then takes an in-depth look at PHC, how the recent emphasis upon PHC affects nurse education, and whether or not nurses are the most appropriate personnel to deliver PHC. Studies have found encouraging results with the approach. It has, however, been argued that some villagers would prefer health workers to provide curative services rather than the message of health promotion and disease prevention. A recent curriculum change in nurse education has shifted the emphasis away from hospital-based work to a PHC approach, with students working in isolated villages. The practical problems of the approach are highlighted, along with the social and cultural difficulties. This study points to the importance of considering the social and cultural values of the population for whom services are intended. For example, young, unmarried nurses from urban areas are not socially acceptable to rural communities.

Radiography education in the United Kingdom.

The U.S. system of educating radiologic technologists is changing to meet the demands of an evolving health care work force. As a result, the educational standards and role of tomorrow's radiologic technologist will be very different from those of today. Many of the changes being considered by radiologic science professionals in the United States already have occurred in the United Kingdom. Beginning this year, for example, all entry-level radiographers in the United Kingdom must be graduates of a baccalaureate degree program. This article describes how radiography programs in the United Kingdom made the transition to a baccalaureate degree standard. It also examines how the role and scope of practice of U.K. technologists changed following the increase in educational standards.

Expression of bone morphogenetic proteins in human prostatic adenocarcinoma and benign prostatic hyperplasia.

There are important interactions between prostatic tumours and bone. This study was designed to examine whether prostatic tissue can express bone inductive factors, in particular, the Bone Morphogenetic Proteins (BMPs). The polymerase chain reaction (PCR) has been used to screen for the expression of BMPs one to six in the prostatic tissue of patients with benign prostatic hyperplasia (BPH), non-metastatic prostatic adenocarcinoma and metastatic prostatic adenocarcinoma. BMPs were expressed in both benign and malignant prostate tissue and in the prostate tumour cell lines, PC3 and DU145. BMPs were also expressed in ocular melanoma tissue, a tissue which rarely metastasizes to bone. BMP-6 expression was detected in the prostate tissue of over 50% of patients with clinically defined metastatic prostate adenocarcinoma, but was not detected in non-metastatic or benign prostate samples or in ocular melanoma tissue. These findings suggest that the BMPs may play a role in the osteoinductive activity of prostate metastases and that the pattern of expression of BMPs may be important in the pathogenesis of osteoblastic metastases associated with prostate adenocarcinoma.

Detection of mRNA for the transforming growth factor beta family in human articular chondrocytes by the polymerase chain reaction.

The Transforming Growth Factor-beta (TGF beta) family of polypeptides elicits diverse biological actions on a wide range of cell types. There are known to be several isoforms of TGF beta coded for by different genes, with possibly differential expression and potencies. We have demonstrated that there is constitutive expression of three forms of transforming growth factor beta in adult human articular chondrocytes. The presence of 10% fetal calf serum in the culture medium may influence expression. The addition of transforming growth factor beta or interleukin 1 beta to the culture medium does not appear to consistently influence the expression of TGF beta by the cells.

Reliability of the acetabular teardrop as a landmark.

This study investigated the effect of tilt and observer reliability on radiographic measurements of the position of a prosthetic acetabular cup in seven dry bone pelves using the teardrop as a landmark. Coronal or sagittal tilt of more than five degrees was easily recognisable and there was effectively no observer variation in the measurements up to this limit. In addition, 90 out of 100 randomly selected antero-posterior pelvic radiographs from an outpatient department were not significantly rotated and 93 demonstrated a clearly defined teardrop. Measurements about the teardrop on routine radiographs are therefore sufficiently accurate to allow assessment of prosthetic position.

Quantification of bone density and mineral content.

To summarise, densitometry is used for measuring trabecular bone sites and morphometry for measuring cortical bone sites. Simple morphometry is still a very useful method of estimating bone loss. In sequential studies sophisticated techniques are now available, linked with computer analysis.

Latent HSV-1 infection in mice immunized with a zwitterionic detergent-extracted HSV-1 antigen preparation.

A HSV-1 antigen preparation obtained by zwitterionic detergent-extraction of HSV-1 infected Vero cells was investigated for its ability to protect mice against establishment of latent infection in the trigeminal ganglion following HSV-1 challenge by ear scarification. The antigen preparation was shown to induce antibody production and correlation between pre-challenge antibody level and establishment of latency was found. Although immunization did not reduce the overall incidence of ear erythema following challenge the duration of erythema was significantly decreased. Latency in the trigeminal ganglion was also significantly reduced in vaccinated mice and in addition, a correlation was found between the duration of erythema and latency, there being significantly more latent infections in mice with erythema of three or more days duration, than in those with erythema lasting less than three days.

Non-neural malignancy complicating neurofibromatosis in two relatives.

In a family with neurofibromatosis, an affected 16-year-old male developed undifferentiated lymphoma that evolved into acute lymphocytic leukemia. Five years later, his 7-month-old nephew with neurofibromatosis developed a prostatic embryonal rhabdomyosarcoma. This illustrates familial neurofibromatosis complicated by non-neural malignancy in relatives.

Chlorine-36 dating of saline sediments: preliminary results from searles lake, california.

Measurements have been made of the ratios of chlorine-36 to chlorine in five halite samples from Searles Lake sediments, previously dated by carbon-14, thorium-230, and magnetostratigraphic techniques. The ages calculated from the chlorine ratios are generally concordant with those from the other methods, implying the constancy of the chlorine input ratio over the last million years.

Homo sapiens radiographica.

This paper is intended to outline the sociological, educational and psychological background of the radiographer. It traces the development through to the final product--homo sapiens radiographica (with apologies to the more pedantic scholars of Latin).